Work Transition Narrative

Work transitions as a journey: The path of a tireless peer support advocate

Piedad Martin-Calero

E-mail: piedad.martin.calero@gmail.com

Tel.: +902 293 4747

It’s Spring, 2015. I find myself in a room full of mental health experts. We have been working for more than a year to bring mental health peer support to our local universities. On this day, we are presented with a job description for student peer support roles that does not require the student to have lived experience of mental health challenges. I am shocked, I feel invisible. As the coordinator of an existing university mental health peer support program I am the only person in the committee representing lived experience of mental health challenges; I feel like nobody has been listening to me.

Mental health peer support is generally recognized as a model of building and delivering mental health services and supports where the person providing the support has lived experience of mental health challenges and uses the knowledge that comes from that experience in their work [1, 2]. Peer support is based on mutuality and reciprocity; without shared lived experience there is no peer support. I am in disbelief that the experts in the room can so easily disregard this.

This poem flows out of me:

In the following days and weeks more evidence of silencing and exclusion becomes evident. Our program has not been invited to a new university committee dedicated to bring student driven mental health supports to our campus. We are the only group in our university currently doing this work, but it is somehow acceptable not to include us.

This is how I come to learn, for the second time, that it continues to be acceptable to exclude and ignore the voices and the knowledge of people with lived experience of mental health challenges in the design and delivery of mental health supports. Our knowledge is not valued. We kind of don’t count. What is particularly shocking is that this is happening even in spaces, such as the two above, that claim to be upholding peer support principles. How does one learn to navigate this?

The first time I encountered espoused but unmet peer support values was three years earlier. I was hired as a peer support worker at a local drop-in centre for youth living with mental health challenges. This centre was designed to follow a peer support model, however, the decision making power rested solely at the top of the organizational chart, with individuals who weren’t themselves peers.

I had been very excited to get this job. Peer support fit with my interests and my own personal journey. I had studied psychology as an undergraduate and felt uncomfortable with the hierarchical and deficit-driven perspectives to mental health I had learned. I was now back in school studying social work; I was learning about power, privilege, and oppression, and was eager to take this knowledge with me into the area of mental health. I wanted to learn to use my mental health challenges to support other people, and felt that the more egalitarian peer support model, which says that we are all a little broken, we all need help, and we can all offer help, could be an exciting and radical approach to mental health.

My employment as a peer support worker, unfortunately, was not what I had envisioned. I did not receive training, or even a clear job description. I tried to use my lived experience to support others with no guidance, and without knowing how to support my own mental health in the process. I thought I would be safe working in an organization that espoused valuing lived experience of mental health challenges; I made myself vulnerable, and felt deeply hurt. My mental health worsened significantly, and the years since have been a journey of healing and of making sense of this experience.

I was hired as a peer support worker, but my mental health was never mentioned after the hiring. What I have learned from this is that the individuals in positions of power within this organization were — in spite of their stated approach to mental health — not comfortable working alongside people with mental health challenges. I believe this reflects how mental health is seen in our society. We live in a world that categorizes people as healthy and helpers or ill and in need of help [3, 4]. In this world, there is no easy space for peer support workers; we challenge this dichotomy by claiming both wounded and healer identities.

At this workplace, management did not know what to make of us peer support workers. I had the sense that they thought we were ‘just hanging out,’ not doing anything much; they dismissed the important work that I knew we were actually doing. I believe they saw us as either broken (when they focused on the ‘ill’ aspects of our identities) or as a challenge to their authority (when they focused on the ‘helper’ part of our identity). More likely, they saw us a confusing mix of both. These peer support people that they saw as broken were rising up and challenging their authority! I think they saw us as a threat and they were scared, scared of us and scared of the risk to their claimed position at the top of the organizational chart.

As we all know, challenging authority does not often go well, especially in very hierarchical settings. And, not surprisingly, I did not remain employed there for long. But my passion for peer support had been ignited, because, in spite of these challenges, the experience was life changing in a positive way. My role as peer support worker offered me a way to embrace emotional experiences that I had disowned in myself. I did not know how hard I had been working to present myself in a ‘good light,’ (“I am competent, strong, I have it all together”) until I found myself in a setting where I did not have to do this, where it was OK, accepted, and expected that I would be (and that we all are) a little messed up. I could stop pretending; it was liberating.

