3 tips for understanding the Self Help Movement’s work on strengths
Post date: Thursday October 22, 2009
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Category: Mike's Blog, Philosophers and practitioners
1) Philosophy and Background.
The Self Help Movement is expressed in many forms. It can include, for example, recovering alcoholics, former drug addicts, victims of abuse, returning war veterans and people suffering illnesses. This article focuses on how the approach helps people to build on their strengths. Let’s start with a few definitions.
The term ‘self help movement’ actually refers to people who help themselves by getting support from ‘peers’, rather than by relying solely on ‘professionals’. These peers have often been through – or are going through – similar experiences to themselves. Such people often participate in ‘self help groups’. This process is sometimes complemented by specific help from professionals.
So what is the difference between ‘self help’ and ‘self improvement’? There are, of course, similarities. In this article, however, I am focusing on people who get support by working with peers to tackle a particular life challenge. Certainly this may result in some personal growth. There is, of course, a whole ‘self improvement’ industry. This ranges from topics such as how to improve your memory to how to achieve peak performance. Being such a wide industry, it contains both real wisdom and off-the-shelf recipes for success.
This article focuses on self help where people are tackling an issue relating to their physical or psychological health. There are, of course, many other such groups in business, education and other activities. The American Self Help Clearing house, for example, defines such groups in the following way.
Beginnings
So when did the self help movement begin? Many people will point to the birth of Alcoholics Anonymous in the 1930s. AA has certainly made a massive impact, something we will explore later, but other people look back even further to trace the origins of the movement. They cite the early advocacy movements – such as people fighting for the rights of those with physical or other difficulties. Those movements were frequently led by strong individuals, however, rather than being groups of people who met to provide mutual support. Looking at the concept of mental health, for example, some people point to the pioneering role played by Elizabeth Packard in the 1860s.
Elizabeth Packard
Elizabeth founded the Anti-Insane Asylum Society. She also published a series of books and pamphlets that provided support for women wrongly committed to mental hospital. Elizabeth was married to the Reverend Theophilus Packard Jr. The family lived in Illinois and appeared to have a good marriage, which produced 6 children. Theophilus had strong beliefs, however, and became upset by his wife having different opinions on religion, raising their children and slavery. Deciding that Elizabeth was ‘slightly insane’, he chose to take a particular course of action. The Law Buzz web site continues the story.
“Illinois law, at the time, required evidence of insanity - in all cases - before a person could be committed to a mental institution. In all cases, that is, except when a man wanted to send his wife to an insane asylum. Unbelievably, the same law existed in many other states. Elizabeth spent three years in the Illinois State Hospital for the Insane based solely on her husband’s assertion.
“When she was set free, her husband thought she was still insane. Taking matters into his own hands, he locked his wife in the nursery and nailed all the windows shut. This time, however, he had gone too far. Illinois law did not allow a husband to ‘put away’ his wife in her own home. Elizabeth managed to slip a note outside the nursery window. Her friend found the note and appealed to a judge for help. The judge issued a writ of habeas corpus (bring forth the body.) A jury would decide her sanity.
“At the trial, Rev. Theophilus Packard Jr. used other people to help him try to prove his wife was insane. Since Elizabeth’s religious views differed from those of her minister husband, religious issues were at the top of his evidence list. Here is a summary of some of the testimony:
* Elizabeth (who wanted to leave her husband’s church) would not leave the church unless she was insane.
* Elizabeth accused her husband of not allowing her to think for herself on matters of religion.
* Elizabeth was angry at her husband when he would not help her weed the flower beds.
“Elizabeth also had witnesses who testified on her behalf. One witness, who was both a physician and a theologian, said he and Elizabeth differed on points of discussion, but she was not insane. It took just seven minutes for the jury to agree. Elizabeth Packard was a free, sane woman. Although Elizabeth didn’t have the right to vote, she had been personally penalized by an unjust law. She spent the rest of her life trying to convince lawmakers … to change the laws on mental confinement and women’s property rights. By the time she died, she had been successful in four states.”
Elizabeth’s work can, on one level, be seen as advocacy. Her support of other women, however, enabled them to believe in their feelings and take charge of shaping their futures. These are often characteristics of self help groups that focus on ‘taboo’ subjects. Survivors of incest, abuse and other crimes may have been told that their feelings are ‘wrong’. Meeting people who have gone through similar experiences helps them to restore their sense of sanity. Recognising they are not alone helps them to feel stronger and more authentic. We will explore this theme later when considering other self help groups in the field of mental health. For the moment, however, let’s consider another person whose ideas had an impact on the self help movement.
