Wellness in 8 Dimensions

Wellness in 8 Dimensions
By Sharon Spieler
A Conference by Collaborative Support Programs of New Jersey's Wellness Institute
On March 26, 2015 I attended a conference sponsored by Collaborative Support Programs of New Jersey Wellness Institute or CSPNJ titled “Wellness in 8D.” The Collaborative Support Programs of New Jersey empower consumers in recovery to realize a lifestyle centered on wellness. For CSPNJ, wellness consists of eight dimensions. They are: emotional, financial, social, spiritual, occupational, physical, intellectual, and environmental.
The conference began with a welcome from the Wellness Conference Organizer Peggy Swarbrick and Executive Director Jody Silver. Attendees were acknowledged from all over New Jersey and New York. These included providers of mental health services, peer specialists, advocates and consumers.
The first speaker of the day was Chacku Mathai, Director of the STAR Center, a National Technical Assistance Center funded by the Substance Abuse and Mental Health Administration (SAMHSA). He spoke on “Making Wellness in 8D Real in Our Communities.” He spoke from personal experience. Not only was he a consumer of mental health services, but had been a substance abuser in his youth. One of the best ways of overcoming his mental illness and substance abuse problems was to become a peer helping others. He offered other suggestions. The first thing to do is to acknowledge that one can recover and that wellness and recovery is for all. We have to believe that we can have an impact on our health and have the confidence and knowledge to do something about it. We then have to act by making decisions to change our actions and make self determined choices. We can do this even under stress. We have to go from doomed thinking to prevention thinking.
The keynote speaker was Patrick Kennedy. He was in the U.S. House of Representatives for 16 years before giving up his seat. It was during this time that he was diagnosed with bipolar illness and alcoholism. He fully admitted this to the audience and said that his life as a representative was on full display for the press to see and report on. He is known as author and lead sponsor of the Mental Health Parity and Addiction Equity Act of 2008. His main belief is that mental illness and addiction are diseases much like any other disease of the body and should be treated as such. This means that mental health services should be covered by insurance companies in the same way as physical health services are covered.
The conference also consisted of various workshops. They included the value of pets and animal-assisted therapy, the role of peers in addiction recovery, how culture can enrich our journey to wellness, yoga, how peers can facilitate groups with consumers, creating places in which to meditate and reduce stress, how to bring the eight dimensions of wellness into our communities, how supported employment can enhance wellness, how music can have positive effects on an individual’s physical, emotional, social and intellectual wellness including stress management and relaxation, and how to achieve financial wellness.
I took part in two of the workshops. The first was how culture can enrich our journey to wellness. We were put up into different cultural groups based on color. My group was green. We were to hug people when greeting them and touch them while speaking. The opposite of the green culture was the orange culture who backed away from people and never touched. The red culture shook hands and touched on the shoulder with their right hands. The yellow culture was to shake hands and touch on the shoulder with their left hands. This was to demonstrate that there were all kinds of people with all kinds of traditions which were not necessarily your own. We have to get to know each other as individuals. Cultural influences are not static. They can change. Don’t create stereotypes. Ask questions. Culture can create barriers but can also create tolerance.
The second workshop I attended was how we can provide leadership in bringing the eight dimensions of wellness into our communities. We broke into groups of two. One person was the leader, the other the follower. Then we reversed roles. This was done by moving your arms in one direction while the other person followed your moves. We lifted our arms over our heads or swayed from side to side. The next exercise was to touch palms and move while touching. We were then told to figure out how we can apply these exercises to everyday situations. We have to look within ourselves. We have to figure out how to work together.

Book Ends: Left of the Dial by Christina Bruni

Book Ends: Left of the Dial by Christina Bruni

Reviewed by Columnist Kurt Sass

Christina Bruni’s book, Left of the Dial, is an uplifting, triumphant account of her ongoing battle with schizophrenia, a battle she is winning every day. I found there to be three main messages in her book: 1) Never give up, no matter who tells you what you can or can not accomplish; 2) Acceptance of an illness is a major component in the battle; and 3) that service to others in life will bring you joy.

The very first thing that struck me about Ms. Bruni’s book is that she pulls no punches and gets directly to the core. No five to ten leading chapters on how I grew up and how grade school was and this and that. The very first sentence, “It happened that night,” within the first chapter of the book we find Ms. Bruni in the psychiatric ward. No pussy-footing around with this memoir.

