You remember that 2006 NASMHPD report on morbidity in the “seriously mentally ill” population, so often cited in the current literature, the main navigational tool charting the course of mental health policy for the past decade or so (that I wrote about here and here)? One of the main policy recommendations to come out of that report was that caregivers should “support wellness and empowerment of persons served, to improve mental and physical well-being.”
Sounds good, but don’t be fooled – they didn’t really mean that. What they want is to “empower individuals to engage in services” – empower people to become lifelong consumers. What they want is controlled [false] empowerment as a strategy for achieving lifelong treatment plan adherence (non-compliance/non-adherence being the $100,000,000,000 problem for pharmaceutical companies – their words.)
Despite the insincerity, the basic policy recommendation for empowerment got me to thinking. What would true empowerment amongst the seriously mentally ill population (or anyone, for that matter) look like?
Define the terms
By now, you’re probably aware – I view words as living entities with history.* Knowing this history is key to using language precisely (ie, making it work for you as opposed to expressing the message of someone else attempting to exert hegemonic control over thoughts and ideas).
1: to give official authority or legal power to. 2: ENABLE. 3: to promote the self-actualization or influence of.
1: to make actual; REALIZE. (self-actualize: to make oneself real or actual)
To make oneself real. That’s a very interesting concept.
[NOTE: the word is “self-actualize.” As in “do-it-yourself.” This means that you cannot “self-actualize” someone else; only you can self-actualize yourself.
Again, this means that you can’t manipulate or talk someone into self-actualizing, you cannot plant the idea to do it in someone else’s head [inception], even if you have decided (out of love, paternalism, condescension, or compassion) that it would be “for their own good.”]
I find it more useful to speak of “supporting the empowerment/self-actualization” of someone else; this phrasing makes it clear who’s in charge. Our hero, seeking empowerment and self-actualization, by asking that all important question “Who am I?” Or, perhaps, “Who am I in the context of my community, my life-world?” Our hero is the owner of the process; we (the supporters) are merely the furniture in the house that he built. Useful – yes. Something to lean on – certainly. And that’s it.
To make oneself real
Now we’re getting into philosophy here, but there are a few things to be said about our hero’s [everyone’s/our] quest that apply at a larger-than-the-individual scale.
The first being that self-actualization must, by definition, be a subjective, individualized process.
Do you require community to be real? Relationships with friends and family, affirmations from the culture as a whole that you are a worthwhile person, that you are an agent? Or does self-actualization consist of a sort of feedback loop between your body, mind, and soul, your actions and your thoughts [ie, the actualizing activity is taking place internally]? This may be culturally determined… or it may be your entirely conscious choice.
Empowerment for me will look different than empowerment for you.
Diversity! Difference! Life!
Self-actualization cannot be compartmentalized.
Can you be self-actualized in your professional life, but remain a non-entity when it comes to dealing with your family? Or with past trauma? Or with authority figures in your life (be they doctors, teachers, government officials, et al)?
It just doesn’t work that way. Being real means being in reality – all of it. The good, the bad, the ugly. Any attempt to abbreviate your realness, confining it to a self-constructed category, will bring with it, inevitably, despair.
This applies to everyone. I especially like the way that Eduardo Duran applies this concept to those therapists who think they can be “healers” in their professional lives while being desperately in need of healing in their own personal lives:
The identity of the healer is critical. Over the years, I have always asked interns and staff a simple question: “Who are you?” The question is not rhetorical, and the answer requires exploration into who they are as a person, who they are in the healing situation, and who they are in their life-world… Very few of the interns understand the question of identity as one relating to who they are as a spiritual being. The importance of spiritual identity starts to become clear as they begin to understand that a relationship with spiritual entities is part of the work that we do in the clinical world.
In most Traditional Healing cultures, the Healers embody the healing energy in their life and in all that they do. Western healers have a way of compartmentalizing their role as a healer from what they do in “real life.” …
At this point, I ask the reader who is interested in the healing process, “Who are you?” If you are interested merely in techniques that will ameliorate behaviors in the short and even long term, then these ideas may not be for you. However if you are even remotely interested in the notion of soul healing from the ongoing soul wounding that is encountered in every aspect of life in the modern corporate world, then I encourage you to read on…
Your own soul must be healed so that you can attend to the patient who is presenting with a wounded soul. You cannot do for others what you haven’t done for yourself.
(Eduardo Duran, Healing the Soul Wound)
To self-actualize: to heal your own soul? And, having healed your soul, to lead by example the rest of us who seek healing [self-actualization] ourselves?
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* I’m talking about LOGOS; words that live. You might be familiar with this example:
“In the beginning was the Word [LOGOS], and the Word was with God, and the Word was God. He was with God in the beginning. Through him all things were made; without him nothing was made that has been made. In him was life, and that life was the light of all mankind. The light shines in the darkness, and the darkness has not overcome it. (John 1:1-5)”