Bev, Harriet and Joyce

My mother, Janet Alice, was tremendously vital to whom I have been and to whom I have become. Three other mothers, Bev, Harrriet and Joyce expanded my concept of motherhood. These women were also role models to me for becoming the best mother I could be:

It is possible.

As a mother, I want to see a world
with less competition
and more cooperation,
Less exploitation
and more mentoring,
Less meager and more real funding,
for services and education benefitting
mothers and children …

Every day of every year.

Bev, Harriet and Joyce were mothers of children with serious mental illness. I met Bev and Harriet first. They were the co-founders of the National Alliance on Mental Illness (NAMI) Dane County, which began in Madison, WI in the late 1970’s. The Madison, WI affiliate birthed the national organization.

Bev was driven to be an advocate for people with mental illness. She wanted essential services and better health care for those most seriously affected by a mental illness. Harriet wanted the same. Bev had a gift for advocating …  fiercely. Harriet’s gift was communication. She was a very fine journalist.

Bev and I got to know and respect each other. She was active physically and mentally throughout her life. Indeed, late in our relationship we discovered her north woods Wisconsin cabin was just a few miles from our families north woods cabin!  I recall the day Bev told me she and I were alike; committed and bold in our NAMI work, be it public or private. (Being alike meant occasionally we were at odds in terms of what we thought was best for people with mental illness.)

Harriet and I became friends through our commitment to leadership and writing. After I had written an article for the NAMI Dane newsletter that was respectful of parents of children with mental illness, she began to trust me. We admired and loved each other. I smiled when I entered her retirement apartment. The bookcases were filled, every inch. She and I were both avid readers. Harriet and her husband had an agreement: neither of them would buy another book until they gave away one of their current books. 

Joyce entered my life in 1993. When told by physicians that she was the cause of her daughter’s mental illness, she rebelled! It was common practice by MD’s and others to blame mothers for their children’s mental illness. Alas, my mother told me my paternal grandmother was thought to be the cause of my fathers recurrent depressions.

How did Joyce rebel? She obtained a PhD in psychology and began a private counseling practice. After gaining experience as a psychologist, she taught families in her home state, Vermont, how to help themselves and help their relatives with mental illness. She conceived and wrote a 12 session Family to Family Education curriculum. Initially Joyce gathered families together in the homes of people like you and me. Mothers, fathers, wives, husbands, brothers and sisters talked and listened to each other. For most of the men and women attending the classes, it was the first time they openly discussed mental illness and the challenges they and their well and affected family members faced. It was a blessing and a comfort to express their concerns in an unguarded manner. To problem solve. To grieve … and to rejoice together.  

The Family to Family program expanded. Wisconsin was the thirteenth state to get onboard. Lucky thirteen. Eighteen people gathered in a very small room for a three day training to learn to teach the Family to Family program in Wisconsin. I was one of the eighteen trainees. From those nine sets of teachers, the program expanded to 100 sets of teachers, as of 2013, when I retired. Becoming educated on mental illness was and continues to be life changing for me … and for people throughout the 48 states of the continental United States.

Here’s the rub: Many mothers like Bev, Harriet and Joyce are thrust into the role of advocate, educator, support person, and major caretaker. 

Sometimes for the entirety of their lives.  

Thank you kindly,
Gail Louise

… I was inspired to think carefully and in depth on motherhood’s impact on children’s development by the writing of Anna Malaika Tubbs in her book: The Three Mothers: How the Mothers of Martin Luther King, Malcolm X, and James Baldwin Shaped A Nation.

WILD GEESE

You do not have to be good.

You do not have to walk on your knees for a hundred miles through the desert repenting.

You only have to let the soft animal of your body love what it does. Tell me about despair, yours, and I will tell you mine.

Meanwhile the world goes on.

Meanwhile the sun and the clear pebbles of the rain are moving across the
landscapes, over the prairies and the deep trees, the mountains and rivers.

Meanwhile the wild geese, high in the clean blue air, are heading home again.

Whomever you are, no matter how lonely,
The world offers itself to your imagination,
Calls you to the wild geese, harsh and exciting
Over and over announcing your place in the family of things.