And no pussy-footing around with Ms. Bruni, either. While still in the hospital, her doctor tells her that she would probably never go to grad school or get into writing again. She also reads in the hospital that only 30% of people with schizophrenia fully recover. Rather than resign herself to the opinions of the “professionals,” she makes a conscious decision “to be determined to be the 30%” and begins to set up goals for herself. Immediately upon her release, she buys a computer (one goal) and was soon writing (another goal).

Shortly after this, Ms. Bruni’s journey takes her to a day treatment program. She is still feeling optimistic about the future until she reads in another “professional journal,” a book titled “Surviving Schizophrenia,” that only 6% of people with schizophrenia go on to obtain full-time jobs. At first she retreats into herself and bows to the pressure, but then summons up the courage to fight the stereotype once again.

Ms. Bruni eventually graduates from the day treatment program into a halfway house, and enrolls in a journalism class. Her hopes are crushed on the first day, however, when one of the requirements are that she keep a journal of news reporter mistakes each night on television, a task she knows will prove impossible, as the halfway house has only one shared television set for all the residents.

There does come a point in which Ms. Bruni believes that once she does in fact find full-time work, she can stop her medication and be drug-free. This day does come as her dreams of becoming the “6%” come true. Unfortunately, even though she tapers off the medication in accordance with her doctors instructions, she suffers a psychotic break and is hospitalized. This break teaches her a valuable lesson, and she comes to the realization that schizophrenia is just one part of who she is. She decides, rather than fight the diagnosis, to work with it.

After accepting her diagnosis, Ms. Bruni continues to flourish. She enrolls in a Masters of Library Science program, finding it a perfect fit. She finds love and loses it when her partner gets an out-of-state career opportunity, but is not crushed. Today Ms. Bruni continues to work full-time as a public service librarian and writer.

It is easy for any mental health consumer who has ever been told by a mental health professional that he or she can’t do something to relate to this book. In 1998, while in my deepest, darkest depression, I was told by a therapist that I would not get much better, and I would just have to learn to deal with it. Today, I celebrated my 10-year anniversary with the non-profit company I work for, so I know, to some extent, what Christina had to go through. I recommend this book very highly for any consumer in the mental health system, or, for that matter, anyone who has ever been told “You can’t do that.” Christina Bruni retorts “Yes you can.”

Primal Therapy

Primal Therapy
By Michael Gottlieb, BS
Healing the Tension Around My Heart
I am the son of Private Benjamin Gottlieb who was killed in action July 23, 1944 in St. Lo, Normandy during World War II.
Can I use the temporary leg paralysis I experienced when I visited my mom as a “trigger” to get deeper into primaling? Just how severe are my wounds?
“Healing is available. The MS, the rheumatoid arthritis; the stiffness and rigidity of your knees and legs when you attempt to walk, the shallow breathing, your 'blindness' or inability to sense what is going on around you are all symptoms of your wounds. My son Michael, the repression of the memories of what transpired when you were alone with your mother after your dad was killed—1944 through 1947—these wounds are extremely hurtful and extremely painful. You were a needy, vulnerable baby and small child and the deprivation of basic nurturing, basic mothering needs is catastrophically hurtful and painful. The body does not release its memories quickly or easily. The repression is a fundamental survival mechanism without which you would have perished as a baby. Your leg paralysis when you visited your mother is a symptom of how deep and painful these repressed memories are. To lose the use of your legs when you visited your mother indicates the devastating wounds you suffered.” And Dr. Janov’s statement that the body titrates the amount of pain one can remember in any one primal session is accurate. “You can only access what you can handle. It is a process that requires dedication, persistence, consistence and determination.” That is why Dr. Janov indicated that primal therapy is not for dilettantes.
The movies “Citizen Kane” and “Home of the Brave” indicate just how painful and devastating it is for an individual to suffer trauma and hurt and not to access those memories and feelings directly as well as the consequences when those mental wounds go unhealed.
Would I describe primal therapy as a blessed healing tool? It hurts, but it hurts good. It heals deeply wounded individuals. It frees individuals from a lifetime of pain, hurt, handicaps, addictions, etc.
Was my head-banging during my primals another symptom of catastrophic wounds? It was the mind-body unity trying to cope with catastrophic hurt and wounding.
I seek to stop struggling with skeptics and non-believers. What say you? Present information and then move on. Struggle with your parents in primals.

