Alexandra L. Adame

Breaking Out of the Mainstream: The Evolution of Peer Support Alternatives to the Mental Health System

The consumer/survivor/ex-patient (c/s/x) movement has been instrumental in the development of a variety of peer-support alternatives to traditional mental health services in both the United States in Canada. This article explores the role of the c/s/x movement in the creation of such alternatives and discusses the various ways peer support is defined and has been put into practice. We also discuss the potential for future alliances and dialogues between progressive mental health professionals and the c/s/x movement as both groups seek ways to reconceptualize mental illness and recovery outside of the medical model paradigm.

“There Needs to be a Place in Society for Madness”: The Psychiatric Survivor Movement and New Directions in Mental Health Care

The psychiatric survivor movement is an international coalition of grassroots organizations that work for human rights in the mental health system. Previous research has examined how the survivor movement has critiqued and envisioned alternatives to traditional mental health services. The current study focused on a unique group of individuals who identify as both psychiatric survivors and work as therapists in the mental health system. I interviewed several people with this dual-identity to better understand their approaches toward activism and psychotherapy. This article focuses on one of the survivor-therapist’s experiences, and I explore the broader clinical implications for both survivors and mental health professionals and next steps for developing viable alternatives to the traditional system.

Negotiating Discourses: The Dialectical Identities of Survivor-Therapists

The psychiatric survivor movement is a political movement dedicated to fighting for human rights in the mental health system. People who identify as psychiatric survivors have experienced human rights abuses in the mental health system. A small number of psychiatric survivors have chosen to reenter the system as mental health professionals, and the current project focuses on the experiences of people with this dual-identity. The primary goal is to facilitate further dialogues between psychologists and the survivor movement by exploring the implications of identifying with both discourses. I interviewed five survivor-therapists, and asked how their identities as psychiatric survivors influence their approaches to therapy, and the nature of the relationship between these two identities.

Dialogical Constructivism: Martin Buber’s Enduring Relevance to Psychotherapy

In this article, the authors explore the connections between a relational— existential approach to psychotherapy, called experiential constructivism, and the work of Martin Buber. They begin by describing the basic principles and philosophical underpinnings of experiential constructivism and the writings of Martin Buber, specifically his writings on the I—Thou relationship. Next, they describe the process of psychotherapy in accord with these principles as well as their thoughts about the overall goals of therapy from a relational—existential perspective. Finally, they discuss the notion of transpersonal reverence and introduce the concept of transpersonal responsibility as they describe the healing process that continues outside of the confines of the therapy relationship.

A Poetic Epiphany: Explorations of Aesthetic Forms of Representation

Alternative forms of representation, such as poetry, are becoming more widely used by qualitative researchers in disciplines such as anthropology, sociology, and psychology. Aesthetic forms of representation highlight the co-constructed nature of the research project, and in this article we will discuss how they can facilitate creative explorations of lived experience in qualitative research. We begin with an example of a poetic representation of a participants story as a starting point for our discussion. Next, we describe the process by which the poem was created. Finally, we will discuss other studies that have used similar representational forms and provide a rationale for why these forms may be an appealing choice for other qualitative researchers.

Fostering Dialogue in Psychology: The Costs of Dogma and Theoretical Preciousness

Methodological discourse has the potential to divide or unite research psychologists depending on our approach and understanding of each other’s work. We note the various ways in which genuine dialogue between qualitative and quantitative researchers has been hampered by dogmatic adherence to certain theoretical and epistemological stances. We point to a corresponding phenomenon in the theoretical orientations of clinical psychologists in which cognitive-behavioral therapy is often polarized with humanistic perspectives regarding the approach to psychotherapy. The nature of such polemics within the field of psychology will be discussed along with an example taken from the authors’ personal experience of dialoguing across methodological difference. Finally, we will discuss practical suggestions for how we can increase openness and genuine dialogue between qualitative and quantitative perspectives in psychology.

The disappointed evangelist: or, how I learned to stop worrying and love ambiguity

Researcher reflexivity is a critical component qualitative research that adds depth to the interpretive process. It is becoming more common for researchers to document their reflexive process explicitly in the research write-up, and in this paper I will present an example from my own work. The story of the ‘disappointed evangelist’ highlights the potential pitfalls of the researcher’s interpretive authority and how our own preconceptions can obscure the participant’s experience. When my understanding of a participant’s experience was off the mark, I was challenged to critically examine my interpretive process that had led to such an understanding. I highlight how we must embrace the ambiguity and complexity of a participant’s experience and not force them into pre-conceived categories that serve our research agendas.

Researching the Survivor-Therapist Identity

This chapter provides a literature review of past research on the psychiatric survivor-therapist identity as well as related studies pertaining to consumer-providers and peer specialists. The authors focus on specific issues related to clinical practice faced by therapists with psychiatric histories of their own, such as self-disclosure to clients and colleagues, stigma, fostering a unique empathy for client’s struggles, and developing ways of working with people that are in accord with the values of the survivor movement. Finally, we highlight literature pointing to the potential for a meaningful integration of the psychiatric survivor and therapist identities in ways that facilitate healing for others.

Influences of the Survivor-Therapist Identity

This chapter opens with a brief review of the literature regarding mental health professionals who also have experience on the receiving end of psychological and psychiatric services. The unique insights affording by being both an expert by training and an expert by experience are then explored in essays written by each of the coauthors. Throughout each of the authors’ accounts, they explain how they regard their lived experiences as a source of wisdom and a relational bridge to empathize with the struggles of others. Finally, as several of the coauthors have experienced involuntary treatment, the theme of trust and the central role of the therapeutic relationship come up as important themes in the practice of therapy.

Respect and Inclusion

This chapter explores the interrelated themes of respect and inclusion, and the authors discuss them in light of past research, their involvement with the psychiatric survivor movement, and in their clinical practice as well. Throughout the chapter, respect for the diversity of the human condition is expressed in various ways, including contextual understanding of experience rather than singular modes of knowing, tolerance for ambiguity, and valuing of lived experience as an important aspect of being a healer. Finally, we explore how societal intolerance for ambiguity and behaviors that deviate from the norm have made genuine inclusion difficult for people labeled with mental illness.