Enabling Recovery and Spiritual Awareness Among Mental Health Staff. Isabel Clarke Consultant Clinical Psychologist

A New Normalisation for psychosis The different quality of experience in psychosis & different quality of spiritual experience – same mode of experiencing (the transliminal) The different quality of experience in psychosis & different quality of spiritual experience – same mode of experiencing (the transliminal) Cognitive science gives us a way of understanding 2 ways of experiencing Cognitive science gives us a way of understanding 2 ways of experiencing Mindfulness is useful for managing the bridge between them Mindfulness is useful for managing the bridge between them

Working with Psychosis using the Discontinuity Model Managing arousal – the transliminal is accessible at both high and low arousal Managing arousal – the transliminal is accessible at both high and low arousal Validate the experience Validate the experience Validate the feeling Validate the feeling Persuasion to join “shared reality” Persuasion to join “shared reality” “Sensitivity” and high schizotypy “Sensitivity” and high schizotypy

The role of spirituality in Recovery.  Breakdown as a stage in life’s journey: The straight road ahead has become blocked, or fallen away: The straight road ahead has become blocked, or fallen away: a gulf opens which can entail terrifying and disorienting experiences – but can also open the way to wider perspectives and new meanings. a gulf opens which can entail terrifying and disorienting experiences – but can also open the way to wider perspectives and new meanings. Hence spirituality is one of the routes to Recovery most frequently cited by service users, and most marginalised by the dominant (medical) story. Hence spirituality is one of the routes to Recovery most frequently cited by service users, and most marginalised by the dominant (medical) story.

Wisdom from the workshops: Recovery & Spirituality: opportunities As Recovery acknowledges spirituality as important, we are allowed to talk about it now. As Recovery acknowledges spirituality as important, we are allowed to talk about it now. People who are interested in spirituality can find each other. People who are interested in spirituality can find each other. Spirituality can power someone's Recovery Spirituality can power someone's Recovery Fostering art, beauty, poetry are important tools in people’s recovery. Fostering art, beauty, poetry are important tools in people’s recovery.

Recovery & Spirituality: difficulties Disapproval of staff expressing interest in spirituality from other staff Disapproval of staff expressing interest in spirituality from other staff Staff find peoples’ religious concerns hard to handle. Staff find peoples’ religious concerns hard to handle. People on the ward are afraid to talk about spirituality because it is regarded as a symptom. People on the ward are afraid to talk about spirituality because it is regarded as a symptom. Inconsistent approaches Inconsistent approaches Staff who try to convert service users to their “religion”: other staff do not feel confident to tackle this abuse of vulnerable individuals. Staff who try to convert service users to their “religion”: other staff do not feel confident to tackle this abuse of vulnerable individuals.

What needs to happen 1. people’s requests about spiritual or religious matters to be taken seriously. people’s requests about spiritual or religious matters to be taken seriously. spirituality awareness training to be available for staff. spirituality awareness training to be available for staff. working for acceptance of spirituality/experience as part of peoples’ wholeness. working for acceptance of spirituality/experience as part of peoples’ wholeness. respect for peoples’ positions – protection against evangelism – a code of practice was needed here. respect for peoples’ positions – protection against evangelism – a code of practice was needed here.

What needs to happen 2. taking a balanced approach to helping psychoses and bipolar disorder where religious ideas and experiences played a role. taking a balanced approach to helping psychoses and bipolar disorder where religious ideas and experiences played a role. encourage a climate in which staff can be open about and acknowledge their breakdown experiences encourage a climate in which staff can be open about and acknowledge their breakdown experiences helping people living through the breakdown/breakthrough journey holistically – role of art and nature helping people living through the breakdown/breakthrough journey holistically – role of art and nature

Opportunities and Sensitivities The relationship between Spirituality and Recovery – particularly the Hope and Meaning aspects of Recovery. The relationship between Spirituality and Recovery – particularly the Hope and Meaning aspects of Recovery. The problems of dealing sensitively with spiritual and religious issues where they conflict with the conviction shared by many members of staff e.g. that spirituality is irrelevant/wrong/unrealistic The problems of dealing sensitively with spiritual and religious issues where they conflict with the conviction shared by many members of staff e.g. that spirituality is irrelevant/wrong/unrealistic The social and cultural aspects of religion, and the social support contact with a church or faith community could afford The social and cultural aspects of religion, and the social support contact with a church or faith community could afford Sensitivity to cultural differences when working with people from different faiths and cultures and the danger of misinterpretation. The importance of simply asking people to find out what is acceptable or the norm. Sensitivity to cultural differences when working with people from different faiths and cultures and the danger of misinterpretation. The importance of simply asking people to find out what is acceptable or the norm.

Dilemmas: spiritual blindness v. evangelisation. Should we leave our spiritual/religious beliefs at the door/ be “aspiritual”? Should we leave our spiritual/religious beliefs at the door/ be “aspiritual”? Should you share your position if asked? Should you share your position if asked? There is a distinction between evangelisation and just being a member of a church or faith There is a distinction between evangelisation and just being a member of a church or faith The danger or exploiting the vulnerability of clients in relation to the power of the professionals’ position The danger or exploiting the vulnerability of clients in relation to the power of the professionals’ position Need to be clear about forbidding evangelisation/pushing of particular beliefs Need to be clear about forbidding evangelisation/pushing of particular beliefs