Peer specialists risk getting bit in the ass. If it is not the illness, it is the people we are supposed to be helping. How much do we disclose to them? What is the limit on honesty and openness?
I disclosed early on in my career. I just could not be bothered hiding the fact that I was just as “out there” as the people I helped. The difference was that I had gone through training and learned how to live with the “normals”. I knew how to talk with them. I competed with them on their academic turf. In short, I straddled both worlds. They were sometimes howling in the hospitals, other times having drinks and finger food with the boss.
My first time having my diagnosis shoved in my face was with a woman in one of my groups.
Everyone knows you have problems
EMB
Peer workers work in two dimensions. On the one hand, peers get paid to use their experience effectively with the clients. On the other hand, they go home to live somewhat marginalized and jeopardized by the illness. If not correctly put in its place, the insidious, dangerous condition threatens to wreak havoc with hard-won economic, social, and psychological gains.
I supervised peer interns from Howie the Harp. For the most part, they were terrific. I met my match, however, in a wild little devil that insisted on reporting me as unfit because I had told her to comb her hair and button her shirt. Luckily, the staff had my back.
I had had enough. The next intern insisted on going over my head to the director and workers she considered more competent because they weren’t peers like I was. So I went offline and waited for her internship out in the psych spa. I came back when she was gone and told my director I was through supervising peer interns. I knew my limits.
Peer workers are people who somehow pull themselves out of a hole. Now they stand on solid ground and throw a rescue line down into the abyss. Jealousy, resentment, and rage get in the way.
No matter. It is a crazy happy day in the neighborhood, and no one is going to mess with my high!
To make progress in life, maintaining a presence in mental health treatment is needed for many people. Personally, I know there are barriers to maintaining a presence in treatment. The goals of a practitioner and someone receiving treatment do not always coincide. It is interesting to determine at what point the purposes of the consumer and practitioner intersect. I know that treatment is beneficial in my life, but communication has become very difficult with service providers. For this reason, support needs to be established with common goals in a therapeutic alliance.
Goal setting in treatment may be one way to establish a common ground and language. However, varying temperaments in a therapeutic relationship will slow the road to meaningful therapeutic gains. There are inevitable conflicts, with baggage on both sides hindering real productive communication and goal setting. Ironically, sometimes it is the practitioner that carries more weight and credence to drive treatment forward. Objectivity is difficult whenever people and perception are involved, as everyone has the best idea.
All too often, treatment gets disrupted, many times, without warning and naturally throughout care. When progress and accurate work in treatment unravel, establishing or resetting a goal and kickstarting the momentum of the work is almost impossible without a social worker communicating the clinical play by play when cases have robust moving parts. When personal ambitions interfere with goals, it also may be challenging to maintain the ethical reins to keep treatment smoothly and without incident.
In fact, specific measures such as more extended unnecessary hospital stays could be avoided in some cases with better communication from the treatment team. Certain attitudes by social workers may exacerbate symptoms rather than give relief when a clinician takes cues from the wrong parties or isn’t truly engaged in their work enough to be a real changemaker and cheerleader in their client care.
All too often, patients are triggered by treatment providers without empathy. These feelings can lead to an ‘episode’ or the unraveling of a patient’s progress to date. Sometimes, these clinical missteps are so critical and negligent they make further treatment and additional clinical services necessary. With proper caution executed, and good listening with precise language, treatment progress can be maintained and preserved during touch-and-go blips that arise during care provision.
With a well-seasoned treatment team, enrollment and selection of programs and tandem services after discharge can be successful for many years. In the end, treatment at one level of care cannot go on or be maintained indefinitely. With time, everything changes, and someone may show the most signs of relapse when significant progress is being made.
For this reason, identifying valuable resources for patient education is critical for long-term progress after discharge and incredible natural support for patients to draw from when other artificial supports are inaccessible. Some supports need to be titrated down for the well-being of the consumer. When someone craves independence, but their goals are being withheld, severe conflict may worsen psychotic symptoms.
In cases of serious conflict, the proper change may be medication, but there may be more going on in the environment, or socially that can ease the episode. Changes in both may be needed, but good communication and appropriate support can certainly help to calm an attack.
In the end, the nature of life is dynamic, mental health treatment should be regarded as such. If life becomes stagnant due to failure to understand the needs of someone, symptoms can flare up. In worst-case scenarios, prison may be an outcome. However, communication and support are more attainable with grasping the history of someone. Responses will be more appropriate, and crises can be avoided with a reasonable, empathetic method of questioning.
