the power of insight

In my work as a peer specialist I talk a lot about the power of insight in recovery. Many times I have launched into an awe inspiring sermon on how great insight is because it can move your recovery forward by leaps and bounds. Then I realize by the glazed look in my client’s eyes that they have no idea what I’m talking about. It’s a challenge I’m working on-thinking that everyone sees things from my world view, is familiar with recovery lingo, and relates to their illness the same way I do.

Insight for me is about acceptance of and relationship with my illness. Coming to terms with the fact that this jumble of experiences I go through are not going away and are real was the turning point for me. To be sure, I so wanted some things to go away, but in truth, there were some experiences that were comforting. There were some experiences that were familiar and even helpful. Like the period when my voices were like wise mentors giving me sage advice about this or that. Then one day the advice went away and was replaced by a barrage of mundane conversations between people I didn’t know. It was maddening because they weren’t even talking to me.

My understanding of insight has been tied directly to my acceptance of my reality that I live with a variety of symptoms and experiences commonly encapsulated by the term schizophrenia. So even though I would never refer to myself as a schizophrenic, I do say when it comes up that I have schizophrenia. There’s a difference. One is an identity and the latter is one aspect of an identity. So, as I’ve stated in previous posts, I am more than this diagnosis. I am mother, healthcare worker, sister, artist, friend, etc.

Insight for me has also been the process of becoming more familiar with my mental illness so that it doesn’t interfere with my ability to live a life of my choosing. It has meant taking a hard look at my warning signs, my triggers, and the kinds of behaviors that I exhibit when things are not going well. I’ve had to think critically about what I alone can do to lessen the negative effects of these behaviors on my life and on my relationship with my supporters.

So how does having insight into a mental health difference further one’s recovery? Insight demystifies our experiences and takes away the painful sting of a diagnosis of mental illness. Insight reduces fear and shame by giving us permission to integrate these experiences, feelings, thoughts and behaviors into our whole being. As our insight deepens, we become for fully integrated beings. We give ourselves permission to be whole. And what are some ways we can cultivate insight in ourselves and the people we serve? There are many strategies. At their core is the state of curiosity. Being curious about who we really are, our authentic selves, and what makes us tick is essential to meaningful insight. We can use creative writing, visual art, and meditation to find out more about ourselves. We can use movement through dance or regular exercise. Then there is the art of touch through massage. We just need to be willing to try new things to figure out what works for us.

Without insight, which in my mind is the opposite of denial, it is impossible to get a handle on our mental health. I mean if we don’t acknowledge that there is something actually going on how can we address it? Acknowledging is not the same as claiming it. Acknowledging it does not mean we allow it to define us. It simply means we accept this one aspect of ourselves and give it the attention it needs. And we do this so that we can be the best version of ourselves that is possible. 

self determination

There is a lot of talk about self-determination and being self-directed in the peer community.  I don’t believe self-determination can be taught. Self-determination is the process by which and motivation to take control of one’s life. I believe it can be nurtured and encouraged by others, but ultimately it comes from within. I also believe that everyone has the capacity to develop a strong sense of self-determination under the right circumstances. Those circumstances include being surrounded by people who believe in one’s ability to direct one’s life with the strengths and talents inherent to them. Given the right opportunities for growth, everyone can develop self-determination.

On the other hand, I do believe that self-direction can be taught. Self-direction is action that comes directly from insight into one’s strengths, talents and abilities. So as a peer specialist I am tasked with the job of assisting other peers in identifying and honoring their strengths. If a peer has clear insight into what they can accomplish with the resources they have then they can direct their life in any way they choose.

In the most practical sense, I never do anything for a peer that they can do for themselves. If a peer needs literacy skills I may research agencies, but they do the foot work of calling to get information and making appointments. If a peer has a goal of going back to college or getting their GED, then I work with them to create an action plan with the steps necessary to make it happen. In the process of “making it happen” people’s self-determination is nurtured and strengthened. As they get to know what they can accomplish their confidence grows and they become more self-sufficient.

While working with people with mental health differences this nurturing can be a challenge on many fronts. Typically, people who live with schizophrenia, bipolar disorder, major depression, anxiety, etc. are told by well-meaning and genuinely concerned supporters that they can’t do much for themselves. They are often times treated like they are fragile and any challenges will send them spiraling back to the hospital. They too often are told that they can’t manage their money, make decisions, live on their own or even choose what they do in their leisure time.

Peers are told they will never work a job, have healthy satisfying family lives or really ever contribute anything worthwhile to their communities. These harmful limitations are not imposed out of malice. These determinations are made by people who care. They are made by do-gooders like social workers, doctors, day program leaders, and family members. These determinations are well intended, but inaccurate and stifling. After hearing what a person can’t do over and over again, a person will come to believe it and sadly expect everyone they come in contact with to do something for them. This may look like an attitude of entitlement, but it is not. It is learned helplessness.

To be sure, living with a mental health difference can be challenging and even limit the kinds of things we can do. For example, I know with my own mental health issues I can’t work a 50 hour a week job. I won’t work nights and weekends to get the job done. I can however, work a solid 40 hours a week and be fully present and effective during that 40 hours. Everyone, mental difference or not, has limitations. The point is, no one should be told what they can or can’t accomplish. Life is about self discovery, figuring out what is and isn’t possible. No one should stifle this process for anyone else. By the same token, no one should impose unrealistic expectations on others. People can do what they do and it’s only our love, compassion and support that will help them catapult themselves into places they never thought they could go.

