Saturday, June 30, 2018

Suicide and 'Safety': This week in Intentional Peer Support

INTENTIONAL PEER SUPPORT PRACTICE SERIES SATURDAYS WEEKLY 5-6:30 pm Eastern FREE  ONLINE Beginners Welcome      This weeks topic: SUICIDE and ‘SAFETY’ (June 30, 2018)  Join by computer: https://zoom.us/j/119362879 Join by phone:  +1 669 900 6833 or +1 646 558 8656 Enter Meeting ID: 119 362 879 International callers: https://zoom.us/u/jkwt3wHh   About IPS:  Intentional peer support (IPS) is a way of thinking about and being in purposeful relationships. In IPS, we use our relationships to look at things from new angles. We develop a better awareness of personal and relational patterns. We support and challenge each other as we try new things. IPS is different from traditional service relationships because it doesn’t ,start with the assumption of “a problem.” Instead, we learn to listen for how each of us has made sense of our experiences. Together, we create new ways of seeing, thinking, and doing. At the end of the day, it is really about building stronger, healthier communities.  More info (& study guide) at:  peerlyhuman.blogspot.com  Left Graphic: Cover of IPS Workbook [picture of a woman wearing a hoodie with images of a tree, a house and a hand.  She is holding a smaller version of herself in her arms.  Written in cursive on the image is ‘What is forgotten is who we are.  Right Graphic:  IPS Promo Poster [picture of a man in a wheelchair, a woman sitting on the grass listening to him, and another leaning against a tree.  Above them on the branches of the tree reads: “From helping to learning together, individual to relationship, fear to hope and possibility” In the horizon below that “Connection/ Worldview / Mutuality/ Moving Towards”]


FREE ONLINE -- Beginners 
Welcome!

Join by computer: https://zoom.us/j/119362879
Join by phone: +1 669 900 6833 or +1 646 558 8656 (Meeting ID: 119 362 879)
International callers: https://zoom.us/u/jkwt3wHh

Intentional Peer Support Practice Series

Weekly on Saturdays 5-6:30 EDT 

Join by computer: https://zoom.us/j/119362879
Join by phone: +1 669 900 6833 or +1 646 558 8656 (Meeting ID: 119 362 879)
International callers: https://zoom.us/u/jkwt3wHh

Full Study Guide

The following study guide has been personalized and adapted with permission from Intentional Peer Support: An Alternative Approach by Shery Mead.  To purchase the full manual (book, kindle, audiobook), see http://www.intentionalpeersupport.org/store/.  To learn more about Intentional Peer Support and available trainings see http://www.intentionalpeersupport.org/

A Deeper Look at 'Safety'

When I was a patient in the mental health system, I heard the language of safety a lot! Was I safe, was I going to be safe, would I contract for safety, etc. etc...?  Through these questions, safety came to mean that I was simply agreeing not to do anything to hurt myself or someone else.

But what did that leave me with?

Reflection questions


  • What has it meant to you when others have asked if you’re 'safe'? 
  • When you’ve asked others if they’re safe?

Frankly, the more safety questions I got, the less I felt reliant on my own abilities to take care of myself. So instead of feeling safe in the world, I felt like a time bomb that could go off at any time.

It also left my clinical relationships with a huge power discrepancy:  If I told the truth -- "I feel like hurting myself" -- the practitioner would feel obliged to take precautions.  Perhaps they were legitimately concerned I would follow through.  Or, maybe they acted more from a need to protect their job, their license or their organization.  Either way, once the magic words got spoken, they mostly had the power and I mostly didn't.

Option two was to lie.  If I denied my true experience, I could keep my power.  But denying my reality - and keeping secrets in important relationships - also have their costs.

This was abundantly true for me.  I felt miserably alone at the most vulnerable times of my life.  I came away feeling like there was no one on the planet who I could really trust.  I was out of my league and I knew it. I desperately wanted human support and counsel.  I desperately wanted to get to the root of my true feelings and to be able to uncover any options I had.  Yet, here I was trying to make a good decision - perhaps the most important decision of my life - without knowing a single soul I could trust to be truly honest with.