~ Mary Oliver

You Do Not Have To Be Good

Some people can live without nature and wild geese; some people cannot. I cannot. It has always been that way for me. I had a lot of time to spend by myself when I was young, despite having two brothers and three sisters! For the two brothers were 4 and 5 years older than me, while the two sisters were 4 and 5 younger. A final sister arrived 15 years younger than I.

Being alone was generally an advantage.

I learned to be an excellent observer of nature, the farm animals, the trees, flowers, grasses, sky as well as an excellent observer of human nature. I had time alone with each of my parents. Good times. That was an advantage as well. Mom and Dad mentored me. My Mother taught me sewing, cooking, baking, preserving, housekeeping, child care, how to speak and sing in public with poise and how to be a public servant. (She was a census taker and worked at the voting poll. Those days for her were vacation from a family of eight!) My Father taught me milking, haying, combining oats, detasseling corn, how to listen to football on the radio when working outdoors, how to drive a tractor and a truck, and a great deal about the good and bad of politics. He took time from his businesses (dairy farming and a hybrid seed business) to take me to two local fairs, and the State Fair, with blue ribbon Holstein yearling cows. One has to learn how to show or exhibit animals, it’s a technique and mannerism to learn. Dad too, always supported voting. Both parents read the newspaper every day.

They had patience with me. The other children, especially those close in age to one another, may not have experienced as much patient guidance from their parents, especially my Dad.

I learned to think independently. I thought a great deal.

Being born with no siblings close in age to me was a handicap in one major way: When there came a crisis in our family I had no one with which to discuss what I observed. I had to work things out in my mind, but usually I was left with little understanding and by myself.

I never discussed my thinking or worries with anyone. My dear neighbor friend, whom I’m still in touch with daily, did not hear of our family’s dilemma – of my father’s major depressive disorder (MDD) – from me. Nor did my siblings, grandparents, school friends or guidance counselors at school … if there were guidance counselors back then. Nor did friends of my parents, aunts and uncles, neighbors, or the Pastors of our church.

I was left confused, greatly saddened, and sometimes very lonely. Very, very lonely.
I played in the sandstone by our barn.
I played under the sumac bushes of our neighbors field.
I played in the huge front lawn and swung on the swing in the back side lawn.
I laid awake at night.

Nature was and is a solace.

For any of you reading, listening and hearing, and especially those who find themselves in circumstances similar to mine growing up, playing out the concerns over and over in my mind, I hope you find solace and peace in the poem which began this posting: WILD GEESE by poet Mary Oliver.

You do not have to be good. I thought if I was good, as a child and as an adult, my hurt and episodes with MDD would be fixed or at least lessened.

You do NOT have to be good.

Thank you kindly,
Gail Louise

Care and Tender Loving Care

I have been mourning the past several months:  My sister Ellen died six year years ago on January 31st. I miss her every day.

And I’ve been reading – All About Love: New Visions by bell hooks.  Here are some quotes from this extraordinary book:

“Love is the will to extend one’s self for the purpose of nurturing one’s own or another’s growth.

“Love is as love does. Love is an act of will—namely, both an intention and an action. Will also implies choice. We do not have to love. We choose to love.

“To truly love, we must learn to mix various ingredients: care, commitment, trust, knowledge, responsibility, and respect as well as honest and open communication.”

What is love? What is care and caring?  I thought long and hard about the kind of care my sister experienced the last several years of her life.  Care is one dimension of love. But simply giving care does not mean we are loving.  I re-evaluated my care to her. I could have done quite a bit more to bring simple happiness into her life.

She needed new knit type pants. I never purchased a pair for her, although I don’t know why. Was she a bother to me? I did buy her other clothes, but not the most essential piece she needed.

I also remembered how often she and I discussed food. In nearly every conversation she would ask what I was preparing for the evening meal. Ellen would ask me how I was going to fix the baked chicken, or if I’d make the chili with or without macaroni, or what I would add to our green salad?  Had I experimented with this herb or that spice?  She preferred chili with macaroni …. The way our mother made chili.

