What makes NAMI Peer-to-Peer unique and effective Trauma Learning

1. What makes NAMI Peer-to-Peer unique and effective Trauma Learning

2. 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.

3. Stigma- What we are up against One psychiatrist’s 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.”

4. Blame responses resulting from stigma • I brought this mental illness on myself • I am too close/too detached from my mother • Lazy • Manipulative • Acting out • Being punished by God

5. NAMI Peer-to-Peer breaks away from the notion that a person is at fault for having a mental illness.

6. NAMI Peer-to-Peer messages: • Mental illnesses are biologically based brain disorders that can have environmental triggers. They are not our fault.They are not our parents’ fault. 2. People with mental illness are often stigmatized. 3. The onset of an episode of mental illness is deeply traumatic and disrupts every area of a person’s life 4. Mental illnesses are catastrophic stressors.

7. 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

8. Typical responses to the trauma of a catastrophic stressor: • An unbearable compulsion to undo (“If I had just done __ I wouldn’t 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

9. 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 don’t absorb information the same way traditional adult learners do

10. Basic assumptions about adult learners: Imagine that you have just signed up to take an astronomy course You likely: • 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

11. Why NAMI Peer-to-Peer participants aren’ttraditional 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 learn We are emotionally overwhelmed by the experience of mental illness.

12. 3) We don’t 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 don’t 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 doctor’s appointments, and may be trying to care for a family at the same time.

13. Basic assumptions about adult educators They have: • A teacherly concern that participants understand everything in the course. • Worry if people don’t understand the materials presented • Use different teaching methods to accommodate a variety of learning styles (“It is my job to entertain the class.”)

14. Why NAMI Peer-to-Peer Mentors aren’t traditional adult educators 1) We don’t 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.

15. 3) We don’t 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.

16. In other words, people dealing with trauma and stress learn differently from others To 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 that’s all” • We are unsure if we want to know what comes next. • We are afraid of the unknown.

17. NAMI Peer-to-Peer understands that people taking 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

18. 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

19. 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

20. 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 one’s personal mosaic 4) Plays into the ability to figure things out on one’s own 5) Eases people into the process of learning

21. Take-home messages 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; it’s 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) Don’t worry about teaching aids; trust the process

22. Take-home messages 5) Don’t worry if people space out; that is the plan! 6) Don’t work too hard to MAKE people talk; they’ll 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!