As a child I had learned that, in order to be accepted, I needed to ‘appear strong,’ invulnerable, as if I had everything under control. I learned to hide the ‘softer’ parts of myself in order to be seen as ‘normal’ and to find belonging. I know now that this hiding is shame. The idea that there was something about me that made me unworthy of love and connection. I learned to hide my emotional experiences; what I later learned to label as mental health challenges. I learned to judge, shame, and hide these experiences, but part of me always resented and resisted the hiding; I did not want to have to hide, I deeply wanted to be seen and accepted for all of me.

What happened in this peer support role was that, as I showed more of myself to others, I began to show more of myself to myself. I began inviting into my consciousness these ‘softer,’ ‘less shiny,’ parts of myself that had become almost secret to myself. I began reconnecting with myself, and it was overwhelming, and it was profoundly healing. Suddenly, I no longer carried the sense of deep unease that had followed me for years. The vague sense that something was always ‘not right.’ I had come to understand this unease as part of my mental health, but I now see it as more of an existential pain. What I had felt for so long was a sense of profound disconnection from the world that had been borne out disconnecting from parts of myself, through the shame that I had taken in as a child. Embracing the shamed parts of myself as I was doing now, I felt a deep sense of peace, a relief. I felt belonging, I felt worthy in my imperfection, and I finally knew I was okay.

Ironically, as I accepted myself more, my work context more or less did the opposite. At work in my peer support role I felt judged, disconnected, not accepted. I remember my immediate supervisor working to avoid my gaze as much as possible, I also remember her telling me, as I was asked to leave, that she had expected me to “hit the ground running like everyone else,” insinuating that my need for guidance and support was unreasonable. And so it happened that I became, at once, unwilling to go back into hiding and terrified of being unsafe and wounded in the workplace. A rock and a hard place.

So, what did I do? Most of all, I wanted to learn how to use the knowledge that comes from lived experience of mental health challenges, because I wanted to create spaces where I could help facilitate for others the healing I had experienced. I wanted to create spaces where peer support could happen, outside of oppressive and stigmatizing workspaces. This led to getting involved with a university peer support program and eventually to the coordinator position within this program.

The experience working within the university peer support program was incredible, we had a the freedom to design our own peer support model, and worked collaboratively with program members and community to design our peer support spaces. We were able to hold three weekly gatherings each week, each targeting different interests and populations. We held a weekly peer support group, where people who identified as living with mental health challenges came to share with, and offer support to, each other. We had a weekly arts and crafts activity where people could come and be together while engaging in an activity, without pressure to identify any one way or to share. Lastly, we had a weekly mental health workshop, were we discussed topics related to coping (and thriving!) with mental health challenges, from the knowledge and wisdom of lived experience.

The conversations that happened within these spaces often touched on the impacts of stigma and discrimination associated with mental illness (sanism) and disability (ableism) and how these -isms impact what we learn about how we ‘should’ be, and about the ways in which we are told we are ‘not measuring up.’ Experiences that, once again, lead us to hide and shame parts of ourselves. In talking about these things we were shedding shame and working to accept ourselves and each other. What I remember most powerfully from my time with the people that made up our peer support community is a feeling of belonging and of love. The spaces that we were able to build felt sacred, they felt like coming home, and like family. I, once again, experienced the healing that comes from being able to invite parts of yourself that you have learned to disown back into your life; and doing this in front of others and being seen and accepted — this is powerful stuff. This is deep healing. I was reaffirmed in my knowledge that this is what I want to bring to others.

The healing and sense of purpose that I received from the peer support within our university program were deep, but the pain from the exclusion and silencing that I experienced from the larger structures was also deep. The silencing hurt. The exclusion hurt. The squeezing out of our voices peaked when, in the fall of 2015, we found that the funding for our university peer support program would not be renewed. I was completely spent. I felt like I had been pulled apart — again. And each time it takes so much effort to put myself back together. I feel compelled by this way of doing mental health work, but the price that I have come to pay is high.