There were many foods she preferred the way my mother prepared them. Roast beef well done with rich gravy and mashed potatoes, for example. My roast beef did not measure up. Neither did my scalloped potatoes.

I understand now. Food made by our mother was the food of our childhood.  Growing up was full of love and care. Full of the comfort and warmth of a well-worn slipper. Familiar.

I rarely bought any of my home prepared cooking or baking to my sister.

One evening, I stayed overnight with my sister in her modest apartment near the end of her time living in Chicago. We mutually decided I would sleep on the coach and Ellen would sleep in her bed.

What happened next has always haunted me.

I entered her bedroom to tuck her into bed. I fluffed her pillows, smoothed her hair and arranged the blankets comfortably and snuggly around her. She turned her head away from me … so I would not see the tears rolling down her cheek.

I wondered then and I wonder to this day:  How often did my sister Ellen have tenderness in her life? 

I gave her care, and so did others.

But tender loving care was rare, if ever, present in her life. Then and now, I pray Ellen would be able to forgive.

Ohenten Kariwatekwehn “The Words Which Come Before All Else” *

Indigenous People’s Day is observed in the US on October 11th. I celebrated the observance with my husband Jim by enjoying a meal featuring The Three Sisters, a trio of delights: corn, squash and beans. 

These staples have fed the world. Sisters?

The story Lize Erdrich, Ojibwe-Turtle Mountain Band, tells of The Three Sisters is fascinating. I discovered the tale when reading Original Local: Indigeneous Foods, Stories, and Recipes. (Heid. E. Erdrich, 2013.) 

Kernels of corn are planted in a depressed cavity in healthy soil. Beans are then added. The corn will raise its stalks to the sky, and will be hugged by the climbing bean plants. This is an advantageous duo as the beans (belonging to the legume family) fix nitrogen into the soil. The nitrogen is fertilizer. Squash seeds are added to the duo. Tantalizing blossoms, bright yellow, both male and female emerge from the squash as they grow. Squash plants have large leaves which shade the soil, keeping the ground moist and weed free. Their vines are itchy! As a result, animal pests are not attracted to the squash. The reward is colorful fruits hiding beneath the squash leaves. Hence, The Three Sisters.

Our three sisters’ meal featured delicata squash topped with  nuggets of gorgonzola cheese and a stew rich with black beans and kernel corn.

I became interested in Indigeneous people as a sophomore in college. In 1966, I volunteered to tutor Indigeneous children attending a nearby grade school. I encouraged the children as they practiced reading and completed arithmetic assignments.

Three years later, during my dietetic internship at UWHC in Madison, I enrolled in two graduate level courses. The first course was biochemistry. I had taken biochemistry as an undergraduate and was surprised how much I enjoyed the study of the metabolism of carbohydrates, fats, proteins, amino acids and other nutrients. This was a tougher biochemistry course than my first biochemistry course, but I did alright. The second  semester course was advanced nutrition therapy as applied to diseases in humans of all ages. The research project I selected was the nutritional status of the Indigenous Peoples living in Wisconsin. I spent hours reading papers in The State Historical Library of Wisconsin, after working eight hours five days a week or more, as a dietetic intern.

Years passed.

Vacationing with our two children, Jim and I visited the Blackfoot Nation in Montana, The Lakota Nation in the Dakota’s, The Rosebud reservation in Nebraska, and the villages and cultural sites of the Maori people in New Zealand. An unforgettable adventure presented itself as we traveled into Alberta, Canada. We witnessed a dig and visited the museum at the Head Smashed In archaeological site.

While preparing food for my family, I also explored many cultures of the world. I started with my 28 volume Time Life Series: Foods of the World. My interest expanded to include the interrelationship of a people’s history, their culture and the land they inhabited as influences on foods consumed and cooking methods used. More recently I began to search for similar relationships within many Indigenous communities living in the United States. 

There is much for non-Native people, like me, to learn about First Nations mental health challenges. Having investigated Indigeneous history in the US as recorded by First Nation author Roxanne Dunbar-Ortiz, having enjoyed Inuit art for decades, and savored the writings of Robin Wall Kimmerer (Braiding Sweetgrass) and Patty Lowe'(Seven Generations), I have learned to appreciate and respect Indigenous ways of knowing.