In retrospect, I don't think there is much that is LESS SAFE for me as a human being in that frame of mind.  In fact, I can only think of one thing that's less safe from my perspective: 
EVEN MORE UNSAFE = to feel coerced or pressured by others who don't understand my unbearable suffering into making a bad decision makes it even worse.  
Unfortunately, that was often where I found myself in times like these, given the mainstream practice of reporting, detaining and drugging those of us who acknowledge the depth of our distress and despair.   

Re-Thinking Safety

The painful contradictions noted above have led to a lot of reflecting on what safety actually means to me.  Here are two bottom lines I've come to:

  1. Real safety doesn’t mean talking to someone with a reporting obligation.
  2. Real safety doesn't mean making a safety contracts or promises to stay out of harms way.

Reflection questions


  • What does real safety mean to you?
  • What makes you feel safe (or safer)? 

Real safety - for me - is about creating culturally respectful, mutually responsible, trusting, trustworthy relationships. It happens in relationships where we don’t judge or make assumptions about each other.  It happens when someone trusts and believes in me even when they’re uncomfortable.  It happens when I'm free to share my deepest truth and you take time to reflect on what I've said. You make the effort and sincerely try to get to the heart and soul of what I'm attempting to get across to you.

When you make that kind of effort and actually 'get' me, everything starts to change.  You've proven to me that you can put your needs aside long enough to hear me out when it really matters.  So I begin to feel ok about letting you into my world and loosening my grip on the urgency of now.

You've also proven to me that you understand the territory.  You've treated me like I have value and like my experiences do too.  So I begin to get interested in what you think and might possibly know.  I get curious about what I might find out if I stick with you.  I feel bouyed up enough to risk the uncertain and the unknown.  After all, you're a pleasant companion and the spent time with you feels bearable. That alone gives me hope that there might be something on the other side to make the journey worth hanging in for.

This buys us time.  The time we need to take risks, learn from them, explore new possibilities, and learn some more.  All the while behind the scenes, subtly, incrementally, without me knowing it, a revolutionary change in my assumptions is taking place.  The way I think about how this world and how it all operates (me, others, the planet) will never be the same.

Reflection questions

  • What happens when you are with someone you trust and feel safe with? 
  • How does actually feeling safe change things?  (Can you do things when you feel safe that you can't do when you don't?)
  • How does being with someone you feel safe with change things? (Have you ever noticed yourself being able to do something with a person you trust that you couldn't do without them...?)

This is what we call building relational safety.  As you can see, it is very different from the liability management practices that are oriented toward legal safety.   It requires both of us to take risks and be vulnerable, instead of just one of us unilaterally protecting our interests. This is what we call shared risk.

How safe the relationship is for both of us depends on...  both of us.  It only works if both of us are willing to learn to share our power and take responsibility to do our part.  This is what we call mutual responsibility.

Relational safety, shared risk and mutual responsibility are foundation principles in creating relationships that work for both people.  You will learn a lot about them - and practice them a lot - in this kind of peer support.

Reflection questions

  • What happens to 'safety' for you if... 
    • I am continually assessing you for 'risk'...?
    • I can unilaterally decide to 'keep you safe'...?
    • I expect you to do all the risking...?
    • I am the authority on what risks you can take...?
Practicing Relational Safety

It's time to put the rubber to the road and practice creating this new kind of safety in our relationships with each other.  Here are some strategies to get us started:

1. Initiate proactive conversations

Whenever possible, it's best to practice these principles proactively (by thinking ahead) rather than reactively (oops...). The idea of proactive conversations is to get our concerns on the table early on, before either of us is in discomfort or crisis.  That gives us the space to look at ourselves from a comfortable distance.  Then we can reflect honestly together about:

  1. The kinds of stuff that often comes up for us (in relationships or in our lives); and 
  2. What we'd like to do differently this time.  

For example, if wanting to die is a common issue for either of us, we can talk about it ahead of time.

