'Many service user workers are still wobbly'
The recovery ideal in mental health has been lost and the NHS is taking advantage of compliant service users. It's time to get radical again says Marion Aslan. By Adam James
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There’s another storm brewing in mental health – this time in the name of Marion Aslan.
It’s time to speak out against the “bastardisation” of the recovery concept which has embedded into mental health policy over the last 10 years, says Aslan. Every NHS trust, mental health organisation and user group has embraced recovery. No government mental health document would be published without reference to it.
But Aslan, who has worked in mental health for 15 years, argues that not only have any emancipatory aspirations to recovery been lost but that radical service users have “sold out” to a diluted version of recovery.
Most controversially, Aslan, a long-standing critic of orthodox medical psychiatry, argues that the NHS trusts embracing this conservative blend of recovery are also hand-picking “unrecovered” and naive service user workers.
"A lot of these employed service users are still very wobbly in terms of their recovery” says Aslan. “So trusts can get away with not having to change.”
Aslan had her own coal-face experience of mental health services, including being sectioned six times from 1994 to 2005 for psychotic experiences. She says she once had a psychiatrist wagging his finger an inch from her face proclaiming: "You are severely and enduringly mentally ill".
Aslan, a former learning disabilities teacher, used to work for Keepwell, a service user-led training firm. Since 2006 Aslan has been running the training collective, Crazy Diamond, with award-winning nurse Mike Smith.
Marion Aslan: " People on disability living allowance earn, in effect, far more than me." Photo: (c) Springupphotography.co.uk
Both have developed a “Thrive” concept of “Mental Wellness”. It is more ambitious and radical than recovery. For example, only when a person does not use psychiatric medication and mental health services, can they be said to be thriving. The approach also promotes a rejection of reductionism when mental illness is seen as a consequence of one’s biology. “Distress is a consequence of life, not a pathology,” asserts Aslan. She also emphasises that thrive necessitates developing a critical knowledge of the politics of madness.
To spread the thrive philosophy, Aslan has established three self-help “Elemental” groups in the UK, with groups also in America and Kenya.
"They consist of very select groups of people who are viewing what the world calls as mental illness is different way,” explains Aslan. “If people say ‘I think I am ill and need medication and psychiatry’ then we’ll tell them we are not a group for them.”
Along the way, Aslan has been unafraid to criticise service-user representatives, including those employed by her local NHS trust. “You don’t change systems without being a little bit radical,” she says.
She adds: “I have recovered to the point that any of us in society can be. I don’t need medication, and I do not need workers. I am not a service user and have not been for many years. I am thriving.”
These might be inspiring words to some with long-term mental health problems. Equally, some may find them insensitive and intimidating. Aslan’s response is forthright.
"The idea of thriving could upset some. I suspect this might be because they recognise the hard work that must be put in. I have been in that situation and used to say that I didn’t have the necessary reserves [to thrive].
"Plus, people on disability living allowance earn, in effect, far more than me. They are wise enough to realise they earn a good wage for their madness, so the concepts of recovery and thriving can upset them because of the potential loss of earnings.”
Provocative words indeed, and Aslan is likely to ruffle many feathers. But others may feel she is helping set a new benchmark for progressive mental health work.
www.crazydiamond.org.uk
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Smug, arrogant and dictatorial
From: Louise Pembroke, 'unrecovered' service user, London, UK
Date: January 22, 2010
So-called radical orthodoxies are no less oppressive than medical orthodoxies. Aslam et al are no less of a sell-out than other people who earn a living out of recovery using pre-determined measures [some of her colleagues have boasted of earning more than consultants and to have a go at people on DLA is a cheap shot - no one chooses it].
So she doesn't need medication/support. Well jolly good, that's her version of recovery, but does this have to be imposed on everyone? Do tell me how this is any less dictatorial than a biological psychiatrist saying that you'll never amount to anything? Same orthodoxy Marion, just different words. Nice that you exclude anyone who doesn't match your standard of recovery or 'thriving'. Just love your recovery scale where there is 'impaired' survival like some people are merely limping compared to you.
How about supporting user workers instead of knocking them? How about letting people set their own benchmark? How about being a little less smug and bitter at the hard work you've put in which you suggest other people are just too weak or scared to put in for themselves?
It's so very easy to judge other people's lives and set yourself as a benchmark - it's also very arrogant.
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Seems like orthodox psychiatry to me
From: Louise Jones,, lecturer, UK
Date: January 22, 2010
I am shocked to the point of not knowing what to write in terms of reading this from Marion. Such a ‘thriving’ position is founded in misguided politics.