The needs of First Nations concerning mental health are complex and often misunderstood. 

Here are 4 take-home messages I garnered from my studies of Native American mental health concerns.

  • There are 500+ federally recognized separate First Nation groups in the US. 
  • “People get things wrong about suicide on Native Lands; non-Natives need to learn Indigeneous perspectives on suicide.” (Native Hope website)
  • Rates of suicide, the contributing factors teading to suicide and the methods to deal with  mental health problems vary with each individual Native nation.
  • Culturally aware high quality resources are available as developed by and with many First Nation peoples. 

Two resources I recommend:

 We in the United States are observing our annual fall feast on Thursday, November 25th. This abridged version of “ The Words That Come Before All Else “ gently instills in me a  thankfulness for each of the blessings bestowed upon us .

Ohenten Kariwatekwehn : “ The Words That Come Before All Else ”

We express our thanks to our Mother Earth, who provides us with all we need to live upon her.

…  to all the waters of the world, for we cannot exist without the lifeblood of Mother Earth.

…  to the animals which live within the earth’s waters for carrying out their duties in harmony with natural law.

… to the insect beings which are upon and within the earth.

… to the animal beings and their leader the deer, as we are  grateful for sustaining us.

… to the medicine plants, which give us their energy so that we may be healed.

… to the food plants which nourish our bodies, particularly the Three Sisters: corn, beans and squash.

… to the trees of the world and to the Maple tree, the leader of all of its kind, whose sap renews our spirits and bodies.

… to the Four Winds without whom life would not exist. 

… to the Thunders of the world who carry rain and energize the earth for our seeds.

… to our grandmother Moon, who gives us light and controls the movement of water on the earth.

… to the stars who give us beauty and direction and to them we return when our spirits leave this earth.

…  to the spirit beings who guide and protect us.

… to those yet unborn that we are to ensure they also have clean waters, clean air and fertile soil.

… and to the Creator for the blessing of life and the gift each one of us is to the other and the world.

So let it be in our minds.

Thank you kindly.

 


This blessing of thankfulness – *Ohenten Kariwatekwehn, “The Words Which Come Before All Else“ – was submitted to Indian Country Today  (ICT) e-news by Doug George-Kanentio, Akwesasne Mohawk, a former member of the Board of Trustees for the National Museum of the American Indian and former editor of the journal Akwesasne Notes. 

I subscribe to ICT. Reading ICT has immensely enhanced my awareness of North American Native Nations, Inuits and Aleuts. My respect for Native ways of knowing and experiencing our Mother Earth continues to increase, a rewarding journey.

Notes from Working with a Psychiatrist

I see my psychiatrist once every month, minimum, no matter how busy or how well or how poorly I am feeling!  Over the years, these regular appointments have proven their worth to me.  Recently I’ve been feeling very well – but I met with my psychiatrist anyway and we had a fruitful satisfying appointment. Just as I normally do, I’d made a list of items to discuss with her. Some of them: Updating her on a change in how I was taking my prescribed medications.  A a summary of how I have been feeling coupled with a description of my functioning this past month. And so on.

She welcomed me warmly and waited for me to start the conversation. I was able to tell her that I’d been feeling very well since our last appointment.  As we went on talking, I told her how I had managed my mood and anxiety during the challenges of Christmas and December. I had been calm, collected and in a good mood. Christmas has always been a most difficult time for me, but this year, wonderfully, I had enjoyed the holiday season with family and friends. How I feel during the holidays is a very good indicator of my brain health!

I went on to say, with enthusiasm, that I was optimistic and excited for the year ahead. To be able to say optimistic is another Very Positive Indicator of my mental health status. I also continued to be grateful for and satisfied with our move to a new house in a different community this past summer.  Before we moved there had been several months of exhausting nervousness and anxiety in anticipation (dread?) of the move and its upheavals.