James Allen – ‘As A Man Thinketh’
James was born in Leicester, England in 1864. Working for much of his life in the manufacturing industries, he moved to Ilfracombe, Devon, around 1902. He then devoted the rest of his life to writing. James believed at: a) We could control our thoughts; b) We could therefore take more control of our circumstances; c) We could spread goodness by having good thoughts and translating these into action. This would help to build a better world. Devoting the rest of his life to writing, he produced phrases such as:
“A man sooner or later discovers that he is the master-gardener of his soul, the director of his life … All that you accomplish or fail to accomplish with your life is the direct result of your thoughts … Good thoughts bear good fruit, bad thoughts bear bad fruit … No duty is more urgent than that of returning thanks … Our life is what our thoughts make it. A man will find that as he alters his thoughts toward things and other people, things and other people will alter towards him … The law of harvest is to reap more than you sow. Sow an act, and you reap a habit. Sow a habit and you reap a character. Sow a character and you reap a destiny … The more tranquil a man becomes, the greater is his success, his influence, his power for good. Calmness of mind is one of the beautiful jewels of wisdom … Work joyfully and peacefully, knowing that right thoughts and right efforts inevitably bring about right results.”
People familiar with self-help groups that stress the importance of ‘choosing your attitude’ will recognise these themes. More surprising is that such ideas were published four decades before Norman Vincent Peale’s The Power of Positive Thinking. James also highlighted another theme explore in such groups – that of focusing on one’s purpose. Below is an extract from As A Man Thinketh. The complete book is available as a free download at:
Thought and Purpose
A man should conceive of a legitimate purpose in his heart, and set out to accomplish it. He should make this purpose the centralizing point of his thoughts. It may take the form of a spiritual ideal, or it may be a worldly object, according to his nature at the time being; but whichever it is, he should steadily focus his thought-forces upon the object, which he has set before him.
He should make this purpose his supreme duty, and should devote himself to its attainment, not allowing his thoughts to wander away into ephemeral fancies, longings, and imaginings. This is the royal road to self-control and true concentration of thought. Even if he fails again and again to accomplish his purpose (as he necessarily must until weakness is overcome), the strength of character gained will be the measure of his true success, and this will form a new starting-point for future power and triumph.
Those who are not prepared for the apprehension of a great purpose should fix the thoughts upon the faultless performance of their duty, no matter how insignificant their task may appear. Only in this way can the thoughts be gathered and focused, and resolution and energy be developed, which being done, there is nothing which may not be accomplished.
James’ writing again shows the overlap between the fields of ‘self help’ and ‘self improvement’. The reason for mentioning him, however, is to highlight the history of self help themes such as: ‘choose your attitude, follow your purpose and care for other people.’ You can discover more about his life and work at:
Let’s move onto another key theme in some self help groups.
The Twelve Step Programmes
Alcoholics Anonymous created the first twelve step programme. Founded by Bill Wilson and Doctor Bob Smith in 1935, it provided the inspiration for organisations such as Gamblers Anonymous and Narcotics Anonymous. People are familiar with the popular notion of an AA meeting, with a person saying things like:
“My name is _____ and I am an alcoholic … I believe alcoholism is an illness … It is an illness that I will have for the rest of my life … I will never stop being an alcoholic, because I cannot control the drinking … I can, however, aim to be a sober alcoholic … I can work at doing this one day at a time … I can get help by regularly attending AA meetings, not only during crises … I can stay sober by following the twelve step programme … This will help me to live as a recovering alcoholic.”
AA literature explains that the organisation is: “… a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.” You can find the official guide to its approach – including the twelve steps – at:
AA has made an enormous impact, helping many people to stay sober. One aspect that surprises some people who look at the twelve steps the first time is the emphasis on religion. At least half of the steps focus on the person’s relationship with God. Step 3, for example, invites alcoholics to turn their lives over to the care of God, as they understand him. (AA is naturally wary of its work being misinterpreted, so protects much of it with copyright. Hence it is best to go to the organisation’s official publications – such as in the link above – to get the complete picture.)
The origins of AA – and the twelve steps – stem from the ideas of Reverend Sam Shoemaker, an Episcopal priest, and Frank Buchman, a missionary, both key members of what became known as the Oxford Group. One story says that Bill Wilson, one of the co-founders of AA, asked Sam to write his famous book Alcoholics Anonymous, but he refused. Sam maintained the book should be written by an alcoholic, such as Bill himself, who had seen his promising Wall Street career ruined by drink. Wilson continued to acknowledge his debt to Shoemaker, however, saying at the 1955 International AA Convention:
“It was from Sam Shoemaker, that we absorbed most of the Twelve Steps of Alcoholics Anonymous, steps that express the heart of AA’s way of life. Sam Shoemaker had given us the concrete knowledge of what we could do about it, he passed on the spiritual keys by which we were liberated. The early AA got its ideas of self-examination, acknowledgment of character defects, restitution for harm done, and working with others straight from the Oxford Group and directly from Sam Shoemaker.”
You can find out more about Sam Shoemaker at the link below.
The Oxford Group attracted both passionate followers and great controversy. Founded by Frank Buchman, its US headquarters were based in Sam Shoemaker’s Calvary Church in New York City. Buchman had strong Christian beliefs. These revolved around acknowledging the reality of sin, living a pure life and surrendering to the will of God. His own behaviour attracted controversy, however, particularly with what some people saw as his dalliance with the Nazi regime. You can discover more about his work – both with the Oxford Group and founding the movement for Moral Re-Armament – at the following link.