Service-Dog Training for Veterans

Service-Dog Training for Veterans

By A.J. Johnson

Helping Service Members Regain a Sense of Self-Worth

I first met Sherri Waters in early April 2014, upon the advice of my next-door neighbor. They were training a German Shepherd that was helping them with their PTSD (post-traumatic stress disorder) symptoms suffered from their tour of duty in the marines. They recommended that I talk to Sherri to see if I would be a good candidate for a service dog to help with my own struggles of PTSD and bipolar disorder.

Waters has had her own private dog-training business since 2001. She began using her skills to help her deal with her own issues of PTSD. But her desire to help others with post-traumatic stress was only matched by the need she saw arising with the war in Afghanistan.

“I wanted to do something for our wounded, because they’re the reason we have everything. So one day I was standing in line at Petco, and I ended up behind a combat corpsman that was looking for dog training. He was a wounded warrior, and I said, 'I’ll help train your dog for you for free.' I started training his dog, and then he started bringing his friends, one by one, and we started a little class about five or six of us initially, and it was like, I got my in, I get to do this for them now.”

With that small beginning, Sherri’s project, Wounded Warrior Pack, was born and has recently acquired their 501c3 certification. They’ve grown to over 100 active clients, with a healthy staff of over twenty. Most of the people working for the project are fellow veterans like Sherri who go through the program and stick around once they graduate.

With an unofficial motto of “We help the hell out of you,” Waters is constantly surprised at the outpouring of love and support the project has received. From fostering dogs to helping families in need with food, shelter, or even getting furniture for their homes, the “Pack” works hard for its clients.

The small project, a labor of love for both Sherri and her husband Joe, is something that she says is nothing short of a miracle. And it’s no small feat what they’ve done. With branches now in Bakersfield, California as well as Michigan, Texas and New Mexico, the Pack focuses on veterans who suffer from combat-related PTSD as well as military sexual traumas. The intention is to expand, but on their own terms, to continue helping with the same level of quality.

Each veteran is initially interviewed for candidacy to be accepted into the program. After a check of credentials, a veteran is either placed with a dog, or they are recommended to a shelter where there is a possible match for them for a dog.

Once the dog is cleared to begin training, all the handlers and their dogs go through a three-stage training process where they are taught basic obedience, distance, and specialized skills before they graduate from the course and are considered a fully functional service dog/handler. Sometimes the course can take a few months; sometimes it can take longer depending on a variety of factors.

Upon graduation, they are awarded a certificate, and legal paperwork to certify their training as well as a patch and a healthy dose of accomplishment. Sherri feels that giving the handler and the dog a certificate adds an element of legitimacy to the program, although according to the Americans with Disabilities Act of 1990, it is not necessary.

If you take a look around at the people who are a part of the Pack, it is easy to see how Sherri’s love and determination shine through in her work. It’s an example of how a labor of love may start small but can build and grow into the stuff that dreams are made of. Veterans and service members alike are flocking in to see her, to become a part of her little slice of heaven as I call it, to gain a sense of safety and independence that was once lost.

There are veterans who have lost limbs and the ability to walk. And then there are people who have lost something that can’t be seen that make them just as vulnerable and in need of a service dog as anyone else. And it’s because of the gratitude of one woman for her fellow service members that the rest of us can regain our sense of self worth and the ability to stand on our own two feet again.