I also told her of my good success dealing with a change in my medication regime. The mood stabilizer I was using had caused me to fall unexpectedly sleepy while driving.  Consequently my husband often drove for me, as he and I had decided the sleepiness was a danger to others and to me. So we wanted to stop taking the med.  I am now able to drive without sleepiness, and as a result driving has again become a pleasant, safe task.  Now my psychiatrist and I are thinking of decreasing the number or the amount of medications I take. Scary, for sure, but another plus!

Why then do I continue to see a psychiatrist: to help me with the inevitable bad days or circumstances; to check that a bad day or two doesn’t become a trend; also for medication reviews, and for affirmation of my own understanding of my mental health.  Lastly, for the great comfort that, should a trend develop into a full blown depressive episode and I become seriously, dreadfully, sick we will both be on top of it.  My psychiatrist, reflecting the caring professional that she is, will be ready to prescribe new therapies, new medications, new approaches and give me hope. I have a real respect for this doctor and a great deal of faith that together we can find workable treatments for me, no matter the challenge.

Thanks, GL

Personal Medicine. A concept formulated by Pat Deegan

As I was preparing my presentation (titled “Living Successfully with Depression and Suicidal Thoughts”) to be given at NAMI Wisconsin’s Family Programs Summit this November, I ran into the term “personal medicine,” meaning an activity that a person does to obtain wellness, rather than something a person takes. The term was introduced by Patricia Deegan, PhD, in early 2003 as a result of qualitative research she did through the University of Kansas – School of Social Welfare [The Importance of Personal Medicine: A Qualitative Study].  Upon interviewing individuals who were taking psychiatric medication, Deegan found that “When describing their use of psychiatric pharmaceuticals or ‘pill medicine’, research participants also described a variety of personal wellness strategies and activities that I have called ‘personal medicine’. Personal medicines were non-pharmaceutical activities and strategies that served to decrease symptoms and increase personal wellness.”

Pat Deegan writes: “Personal medicine is what we do to be well. It’s the things that put a smile on our face and that make life meaningful.” She continues “Many of us have learned that finding the right balance between Personal Medicine and psychiatric medicine is the road to recovery.” [Common Ground Toolkit and Recovery Library]

She cited three examples of personal medicine that work for her: playing with her dog, taking care of her daughter, and reading scripture. I jotted down six examples to begin with: parenting and grand-parenting, cooking and baking, singing, texting and emailing Rebecca and Benjamin, sending notecards to people, and writing. Oh -and reading is a ready seventh activity; it’s the way I start every morning! Listening to music, often at the end of the day, is an easy eighth.

Reading Pat Deegan’s research closely, I see she identified personal medicines as falling into two broad categories: those activities that give life meaning and purpose, and self-care strategies. Both types increase feelings of wellness and help keep psychiatric symptoms and/or undesirable outcomes such as hospitalization at bay.

Necessary personal medicine is sometimes serious work. There was a year in my life when I was moderately depressed. I felt I had to bake five days a week: I had to bake every day I was home alone, at the time between jobs, every day that my husband Jim was away at his work. I baked for three hours every day, minimum. Why? I needed to structure my time, to accomplish something and to knead and stir down pain and numbing thoughts. It was always a batch of chocolate chip cookies one day and bread the next day. This period occurred after the children were grown, so what we didn’t or couldn’t eat ourselves, which was a lot, we gave away.

I learned this lesson [Partners in Recovery – PIR, June 2010] from Ms Deegan:  “It is so easy to get lost in thinking that we are not good enough or that we are irrevocably flawed because we have a diagnosis of mental illness. But healing does not come from outside us; healing comes from within.”

Now I realize that at that time in my life I was using baking as a self-care strategy, without being alert to my decision to do so. Baking simply kept me on my feet, kept me “productive,” and stopped the grinding negative thoughts. The joy and creativity I normally found in cooking and baking was absent. No lofty thoughts occurred while the warm dough was molded under my hands. No images of Grandma or my Mother – my bread-baking teachers – formed in my brain that I can remember. No smell of yeast permeated my mind. I simply did the tasks and came out with good home-baked items.