Self-determination is personal. No one can tell another what direction they can or should go in. No one else can do that for us. There is no timeline either. Everyone moves at their own pace. Those of us who support peers in moving forward know all too well that sometimes we have to “hold the hope” for others. We can see the potential in them for growth, but until they see it for themselves and embrace it nothing will happen. So we hold the hope for them until they can hold it for themselves. 

extraordinary experiences

Many people live with extraordinary experiences like voices, visions and uncommon beliefs. The clinical world uses words like hallucinations and delusions to describe these experiences and to assign meaning to them. The psychiatric community assumes that the most appropriate response to these experiences is to medicate them into nonexistence and even more damaging, discount the realness of these experiences to people who live with them.

What’s the alternative? After all, who wans to go around seeing, hearing and believing things that others don’t? The alternative is compassion. For those living day to day with voices and visions they are real and have meaning beyond the label of mental illness. But how are they real? Who gets to assign meaning?

I dare to say that these experiences are real. If a person who is hearing a voice that tells them that someone is out to kill them that person becomes afraid. The fear is real. To invalidate that fear is to act without empathy and compassion. So what if no one is actually out to kill this person. The sense of helplessness, desperation, and agony are real. So why not address the trepidation instead of getting bogged down with the need to correct that person’s perceptions?

If a person believes they are Jesus Christ and is responsible for saving every living person on the planet from their sins, the sense of responsibility for others is real. Instead of confronting the person with statements that invalidate their feelings, why not address how overwhelmed they feel by their perceived responsibility? If someone has a reoccurring vision of the end of the world and believes these visions are messages from God, why not address their anxiety about the state of our world and their future?

What about meaning? Who gets to decide what these experiences mean? I say the person going through it gets to make meaning of it. So many factors need to be considered like culture, race, gender, family dynamics, ethnic traditions, etc. When I was a child I spent a lot of time with my grandmother. She helped my mother raise me and my siblings. She believed that dreams could teach the dreamer things about their life and predict future events. We had a very specific dream vocabulary in my family. My dreams have always been vivid and full of symbols. I choose to believe what my grandmother believed. I choose to take guidance from my dreams and maintain a bond with my grandmother who is now my ancestor.

I choose. What harm is there in the meaning I make of it so long as it does not interfere with me living a life of my choosing? What harm can come from the meaning I assign to it as long as I don’t impose it on others or trample on the beliefs and rights of others?

There is an organization that supports this way of thinking. It’s the Hearing Voices Network USA. I support this organization by serving on its Board and facilitating support groups. So often when people try to reach out to doctors, family members and other supporters, they are met with worry. They are usually asked if they’ve taken their meds and the assumption is that they want the experiences to go away. Hearing Voices Network USA support groups don’t make any assumptions. What you will find at these meetings is compassion and validation. Meetings are weekly for about an hour in a safe and nurturing environment. Currently there is one group in Georgia that meets every Wednesday from 5-6 pm at the Decatur Peer Support Wellness and Respite Center. Anyone who is 18 or older can attend. Contact this writer for more information. 

triggers

It seems like everyone, whether in the recovery movement or not, throws around the term “trigger.” It’s as if it were a catch-all phrase for all things that irritate or annoy us. But what does it really mean for people living with mental health differences? Exactly what are triggers?

From my experience and the experiences relayed to me by other peers, at their core triggers are the catalyst for distressing feelings and thoughts. Triggers are events, conversations, actions, smells, physical sensations, places, etc. that cause a negative emotion, thought or response that overwhelms one’s coping mechanisms. These catalysts for distress are most commonly associated with past trauma. Something awful happened and a trigger takes a person back to that time and space.

How do we identify our triggers? The best way I have found to identify what triggers me is to analyze my response after the fact; especially when my response seemed disproportionately high. So, once things have settled back down and I can look objectively at the situation, I break the experience down. It is difficult for most people to be logical and rational when they are being triggered. In the moment, it is almost impossible for people to say this or that is triggering me. After the fact, I can ask myself what happened just before or leading up to the distressing response. What sensations did I go through preceding the reaction? What were my thoughts and feelings?

What can we do to take care of ourselves when we are triggered? I have developed a toolbox of affirmations that I use when I find myself being transported back to darker days. I worked on these very personal mantras at a time when I was doing well and stored them away for the tough times. One mantra is “I’m okay, I’m safe, I’m an adult.” This helps me stay in the present instead of going back to the time of the trauma when I felt helpless. The key is to remain in the present moment. Another way to stay present is to rely on your senses. You can use your sense of smell by wearing a scented body oil on your wrists and smelling them when you feel unsafe. You can use your sense of touch by rubbing your hands together until they are warm and focusing on that sensation. The easiest solution is to just remove yourself from the situation that is triggering you.

What do we do when our triggers cause us so much distress that we behave in what others view as inappropriate ways? How do we handle the aftermath? As I said, when we are being triggered we are probably not in a position to communicate very well what is happening. Our coping mechanisms are being overwhelmed and we are likely feeling out of control. That being said we need a plan in place to deal with these inevitable events. We need to let our supporters know in advance what might take us to these distressing places. And just as important, we need to have a plan to make amends if our words or behavior negatively affects others. It’s not all about us. We have a responsibility to the people we come in contact with to apologize and to the best of our ability explain ourselves. Having triggers is not permission to act out without regard to how our actions affect others.

So, if we are compassionate with ourselves and honest with others we can get through these challenging experiences. A tool I have learned as a peer specialist is the formula “I see, I feel, I need.” If we can stay present enough when being triggered we can use this formula to communicate on the most basic level without blaming or attacking others. After all, for the most part, people don’t set out to push our buttons. Stating what you see, acknowledging how you feel about it and asserting what you need are healthy ways of moving through these kinds of experiences.

Finally, I think if we can keep in mind that triggers have their base in past traumatic events, then we can be kind to ourselves and others when situations occur. I think if we can avoid taking the actions of others personally when we are triggered we have a better chance of maintaining and even deepening our relationships. The more we understand ourselves and others, understand what makes us tick, the better we will get along.