Here’s Why the Issue of Recovery, Healing, and Diagnosis Can Be Too Confusing

Maxwell Guttman, LCSW, (2021, August 25). Here’s Why the Issue of Recovery, Healing, and Diagnosis Can Be Too Confusing. Psychreg on Mental Health Stories. https://www.psychreg.org/recovery-healing-diagnosis/

Reading Time: 4 minutes

I am an extremely disillusioned peer. I have spoken up about issues in the peer community. Both cover and overt, I am pointed to problems that require urgent attention and corrective action in our peer community. Well, I have held my tongue far too long about the most insidious problem of all. I gestured to it in an article when I talked about the mishandling of my peer supervisor’s relapse and the fallout in our agency and peer programme.

Well, I apologise for just gesturing to the issue. I should have done more than just signal to the problem; I should have held a spotlight. The issue at hand is the taboo unresolved question surrounding relapse as a peer. Peers, by definition, in the mental health community have experienced the impact of a mental health disorder, and sometimes, mental severe ‘illness’ in their life. While there is no rule or prescribed limits written down in the Academy of Peer Services (APS) around how long a person should be in recovery or healed from their illness. There is a generally understood notion that this peer should be active in the recovery process if not fully ‘recovered.’

Here is where the issue of recovery, healing, and diagnosis all confuse and complicate things. Depending on what you consider ‘healed’ or ‘recovered’ and how you conceptualise diagnosis will impact, unequivocally, the level of rigour and how you can perform and carry out your job as a peer. I am saying, in no uncertain terms, if you are only just embarking on your recovery journey, you might experience a few more blips or issues while working as a peer as s direct result of not being fully recovered.

Think about it if you are still experiencing some ‘symptoms’ of a ‘disorder’ or haven’t learned how to make yourself the best possible self-care. The more likely you may need more time off or might be triggered more (as a result of being less familiar with your disorder and how your ‘symptoms’ re-activate), you might need additional time to heal and recover as you continue on your healing journey.

Either way, there is undoubtedly a vast spectrum to healing, recovery, and the level of rigour and resultant performance of peers in the workplace. I’ll be brutally honest when I first encountered another peer – introduced to her and a few others at my local mental health agency. My heart dropped, and I was highly concerned.

I was worried and sullen because I was shaking hands with glassy-eyed people who looked highly medicated. In some cases, tired-looking, again, perhaps because of medication, or overmedication, and a general attitude I picked up from them as being overly grateful and happy just to be working in the same environment as their ‘professional’ counterparts. Seeing this was difficult for me, even merely on the level of observation, because I was one of them. I was a peer myself.

I wondered, do other folks see me in this light? Because I was a social worker, too, I asked if it was even a good idea to reveal my whole identity as someone who had lived experience with schizophrenia. But alas, as I got to know my first peer supervisor, she taught me how I was more powerful as an agent of change, a testament to the upper limits of success and career growth that a peer was truly capable of during their career.

My supervisor reminded me, reinforcing at every intersection of practice, how important it was that I came out and stayed out as a peer and someone with lived experience. In concise declarative terms, she also told me that my resolve and health would be under scrutiny from everyone around me in the agency.

And, as my other article talks about so frankly, the irony around my supervisor’s warning after she relapsed and ultimately lost her job under very unsettling circumstances at the agency and the behaviours, taboo, and missed learning moments that persisted to no end until her termination. However, I left out of that article, and the very issue I want to spotlight is the betrayal from other peers when someone with lived experience relapses.

Oh, if you don’t know what I am talking about, you have got the blinders up so high that you’re probably negligent in your work. Why am I making such a bold and declarative statement about peers betraying other peers they think are relapsing or getting ‘sick’ again? Because I’ve seen it repeatedly, for so many yet complex, and ultimately, petty, cowardly, and distasteful reasons.

The reasons are so multifaceted and nuanced, flagrant, and most assuredly un peers like, that I could do a full-length presentation about it at the next peer conference and probably should. But like most double standards that are taboo and not talked about, the expression would likely be terminated, cut off, and go terminal before I even got to speak. Heck, I am confident my proposal wouldn’t even get selected as a speaker at this hypothetical conference.

Why you might wonder, should such a courageous and essential proposal be shot down? I could speculate. I could imagine some folks are uncomfortable when they look in the mirror. When they hear about their behaviour from others, they become resistant to being challenged and quite defensive. Again, this idea is hypothetical and speculation, but indeed, quite probable, wouldn’t you say? Think about it and think back on your experiences. Have you observed or heard stories about other peers who have relapsed and got fired when accommodations or other measures were not put in place to avoid their termination?

I fully believe that in a profession based on living out and healing from a disorder, we should not just expect but be prepared for our fellow peers to relapse. There should be active protocols in place in every agency when this happens. From HR to agency-wide discussions and conversations around this very natural part of living with a mental health disorder. Now, back to that piece that makes this conversation ever more complex. What does ‘relapse’ really mean? What exactly is the correct term or way of speaking about this behaviour?

Maybe, or maybe not. In my book, the most important item here is that we begin to fully prepare the ongoing conversation in agencies and the larger peer community around relapse and what it might mean for a program or a community of peers. I have often seen the taboo treatment of ‘relapse’ mean withdrawal or removal of support between the person relapsing and their fellow peers. This phenomenon is the very converse of what should happen between peers. We need to augment support in a crisis, not remove it, folks.


Maxwell Guttman, LCSW teaches social work at Fordham University. He is also a mental health correspondent for Psychreg.

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