Sam Shoemaker and Bill Wilson took part in some activities with the Oxford Group, but it wasn’t until Bill’s famous awakening in Akron, Ohio, that AA was born. Gripped by an overwhelming desire to drink, he sought to meet another alcoholic who could help him stay sober. Eventually he met up with Doctor Bob Smith and together they founded AA. Within two years they had over 100 members and Bill Wilson published Alcoholics Anonymous – what became known as The Big Book - in 1939. This outlined the Twelve Steps and was translated into many languages around the world. You can find the whole book online at:
AA also developed the concept of The Twelve Traditions. These traditions focus on the way the organisation should work and include, for example:
“The only requirement for AA membership is a desire to stop drinking.”
“Our common welfare should come first; personal recovery depends upon AA unity.”
“Every AA group ought to be fully self-supporting, declining outside contributions.”
“Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.”
“Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.”
You can find out more about the traditions at:
AA has a strict policy on ‘sponsorship’. Each alcoholic who wants to join is encouraged to find an experienced alcoholic who will help them to follow the programme. The new member may be going through a difficult time, however, and open to exploitation. So AA has strict guidelines about the role and character of such a sponsor. For example, it ensures the new person is not in danger of sexual exploitation.
AA has two kinds of meetings – ‘open’ and ‘closed’. The former are open to anyone, the latter are for those who want to stop drinking. Meetings often start by the chair person leading a short prayer or meditation. ‘Beginners’’ meetings may include a recovering alcoholic describing their own continuing journey to stay sober. Other meetings may comprise of studying a specific topic or particular section of The Big Book. Frequently the meeting ends with either The Lord’s Prayer or an adaptation of The Serenity Prayer, the original version of which was thought to be written by Reinhold Niebuhr. The AA version is:
God grant me the Serenity to accept the things I Cannot change…
Courage to change the things I can
And Wisdom to know the difference…
No ‘Cross Talk’
AA meetings give people the opportunity to talk about their own struggles on the road to staying sober. It is therefore important to create an encouraging atmosphere in which they can reveal their vulnerabilities. One concept that applies in some meetings is that of no ‘cross talk’. ‘Cross talk’ can be either: a) interrupting a person when they are speaking; b) passing judgement on their behaviour; c) giving advice or lecturing them about their actions. Certainly it is important for people to share their own experiences to help others. In many self-help groups, however, it is important for individuals not to be perceived as trying to ‘do therapy’ to others. (This is a point we will explore later in the article.) Whilst AA does not actively forbid cross talk, many of its groups have a tradition of creating an atmosphere where people can talk without fear of judgement.
AA continues to help people and, at the turn of the Millennium, was said to have around 2 million members. During its history it has, like most organisations, had internal arguments and people moving on to found their own groups. Some have adapted or invented their own versions of the twelve step programmes. Let’s consider some of those self help groups.
Other Twelve Step Programmes
Narcotics Anonymous was founded in 1953. Given permission by AA to use The Twelve Steps and The Twelve Traditions, its web site says:
“These principles are the core of the Narcotics Anonymous recovery program. Principles incorporated within the steps include:
* admitting there is a problem;
* seeking help;
* engaging in a thorough self-examination;
* confidential self-disclosure;
* making amends for harm done; and
* helping other drug addicts who want to recover.
“Central to the Narcotics Anonymous program is its emphasis on practicing spiritual principles. Narcotics Anonymous itself is non-religious, and each member is encouraged to cultivate an individual understanding - religious or not - of this ‘spiritual awakening.’”
You can find out more about Narcotics Anonymous, and its history, at:
Nowadays there are many ‘Anonymous’ groups – such as Gamblers Anonymous, Survivors of Incest Anonymous and Spenders Anonymous. They range from the spiritual to the secular. Some follow the original Twelve Steps; others produce their own versions. Some people find such groups helpful: others are wary. They believe such programmes replace one addiction with another – becoming dependent on the group for support. Other critics see Twelve Step programmes as cult-like or vehicles for religious conversion. On the other hand, AA has helped to give birth to famous clinics, such as Hazelden.
Later we will explore other recovery programmes that incorporated various ‘steps’ into their work. For the moment, however, let’s consider another development in the field of self help.
The ‘self-help’ therapeutic communities
The therapeutic community movement has a long history. It includes a wide range of establishments - such as The Camphill Communities, Homer Lane’s ‘Little Commonwealth’, Finchden Manor, Peper Harow, Fountain House, The Cassel Hospital, The Henderson Hospital, Dingleton, The Richmond Fellowship, Daytop and many others. Virtually all these were geared to the person helping themselves. Here we will focus on some that adopted the ‘peer help’ approach - rather than opted for the ‘professional intervention’ model. (Some communities also evolved from one approach to another.) Looking back at Elizabeth Packard’s work, she wrote the following piece that inspired patients to take care of themselves.