The growing trend in most mental health centers is banning tobacco products and their use on campuses that deliver treatment and other supportive programs.
This trend defies the age-old image of ‘mentally ill’ folks pacing around outside their treatment center or a hospital smoking like chimneys. What is the result and impact of these bans on the folks in my image?
When I first entered the mental health system in 2003, I was an adolescent in an inpatient unit in New York State, and smoking was already banned for adolescents. After all, you would be hard-pressed to find a smoking section in a restaurant anymore. Adults still could smoke, but only in certain restricted areas and at certain times.
Before the banning, adolescents could smoke outside the building when they were granted outdoor privileges, similar to adults. The rationale, staff told me at the time, were minors weren’t allowed to purchase cigarettes in the community. They shouldn’t be smoking in the hospital.
I accepted with a giant grain of salt. After all, I was a smoker, irritable, but appreciative enough of logic in a place and time where reason wasn’t readily available.
However, when I was hospitalized in the New York State Psychiatric Center in upstate New York a mere five years later, smoking was banned for all patients, staff, and visitors on the hospital campus. At this point in my inpatient career, I drew a line in the sand and took issue.
As an adult in the hospital, I wasn’t just agitated. I was dysregulated, manic, and psychotic. I needed something to self-soothe, and meds and therapy were not cutting it.
Given how bewildered, uncomfortable, and upset I was back from new active schizophrenia symptoms, I couldn’t understand why I wasn’t allowed to smoke cigarettes.
I needed relief and quickly. To be even blunter, I needed a cigarette.
My theory about smoking in the hospital is straightforward. My idea is also within the margins of psychology and elementary logic. When a person is so far from a baseline that all previously learned coping skills don’t work anymore, why deny people the use of their existing mechanisms for finding relief in the most challenging moments of perhaps their life?Why take away the only coping skill that has been working to date? Why must we throw additional barriers in someone’s way to deescalating and finding a moment of peace in a disordered mindset when someone is so sick?
I understand the need and push to ban tobacco use in community health settings. Sure, teach people to access coping skills free of tar, toxins, and health-compromising chemicals. Instead, we need people to learn how to lean on healthier supports and access community resources. In this vein, I am not suggesting pushing cigarette smoking on people who do not already smoke. We certainly cannot allow tobacco companies to come into the hospital and hand out products to vulnerable people and get them addicted to another chemical they will need to manage moving forward discharge.
However, for people with existing habits and already smoke. Why limit, restrict, and agitate these folks further when they could be enjoying a smoke outside like at their own home and maybe feel the impetus to work towards discharge to do just that.
People at the out-patient level are more likely to use other coping mechanisms to find relief instead of smoking or waiting until they get back home at the end of their session or program. Still requiring research is the threshold, that space where the risks of smoking outweigh the benefits of non-smoking and wearing a nicotine patch until that is ultimately discontinued, especially for highly disordered, chronic, and comorbid smokers.
In my opinion, this new shift in so-called healthier practices and wellness overlooks a part of human nature, personal freedom, and introductory psychology. Some people with cognitive deficits and symptoms are so intense that learning new skills will not outpace the cravings or pleasure of puffing a cigarette.
These people will not learn new coping skills fast enough to benefit from not smoking and will be even more uncomfortable and agitated during a tremendously already agitating point in their mental health.
When people are pushing freedom and personal choice in treatment, I am genuinely shocked the hospitals were so fast to embrace the smoking ban. I have been so sick that I wouldn’t get out of bed for days at a time. It wasn’t a pill or the promise of deep breathing that motivated me to get out of bed. It was a cigarette and coffee.
When a person is genuinely symptomatic, in terms of coping skills, it is genuinely about going back to the basics and clinging to what works, what you know, and what you feel will make you feel better in the moment. I genuinely hope the hospitals discontinue this movement and revert, at least in part, to an earlier time when life’s pleasures weren’t removed or banned without consent or our choice.
“Hey, over there, that man is pulling that lady by her hair across the avenue.”
“Watch out, pastor, those mean guys by the broken window are beating up those women with glass and blood flying everywhere. Someone, please call the police!”.
Abuse like this is becoming commonplace, and unfortunately, increasingly frequent in today’s society. There is never, ever an excuse for abuse. Anger, jealousy, alcohol, and drugs are not acceptable licenses to harm other people. In most instances, minor issues can escalate into more significant problems.
Since 1987, October has been Domestic Violence Awareness Month. A month to connect and unite individuals and organizations around this global problem.