Good home-baked items. And I did not deteriorate in my mental status. I improved with time, never needing hospitalization or respite care. There is something good and healthy in people with a diagnosis of mental illness. Medicine doesn’t only come from a doctor or a mental health provider team. “Discovering personal medicine is powerful medicine and connects us to the resilient, healing parts of ourselves.” [PIR]

Today, much of the time I spend cooking and baking takes the form of personal medicine that makes my (recovered) life sing with purpose and meaning. I love the seasonal foods and the celebrations that each represent. In our family, every spring, there is homemade cream of asparagus soup with a twist of lemon on the side. Summer brings ruby red strawberry shortcake with berries from the field and real whip cream, plus new leaf lettuce for many simple tasty salads. Then late summer taught me to appreciate warm peach cobbler. Fall is chili and beef stew and the first cinnamon apple pie. The December holidays are hot chocolate from scratch, my delectable Mustard Apricot Glazed Ham, baked sweet potatoes, and pecan pie. All this is done with flow and calm that brings a great deal of satisfaction and attention to detail. My mind and senses are stimulated and utilized in a very positive and reinforcing way. And my family eats well too!

May each of you find the personal medicine that connects you to the resilient healing part of yourself.

The Strengths Model: Meaningful Relationships and Reciprocity

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.

The Strengths Model’s Focus on Meaningful Relationships

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.

The Strengths Perspective

Here’s a statement that intentionally “turns around” our usual way of evaluating mental health outcomes: If we want a successful mentally ill person, we could create a group home and help the ill person thrive within it. But if we want, simply, a successful person with mental illness who thrives in the same community with everyone else, we should help them find persons and resources in the community that will empower their strengths and also help them persist and persevere in working to minimize the disabilities brought on by their mental illness.

You help them persist and persevere by engaging them in their areas of strength, not in focusing on their deficits and defeats.

This suggests we should use a strengths model, rather than the problem-based or deficit model for providing services to those suffering from mental illness or disorder.


 

I first heard of the Strengths Model back in 2000, when I was in graduate school studying community mental health from Professor Charles Rapp’s perspective. A recent text co-authored by Charles Rapp and Richard Goscha, The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, Third Edition, 2012 simply reaffirms its importance in my thinking. I learned to focus on an individual’s strengths as building blocks to manage a situation or a life. I believe that people with mental illness would be >much< better served if all of mental health services had a strengths-based foundation rather than the traditional deficit- focused orientation.

“The strengths model posits that all people have goals, talents and confidence.” Furthermore, “All environments contain resources, people and opportunities.” (Link) But with the deficit-mindset, our perceptions of these are limited and modest and full of considerations of barriers and pathology. Strengths pale in comparison to the deficits.

“The strengths model then is about providing a new perception. It allows us to see possibilities rather than problems, options rather than constraints, wellness rather than sickness. And after being seen, achievement can occur.

It is Rapp and Goscha’s belief that if those involved in mental health services and policy insist on the “muck and mire of deficits” perception, we cannot be of effective help to all of those affected with mental illness.

I learned that the Strengths Theory has nine key propositions. Several of the nine are block-busters that can explode our current ways of thinking about mental illness services.

Here is their first key proposition: The quality of the niches people inhabit determines their achievement, quality of life and success in living.

A niche is defined as the environmental habitat of a person or category of persons. There are two types of niches at the extreme: entrapping and enabling.

Here are four characteristics of entrapping niches (there are others):

  • Entrapping niches are highly stigmatized; people caught in them are commonly treated as outcasts.
  • People caught in an entrapping niche tend to “turn to their own kind” for association, so that their social world becomes restricted and limited.
  • People caught in an entrapping niche are totally defined by their social category. The possibility that they may have aspirations and attributes apart from their category is not ordinarily considered. To outsiders, the person is “just” a bag lady, a junkie, a schizophrenic….and nothing else.
  • In the entrapping niche, there are no graduations of reward and status. …… Thus, there are few expectations of personal progress within such niches.

Here are four describing enabling niches:

  • People in enabling niches are not stigmatized, not treated as outcasts.
  • People in enabling niches will tend to “turn to their own kind” for association, support, and self-validation. But often the niche gives then access to others who bring a different perspective, so that their social world becomes less restricted.
  • People in enabling niches are not totally defined by their social category; they are accepted as having valid aspirations and attributes apart from their category.
  • In the enabling niche, there are many incentives to set realistic longer term goals for oneself and to work toward such goals.

