Keep your friends close and your enemies closer, goes the saying.
My spiritual practice and basic reading of Buddhist philosophy has taught me that it is not other people who are the enemy but oppressive states of mind: fear, ignorance, greed – the things that drive us to hurt and oppress others.
I wrestle with these questions as I prepare a presentation to a group of psychiatric nurses holding a conference on recovery. It will be the first time that I speak formally to a group of mental health providers. Some of the attendees will still be in nursing school, and some will be long-time psychiatric nurses.
From a certain point of view our real enemy, the true troublemaker, is inside, says the Dalai Lama.
Given my experiences in the mental health system, I have a deep, abiding, built-in distrust of all providers. I am aware that I am still making them the enemy. But hey, if the Dalai Lama can hang out with the Chinese, than I can talk to psych nurses, right?
I think about my friend Mindy Lewis, author of Life, Inside, a spectacular memoir about her psychiatrized adolescence and its long-term impact on her life. Now she gives talks to psychiatry students on Grand Rounds. She’s written about this experience in the book a bit, too. I know it’s been a healing one for her in many ways and has had a profound impact on the students as well. I am aware of a lot of other folks in the mad movement who interact daily with mental health provider people, or work within the system itself. I admire them for doing that, but I don’t know if I am that bridge-building kind of person. I may be too close to my anger and pain. Too raw and unhealed.
I struggle – not just because of my discomfort in speaking to providers but also because I have some concerns about the whole “recovery” movement in mental health. The concept of recovery, as defined in the National Consensus Statement on Mental Health Recovery is extremely positive in some ways, stressing self-determination, recovery as a non-linear process, respect, responsibility, peer support, etc. I know a lot of people worked very hard on the statement and I respect their effort and convictions.
But one of my worries is that mental health professionals will jump on the hot and trendy recovery bandwagon but twist it to suit their own purposes, skipping over the “self-determination” piece and finding a way to dictate “recovery” to the “patient.” I worry about “peer support” becoming a way to turn peers into an even lower-paid sub-class of caseworkers, in the name of “recovery” and providing “peer led” services. I am told that this is already occurring in some settings. The potential for the recovery concept to be co-opted is great.
I have also been thinking about what recovery means to me personally. Truth is, I don’t wish to recover from the “symptoms” that got me into the system in the first place. My experiences of madness, no matter how frightening they can be at times, are intrinsic to my being and I wouldn’t ever wish them away. I love my mind, with all its complexity and quirks and blips.
What do I need to “recover” from? Not madness, not a “brain disorder,” but from the way I was treated as a young woman in mental health systems. My psychiatrized girlhood represents a cumulative pile of frightening and painful experiences that I am still struggling to make sense of, to make peace with.
Recovery is a word that worries me for another reason. The recovery movement, by and large, seems to be divorced from our civil and human rights. There are concepts that approach it – like “self-determination,” but the Consensus Statement is basically silent about our rights. It’s a dangerous omission, in my view.
How can you begin to recover from anything when you are being drugged, institutionalized, or electroshocked against your will? How can you recover if you are given drugs without being told about the potential side effects (including death) or potential (almost guaranteed) difficulty withdrawing?
Which brings me back to working with the “enemy.” If the psychiatric nurses are the not, themselves, the “enemy,” they are part of a system – an industry – that is still actively denying human rights to my brothers and sisters and promoting harmful “treatments.” They are part of a system that is still predicated in large part on fear, ignorance, and greed.
I still don’t know what I will say to that room. In some ways, all I have is my story and what follows from it. Clearly I have much left to do in healing my own response to mental health providers as a group, which often involves fear and a fair bit of loathing.
One thing I will need to say to the room is that it’s great to be discussing recovery and hope and all that, but recovery without human rights is essentially meaningless. In my view, one thing that would go a long way to healing the pain and oppression of the past and present is for more providers join us as allies in the struggle for our human rights.
Call me idealistic, but I would like to help build a world predicated on the human rights framework, which also just so happens to includes the highest ideals of the recovery movement as well: freedom, dignity, autonomy, self-determination, and a holistic approach to well-being, both as individuals, and within our communities.