Relationship abuse occurs across a broad spectrum of the population. Victims and abusers can be male or female or someone with gender identity, white or black or even yellow, be tall as seven feet or five feet or smaller. Harm occurs when someone uses behaviors to control and manipulate another person.
Perpetrators of emotional abuse are dominating and exert undue power over other individuals. In doing so, some resort to name-calling, humiliation, and threats. People can also be abused sexually in relationships. Husbands can sexually abuse a married woman. An example can be a wife who has consented to sex in the past, even when she does not want to have sexual intercourse and forces it upon her.
Victims of abusive relationships are subject to the dominance of their abuser, who want to be in total charge of their relationship. They tend to humiliate their partners to reduce their self-worth and exert power. Another way they use their passion is to isolate their victims from friends and family.
Some people become more vulnerable if they don’t have any support systems around them. Also, abusers tend to scare their victims with threats and an array of intimidation tactics. When the wrongdoer blames the victims, the abused may feel that they are lower than low and worthless.
Many of us wonder why victims of abuse don’t leave their current relationships. One reason may be that the victim is in severe danger if they go into the relationship.
An offender could seriously hurt their partner or family member, including their children. Another reason that victims stay in their horrible situation is due to financial reasons or obligations to their partner. Victims may not be able to support themselves and their children without money from the abuser.
If you know someone in an abusive relationship, listen to their reasons for staying in their predicament. Understanding these rationalities can make one a better resource for this person.
According to New Hope, Inc., located around the country, there are warning signs of Abusive Relationships.
One can call New Hope at 800 323 HOPE between 9 am and 4 pm Monday thru Friday, or visit their website for more information.
Signs of an Abusive Relationship:
EXTREME JEALOUSY
CONTROLLING BEHAVIOR
QUICK INVOLVEMENT
UNREALISTIC EXPECTATIONS
ISOLATION
BLAMES OTHERS
HYPERSENSITIVITY
CRUELTY TO CHILDREN AND OR ANIMALS
DR JEKYLL AND MR HYDE BEHAVIOR
PAST HISTORY OF AGGRESSION
“PLAYFUL” USE OF FORCE OF SEX
VERBAL ABUSE
USE OF VIOLENCE OR THREAT OF VIOLENCE
FEELINGS OF ISOLATION
EMBARRASSMENT
DEPRESSION
ANXIETY
FEELINGS
ADDICTIONS
INJURIES
FINANCIAL PROBLEMS
WebMD stated that people targeted by these controllers and have any connections with them could have dire consequences. They often live with many residual problems that can last for years or the rest of their lives. As a result, they can develop some of the following:
Talk to friends and family members about the signs of abuse. Reach out to someone who we believe might be abused by his partner. Assist domestic violence shelters or volunteer at a domestic violence shelter or hotline. If we’re being beaten and want to help others, there are several options to consider.
If you know about someone in an abusive relationship or dealing with domestic violence anywhere else, please provide them with education, hope, and this hotline.
Recovery cannot and must not be defined as occurring only when a person returns to having a normal life. The definition of normal: of or having ordinary or average intelligence; conforming to a standard or type; free of mental defect.
I have given a talk saying that everyone’s recovery is as individual as their thumbprint. Recovery comes to each of us in different guises. Bake a cake. Sing in a choir. Ride a Skateboard. It’s all great is what I said.
Who wants to be average? Not I. It’s okay if you want to have an ordinary life. I’ve come to accept that everything I do is so unusual (cue the lyrics to the Cure song “Why Can’t I Be You”). I’m constitutionally unable to conform nor do I want to.
I haven’t met a box that I liked being put into. Not when I was 22 and told recovery wasn’t possible. Not today when I’m going to publish a first-of-its-kind career book for individuals living with mental illnesses.
Here’s the thing: having a normal life shouldn’t be the barometer of how well a person is doing in recovery.
I have worked with a rude and hostile male coworker who didn’t have a diagnosis. He is proof that having a job doesn’t make you any better than a person collecting a government disability check.
Within three years of being diagnosed with schizophrenia I had a full-time job as an administrative assistant. For the first 9 years I worked in corporate and law firm offices. It appeared that I had recovered because I had a normal life.
Only I wasn’t thriving and was ill-equipped to succeed in those ill-fitting jobs. I consider myself to have recovered fully when I started my job as a professional librarian when I was 35. Finding the job I love enabled me to recover. It wasn’t the other way around. I hadn’t found this job after I recovered. Getting this ideal job was the gateway to my true recovery.