  • We can explore what will help the relationship feel safe for both of us if those kinds of feelings come up again.  
  • We can both acknowledge (honestly, out loud) the extent of our “bottom lines.”  
  • We talk about how we each are likely to react when we feel untrusting or disconnected. 
  • We can figure out together what we will do, should we get to that edge. 
By proactively exploring potentially sensitive issues like these, we pave the way for negotiating our relationship when future challenges arise.

2. Talk (and talk and talk) about power

Power and safety are totally intertwined.  I, for one, feel safe and optimistic when I have power.  I also feel vulnerable (and worried, angry, confused, sad or overwhelmed) when I don't.  I suspect it works that way for lots of us, though I don't hear this talked about very much.

Being aware of the impact of power is critical for this kind of peer support.  Relationships are a virtual land mine of power dynamics.  There's a zillion ways to feel more or less powerful than someone else.  Taking risks, sharing responsibility, being vulnerable, creating safety - these things are all about power.

As you can see, the fact of power is inescapable in peer support.  But power itself is not a problem.  What matters is how we choose to use it.

Reflection Questions


  • Do I use the power I have to build respect, equality and participation in relationships?
  • When am I tempted to use power to advance my own self-interest?
  • What does that do to my relationships?

Can you begin to see how our use of power affects the quality of our relationships...?  That's why, in this kind of peer support, we talk about power a lot:  What it’s like to have it, use it, lose it, abuse it and try to share or balance it.

We tend to talk about power imbalances again and again because, well... we're human.  So these issues come up again and again.

3. Practicing mutual responsibility

Most of us who have seriously considered giving up on life have experienced the kinds of assessments, safety contracts, and evaluations that I talked about above.  This affects our 'mental health relationships' and how many of us learn to think about them.  

Reflection questions

  • Think about mainstream mental health relationships (therapy, psychiatry, case management): 
    • Who defines 'risk'/ 'safety'? 
    • Who or what is considered 'risky'/ 'safe'? 
    • Who decides what risks are acceptable?  Required?  For whom?  
  • What happens in a relationship when you feel like someone is always assessing your safety?
  • What assumptions do you make about who holds the power or control?
As a mental health client, it went unsaid that the clinical professionals were the one's who defined the realm of risk.  They told me the risks I was supposed to take - e.g., share honestly even if I don't trust them; do what they tell me to even when it doesn't make sense to me.  They also were the ones to decide whether my thoughts or actions were 'risky', how 'risky' they were, and when additional management (treatment) or surveillance (prevention) was required.

As noted above, the peer support we are learning here makes very different assumptions.  It assumes both us of have things to share and things to learn.  It assumes that risk is a part of living and that we will both take risks and create them.  It assumes we both have power -- as well as a mixed record when it comes to the choice of taking it for ourselves, giving it up to someone else, or negotiating and sharing it with others.

Consequently, the most important thing we learn to do with each other is put our cards on the table and talk honestly about our needs and concerns.  Some suggestions for doing when either of us struggles with wanting to die include:
  • Talking about our own reactivity to these kinds of situations, and then mutually negotiating a new response.
  • Building a relational ‘crisis’ plan (e.g., a WRAP plan that we create together for our relationship).
  • Talk about hot buttons for both of us and how we’ll deal with them.

4. Reflective Feedback

A huge challenge for me in building relational safety is when I think your needs, views or reality conflicts with mine.  Reflective feedback is a way for me to voice my own reality without defining yours or taking away your power.  The process is fairly straightforward:

Say what I see 

This is just simply owning up to the thoughts going on in my head about a situation.  They may be true for you too, or they may not be.  The point is that they are real for me, so I own them as my thoughts.  Then I take the risk of saying something like this:
I'm having a really hard time with they way I'm experiencing the energy between you and me.  The story I'm telling myself is that you think I'm going to kill myself so you're watching me like a hawk.