Psychiatric care improved immeasurably during the 20th Century, but many patients were still kept in institutions. During the 1940s a group of patients in America formed an organisation called ‘We Are Not Alone’. This eventually evolved into Fountain House and the ‘Clubhouse’ movement. Here are excerpts from Stephen B. Anderson’s history of the organisation which can be found at:
Fountain House and the Development of Clubhouse Culture
Stephen B. Anderson
The notion of self-help came first. In the early 1940s, a psychiatrist at Rockland State Hospital, about twenty miles from New York City, conceived the idea that self-help, as practiced by Alcoholic Anonymous, could be applied to mental patients. The psychiatrist, Dr. Hiram Johnson, activated the idea by forming a small self-help group among patients at Rockland. Self-help correlated with the notion of membership. Though meetings were held in the hospital, the participants considered themselves members in respect to the self-help group.
Dr. Johnson brought into the group a woman, Mrs. Elizabeth Schermerhorn, who had taken a job as an aide at Rockland. Mrs. Schermerhorn had developed an innovative understanding about mental illness, not through education in the helping professions, but rather by undergoing Jungian analysis and by studies with a Harvard sociologist. She, too, saw people with mental illness as related to, rather than differentiated from, the rest of humanity.
Mrs. Schermerhorn became physically ill late in 1943 and left the hospital job, thinking the self-help group a failure. The enduring historical significance of the group, however, stemmed from its effect upon one member, Michael Obolensky, who was discharged to live in New York City during l943. He had found the group helpful enough that he wrote to Mrs. Schermerhorn and proposed starting a similar group of former hospital patients living in New York City. Through the organizing efforts of Michael Obolensky and Elizabeth Schermerhorn, ‘We Are Not Alone’ (WANA) was formed early in 1944.
WANA carried over from the hospital group the idea of self-help operating through membership in a club. With WANA not affiliated with a mental hospital, or any other larger organization, the entire operation of WANA was run by the former hospital patients themselves. At first, members took turns acting as presiding officers at meetings. But shortly, a president and other officers were elected.”
WANA saw itself not merely as a self-help group for its members, but also as having a mission of service to people still hospitalized. WANA members visited patients at Rockland and other hospitals, printed bulletins and distributed them to the patients, and collaborated with hospital officials in finding housing and jobs for people ready to be discharged. While starting with ten members in 1944, an article in a national magazine on WANA in September 1946 reported a total of about 100 members.
As the numbers increased, however, so did the problems. Factions and dissension developed within the membership. A hope of acquiring a building which would serve as a WANA clubhouse never came to fruition. Sometimes the meeting room at the YMCA was not available, and WANA was forced to gather on the steps of the 42nd Street public library in Manhattan or around tables in a cafeteria.
During 1947, or early in 1948, some of the members of WANA, along with Mrs. Schermerhorn, started planning for a new organization which would rectify these problems. The plans included two primary goals: the acquisition of a clubhouse building, and the formation of a Board of Directors with responsibility for owning the building and raising funds. These plans were realized in June l948 with the discovery and purchase of a house on West 47th Street in Manhattan. With a fountain in a back, outdoor patio inspiring the name, a Board of Directors was incorporated as the Fountain House Foundation.
John H. Beard, Fountain House and the Clubhouse Model
Mrs. Schermerhorn acted as president of the organisation for several years, but eventually came to believe it had lost its way. Meeting John Beard in 1955, she immediately saw him as somebody who could revitalise Fountain House’s sense of purpose. John was in his early 30s at the time. Employed as a social worker with chronically ill patients on a back ward in a custodial institution in Michigan, he was producing remarkable results. His approach was to focus on the ‘healthy’ part of the person and build on their strengths. Stephen Anderson writes:
“John Beard had developed a type of ‘therapy,’ based on the conviction that mental illness was not the whole of a person … His therapy consisted of developing relationships responsive to expressions of health, rather than symptoms of illness. With a patient who mostly muttered about persecution by government agencies but indicated an interest in algebra, John Beard, as the therapist, developed a relationship based on working algebra problems together.
“He involved small groups of patients in normal types of social activities, taking them away from the hospital to attend baseball games or to eat together at a restaurant in downtown Detroit. Finally, he convinced several employers to hire patients at part-time jobs, with John himself training the patients, working with them some of the time, and taking responsibility for meeting performance standards.”
Mrs. Schermerhorn persuaded John to move to New York and he became Executive Director of Fountain House. He stayed there until his death in 1982. During this time John revitalised the organisation and spread the Clubhouse Culture. For example, he had high expectations of the former patients and built on their strengths. Asked about his approach to one specific member, he said:
“I had no interest in why he was sick. That was not my job … I wasn’t interested in trying to review his psychopathology. I had no interest in that at all. I was terribly interested in how normal we might get him to function.”
You can find this quote – plus a picture of John – in the book Psychiatric Rehabilitation. An excerpt can be found on Google Books via the following link.
John provided outstanding leadership and, in 1982, received an award for Extraordinary Commitment and Dedication in Serving the Mentally Ill of New York. The citation read:
His leadership has provided:
Dignity where there was shame
Belonging where there was alienation,
Empowerment where there was helplessness.
