What makes NAMI Peer-to-Peer unique and effective
Once upon a time..
Historically, families have been blamed for causing mental illness in their loved ones.
Historically, people with mental illnesses have also been blamed for their conditions.
Stigma- What we are up against
One psychiatrists evaluation of a man diagnosed with severe and persistent psychotic mania, 1997:
He tests in the superior range of intelligence, but has a passive aggressive personality. It is based upon very infantile egocentric ideas in which he is maximizing the secondary gain related to his disability in quite a manipulative fashion. He is heavily enmeshed in patterns of family pathology, particularly in relationship to his mother. He is unlikely to benefit from therapy unless he is willing to disengage himself from this family and maintain an independent life style.
Blame responses resulting from stigma
I brought this mental illness on myselfI am too close/too detached from my motherLazyManipulativeActing outBeing punished by God
NAMI Peer-to-Peer breaks away from the notion that a person is at fault for having a mental illness.
NAMI Peer-to-Peer messages:
Mental illnesses are biologically based brain disorders that can have environmental triggers. They are not ourfault. They are not our parents fault.
2. People with mental illness are often stigmatized.
3. The onset of an episode of mental illness is deeplytraumatic and disrupts every area of a persons life
4. Mental illnesses are catastrophic stressors.
What is a catastrophic stressor?
An unanticipated event
No time to prepare for it
No previous experience about how to handle it
Has a high emotional impact
Involves threat or danger to self or others
Typical responses to the trauma of a catastrophic stressor:
An unbearable compulsion to undo (If I had just done __ I wouldnt have gotten sick)
Fear of trying anything new due fears that our illness could get worse
Isolation from family and peers
Embarrassment when talking with others due to stigma
An incessant fear of the illness recurring
A constant flood of feelings like anguish, horror, and fear
Why NAMI Peer-to-Peer is taught how it is:
As we have just mentioned, the experience of mental illness is deeply traumatizing
People going through trauma dont absorb information the same way traditional adult learners do
Basic assumptions about adult learners: Imagine that you have just signed up to take an astronomy course
Have a genuine curiosity about the subject offered-I want to be here
Are willing to master a comprehensive range of materials
Are ready to learn all the content (This is an intellectual pursuit)
Have the time and energy to take the course
Why NAMI Peer-to-Peer participants arent traditional adult learners
1)We are not simply curious. Our interest in and response to course topics are highly emotional; we understand the importance of the course but may not wish to be there.
2)We are not ready to take in everything we learnWe are emotionally overwhelmed by the experience of mental illness.
3) We dont have a dispassionate interest in the material.Our relationship to course topics is intensely subjective. It is unlikely that we will take in all of the information presented.
4) We dont have the energy level or time adult learners typically do We use a lot of time and energy holding it all together. We experience drowsiness caused by medications, have less time due to doctors appointments, and may be trying to care for a family at the same time.
Basic assumptions about adult educators
A teacherly concern that participants understand everything in the course.
Worry if people dont understand the materials presented
Use different teaching methods to accommodate a variety of learning styles (It is my job to entertain the class.)
Why NAMI Peer-to-Peer Mentors arent traditional adult educators
1) We dont expect our peers to grasp everything that is presented.
We are emotional guides. We help peers take in only the material they are ready to absorb.
2) We fully expect that some folks will zone out, seem to not pay attention, or rest.
It is our responsibility help our peers stay within their comfort zones. We give each person space, recognizing that it is normal for their focus to fade in and out.
3) We dont use a large variety of learning tools (power points, videos, graphs, etc).
This is because people attending NAMI Peer-to-Peer are not doing so as an intellectual pursuit.
Teaching aids distract from the emotional content of the course.
In other words, people dealing with trauma and stress learn differently from othersTo survive, we typically:
Have a narrow, personal focus
Develop tunnel vision and are very self absorbed
Have radar out only for information and support
Operate from fight or flight mode (look only at what might be helpful to us and leave the rest)
I need to know X and thats all
We are unsure if we want to know what comes next.We are afraid of the unknown.
NAMI Peer-to-Peer understands that peopletaking the course are moving through experiences of trauma.
This is NOT a group that can be reached through conventional adult education.
We have to find other ways to help our peers learn what they need to know, and what no one else is telling them
Techniques used in NAMI Peer Education
1) Uses an easy to follow lecture and read-along format that, allowing people to take in as much or as little information as they wish
2) Provides Information linking brain illnesses to the body.
3) Teaches coping skills
4) Moves people toward a greater awareness and understanding of their own lived experiences
Techniques used in NAMI Peer Education
5) Normalizes thoughts, feelings, body sensations and behaviors connected to mental illness
6) Teaches that recovery is attainable
7) Shows that mental illness symptoms are REAL, not just behavioral
8) Provides group support
9) Uses information overload to break through long-held stereotypes
Plus, the comfort of being read to ....1) Someone else is in charge, taking the lead
2) Allows for concealment of emotions, and permits zoning out
3) Makes available a vast array of information to select from in building ones personal mosaic
4) Plays into the ability to figure things out on ones own
5) Eases people into the process of learning
1) The experience of mental illness is deeply traumatic.
2) People attending the course will not approach it as adult learners.
3) You are an emotional tour guide not an adult educator; its not your job to make sure they learn everything in your course; it is your responsibility to expose them to the material and show them how to take what they need
4) Dont worry about teaching aids; trust the process
Take-home messages5) Dont worry if people space out; that is the plan!
6) Dont work too hard to MAKE people talk; theyll talk when they are ready.
7) Be aware of the pull of the group toward a support group format- wanting to just talk. This is a class even though we approach teaching in a unique way
8) There is a critical connection between using a scripted manual and our research eligibility.
Fidelity, Fidelity, Fidelity!