There’s a need to write though as I would like some clarification on Marion’s position here around ‘recovery’. I have a few questions. Is she rejecting it? Doesn’t sound like it to me... is she critical of the providers who are endorsing it?... yes, but that’s not new and radical, service users and survivors have been dissatisfied with ‘recovery’ for a longer time ...Is she trying to set up ‘thriving’ as some sort of ‘beyond recovery’ position that service users must aspire to achieve else they be failing at their own ‘recovery’ and subsequently ‘rejected’ by her models of working.
This new ‘radical’ position Marion seems to be taking seems to be about being ‘outraged’ by something for the sake of being ‘outraged’. Maybe to obtain some self serving publicity? Recovery as a concept and a definition is fraught in difficulties and I (as an ‘unrecovered voice hearer’ have utterly rejected it)... but I would never reject or be critical of the people who find themselves trying to negotiate their lives and use of mental health services within our recovery-dominated climates. And to do it from some self-proclaimed ivory tower is just wrong and cruel.
Service users have less and less choice these days (dispite all this loverly personalisation chatter). This does not mean they are any less compliant, as they find other ways to tackle their struggles and problems on both personal and political levels.
Service users, like the human beings they are, are not a bumbling mass of fragility that Marion seems to imply they are: either struggling with ‘recovery’ or suffering in some other way from some sense of false consciousness by not subscribing (or being any good) at ‘thriving’
‘Thriving’ groups sound very similar to orthodox psychiatry to me, still very much within a model of ‘doing something to someone’, also about meeting an arbitrary criteria, else risk being cast out. Only being allowed to attend a group when you have been ‘cherry picked’ as having the potential to ‘thrive’. How is that estimation made?
People on disability benefits do not have a vested interest in ‘being sick’ : the systems that exist and the contradictions inheritant within recovery mean that the relationships that service users have to form with services force them into positions of staying on low incomes. The poverty trap that is inherent within the welfare system is not the fault of the people who are reliant on it; it is the fault of the system and the (current) economic climates that exists.
Recovery has been bolted on to the back of the medical model, a sticking plaster which makes taking the drugs/CBT/DBT etc (allegedly) taste a little sweeter as it ticks some box somewhere for some commissioner and service provider. The problem lies, not with the service users who have it rammed down their throats within every aspect of mental health (and social / education / employment) service provision but with the fact that Marion is now trying to bolt ‘thriving’ on the back of recovery and she appears to be doing it with that same wagging finger that she so disliked within her own psychiatrist.
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Thrive is an alternative
From: Amy Smith, service user and 'Thriver'. USA
Date: January 22, 2010
Ms. Pembroke,
It is apparent you do not know your history well, to pronounce such an ugly judgement on such a loving, gentle soul as Marion Aslan. I would say the rather glaring difference between the orthodoxy of the medical maintaince model and the spiritual or THRIVE models of living is that people like Marion Aslan have never attempted to remove my teeth or intestines, scramble my brains with an icepick, force me to experience ECT or subject me to dangerous chemicals they do not fully understand the functioning of. Medical professionals HAVE.
I only got in on the dangerous chemicals bit, but that stole away 35 precious years of my life as I stumbled blindly along, arms outstretched, from one provider to another, seeking something beyond what I was offered. On as many as 13 psychotropic drugs at a time, incontinent, balding, drooling, falling over and flailing wildly in my attempt s to get back up, my little son tugging feebly on my clothes, trying to help…I, too, heard I would never recover, to get my affairs in order, because I was “going in and not coming out”.
In 1999, I heard the word “recovery” for the first time, from the lips of Pat Deegan. That moment changed my life - I got well, IN SPITE OF what my providers did to me, and so of course I was labeled, despite my increasingly good mental health, as non-compliant and borderline personality disorder was added to my lengthy list of labels, joining schizoaffective disorder, major depression, general anxiety, PTSD, ADD, etc., etc. Many more.
Then, in 2008, I heard the word THRIVE, and my life changed again, and just as dramatically. I had been the dog-and-pony-show for my state for eight years, sitting on various boards and councils, representing the voice of consumers in my state. I never spoke without a page of bullet points in my hand that THEY gave me, I was constantly called on to “rein in” contentious “loose cannons”. It was a disgrace. I hang my head in shame.
Anyway, my point is, Ms. Pembroke, is that until you can tell me in one sentence how Adolf Meyer, Henry Cotton, Dorthea Dix, William James, Clifford Beers and Walter Freeman all related to each other - because they did, in a very significant way - then your opinion means nothing to me. Those who do not know their history are doomed to repeat it, you know, and these are precarious times. Quite similar, politically and sociologically, in fact, to the time of the characters listed above.
It is time for an alternative system, and the emerging spirituality movement in the United States - which is quite significant - clearly refutes the medical model and embraces models such as THRIVE. Think for a minute about economics, eugenics and the bio-medical genetic model the psychiatrists currently embrace, and think about what may be next. It is dangerous to support a biological model.