That was when I started my pro bono Advocate work. Promoting my vision of recovery despite detractors (even mental health staff) parroting that no one could recover at all. Their view of how to define recovery has always been limiting and restrictive.
Of course a lot of people who don’t get the right treatment might not recover. They might be severely ill. They have Advocates on their side. We need Advocates on the side of people who can and want to better themselves.
The average Joe or Josephine on the street doesn’t get their behavior scrutinized like us peers do. A normal person can work as a cashier in Rite Aid. The minutes a person with a mental illness works in Rite Aid they’re looked down on.
This prevailing discrimination sets peers up to fail. It can be hard not to internalize shame and guilt and not to feel “less than” when others have given up on your prospects.
Not everyone can or should get a Masters’ degree like I have. Whatever you want to do is perfectly fine for you. The fact is you deserve to try to achieve a goal. “The only real failure is the failure to try.” When you give something your best shot there can be no shame if it doesn’t work out.
In the end the choice is yours. You don’t have to set the bar high. You just must set it—because no one else will.
During the early phases of my recovery from Schizophrenia, two things were important to me that I was unwilling to compromise because of a significant mental health disorder: working and further healing.
I was tired, not just from the impact of my symptoms or side effects from medication, but from laying in bed and feeling useless.
My parents, specifically my mother and father, were critical in dispelling the idea that my future was limited because of illness. They reminded me to take outstanding care of myself, and my career would follow. Well, they were right on the money.
With the help of my therapist and a good psychiatrist, all reinforcing the concept of self-care, I went back to graduate school in social work. Within two years, I graduated from SUNY Binghamton with a master’s (Masters in Social Work). The same college I had my initial ‘break’ from first-episode psychosis (ultimately diagnosed as Schizophrenia).
As a young licensed social worker, I taught my clients about self-care as well. Later on, I would teach self-care at the level of education. Specifically, I taught social work education to new social work students as an adjunct professor at Fordham University at their Manhattan campus. I had come just about full circle since my initial illness.
When my illness was first blossoming, I was an English major at Binghamton University with dreams of becoming a professor. One decade later, I was teaching young therapists how to be future social workers. In some cases, these future social workers would be future therapists, reinforcing the importance of self-care to their patients, similar to how my therapist did ten years ago.
Today, I am confident, knowledgeable, and polished in my education and skills. But, this wasn’t always the case. Schizophrenia had struck me at the most inopportune time, right the peak of intellectual ability and personality development. Research indicates Schizophrenia often becomes diagnosable at this point in the development of young adults. This fact about Schizophrenia is sad and difficult for many people to manage (and understand), but it doesn’t have to be the terminal point in your career or education.
There are few things to keep in mind as you pick up the reigns of your education again, or for the first time:
You are in charge of how far you take your education, with or without a mental health disorder.
The limits of your career and skills are where you set them.
So, when you go back into the classroom, remember that you choose the career you want. Please, don’t let your symptoms, as tricky as they may be to deal with while going to school or to work, dictate what you want to do in life.
Should work or education prove to be ‘too much’ or triggering, look inward, and ask yourself: are you taking the best possible care of yourself as possible? If you cannot identify the reason or roadblock that triggers or activates your symptoms and makes it difficult to work or study, consult with a therapist. Troubleshoot with a psychiatrist.
Just don’t give up or throw in the towel because of a label. A Mental Health disorder is only as disabling as the power you give it to rule over your life. Sure, there will be days when you can’t make it to work because of your symptoms, but that is OK.
Just like the flu, some signs make it too uncomfortable to go in and do our job correctly. Heck, going to work or school in such cases might even be a bad idea, should you be contagious from the flu or tired from depression to get your work done correctly. But these are blips and moments and should not influence your potential for lifetime achievement!
“Summer Breeze, Summer Wind” and “Summer in the City” are just two of the songs that give us hope for the summer season.
We have to start somewhere in our journey. “Let’s start at the very beginning; a perfect place to start.” from the song “Do Re Mi” in the musical “Sound of Music.” Everything is done step by step (not steps by steps), and the more we understand this, the more hope we can achieve. This process is especially true for me. This song, “In the Good Old Summertime,” resonates here. All trips have an entrance point, and each individual must find their way.
During my life, just like the significant cast of “The Wizard of Oz,” I tend to “Follow the yellow brick road,” but not to end up in Emerald City. Maybe this is too idealistic, but it helps me be me. Life for me makes more sense thinking this way.
Also, we always need to do our best, and only then hope can be realized. Please, everyone go at their own pace; there is no rush to finish.
