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Spreading Recovery to Portugal, N. Ireland and England

By Daniel Fisher, M.D., Ph.D., October 30, 2006

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Dan Fisher's Presentations on Recovery

Recovery and Discovery of a New Life in Portugal for People Labeled with Mental Illness

Lisbon, Portugal, October 10-12, 2006

Lisbon, Portugal, October 10-12, 2006
Belfast, N.I., October 17, 2006
Nottingham, England, October 18, 2006

I was invited to speak at three occasions in Portugal this October.  Dr. Jose Ornelas was particularly interested in having me address several members of the Portuguese Mental Health Commission. I also spoke at a national conference on rehabilitation and on my last day gave a workshop on empowerment to their emerging consumer leaders. I was particularly happy to meet their emerging leaders, in their newly forming Empowerment Center. The six leaders were very interested and understand a great deal of what I shared. I was struck again by how universal the issues are. They too had felt hope had been robbed of them. They asked when psychiatrists would learn about recovery. They understood that having a voice meant having power to be taken seriously. They were eager to make copies of my material and to translate it into Portuguese. I gave them some advice on how to address their Mental Health Commission. I was also interviewed by a journalist, Manuela Garcia who is preparing an article for their magazine, Psicologia Actual on the topics of my talks here.

 The National Rehabilitation Conference, Oct.11, 2006, Lisbon, Portugal
The National Rehabilitation Conference, October 11, 2006, Lisbon, Portugal

The previous day I participated in a round table discussion on the topic of recovery. One of their commissioners, Dr. Joao Sennfelt, seemed to understand the points I raised regarding the importance of having a consumer voice in the deliberations of the Commission. I pointed out they should have had at least one user on their commission and he agreed. He said it was too late for adding a new member but he said he would ensure there were opportunities for the consumers to get their ideas across to the commission. I then pointed out to Teresa Duarte, who is an important advocate, that such a public statement was very important. I suggested that very quickly the advocates and consumers should prepare a letter to the Commission outlining 4 important ways for consumers to have a voice in the Commission:

  1. There should be at least 3 hearings held at different locations in the country at which a commission member could collect verbal testimony from consumers. I suggested that the testimony be limited to 4 minutes each and that it be recorded, transcribed and sent to all the other Commissioners
  2. There should be a public portion to the commission meetings and that each meeting should accept public testimony of up to 45 minute period
  3. That the Commission be able to accept emails directly from each of the stakeholder groups; that a staff collect these emails, categorize them and send them to each of the commissioners
  4. That there be an opportunity for consumers to form an expert panel no address the commission as a whole on specific topics
  5. That Dr. Ornelas be allowed convene a subcommittee on consumer issues, and be able to hire a consumer consultant to prepare a subcommittee report which then would become part of the record of the Commission

Dr. Sennfelt also said that he thinks Portuguese society is behind other counties in the west because its long-standing history of looking up to higher authority. He feels that for recovery and empowerment to succeed there will need to be a change in that aspect of Portuguese society. This sentiment echoed a similar view of the consumers in Japan.

Round table discussion about recovery at National Rehabilitation Conference Round table discussion about recovery at the National Rehabilitation Conference

The first day, Oct. 10, 2006, was the major conference at which I gave a keynote address. Although it served an important official capacity of my putting forth the issues of recovery before the President of their Commission, it did not afford the same opportunity for shifts in thinking that the smaller venue the next day afforded. I am realizing more and more that these smaller more informal meetings are the greatest opportunities for reaching people and communicating new ideas. My experiences in Northern Ireland the next week reinforced this message:

Tears Reach Beyond Religion

Belfast, N.I., October 17, 2006

These words echo still in my heart days after meeting for 3 intense hours with users and carers in Belfast, Northern Ireland. The meeting took place the night of October 17, 2006. It was the night of the day conference on youth, which I had keynoted. It was an impromptu meeting, largely organized by Marie Crossin, Director of C.A.U.S.E . Marie whom I had met 2 years previously. The particular magic took place near the end of an intensely meaningful period of sharing by equal numbers of both carers and users. They have a much closer unity than I see among our consumers and families, which I think is due to a combination of less influence by the pharmaceuticals and a recent shared struggle to end the troubles between the Protestants and the Catholics. At that time a mother shared her very painful story of one of her twin sons. He has been nearly continuously hospitalized for 9 years. His initial difficulty was that he had panic attacks. He then refused medication and has been fighting with the staff ever since. At this point he is in a high security hospital, though he has not committed a crime. She cried freely as she shared that she is not even allowed to take paper and pencil with her on visits and there is no prospect of a second opinion to see if his medications could be reduced or changed. The outpouring of assistance by the group was heart warming for all involved. My hugs and cries, and exchanges of telephone numbers followed. The woman began to smile. She said she felt hopeful for the first time. She had tried to solve all these issues alone, and now she realizes she is not alone. Now she realizes she has allies who want to help her. The offers of help went beyond the traditional barriers of religion and mental health identification. The immensity of this unity did not strike me till one of the woman triumphantly emphasized that their tears allowed their cooperation, which had evaded them over the last 30 years. That’s when she said she understands now that “their tears dissolve the differences between their religions. “ This is a land still reeling from the trauma of the troubles. This is a land sorely wanting unity of purpose and meaning. Perhaps through meetings of reconciliation such as these they can heal those wounds and move on together as one country as so many wish.

Learning about Recovery

Nottingham, England, October 18, 2006

I realize more than ever, that what helps me the most in my recovery and continued growth is passing on hope to others. I have been doing so in Portugal, Northern Ireland, and England. I find that I learn so much and gain so much from my experiences of sharing. Last night, in Nottingham, England, I felt connected to the spirit of Robin Hood. I met with 140 mostly consumer/survivors in the basement of a church and our passion was immense. Near the end, in addressing the question of how do we answer the people who want to explain all our behavior by our biology alone, I pointed out that studies are showing that our position in the society plays a big role in our chemistry. At that, a woman in the audience chimed in that she was sure that her chemistry had changed during the evening's discussion in a very positive direction. She felt full of energy and enthusiasm. I also pointed out that we have a great secret strength that our doubters in the professions and administrations lack. We have the power of giving encouragement and strength to each other. Near the end of the evening the sympathetic nurse who had sponsored my speaking said with surprise that I seemed to have more energy at the end of the 2 hours of discussion than at the start. I said that was because when I can find the right way of connecting with peoples' positive, hopeful spirit, it gives my spirit more energy. It is because I genuinely believe that I can always learn and be helped as much by others as I can help them. I would call this type of assistance a type of Robin Hood Recovery, since both parties gain from it. It seems like a spiritual redistribution of the health to those who often lack wealth. It seems we can only level the playing field of power by redefining the cultural norms upon which power is based. In ordinary industrial society, power is mainly defined by material possessions. The size and speed of your car, house, clothes, etc. In a post as in a pre-industrial world, power is defined more within relationships of meaning, and connection. These connections appear to be more closely related to health of both mind and body. Thus we find that the recovery from severe emotional distress is much higher in the pre-industrial world than in the industrial world. We also find that the health problems of rich and poor are much greater in societies with a greater discrepancy between rich and poor. It would seem that in these countries there is a greater sense of community and shared purpose. Another time of such sharing is during war, when the rate of suicide goes down. In contrast, the more traditional, professional, royal model of assistance whose one directional quality leads to an impoverishment of the spirit of both parties involved. (Luckily I escaped from Nottingham before the Sheriff discovered that I was spreading such Robin Hood like ideas among the c/s's.)