The strengths model proposes that finding, cobbling together or creating enabling niches should be the major focus of work for mental health services and professionals. The authors continue, “There is good reason to believe that the niches available to people with psychiatric disabilities influence the recovery process and their quality of life.” (pp. 37, The Strengths Model)


 

I am thunder-struck, when I think of my life and the quality of my life and its influence on my recovery process. A few thoughts:

I have been very fortunate, that the niches in my life have been enabling in my recovery journey with mental illness. I’ll look at a variety of life domains: home or living arrangement, work, education, recreation, and spiritual . Yes, I did a lot of work to gain recovery….but I had a stable set of niches or habitats. Read on:

I lived in a home all the years I have had an illness.   And since the very time of diagnosis and onset I had my own family …… a loving supportive husband and 5 year old daughter and I was pregnant with our second child. We still live in our own home, although it is a different house now, for after 30 years our children are grown. They are fine and healthy and love and care for us as do our two grandchildren. Jim and I continue to enjoy a rich relationship with each other and with our family.

I have had rewarding work. I was employed at St Mary’s Hospital Medical Center and at two nursing homes and one small alcohol and drug rehabilitation hospital as a Registered Dietitian (RD). For 15 years I also taught as a clinical instructor and later lecturer in Nutritional Sciences Department at the University of Wisconsin-Madison. After this career within dietetics, I turned to the mental health field.

I had been able to earn an undergraduate education without much trouble. But much later, when I returned for graduate school, I had a relapse and asked for accommodations. My request was met professionally and I was able to complete the work after some delay but with full effort. I am happy to say that I received my Masters Degree in 2003 from Southern New Hampshire University. In 1993 I had begun a 20 year career of volunteer work with NAMI. After 2007, I joined the staff of NAMI Wisconsin as their Coordinator of Family Programs.

All this work was challenging with a mental illness, but I certainly had roles I valued and that other people valued which were separate from the “role” of being a person with a mental illness. AND NOW, recovered and moved by my life experience I write about mental illness issues and affirm the lives of those who live with them. Today, this website is my vocation in more ways than one.

I’ve lived a whole, stimulating and enjoyable life in large part because the places and people – the niches – I lived in and among were consistently empowering. We must strive to have these empowering environments available in reality for all people with mental illnesses!

Part V – Why does all this recovery happen?

One doesn’t recover from a mental illness in the same way one recovers from a broken arm. Yet recovery and healing is possible, and life can be enriched. We refer to that healing as a personal recovery.

Reading more of Professor Mike Slade’s work on personal recovery I found that my journey rediscovered something essential for the recovery to succeed: a sense of personal agency. This is the belief and assurance that one has the power to positively impact one’s own life; the power to act in one’s best interest. He writes that developing a sense of agency can be a difficult process precisely because mental illness often takes away that assurance and belief. He urges professionals, staff and family to show support which recognizes the importance of renewing the individual’s sense of self agency.

Finding and supporting that sense of agency – the ability to act in your own best interest – in yourself and for those you love is a crucial part of personal recovery.


I developed a great deal of authority over my life when I successfully quit smoking, a task I once thought was impossible for me. You see, when I quit I’d found I could make a difference in my health care, a truly enormous difference; perhaps a life-saving one. And I learned people would support me in this difficult but worthwhile goal!

Now I hopefully approached a new goal, to learn tools and techniques to help counter the persistent negative thoughts common to major depression. The experience of power over my life I’d had when I successfully quit smoking taught me to seek new tools which I could use to achieve new goals: It was time to learn Cognitive Behavior Therapy, and I had no problem learning and practicing its techniques. I continue to be an agent in my own life: Here in my 67th year I set out to find a Personal Trainer so the physical work-outs I desired would be effective and fun. I found one through a good friend; hired her, and have lost weight and body fat while building muscle, etc. I think more clearly and can concentrate more fully since I have been on a regular exercise schedule.

The symptoms of depression and bipolar II persist but weaken; the sense of authority over my own life increases; I’m healing.