1. The Trauma Learning Model Why and How NAMI Education Programs are Different than Typical Adult Education

2. Families have been blamed throughout history for causing mental illness in their loved ones. The person living with the illness has also been blamed for their own conditions. Once Upon a Time….

3. A genuine entry from a psychiatrist’s evaluation of a man diagnosed with bipolar disorder: “He tests in the superior range of intelligence, but has a passive aggressive personality. It is based upon very infantile egocentric ideas in which he is maximizing the secondary gain related to his disability in quite a manipulative fashion. He is heavily enmeshed in patterns of family pathology, particularly in relationship to his mother. He is unlikely to benefit from therapy unless he is willing to disengage himself from this family and maintain an independent life style.” Stigma – What We Are Up Against

4. Theories of Family Role in Mental Illness as a Result of Stigma Parents were overprotective (usually mom) Parents were cool or indifferent Families have enabled the “bad” behavior Families have sabotaged treatment The family is dysfunctional so the child never stood a chance It must be the parents’ fault!

5. NAMI Education Programs Break Away from the Notion that Anyone is to “Blame” for Mental Illness

6. What We DO Believe Mental illnesses are biologically based brain disorders that can have environmental triggers - they are not the fault of the family, or the individual with the illness People with mental illness and their families are often stigmatized The onset of an episode of mental illness is deeply traumatic and disrupts every area of the life of the individual affected and their family Mental illnesses are catastrophic stressors in our lives

7. What Is a Catastrophic Stressor An unanticipated event There is no time to prepare for it We have no previous experience about how to handle it It has a high emotional impact on us It usually involves a threat or danger to us or others

8. Typical Responses to the Trauma of a Catastrophic Stressor are to Feel An unbearable compulsion to undo: “If I had just done something different maybe my child wouldn’t have gotten sick” Frozen in time; protective unwillingness to move forward; it might get worse! Isolation from or by our extended family, friends, community – mental illness is not a casserole illness Embarrassment about talking to others about what is going on, but we are desperate for support A nagging fear that symptoms will recur or even get worse A constant flood of mixed up feelings

9. The experience of mental illness in the family is a catastrophic stressor that is deeply traumatizing to everyone involved People going through trauma don’t absorb information the same way traditional adult learners do Why NAMI Education Programs Use the Trauma Model of Learning

10. Basic Assumptions about Students in Traditional Adult Education Imagine that you have just signed up to an astronomy course You likely… Have a genuine curiosity about the subject offered Are willing to master a comprehensive range of materials Are ready to learn all the content - this is an intellectual pursuit Have the time and energy to take the course

11. How NAMI Program Participants are Different from Traditional Adult Learners We are not simply curious. Our interest in and response to course topics are highly emotional. We understand the importance of the course but may not wish to be there. We are not ready to learn everything there is to know about mental illness. We are emotionally overwhelmed by the what we already know, much less what we don’t! We are not taking this course as an intellectual pursuit. Our relationship to course topics is intensely personal. We are taking this course to save our family. It is unlikely that we will be able to take in all of the information presented. We don’t have the energy level or time traditional adult learners typically do. We use most of our time and energy just trying to survive and take care of our family. We would rather be anywhere but here.

12. Basic Assumptions about Teachers in Traditional Adult Education Have a teacherly concern that students understand everything in the course Worry if people don’t understand all the materials presented Use different teaching methods to accommodate a variety of learning styles –“It is my job to entertain the class”

13. Why Teachers of NAMI Education Programs are Not Traditional Adult Educators We don’t expect our peers to grasp everything that is presented –We are emotional guides - we allow families to take in only the material they are ready to absorb We fully expect that some students will zone out, seem to not pay attention, and even rest –It is our responsibility share the information we have and keep the climate comfortable for families to take what they need when they need it, recognizing that it is OK for their focus to fade in and out

14. We don’t use a large variety of learning tools – our participants don’t have time to be entertained NAMI Education programs are purposely designed to be taught as simplistically as possible, so that all our volunteer teachers feel equally prepared and equipped to share vital information with participants while providing the support and safety necessary for people who often would rather be... anywhere but here! Not Traditional Adult Educators

15. In Other Words, People Dealing with Trauma and Stress Learn Differently from Traditional Students To survive, we typically: –Have a narrow, personal focus –Develop tunnel vision and are very self absorbed –Have radar out only for information and support –Operate from fight or flight mode (look only at what might be helpful to us and leave the rest; “I need to know X and that’s all”) –Are unsure if we want to know what comes next –Are afraid of the unknown

16. That people taking a NAMI Family-to-Family course are moving through experiences of trauma This is NOT a group that can be reached through traditional adult education We have to find other ways to help families learn what they need to know, and what no one else is telling them We Understand…

17. Techniques used in NAMI Peer Education Easy to follow lecture and read-along format that allows people to take in as much or as little information as they wish Provide information linking mental illness to the body Teach communication and coping skills Move people toward a greater awareness and understanding of their own lived experiences

18. Normalize thoughts, feelings, body sensations and behaviors connected to mental illness Teach that recovery is attainable Show that mental illness symptoms are REAL, not ‘just’ behavioral Provide group support Use information overload to break through long-held stereotypes and false beliefs Techniques used in NAMI Peer Education

19. Plus, the “Comfort” of Being Read To... Someone else is in charge, taking the lead Allow for concealment of emotions and permit “zoning out” Make a vast array of information available, allowing the student to select what they need Empower students’ ability to figure things out on one’s own Ease students into the process of learning

20. Take-Home Messages The experience of mental illness is deeply traumatic People attending the course will not come in as traditional adult learners You are an emotional tour guide not an adult educator; it’s not your job to make sure they learn everything in your course; it is your responsibility to share the material and show them how to take from it what they need Don’t worry about teaching aids; trust the process

21. Take-Home Messages Don’t worry if people space out; that is the plan! Don’t work too hard to MAKE people talk; they talk when they are ready Be aware that students may continue to try to become a support group; wanting to” just talk” - this is a class even though we approach teaching in a unique way and we have to cover all the information There is a critical connection between using a scripted manual and our designation as an Evidence-based Practice Fidelity, Fidelity, Fidelity!