Editor At Large/As I See It

Editor At Large/As I See It
A Column by Marvin Spieler
My Friend Nancy, As I Remember Her
One night Nancy arrived at my support group in Sunnyside, Queens, New York City and she became a regular participant. Usually, when the group ended, I walked her to the bus stop as the neighborhood was in transition, but not for the better. As a woman, she didn’t feel comfortable standing at the bus stop on a deserted street waiting for the bus. We had time to talk about the night’s group. I realized Nancy was easy to talk to as she didn’t pretend to be a hotsy-totsy. Also, as I got to know her, I learned that she wasn’t a Jewish American Princess either. Nancy was down to earth, not a gold digger, honest, and a good person.
Nancy, unfortunately, had schizophrenia. In a sense it was self-induced. Sounds like a weird statement, yes? Well “acid” was in vogue in the nineteen-sixties. Nancy took, I guess, her fair share of it. Many years later, she had a major side-effect from it. Up until I met Nancy, I never met anyone who had become schizophrenic from taking acid, but I heard of this side effect. Thank God acid is not as popular a drug now as it was then. It is a mind-altering drug. Different people had different experiences with acid, some good and some bad.
I never asked Nancy what her experiences were like. I was curious. Whether her experiences were good or bad, I had no way of knowing. She’s dead now, unfortunately. In my eyes, she died because of one major side effect of acid—schizophrenia. I had read about this potential problem, but never knew anyone who had it until I met Nancy.
We cared for one another and helped each other when we could because we were friends. Our relationship grew. We saw each other frequently as we both had a lot of spare time. She was unable to work as was I. We got to know one another. Basically, she was a kind individual. She never said a bad word about anyone. She was bright, had attended college and graduated. She had a good mind. She was no dummy. She especially cared about her friends and helped them when she could. She showered us with gifts of needed items we couldn’t afford or didn’t want to spend money on ourselves. In a word, Nancy was generous. She was there for her friends when needed. Nancy had a good soul.
Why she actually died couldn’t be determined. An autopsy was inconclusive. But I felt it was a suicide. Nancy was depressed a great deal of the time. This went on for weeks. The last book she was reading was on the afterlife. The book seemed to calm her. Unfortunately, none of her friends picked up on this signal, which lead to her eventual death. This is what I feel she did to herself. She’s missed greatly.
Her symptoms of schizophrenia were primarily of being paranoid. She also had low self-esteem and she may have heard voices. I really don’t remember for sure. She kept a journal, which was full of her weird thoughts and feelings.
But the cure that she did experience eventually, in a way, made her worse. Her sanity after being put on Clozaril really didn’t help. She felt miserable knowing how sick she was previously. She couldn’t accept who she had become—a sane individual. Is this a crazy statement? It sounds that way, but she was very uncomfortable with her new found sanity.
Another major problem developed that I felt actually did her in was Tardive Dyskinesia. She had a severe case. Her hands shook and her mouth movements were also very severe. It embarrassed her. Nancy kept a towel over her hands so they wouldn’t be seen. Her mouth movements she couldn’t hide. This in effect did her in. She couldn’t live with these involuntary movements. Eventually, this problem became constant. She was severely depressed as a result and spent a lot of time at home. Nancy was seen infrequently. She didn’t answer her phone regularly. At some point she must have taken an overdose and was finally at peace with herself.

NYAPRS' Annual Legislative Day in Albany

NYAPRS' Annual Legislative Day in Albany
By Sharon Spieler
Outlined Are Their Priorities
The Annual Albany Legislative Day sponsored by the New York Association of Psychiatric Rehabilitation Services (NYAPRS) took place on February 25, 2015.
Consumers from all counties throughout New York City and New York State attended. There was a full schedule of events for the day. The morning began with a welcome from NYAPRS Co-Presidents Carla Rabinowitz and Alison Carroll and Public Policy Co-Chairs Carla Rabinowitz and Ray Schwartz.
After this, NYAPRS laid out the 2015-16 State Public Policy Priorities. Various speakers made their case:
1. There is a housing crisis. Funds are needed for supported housing as the cost of these houses has risen over 50% and are now underfunded. Add $82 million to the Executive Budget’s $17 million allocation;
2. Expand housing for the homeless by creating 30,000 New York City and 5,000 statewide units of supportive housing;
3. Adult home residents with psychiatric disabilities have been promised a transition to community-based residences and in order to achieve this, an approved $30 million allocation must remain;
4. Much was said about criminal justice reforms such as expanding crisis intervention teams, raising the age of youthful offender status to 21, prohibiting solitary confinement for any person with a psychiatric or physical disability, establishing Medicaid eligibility for all individuals discharged from forensic settings to enable immediate access to needed services and supports, and expanding the New York State's Office of Mental health (OMH) criminal justice services for persons leaving state prisons through discharge planning, wrap-around community supports and supported housing. Use the $22 million executive budget allocation for this;
5. Those persons with disabilities should have access to a home health aide for personalized assistance and a smooth community transition from institutional settings;
6. There should be no interference in what kinds of medication can be prescribed to patients to ensure the safety and choice of public benefit consumers regarding their medications and restore $4.1 million;
7. Preserve $115 million in Medicaid funding to support a recovery-focused transition to Medicaid managed care; and finally
8. Approve $15 million in new community-funded services such as urgent care, crisis respite, housing and recovery supports.
The featured Speakers included Assistant Deputy Secretary for Health Tracie Gardner, OMH Commissioner Ann Marie Sullivan, Assembly Mental Health Committee Chair Aileen Gunther, Senate Mental Health Committee Chair Robert Ortt and Assembly Criminal Justice Committee Chair Daniel O’Donnell.
NYAPRS Awards were presented to Jennifer Parish, Karen Wera, Dottie Harie and Michael Virtanen. A rally took place in front of the Capital Building and groups of Consumers met with their own state legislators to discuss these mental health issues.