πŸ˜•πŸ˜Ÿ

Say what I feel

Here is where I own up to the effect that my way of seeing is having on me.
I'm finding myself shutting down and hiding from you.  I'm also spending all kinds of time in my head telling you off and arguing with you about why I think you should act differently.  This isn't how I want to be.  It's bothering me a lot.

😐😐

Say what I need

Here is where I say what I'd like to be different.
 I'd like to get out of my head.  I'd like to see you as an ally and on my side.  I'd like to be able to believe that you trust and respect me.  Or at least I'd like to figure out how we can relate in a way that feels more equal.   
Do you have some time to talk about it?  Would you be willing to tell me how you see things? Do you see it the same as I do or differently...?

😏😏


These are the kinds of conversations that allow both people to take risks and grow. These are the kinds of conversations that can lead to fundamentally different ways of thinking about help.

Practice Exercise

Practice having a relational safety conversation.  Two people can role play a conversation or everyone can take turns jumping in with new lines.  Notice the responses that make you feel more or less safe. Discuss this as a group at the end.     

Relational safety in real time

Sometimes, we don’t have these conversations in advance.  Or suddenly, we find ourselves in the thick of it anyway.  During these times we’ll need to negotiate on the fly.  A couple of the skills here include:

  • Talking honestly: What does it feel like for each of us? Are we scared, frustrated, confused, angry, etc? 
  • Self-reflection:  Where is my reaction coming from?  Life and death danger? Break with routine protocol? Difference of opinion?  Unfamiliar territory?  Added workload? Not my preferred was of operating?  Past experiences?  Gut feeling...? 
  • Go back to the relational WRAP and follow what was agreed to.

Debriefing After the Fact

After we’ve come through a difficult situation and we’re on the other side, redefining safety is still important. We both probably have some feelings about what happened.  We maybe even created a little mistrust and now need to re-establish what’s going to work for both of us.

Some useful skills here might be:

  • Re-define together what safety and shared-responsibility means for us.
  • Talk about how it felt for both of us and what’s happened with our feelings since.
  • Figure out what’s going to help both of us regain trust.
  • Revisit / create a relational WRAP…


Summing up

  1. Have you noticed some ways that this kind of peer support different from other kinds of ‘help’ you might be familiar with?
  2. What differences do you see?   

PAST TOPIC

Sat. 6/30/18:  Suicide and 'Safety'

  • Is 'safety' about legalities or relationships?  
  • Do risk assessments and safety contracts make us less likely to attempt suicide - or can they actually backfire and increase the risk...?
  • What can we do instead...?

Sat. 7/7/18:  Supporting others who want to die

  • How do our own needs affect how we support others?
  • What assumptions might we make about supporting others based on our own needs or experience?
  • What are the gifts and limitations of such assumptions?

Sat. 7/14/18:  Practicing relational safety

  • What makes a relationship feel safe (trusting/ trustworthy) to me?
  • What kinds of things seem to come up that can get in the way of for me (stuck points, patterns, bad luck streak, etc.)?
  • How have I tried to cope or manage that?
  • What (if anything) would I like to hold myself accountable try differently for next time?
  • What (if anything) have I been able to do to make a relationship better rather than worse when things started taking a turn for the worse...?

Sat. 7/21/18:  Suicide and Power

  1. What is the relationship between suicide and power?
  2. How, if at all, does power (having it, not having it, losing it, feeling used, abused, put down or ignored by others who have it) affect my feelings about living or my will to live?  
  3. How is power different depending on whether I am a 'helper' or a 'helpee'?
  4. Is power different when I 'feel suicidal' compared to when I don't?
  5. What implications might that have for our relationship if one of us starts talking about wanting to die...?

    Sat. 7/28/18:  Suicide and Responsible Relationships

    Most of us who have seriously considered giving up on life have experienced a variety of assessments, safety contracts, plans, checks and evaluations intended to 'help' us act 'responsibly.'  This affects our relationships with important others in our lives.  That includes professional helpers, as well as friends, family and community members who would sincerely like to be helpful.  It also affects how many of us - both helpers and helpees - have come to understand what 'help' means when human needs feel high and options low.  