Self-respect where there was self-denigration.
Hope and opportunity where once there was only despair.
Following John’s death, the Clubhouse movement that grew out of Fountain House went through several stages of development. Some establishments in the US and other countries used the Clubhouse name but operated quite differently. During the 1980s and 90s the movement held several conferences, finally settling on the agreed key principles. This resulted in a continuing development of the Clubhouse culture. Here are some of the guidelines that the organisation follows.
The self help approach to mental health became more widespread. Established organisations often struggled to implement the principles, so this left a space for pioneers to fill the vacuum. Some of the later ventures were quite extreme – such as Ronald Laing’s work with the Philadelphia Association at Kingsley Hall in London. Other projects were equally daring, but perceived as being enough on the ‘safe side’ to attract government funding. Let’s explore one of these ventures.
The Richmond Fellowship
Elly Jansen founded The Richmond Fellowship in 1959. Thirty-years-old at the time, she had grown up in Amsterdam and had just finished theological studies in London. The Mental Health Act of 1959 made some provision for patients leaving psychiatric hospitals, saying:
“Under this section it is the duty of the local health authority and the local social services authority to provide after-care services for you. This should be done in cooperation relevant voluntary agencies. These services have to be provided until the health authority and social services are satisfied that you are no longer in need of them.”
Unfortunately there was little provision for patients being discharged from the older style asylums that dominated skylines around the country. Elly decided to fill this need. Buying a house in Richmond, Surrey, she invited several discharged psychiatric patients to live with her in what became known as a ‘half way house’. Some local authorities had misgivings about the approach, but others became firm supporters. Elly, like many pioneers, was sometimes controversial, but The Richmond Fellowship went from strength to strength. Nowadays it has over 100 specialist services and is represented around the globe. You can get more information on the official site.
Elly’s original idea called for the ‘residents’ – as they were known – living and working together in the half way house. At first there were few staff members, which increased people’s need to become more self-reliant. The Fellowship’s success led to more houses being purchased and developing specific kinds of therapeutic communities. (For example, I ran a RF community dedicated to caring for young people.) Throughout its history, however, the Fellowship placed an enormous emphasis on self help.
Sometimes this produced difficult dilemmas. For example: How do you: a) provide sufficient ‘professional staff care’ to satisfy the paying local authorities, whilst at the same: b) providing enough challenge to ensure the residents take responsibility? This called for making crystal-clear contracts at the outset with both the residents and the local authorities. The Richmond Fellowship frequently managed this balance successfully. Other communities took a more direct approach to what they called ‘self help’.
The ‘confrontational’ therapeutic communities
Alcoholics Anonymous influenced many people to set up other recovery programmes. These included treatment programmes such as Daytop and, more controversially, Synanon.
Daytop was founded in 1957 by Father William B. O’Brien, who worked at St. Patrick’s Cathedral in New York. Appalled by street crime and the tragedies it caused, he found the main cause revolved around drugs. Most ‘conventional’ treatment of addicts seemed to fail, so he began exploring other approaches. Coincidentally, several key figures in Brooklyn had been charged with finding more effective ways to treat addicts. One of these people, Dr. Dan Casriel, visited Synanon, an experimental community for addicts, on the same day as Father O’Brien. Synanon, and its founder, were later to be discredited, but the two visitors were impressed by aspects of what they saw. They went on to start Daytop, which continue to do outstanding work to this day. You can learn more about the community’s approach at:
One element of Synanon’s work that was adapted at Daytop was the concept of ‘The Game’. This was a group therapy session where addicts confronted each other about their behaviour. At a given point, everybody in the group would focus on one person. They would then outline – in great detail – how that person behaved irresponsibly. The theory behind the need to confront the addict is outlined below.
Such sessions could be brutal. The group members all turned as one and, for around 15 minutes, pointed out how the selected person avoided taking responsibility. The effect of 10 people, for example, pointing out a person’s shortcomings could be extremely powerful. There was little defence. Then, as if a tap had been turned, the group members switched their attention to confronting another person. Such communities maintained this was the only way to get through an addict’s defences. They also argued that the person was in a caring environment where, after being broken down, they would be built up again.
(During my training for working with addicts, I was actually on the receiving end of ‘The Game’ for around 15 minutes. It was an illuminating experience, but not one to repeat too often.)
Confrontational approaches became more common in therapeutic communities and other aspects of psychotherapy. Whilst useful – even vital – in some cases, the approach could also overstep the mark. Much depended on the initial ‘contract’ between: a) the person seeking help, and: b) the group providing support. If the person wanted to be confronted, that was fine, but sometimes this was not the case. Some people were therefore attracted to gentler methods of self help.
Counselling as an aid to self help
Carl Rogers is a name known to everybody who has done a counselling course. Today it is hard to realise how revolutionary his ideas were in the 1930s and 40s. In those days the medical profession treated people with psychiatric difficulties as ‘patients’. The doctor saw the patient, made a diagnosis and prescribed a ‘treatment’. Few sat down with a troubled person to encourage them to clarify their feelings, set goals and take responsibility for shaping their future. Psychoanalysis was an option for the rich, but few people had the opportunity of basic ‘counselling’. Carl Rogers changed all that and, during the 1950s and 60s, many people became familiar with his work. They adopted his approach as a framework for counselling. This became a vehicle for enabling self help.
Carl believed in creating a sanctuary where a person felt valued and free from judgement. They were then able to be their real self, express their feelings and develop their inner strength. He wrote in his 1942 book Counselling and Psychotherapy:
“Therapy is not a matter of doing something to the individual, or of inducing him to do something about himself. It is instead a matter of freeing him for normal growth and development.”
Carl believed the key was to provide the right environment. People could then find and follow ` their chosen path. Counselling was one vehicle for enabling people to become what they wanted to become. Carl outlined what he saw as the ‘core conditions’ for building a good therapeutic relationship. He saw the helper’s role as:
* To be ‘congruent’: to be genuine and honest with the client;
* To show ‘empathy’: to understand and experience the world from the client’s point of view;
* To have ‘unconditional positive regard’: to show respect and accept the person as they are, rather than be judgemental.
This may sound basic: but it was radical for an era in which the doctor, psychiatrist or other expert was expected to stay aloof. You can discover more about Carl’s work on strengths at the following link.
Carl Rogers’ Work On Strengths
Other people were also discovering the value of providing an encouraging environment in which people could talk, make sense of their experience and move on. One of these was Chad Varah.
Chad Varah and the Samaritans
Chad was an Anglican clergyman who founded the Samaritans in 1953. Suicide was illegal at the time and he felt something could be done to help people in distress. The official Samaritans site explains:
“The first funeral Chad Varah took as a curate prompted his lifelong commitment to suicide prevention and education. The funeral was for a 13-year-old girl who had taken her own life because she feared she was seriously ill; in fact she had started to menstruate … Chad vowed at her graveside to devote himself to helping other people overcome the sort of ignorance and isolation that had ultimately caused the young girl’s death.”
Chad was born in Lincolnshire and studied at Oxford before attending Lincoln Theological College. He was ordained in 1936, then worked as curate in various parts of the UK before serving much of his working life in London. Always daring to be different, he supplemented his early income by working as a children’s comic scriptwriter. He helped to create Dan Dare, the spaceman, for The Eagle comic. The official Samaritans site continues:
“An early proponent of sex education, Chad Varah alerted society to the approach of the permissive society, usually associated with the 1960s, with an article in the Picture Post in 1952. Far more important to him than the outraged responses of conservative society were the 235 people who wrote in afterwards to bare their souls, 14 of whom showed signs of considering suicide.
“The opportunity to act on his earlier promise to help people in emotional need came in 1953 when Chad was appointed Rector at the Church of St Stephen Walbrook in the City of London. In the early 1950s, three suicides a day were officially recorded in Greater London; suicide was still an illegal act and sex education hardly existed. Chad advertised in the press for people to help – not as trained counsellors, but as ordinary human beings offering a listening ear and emotional support.”
“Inundated with offers of help, he opened the first drop-in centre where emotionally isolated and distressed people could go to find a sympathetic ear – and Samaritans was born. Chad continued to run Samaritans until 1987, thereafter remaining an active member of the organisation and retaining a watchful eye over it even after his retirement. The movement now has 202 branches in UK and Ireland, with 15,500 volunteers providing emotional support around the clock. Its international arm, Befrienders Worldwide, works in more than 40 countries.”
Samaritans found that ‘providing a listening ear’ could enable people to take more charge of their lives. Certainly some might use it as a constant emotional crutch, but it was still worth it, even if it helped only one person to live longer. Chad pioneering work created a caring framework. This enabled many people to help themselves and live more fulfilling lives. You can discover more about the Samaritans at:
The reaction against institutions
– taking charge of your own life
Counselling, group work and other movements gave people an opportunity to take stock. During the 60s, 70s and 80s there appeared another phenomenon that encouraged people to take responsibility for helping themselves. People began questioning the role of ‘experts’ in education, medicine and other institutions. As a result, people took several steps. These included:
a) They believed more in their own experience, rather than simply relying on experts. (This often had a positive effect, but in some case it led to actually ignoring good expert advice.)
b) They took more charge of helping themselves – their bodies, well-being and futures.
c) They took a more proactive and informed role in clarifying what they could and could not get from institutions. They then took more charge of their relationships with those institutions.
Many writers and practitioners contributed to this shift. So let’s explore just a few.
* Ivan Illich
Illich was a Catholic thinker who became famous for books such as Deschooling Society and Medical Nemesis. His maintained that institutions were often set-up: a) To maintain the power of the ‘professionals’ who ran them, and: b) To depower – rather than empower – the people they were meant to serve. Illich believed that self-development, autonomy and dignity for all were the highest good. Modern institutions, however, seemed to be going in the opposite direction.
Schools resembled factories, maintained Illich. Education should enable children to develop their talents and take charge of their ongoing development. Instead, schools divided knowledge into specialisms, removed connections between the different fields and turned children into passive consumers. They then graded children on their ability to repeat information. He wrote: “Together we have come to realize that for most men the right to learn is curtailed by the obligation to attend school.”
Illich was equally damning of modern medicine. He wrote: “Effective health care depends on self-care; this fact is currently heralded as if it were a discovery … Healthy people are those who live in healthy homes on a healthy diet; in an environment equally fit for birth, growth, work, healing, and dying … Healthy people need no bureaucratic interference to mate, give birth, share the human condition and die … Modern medicine is a negation of health. It isn’t organized to serve human health, but only itself, as an institution. It makes more people sick than it heals.”
You may or may not agree with Illich, but his analysis certainly had an impact. Many people felt that education, medicine and other fields had become over-industrialised. Students, patients and other users felt ignored as human beings. They wanted to take charge of their health and lives. Let’s look at another writer who railed against institutions.
* Thomas Szasz
Thomas Szasz is famous for his book The Myth of Mental Illness and perhaps his best known saying: “If you talk to God, you are praying. If God talks to you, you have schizophrenia.” He argued that psychiatry defined many people as ‘mentally ill’, when they may simply be experiencing problems of living. Life can be challenging, maintained Szasz. You either develop the skills to manage it or you don’t. People should be encouraged and enabled to shape their futures, rather than labelled and lulled into questionable treatments. You can read more about his views at:
Szasz believed that ‘the person who does the defining’ is the one who exerts the power. For example, imagine you are facing a difficult challenge in life. If you define yourself as a person with talents who is will overcome the challenges, you feel stronger. If an outside institution or expert defines you as a ‘problem’ - or suffering from an ‘illness’ – and treats you as if you are helpless, then you will feel less powerful. It will be hard to break out of the role. Szasz also wrote:
“Inasmuch as we have words to describe medicine as a healing art,
but have none to describe it as a method of social control or political rule,
we must first give it a name. I propose that we call it pharmacracy, from the Greek roots pharmakon, for ‘medicine’ or ‘drug,’ and kratein, for ‘to rule’ or ‘to control.’ … As theocracy is rule by God or priests, and democracy is rule by the people or the majority, so pharmacracy is rule by medicine or physicians.”
As with Illich, you may or may not agree with Szasz’s views, but he got many people thinking. Below is a link to a book about his ideas and those of his critics. Let’s consider one more person who encouraged people to take more charge of their lives.
* Elisabeth Kübler-Ross
Elisabeth is best known for enabling people to talk about what was then still a taboo subject – death. Published in 1969, her book On Death and Dying touched a nerve. Sometimes it seemed as if terminally-ill patients were more prepared to talk about their forthcoming death than some of those in the medical profession. Elisabeth also introduced a model to explain the five stages of grief people may go through when faced with death. These are:
1) Denial: “I feel fine … This can’t be happening … Not to me!”
2) Anger: “Why me? It’s not fair.”
3) Bargaining: “Just let me live to see my children graduate … I’ll do anything, can’t you stretch it out? … A few more years.”
4) Depression: “I’m so sad, why bother with anything? … I’m going to die … What’s the point?”
5) Acceptance: “It’s going to be OK … I can’t fight it, I may as well prepare for it.”
Elisabeth explained that the phases were not necessarily sequential and people might go through some, but not all, of the stages. Nevertheless, the model provided a framework people could use to make sense of their experience. This was in itself liberating. Like many epiphanies, it started with the person realising: “Ah, now I can see what is happening. It isn’t only me who feels this way.” Each person would negotiate the stages in their own way. You can learn more about Elisabeth’s life and work at:
The rise of self help groups
During the 1970s, 80s and 90s more people began to realise: “We are not alone.” Many different groups of people decided to take charge of their lives. They chose to meet with kindred spirits, provide support and work together to achieve their goals. These groups included, for example:
* Survivors of sexual abuse – such as those who had suffered in their families or been abused by members of the church.
* Medical patients – such as those working through cancer treatment, living with HIV and experiencing other illnesses.
* People experiencing a loss – such as those who had suffered a bereavement.
In the medical field, for example, people gained strength from each other at places such as The Bristol Cancer Help Centre – now the Penny Brohn Centre – and many other treatment centres. Doctors and nurses saw such groups as an aid to medical treatment, rather than a hindrance. For example, the former US Surgeon General, Charles Everett Koop, said:
“My years as a medical practitioner, as well as my own first-hand experience, has taught me how important self-help groups are in assisting their members in dealing with problems, stress, hardship and pain … Today, the benefits of mutual aid experienced by millions of people who turn to others with a similar problem to attempt to deal with their isolation, powerlessness, alienation, and the awful feeling that nobody understands.”
Bearing this in mind, let’s consider some of the principles such groups follow to be effective.
2) Principles.
Self help groups bring together many of the strands already mentioned in this article. Elizabeth Packard enabled women to believe in their own sanity, rather than be defined by other people. James Beard encouraged people to build on their strengths. Elisabeth Kübler-Ross provided models that people could use to make sense of their experiences. These are just three of the many people who have contributed to the development of the self help movement. So let’s consider some of the key principles that underpin this approach.
* People can share their feelings and get support from others who have been through similar experiences. This support can be from individuals, a network or a group.
This is often the first step. Imagine you have been abused. The pain is awful, but it is compounded if, when you voice your feelings, the abuser says: “That is wrong. You can’t feel that way. And if you tell anybody, I will say you are lying.” For years you have been told that your feelings are wrong. Even when you express them, you are the person who seems to be on trial. Failing to see a way out, you doubt your own sanity. Sounds far-fetched? Perhaps, but this is the bind experienced by many sufferers. This first steps for such people are:
* To be able to express their feelings openly in a supportive environment.
* To have their feelings acknowledged as real – they are not mad.
* To learn how other people have found ways to manage similar experiences successfully.
“My first reaction was one of relief,” said one person. “For years I felt there must be something wrong with me. Then others in the group began to explain their experiences. Suddenly I did not feel alone. It was okay to accept my feelings, even though it took months to express them properly. Then, one day, somebody in the group told about the time they had decided to ditch their anger and move on. I’d heard the words before, but this time it made sense. That was when I decided to get on with my life.”
Sometimes it is relatively ‘easy’ to create an environment in which people feel able to talk. The group members can make a new person feel welcome, provide encouragement and, if appropriate, share their own experiences. Sometimes it can be more harrowing – such as when a person has suffered abuse or other pain.
Al Siebert, author of The Survivor Personality, provides guidelines for enabling people to talk through difficult experiences. For example, below are some principles he gives for listening to war veterans. The key, however, is that the person must really want to talk about their experiences. Here are the overall guidelines. You can find the complete article at:
* People can take responsibility, set goals and - where appropriate - follow a specific model to reach their goals.
People in self help groups often go through a catharsis. Then, at a certain point, they choose to move on. They choose to take responsibility and ‘control the controllables’. When facing a difficult illness, for example, they may enjoy appreciating their assets – such as their relationships – whilst also pursuing their chosen form of medical care. Going beyond denial, they choose to set personal goals.
People sometimes find it useful to understand and follow a particular framework, such as Elisabeth’s five stages of dealing with grief. This is not to say the model is ‘perfect’, but it provides a vehicle for making sense of their experience. In the therapeutic community I ran, for example, we used a model that encouraged people to acknowledge the past, but also use it to shape their future. Sue Carter was one person who went through the community. Below are extracts from her story that illustrate some of the stages that people often go through in self help groups.
* People can get ongoing support to reach their goals. They can also give support to other people in the group.
People can become addicted to self help groups. Is that a bad thing? It depends on the relationship they have with the group. After all, they may have shared more with those people – who they now consider kindred spirits – than with many others they know. The key is the role people play in the groups or with their new friends. Do they take responsibility and help others – or do they become a drain on people?
Looking at the self help groups I have known, several patterns emerge. Many individuals give and get what they can from other people. They then spend increasing amounts of time with a few people who become friends. Frequently they talk about many topics other than the challenge that brought them together. Some individuals rely on the support group for a long time. Others revisit the group until they get tired of it – or it gets tired of them!
Self help groups have their critics. Steve Salerno, for example, wrote the book SHAM: How the Self-Help Movement Made America Helpless. He is particularly critical of how some approaches encourage people to see themselves as victims. Whilst the book has many valid points, it tends to cover the overlapping fields between self help and self improvement. You can discover more about Steve’s views at the link below. Micki McGee focuses on the wider forces driving people in Self-Help, Inc.: Makeover Culture in American Life. She explains that ‘constant self-improvement’ is seen by some people as the only way to stay employable. This has led to people become ‘belaboured’ as they strive to become all they can be. She writes a blog that you find at the link below.
3) Practice.
Today there are self help groups in virtually every field. These bring enormous pluses, but there are also some minuses. Let’s begin by considering the pluses. First, people have taken more responsibility for shaping their future lives – their health, well-being and work. Second, they have received enormous help from others who have been through similar experiences. Third, they have learned to get a better balance between developing their own personal self help and seeking the necessary professional help.
The minuses include the following. First, some people have become addicted to self help groups. Such a habit may, of course, be less harmful than their previous addictions. Second, some people have used the groups as places to continue talking - rather than changing their behaviour. Third, some people have taken the ‘mind over matter’ approach too far, rejecting useful professional help. That is their human right. But there are times when expert help can be useful, particularly in the field of health.
Contribution to the strengths approach
The self help movement has made a big contribution to the strengths approach. For example:
a) It has enabled people to share their feelings, get support and develop their inner strength.
b) It has enabled people to take responsibility, set goals and manage challenges successfully.
c) It has enabled people to take more responsibility for shaping their lives - their health, well-being and work. This has provided the foundation for building on their strengths and achieving their picture of success.
The self help movement is with us to stay. It has, by and large, been a major force for good. People have been able to take the tools they like and use them to live fulfilling lives.
January 8th, 2009 at 6:00 am
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