More Sensitivity Needed Toward Trauma Survivors

More Sensitivity Needed Toward Trauma Survivors
By Angela Cerio, Psychiatric Survivor and Certified Psychiatric Rehabilitation Practitioner
Insights Gained from Trauma Informed Peer Support Training
How much do you know about trauma? What comes to mind? The Veteran, returning from combat with “Post Traumatic Stress?” The disaster survivor? The battered spouse? The abused child? Abandonment?
Trauma goes much further than that, as I recently learned in a Mental Health Empowerment Project (MHEP) sponsored training on “Trauma Informed Peer Support.” Studies show that over 90% of people with psychiatric diagnoses, and nearly 100% of incarcerated women are trauma survivors. Trauma can be defined as “extreme stress brought on by shocking or unexpected circumstances or events that overwhelm a person’s ability to cope.”
According to SAMHSA, there are three E's to a traumatic experience: 1. Events and circumstances which cause trauma; 2. The person’s Experience of these events determine if the event is traumatizing; 3. The Effects of the traumatic event on the individual, which includes adverse physical, social, emotional or spiritual consequences.
We use language every day which reinforces the violence in our society. These words in themselves can remind the survivor of the original trauma—perhaps without conscious awareness of the connection.
A list of dotted points in a presentation are referred to as “bullets.” Those things which evoke powerful negative emotions in us are called “triggers.” The professionals we deal with every day in behavioral health programs are frequently referred to as “front-line staff.”
As a peer support specialist, I learned early on to see “coping mechanisms” where clinicians see “symptoms.” One of the key elements needed to avoid “triggering” those behaviors we have developed to cope with trauma is feeling safe in the present.
When confronted with a threat whether real or perceived, the brain signals the body to respond with “Fight, Flight or Freeze.” When the threat is gone, the switch turns “off” and the body returns to “baseline.” If the switch is stuck in the “on” position, and the body remains prepared for threat—this is a “trauma response,” evoking whatever mechanisms the individual has developed to cope with the traumatic event. Instead of “think, process, act,” the individual goes immediately to “act.”
I cringe when I hear a mental health professional talk about a client “acting out.” “Fight” becomes “non-compliant” or “combative.” “Flight” becomes “treatment resistant” or “uncooperative”. “Freeze” becomes “passive” or “unmotivated.”
In the language of trauma-informed peer support, we see “Fight” as a struggle to hold onto or regain personal power. We see “Flight” as disengaging or withdrawing to feel safe. “Freeze” becomes giving in or giving up to those in power to avoid further harm.
The consequences of trauma include mistrust, loss of power and control, manipulation, silencing of one’s voice, invalidation of personal rights, helplessness and hopelessness, violation of personal boundaries and sense of safety. It leaves people feeling powerless and has a lasting effect on a person’s ability to trust others and form lasting relationships.
People are frequently unaware that their emotional challenges are related to past trauma. They may be responding to the present through the lenses of the past. Their coping mechanisms could lead to punitive reactions from others who may label their reaction as “non-compliance.” Trauma survivors have good reason to be sensitive to misuse of power and authority.
Healing from trauma requires first a sense of safety. Then the survivor may be able to develop the ability to trust themselves and reconnect with (or connect for the first time) and trust others. Healing begins when the trauma survivor regains a sense of control over their life and environment.
Trauma-informed services could change the way we receive help for our emotional challenges by creating safe, welcoming environments, by avoiding reoccurring trauma and victimization, by using our listening skills toward collaboration and mutuality, by giving people voice and choice, by focusing on “what happened to you?” rather than “what’s wrong with you?” Safety for us as people with emotional challenges means controlling our own lives. For providers, safety means maximizing control over the service environment and minimizing risks for both the client and the agency.
One last thing to remember is that people with emotional challenges are not limited to those of us who have been labeled by psychiatry. Clinicians are not immune to trauma responses and may not be aware when they are reacting to our challenges through the lens of their own past.
Note: Thanks to the Mental Health Empowerment Project, Cathy Cave, Bill Gamble and the NYC Department of Health and Mental Hygiene's Office of Consumer Affairs for making the training on trauma-informed peer support possible.