    Reflection questions
    • Think about mainstream mental health relationships (therapy, psychiatry, case management, formal or informal caregivers): 
      • Who defines 'risk'/ 'safety'? 
      • Who or what is considered 'risky'/ 'safe'? 
      • Who decides what risks are acceptable?  Required?  For whom?  
    • What happens in a relationship when you feel like someone is always assessing your safety?
    • What assumptions do you make about who holds the power or control?
    As a mental health client, it went unsaid that the clinical professionals and 'responsible caregivers' were the one's who defined the realm of risk.  They told me the risks I was supposed to take - e.g., share honestly even if I don't trust them and follow their advice or instructions even when this doesn't make sense to me or fit with the needs, values or dreams I experience for myself.  They also were the ones to decide whether my thoughts or actions were 'risky', how 'risky' they were, and when additional management (treatment) or surveillance (prevention) was required.

    The peer support we are learning about here, however, makes very different assumptions.  It assumes both us of have things to share and things to learn.  It assumes that risk is a part of living and that we will both take risks and create them.  It assumes we both have power -- as well as a mixed record when it comes to the choice of taking it for ourselves, giving it up to someone else, or negotiating and sharing it with others.

    Consequently, one of the most important things we can learn to do with each other is put our cards on the table and talk honestly about our needs and concerns.  Some suggestions for doing this when either of us struggles with wanting to die include:
    • Talking about our own reactivity to these kinds of situations, and then mutually negotiating a new response.
    • Building a relational ‘crisis’ plan (e.g., a WRAP plan that we create together for our relationship).
    • Talk about hot buttons for both of us and how we’ll deal with them.



    4 comments:

    1. This comment has been removed by a blog administrator.

      ReplyDelete
    2. This comment has been removed by a blog administrator.

      ReplyDelete
    3. Tantrik Astrologer Ramdas Ji. in India Best Vashikaran Specialist, Contact Me : +91-9587008635 If you are looking for the cure of your problems with help of vashikaran and black magic then vashikaran specialist ramdas baba ji can be the best motivator in all sorts. You just have to call us and he can perform all the rituals to solve your problem. The spell and mantras of their vashikaran and black magic is too powerful to make your dream come true.

      Love Problem Solution
      Enemy Kill Mantra
      Kala Jadu
      Black Magic for Destroy Enemy
      Black Magic Removal Specialist
      Aghori Mantra to Kill Enemy
      Boyfriend Vashikaran Specialist
      Enemy Died Mantra
      Black Magic to Kill Enemy
      Enemy Died Mantra by Black Magic
      Destroy Enemy By Maran Mantra
      How Can i Kill or Destroy My Enemy
      How To Get Your Ex Boyfriend Back
      Vashikaran Specialist Astrologer
      Maran Mantra to Kill Enemy
      Black Magic To Kill A Person
      Husband Wife Relationship Problem Solution

      ReplyDelete
    4. Tantrik Astrologer Ramdas Ji. in India Best Vashikaran Specialist, Contact Me : +91-9587008635 If you are looking for the cure of your problems with help of vashikaran and black magic then vashikaran specialist ramdas baba ji can be the best motivator in all sorts. You just have to call us and he can perform all the rituals to solve your problem. The spell and mantras of their vashikaran and black magic is too powerful to make your dream come true.

      Childless Problem Solution
      Kala Jadu Specialist Aghori Baba
      Famous Astrologer Tantrik
      Kamakhya Sindoor By Vashikaran Mantra
      Inter Caste Love Marriage Solution
      Get Your Love Back
      Black Magic Specialist
      Lottery Number Specialist
      Black Magic to Get Lost Love Back
      Get Lost Love Back By Astrology
      Black Magic Mantra To Spells Destroy Enemy Kill
      Husband Wife Problem Solution
      Love Vashikaran Specialist
      Love Marriage Specialist
      Get Love Back By Vashikaran
      Divorce Problem Solution
      Kamdev Vashikaran Mantra

      ReplyDelete

    Please share your thoughts: