Reciprocity – and the mutuality it implies – is always present in a meaningful relationship……. Each participant sees themselves bringing something of value to the relationship.

Yes, to a relationship between a person with a mental illness and a mentor/other in a helping role. Listen to this wisdom gleaned from The Strengths Model: A Recovery-Oriented Approach to Mental Health Services by by Charles Rapp and Richard Goscha; their chapter entitled “Engagement and Relationship:”

View the relationship as an experience in Mutual Learning. Put the recipient, or the person with the mental illness, in the role as teacher. The mutual learning approach doesn’t only want to know a person’s diagnosis, for example, they want to know about a highly individualized set of experiences. The person being helped, when viewed as a teacher, enters an empowering role. As teacher he/she is engaged in meaning-making and self-understanding. The helper, by listening and learning, seeks to enter the reality of the person by knowing the objective conditions of their lives and their subjective experience of that reality.

Yet the reciprocity inherent in Mutual Learning is easily missed: When the friend/caregiver/mentor/professional is always the giver and the person with the mental illness is always the recipient, the idea is perpetuated that the helper always has what is most valuable. Most helpful relationships have a balance based on mutuality and reciprocity. Refusing offers of reciprocity — whether it is an offer of a cup of coffee, a small gift, or knitting lessons — may be as rejecting as outright stating to the person “You have nothing of value to offer this relationship.” And, as our authors  observe, such condescending behavior “….is downright unfriendly.”

It is interesting to note that actions refusing reciprocity can stay with one for a long time. Here are two examples: Both helpers were excellent psychiatrists and good doctors for me. Both provided me with therapy as well as assessment and medication management.

The first helper happened to retire just as I was beginning to experience recovery. This psychiatrist had been through moderate to severe depressions with me, many drug trials, hospitalizations, and had “seen” my children grow up. He was very helpful to me and I admired and trusted him. Today I think of him fondly and with respect. He got me on the right road to treatment and a progressive, wholesome doctor-patient relationship.

The problem in short is that he didn’t accept a small gift from me of two tickets to a University of Wisconsin Choral Union concert. I was performing in the Choral Union and this doctor had been a backer of my quitting smoking and learning to use my voice, once again, to sing. It was a milestone for me to sing in the University’s acclaimed choir under the well-known and highly regarded Choral Director Robert Fountain. My doctor thanked me for the tickets but mailed them back to me with an apologetic note. Even though our professional relationship had ended, he felt accepting these tickets in any form would violate the professional-patient code of conduct.

I understood, but I cried.

Recently another psychiatrist retired. I had been with this person a long while as well. Through my blossoming periods of experimenting with recovery and hard times as well. Through my periods of NAMI activism and Family to Family service role. Through the empty nest syndrome. There was also a period when Jim became clinically depressed, followed by a period of great doubt and casting about from which, with Mutual Learning, Reciprocity, and Respect, we have since grown and recovered.

This psychiatrist accepted my gifts, which were two. At our last appointment, I bought a picnic lunch, complete with tablecloth and picnic basket filled with delicious finger food. We enjoyed the food and each other’s company. We talked about her future and my own.

I also gave her a book, One Hundred Names for Love, a true story of genuine love in which the author, Diane Ackerman, recounts the challenges and victories she and her husband lived through following his stroke.

The book was appreciated and accepted as a gift. The lunch was relished.

I will always remember that last appointment. It was delightful, reciprocal in nature … and empowering.

In my last post, I wrote about the Strengths Model – a progressive attitude about mental health thinking, care and services put forward by Charles Rapp and Richard Goscha in their book The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, Third Edition, 2012.

The first proposition of their Strengths Model is: “The quality of niches people inhabit determines their achievement, quality of life and success in living”.

Here I address an equally important principle underlying the Strengths Model: “People who are successful in living [with mental illness] have a meaningful relationship with at least one other person.”

As a person living with mental illness, I have been fortunate. I’ve had two relationships especially meaningful and empowering to me at most times throughout my adult life. One meaningful relationship was with my husband, Jim. We had the great good fortune of always being able to talk over the hard issues of mental illness. He was, and is, my sounding board and advocate, too. Important also to me was the relationships I’ve had with a succession of strong women mentors. Sometimes that second person was a colleague; sometimes that person was one of my psychiatrists, but a second meaningful relationship was nearly always there.

Why was that second meaningful relationship so important? At times I was unsure just how objective my husband could be. “Of course,” I might (and sometimes did) think, “my husband will encourage and believe in me; he is my husband.” Jim would “have” to be on my side. In the face of negative thinking, a second meaningful relationship was very helpful.

These Meaningful Relationships are characterized by a partnership which is Reciprocal, Empowering, Genuine, Trusting, and Purposeful. Partnerships that intentionally strive to avoid Spirit-Breaking words and actions and focus on Hope-Inducing Behaviors.

It’s also a partnership characterized by continuity in the face of struggle.

For little did I know then how many persons with mental illness lose the support, understanding, respect and love of those with whom they had meaningful relationships, as they progress through life.

I will continue to write about these special partnerships and their characteristics. For these are relationships that can ignite and fuel successful living with mental illness.