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Recovering Sanity Session 1a: Beyond the Medical Model

Over the course of the next few months, Windhorse Northampton will be having discussions about Podvoll’s Recovering Sanity which is a principle book towards the Windhorse approach to recovery. The discussion is lectured by staff members and open to the wider Windhorse community. This first post was lectured by Mary Tibbetts and Phoebe Walker. The following is an edited (for ease of reading) transcript of both the lecture and talk back.When listening to the discussion we thought it best to break the discussion into two themes highlighted in the talk; the differences and evolution between two of Podvoll’s books and thinking beyond the medical model. We hope that these series of talks further highlight our history and approach to recovery.

Phoebe: It also strikes me about how that if there is a sense of being familiar with one’s own mind and one’s own mental suffering is what helps or informs the second part of the book, which is about being of service. Knowing the places our own mind can go, and our own suffering, affects how we would try to be of service. And in the absence of some lived experience of this suffering, trying to be of service can be clumsy or it can be like trying to drag somebody along or can sort of miss the point of the suffering altogether.

Mary: Right.

Phoebe: And then from that frame of mind “helping” seems to be more about what the helper wants, where they’d want a person seeking services to be, as opposed to being of service in an informed way. I think there’s something really fundamental, as Ed describes in the introduction, about how everything has become medicalized. There’s a fundamental shift here about not fixing the situation, which is what the medical model might advocate doing. But Ed’s revolutionary point is about understanding the situation in a totally different way, which to me connects with the Buddhist understanding that suffering is happening all the time and for everyone in one way or another. There’s no way suffering is ever going to totally go away. And from that frame of mind, how do we be of service to somebody in the face of their suffering? And suffering, in many ways, is something that we have no control over.

Mary: What, if anything, does fixing have to do with it? I know I’m programmed by the way I’ve grown up and our culture’s general way of thinking that suffering shouldn’t happen. Suffering is bad. Even sometimes in our most idealistic ways of mind, we come to this work because we want to alleviate suffering. And then we feel like we failed if we haven’t alleviated suffering. Over and over and over again, you have the hope of alleviating suffering, and that’s a genuine desire. I think it’s a deeply human desire, but there’s a trap there. If you think about dropping that …

Phoebe: I wonder sometimes in the book why Ed doesn’t come out more clearly and say this.. But at the same time, in my position of responsibility, I sometimes feel like if I come from the place of accepting suffering without promising a fix, I’m irresponsible. And yet it’s truly the only thing that makes sense to me.

Mary: Right. What is that perspective that says, “the ‘responsible’ thing to do is, well, we can’t have such suffering. We have to do something about intervening in the situation in some way to alleviate this suffering.”? What is it that you feel is most important at a time like that?

Phoebe:             Well, for me, I only know how to be of service when I don’t think that way. I don’t know how to be of service when I think that way.

Mary:                   Right.

Phoebe:              I find myself in the suffering that’s happening, and realize that the best I can do is be of service to this person.

Mary:                   Some way of being intimate with them in that context of that suffering.

Phoebe:              Yeah. Not just even intimate, but just …

Mary:                   There.

Phoebe: There’s something about respecting and offering something just to make [their week 00:01:13] a little bit gentler to preserve their sense of humanity and dignity. That’s about the best–or it’s not the best, it’s all I can do, really. If I come from the “fix it” mentality, it doesn’t feel like I actually end up being of service.

Mary:  With “fix it” mentality, you distance. I was telling you that story about my mother where she was very close to the end of her life. I knew that she was going to die. I sort of came up close to this feeling of despair. No matter how good I was at taking care of her, no matter how much I could be present, no matter how much I could do, whether it was making the meals perfectly or helping her get dressed in a way that was not uncomfortable for her, she was going to die. In a way, I see that in Basic Attendance that no matter what is done, there’s going to be suffering.

Nonetheless, there was a particular thing that happened that within her time of demise, a nurse came in and I saw the nurse doing Basic Attendance. She related to my mother’s pain, her suffering, in a way that attended to her dignity and allowed her to feel good because those things had been taken care of.

She was able to take [heart 00:03:15]. Similarly, the first time we talked, I felt your very strong connection to not backing away from suffering. I think one of the challenges we face in taking care of people is the despair we feel and the hopelessness that we feel. Where’s the hope that we feel in the face of this suffering?

 I think hope can actually unground us in a certain way if we’re not able to be with how things are.

Phoebe:              I was just thinking about the momentary nature of life. And the momentary nature of recovery, too. That word is always challenging.

Mary:                   Recovery?

Phoebe:   Recovery, yeah. We can sometimes have such a grand idea of what recovery looks like that I think it’s a little bit misleading sometimes, too. Yet, there’s this belief in the book and in us that recovery happens. It’s possible. It makes me think about moment to moment, recovery popping out. It happens in moments. Maybe it’s the islands of clarity, but it happens in moments. That often isn’t enough for us, somehow.

Mary:   No, we want concrete proof. I remember talking about recovery with the first client that I worked with here. At one point he said, “I don’t think I’m gonna have a white picket fence recovery. That’s not what recovery means.” So in addition to moment-to-moment recovery, it is also very personal. Recovery is deeply meaningful to each individual, it is different for each person, and it relates to what they find within themselves when they are given the opportunity.