Remember, who won the race between the tortoise and the hare! (The tortoise!)
How does one have hope when they are or feel stuck at the start? Find one or two techniques that worked for us before and try them again. One idea that achieved success for me is that I was encouraged that there would be rewards ahead. For every step I took, maybe I could feel better about myself, and that gave me hope that I’d get to the next step. It did not always help, but I might feel or still be stuck if I did not try.
Eventually, looking for hope and the idea and the concept of “hope rewards” was successful for me to move in a positive direction. Also, attempt not to get discouraged! Again, one step at a time. We will move ahead. I did!
As Reverend Jesse Jackson said it:
KEEP HOPE ALIVE!
KEEP HOPE ALIVE!
Like a song from The Beatles, hope can be “Here, There and Everywhere,” plus we do our best to find hope. We need to just try. It does help us to get through the day. During the summer, there are many more opportunities for hope and pleasure. Some people find that the energy one gets from doing physical activities gives them hope.
They will run, jog, take a walk in a park, go for a bike ride, hike up a hill, or go swimming. Hey, I like to walk on the boardwalk or go to a pool. Or, if you are sun-sensitive, go to an indoor pool, exercise and or go to a weight room or relax in a sauna. If physical pursuits are not what make you hopeful, try reading a book on self-help, going to a relaxing movie, listening to upbeat music, or talking on the phone.
No matter the season, find something you like to do, and that is enjoyable to you and turn it into a hopeful moment. Rally your strengths, and this may assist in your quest.
Yes, youhave power. Remember, we all have inner resilience. This resilience is an integral part of our power. The general rule is always try as hard as possible, even if it seems almost impossible.
Doing this like the song from “Man of La Mancha” says, “To dream the impossible dream”. Dreaming like this may not easy but get started and try anyway. Build up slowly and give one another some hope, one item at a time. Primarily, this works for me.
Remember, hope builds on hope, which can carry us towards our ultimate “hope dream.” Also, success builds on success. At all times, be honest with ourselves and others.
A more hopeful situation in the end is a good reminder to keep on hoping, dreaming, or whatever makes us feel like a more optimistic person inside and out.
ALL OF US CAN DO THIS! I DID!
Summer is for hopefulness, positive thinking, and dreams. So,what are we dreaming about this year? Our plans must be more realistic, I suppose. Hmm, more in another piece? To all, enjoy the summer, we deserve this, and I will do my best to do the same.
When confronted with a disturbed loved one, especially one who has been in the hospital with a psychiatric diagnosis, many people hear the word “psychotic” used to describe their behavior or thought patterns. What exactly does this term mean?
First of all, it is imperative to understand that those suffering from “psychosis” are often lost in their reality and thus are unaware they are “out of touch with reality” no matter how bizarre their behavior or ideas appear to other observers.
“Psychotic” is a clinical judgment.
It is not a diagnosis but rather a symptom describing the status of a disturbance of a person’s mind. The difficulty with the word ‘psychotic’ is that there is no absolute state, or judge, of what constitutes “reality.”
The word all too often is used to assess the condition of an apparently “sick” individual. Here is the issue– since all people live and operate in their perception– how can a court or clinician discern what a healthy reality is or is not unless their safety is a factor?
A person with delusions of being God might well be perceived as psychotic (as was my case) and firmly believe their ideas. On the other hand, the constituents of a radical politician may applaud them for their “honesty” despite the negative emotions they might induce. After all, if people are not ‘harmed,’ what do feelings matter regarding health and perception.
Reality is always relative and never absolute, so that every diagnostic judgment is ultimately subjective to the clinician using it.
In society, “reality” is a cultural construct defined by the majority of that culture. In my case, I accept that it took me six years to return from my delusion enough to be able to have the mental and social focus to return to college after a schizophrenic “break” at my first university. It took a growing awareness and insight in a private “program” and nine hospitalizations before I was ready to re-integrate into an educational setting without regression to a state of illness.
But it was the transformation of my self-perceptions that finally freed me from the internal mental structures upon which my religious beliefs. All this work on myself and the steps to these changes has convinced me that my path forward hinges on bringing this awareness to the families of those diagnosed with schizophrenia. I want to help them navigate the challenges not only presented by their loved ones but more especially to themselves so they can believe “Recovery is Always an Option.”
The funny thing about my musical and artistic sides: these parts of me did not start to surface until around the same time as my diagnosis of bipolar disorder.
I was about 16 years old: an adolescent gripped by raging hormones.
