Frequently when people with mental illness describe their experience with recovery, they speak of having become empowered. Mental health programs often claim to “empower” clients. What is empowerment? Is there a clear definition – or is it just rhetoric?
I have my personal definition – It’s the opposite of helplessness and hopelessness; it is not obedient, tongue-tied and apologetic. Here’s another perspective:
Judi Chamberlin, prior to her death in 2010, was an activist, author, researcher and pioneer organizing on behalf of people with mental illness. She was affiliated with the Boston University Center for Psychiatric Rehabilitation, where she served as Senior Consultant on Survivor Perspectives and directed a research project on user-run self-help services. Many of these services included the term “empowerment” in their program definitions. “It was clearly a key concept, making it necessary to define empowerment as part of the project,” Judi wrote. In her paper, A Working Definition, she offered a definition of empowerment based on those she was studing.
I’d like to discuss this definition of empowerment and why I think it’s important that it be understood in this way.
Empowerment has elements in common with self-esteem and self-efficacy, but these do not capture the distinctive aspect that empowerment brings. I found myself paying attention, because their definition of empowerment is instructive and stimulating and consists of a number of qualities. They are,
Having decision-making power.
Having access to information and resources.
Having a range of options from which to make choices.
A feeling that the individual can make a difference (being hopeful).
Speaking in our own voice.
Learning about and expressing anger.
Not feeling alone; feeling part of a group.
Understanding that people have rights.
Effecting change in one’s life and one’s community.
Learning skills that the individual defines as important.
Changing others’ perceptions of one’s competence and capacity to act.
Coming out of the closet.
Growth and change that is self-initiated.
Increasing one’s positive self-image and overcoming stigma.
Empowerment is a complex, multi-dimensional concept. It is a process rather than an event. Therefore, an individual does not have to display every quality to be considered “empowered.”
Let’s take a closer look at some selected elements of empowerment articulated by the consumer/survivor advisors of Ms. Chamberlin’s research project.
Having decision-making power. Programs and people sometimes assume people with mental illness have limited decision-making abilities. They may act paternalistically by limiting the number and quality of decisions allowed. Yet, without practice in making decisions, long-term dependency relationships can develop.
Having access to information and resources. Decisions are best made when the individual has sufficient information to weigh the potential consequences of choices. If information is withheld in the clients “best interest,” clients may make impulsive choices that confirm other’s belief in their inadequacy.
Assertiveness. People without mental illness are rewarded for this quality. Assertive consumers may find themselves labeled “manipulative.” Being able to clearly state one’s wishes and to stand firm for oneself helps an individual become self-sufficient.
A feeling that the individual can make a difference. Hope is part of empowerment, it is needed for future change and improvement. The labels “chronic” and “incurable” contradict hope and interfere with the motivation to take action and make changes.
Effecting change in one’s life and one’s community. When a person participates in actual change, he or she feels mastery and control. More effective change may occur. Empowerment has a group and a personal dimension.
Changing others’ perceptions of one’s competency and capacity to act. It’s widely assumed that people with mental illness are often unable to know their own needs or to act on them. But it is not an either/or circumstance. As we improve and recover, we are able to take more control of life. Earning the respect of others increases self-confidence, thus further changing outsiders’ perceptions.
Increasing one’s positive self-image and overcoming stigma. In the process of becoming empowered, a consumer feels more confident and capable. He or she has a better ability to manage one’s life, resulting in a still more improved self-image. An internal negative identity of “mental patient” may be discarded or redefined to convey positive qualities.
Judi Chamberlin concludes: “The desire to protect (and to be protected) is a strong one; nonetheless, there are genuine benefits when clients begin to control their own lives, and when practitioners become guides and coaches, rather than assume the paternalistic role of supervisors.”
Empowerment has risks for the person with mental illness. But empowerment can transform – just ask us! It is part of a recovery process that occurs to an individual, with the help of family, friends, professionals, and others who earnestly wish to see them empowered.
Here is a video interview and tribute to Judi Chamberlin from the National Coalition for Mental Health Recovery.