I have been looking, and continue to look, for ways to get myself back up each time, so that I can do the work that I know I can contribute to the world; that of creating and fostering ‘safe spaces’ where people with mental health challenges can connect and find healing. Building Sanctuary. But because just doing the work itself was not proving to be getting easier, I approached this new stage of my learning through research. I wanted to make things right, to reclaim my dignity, my voice, and my knowledge and in this way speak back to the people that had excluded me. Building academic knowledge seemed like a way of giving legitimacy to my voice and knowledge and the voice and knowledge of others like me. In addition to this, I wanted to know whether others were also experiencing similar challenges at work, and thought that others might benefit from access to this knowledge as well. This led to my recently finished Master in Social Work thesis: “The Workplace Experiences, Practice, and Practice Knowledge of Mental Health Wounded Healers: A Collective Learning”.

In this research, a single cohort of participants met as a group on three different occasions, with the goal of developing trust and a sense of community (albeit short) among us. I hoped to bringing together and bring forth our voices and knowledge, which my experience, and literature [5, 6] showed were often silenced and marginalized. The focus groups in this research were designed on the principles of feminist consciousness raising [7] and within a transformative-emancipatory paradigm [8], based on the idea that it is through dialogue with others in similar marginalized situations that knowledge is generated.

What this research has taught me is the key importance of silenced voices coming together, both to cut across the isolation that comes from oppression (and its internalized version — shame) and so that we grow strong, and loud, and savvy enough that we can make our knowledge heard. Participants spoke about a dominant medical narrative of mental health as well as about two alternative narratives of resistance and connection. The narrative of connection, mediated by vulnerability, openness, and love, was the preferred framework for these workers and seemed to facilitate empathy and relationships. The narrative of resistance was, on the other hand, mediated by anger and frustration, and was used as a tool for social change. The research showed that these narratives mutually reinforce and extend each other, as these workers connected, learned, and organized toward change in mental health.

This brainy research knowledge is slowly sinking in and becoming integrated into who I am and how I am in the world; it is merging with my emotional knowledge and my spiritual knowledge. I’m trying to help this process along, bringing it to this reflection about my work transitions, not only for this piece, but also in preparation to getting back out into the world of jobs. I am asking myself: what is it that I need, so that I can continue to do this work, knowing that the world (or at least the professional mental health world) may not be ready for it (for me)? How can I endure the challenges and not feel dismantled? How can I endure the challenges and remain strong and committed to this work? The answer is TOGETHER.

I am committed to peer support and the use of lived experience, because I know that what we do counts, it matters, it is important. I know this in a deep way. The healing and community that I have found, and have witnessed others find, in our shared spaces is profound. This is how I want to do the important work of healing; through connection. But I cannot do this alone.

These healing spaces are radical in that they do not depend on experts, and thus, just by trying to exist, our spaces challenge the way that most mental health work is currently done (i.e., excluding the voice of lived experience.) Knowing this, it should, perhaps, not come as a surprise that experts are not rushing in to support the growth of spaces in which they are not needed (or wanted.)

If it turns out that the expert approach that dominates the field is not the only (or perhaps the best) way of supporting individuals living with mental health challenges, then expert knowledge, identity, and status are all at risk of being challenged. I know now, more clearly than ever, that the sites where the medical, expert-driven, approach to mental health meet with the love and connection approach of shared lived experience and peer support are bound to be full of strife. When we present our approach and challenge the current way of doing things there is going to be push back. There is risk when we challenge — it is on our skins that we bear witness — but, if we are here to stay, this is hard work that we will need to prepare for.

How to do this is what I am working on now: I believe we need to learn to speak the language of the experts so that we can use it to speak back to, and be heard by, the mental health structures; and we need to do this without taking in the values that come with that language. To do this we need each other; we need shared spaces to regroup, recoup, and restart, so that we can go back at it, over and over again. We need our brains, hearts, and spirits; energized, open, and uncorrupted. We need compassion, tenacity and, of course, strategy — we need to plan for the long game.

We need each other. I am here. I am (more or less) ready.

Reflexive Questions:

What is needed to support workers who experience painful struggles in transitioning into peer support roles due to the feelings of powerlessness in contexts that often don’t understand or support (or are even threatened by) non-expert approaches to mental health work?