At the beginning of my sophomore year of high school, my elder sister, by three years, brought home a classical guitar. With some sheet music and some instructions from my music major sister, I became engrossed in methods of playing the guitar.
I had dreams of playing on the stage with a rock band. I learned Led Zeppelin and the Grateful Dead and increased my classic rock CD collection. Led Zeppelin was my usual go-to for listening, as well as Jimi Hendrix and the Grateful Dead.
Although there were times out with drama club and occasional trips with friends who performed punk music, I felt less connected with peers.
As “Dust in the Wind” by Kanas plays in the background, I reflect on how sad it is that my dreams of being a rock and roll star never came to fruition. The reason this never materialized is a story that is at least as sad as this song.
The last two years of high school brought friends who got me further involved in playing rock music both in parties, and on stage.
Going to college brought an upheaval for me, newly diagnosed with bipolar illness with psychotic features. Conflicts between my party life, romantic life, and study life made it impossible to manifest a balanced lifestyle. However I burned extra energy by exploring my artistic side, and by producing professional level work for my drawing teacher.
Later on, in my early twenties, unfinished with undergrad, I moved into the city to live independently of my parents. For the first three years of life in Buffalo, I had the luxury of a car, which allowed me to make it out to music shows and get involved with local musicians.
Most of my music was solo, although there was some collaboration with friends I met on alternative rock and folk music. My songs, performed solo on acoustic guitar, were praised by musician friends for their expressive and theatrical dynamics.
My time playing was plagued by paranoia and hallucinations in the meantime.
My theatrics while performing guitar was replaced with shame and fear of public performances. I projected my self-destruction during that time.
I entered into a mixed manic and depressive episode in between performing live music followed by a year and a half of hospitalizations.
I still don’t have a car, as additional diagnoses make it more challenging to focus.
After ten years of group homes and supervised apartment living, I started the crawl towards further independence…
In 23 years of being treated for mental illness, I have learned that it is common for some treatment providers to assume flawlessness. Although a practitioner may have training, practice, and experience on their side, It is questionable how much this experience should override someone’s right to think independently. Putting out a statement in treatment that questions the validity of a claim should be respected for its originality, not delegitimized.
The interrogation of my ‘Lived Experience’ has been commonplace with many psychiatrists, therapists, or peer specialists. Çommunication can become rocky when a person with a diagnosis expresses their rights in treatment. In treatment, it is the right of a patient to say their preference for the exercise and provision of care.
It has been my experience that practitioners can get hung up on how they do things, clinically speaking. Even more problematic, clinically speaking, everyone is quite different, and treatment should be person-centered. However, it seems as if theoretical example person ‘A’ may be getting too similar a treatment to person ‘B’ for very different disorders and presentation.
Clinicians must respect our rights; this should go without saying in mental health treatment. Expressing our needs may become a life or death situation for patients. When patients question the quality and provision of their care, it can create volatility.
When people feel that treatment is not going well and the therapist does not agree to change mental health treatment, this should be a red flag. It has been my experience that therapists can distort the severity of someone’s symptoms in their care when their motive is to retain their job as a therapist. I have seen this happen firsthand.
I think this is common due to the origins of mental health treatment. In psychoanalysis, the responsibility is given to the therapist to have an absolute understanding of the workings of a patient’s mind. In my opinion, this power differential helped give birth to the hegemony within the psychiatric profession. Finally, in the 1960s, mental health advocates began to question this hierarchy. Soon, the advent of patient rights came into being. I have learned that practitioners who call themselves peer specialists often betray their practice. They also often fall victim to a paradigm of teaching ‘learned’ helplessness.
Peer specialists especially should have respect for the position of a consumer. Taking on a superior attitude due to being a peer specialist runs contrary to standards of being a peer in the first place. Yet being with somebody, and thinking on their level, is essential in peer practice. However, before peer certification became the norm in New York State in 2015, empathic communication was more commonplace in peer agencies.
The hiring of peers may have to do with funding streams or simply because agencies get grants when they hire peers and get opportunities for other ‘reimbursable allowances’ having to do with money. Peers don’t require as much money as social workers when it comes to salary.
So I see the practice of hiring peers as being cheapened, and the real value is disappearing. Peers are overworked and don’t love their jobs anymore. While it is excellent that peers are more valued now than before, I see some themes remain the same between therapist practice and peer practice.
When it comes to peer practice in the future, it is essential to deeply examine the dynamics and the absolute authority present with therapists. Having volunteered at multiple peer agencies spanning my treatment, I feel this is critical as we move forward.