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A true revolutionary
From: Grainne Humphrys, Elemental Lead, Ireland
Date: January 22, 2010
Marion Aslan is a brave woman. Where others fear to tread, Marion kicks down the door! If I want to voice a painful truth, like the fact that the Irish psychiatric mental health services have turned my partner, John, into a psych drug addict.
I know Marion will acknowledge that painful truth with me and, more importantly, she will believe me. Not only that, she will tirelessly campaign for John's release and give me strength and hope again. Unlike others, she refuses to abandon John to the back wards. She understands at a deep level that John is a 'trauma survivor'. Many others give me lip service but Marion helps me to find real ways to empower myself further and to challenge the totalitarian state and dictatorship that is bio-psychiatry.
Marion is a visionary and a true revolutionary and, Lord knows, there aren't many of them left! She isn't afraid to tell the raw truth and I find that refreshing in a red-tape climate. Not only does she challenge the status quo but she offers real alternatives; peer support and ways of working through transformational crisis and distress. Marion is a trail-blazer and she has been a pillar of support to John and myself.
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Insulting and sinister
From: Shaun Johnson, survivor activist, Leicestershire, UK
Date: January 22, 2010
I find it funny that Marion Aslan sees herself as somehow radical when, reading this, she seems intolerant and only interested in people who are willing to essentially do as they're told. Since one of the big problems with psychiatry is its emphasis on compliance, I'm not sure she is offering anything different from what psychiatry already offers.
Yes, 'recovery' has been bastardised and diluted, but Ms Aslan\'s version of 'recovery' – everyone living according to her terms and her dictates - is no better.
Referring arrogantly to 'unrecovered' service users employed by trusts, she tries to give us the impression that her class of service user are somehow more 'recovered' because they agree with her and can be persuaded to come off their medications and give up all services, and presumably all state benefits, so that they can all tag along to her Pied Piper tune of 'Thriving'. All sounds rather sinister to me. She seems to be saying that because she can do it, everyone else should be forced to. No doubt she would complain about a one-size-fits-all psychiatric system, whilst in effect she’s advocating it herself!
Marion Aslan isn't a radical at all, she's just another oppressor of people's right to self-determination. Who's she to say that people shouldn't do anything that might help and support them? In the midst of mental distress, sometimes that's the only thing that can keep you going.
She says that “the idea of thriving could upset some. I suspect this might be because they recognise the hard work that must be put in." No it isn't, it\s because it's advocated by someone who obviously loathes people on benefits - to say that people on disability benefits are "earning a good wage" shows how little respect she has for them - and wants to replace the oppression of the psychiatric system with her own version of it. To condemn anyone else at all for selling out is hypocritical. She’s joined the Recovery bandwagon that she condemns but has tried to give it a twist to make it more suited to her own patronising and insulting view of people with mental distress. It’s strange that she condemns the NHS of taking advantage of service users when, by the sounds of it, she does it herself by trying to mould them in her own image. If thriving means being like Marion Aslan, I think I’ll give it a miss thanks.
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Since when has DLA been alot of money?
From: Keir Hardie, Highland User Group, Inverness, Scotland
Date: January 22, 2010
I reject Aslan's Thrive concept. It implies that all my friends and colleagues who are doing very well with their recovery and who feel that medication is an important part of keeping well for them are losers. They are not, they are winners. I, fortunately, don't need medication. But that's me, and I'm not deluded enough to think that that's best for everyone.
Sad also they Aslan buys into the myth of everyone on DLA getting a lot of money - I get DLA, £18.65 a week, and I'm far from unique. I wonder what other ill-informed preconceived ideas she may be carrying around? I think it's ironic for her to be calling anyone naive. Maybe these workers she's talking about are naive and unrecovered, but maybe they just have their own minds and don't subscribe to her views.
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Aslan's pushing the debate forward
From: Thomas Jones, UK
Date: January 25, 2010
Did the critics' posting responses actually read the article or just choose to snipe because they are all singing from exactly the same contrived hymn sheet or sheep!
I see it all over the, redefining of maintainance as recovery. At least Aslan has tried to push the debate forward, many of my friends are trapped in a dependancy system and that's not self determination as the critics suggest.
Louise and the others call Aslan arrogant yet are asserting arrogance themselves, say she doesn't know, but yet they do!! Mrs Kettle alleging Mrs Pot me-thinks. It's a shame some "activists" don't do more to get out of dependency instead of reframing it as individualism. Still we all have to get on in this world so we have to explain ourselves in a seemingly accceptable way.
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Legal drug addicts
From: Mary Maddock. board member of MindFreedom International/ European Network of (ex-) Users and Survivors of Psychiatry
Date: January 25, 2010
I believe it is much better to support our strengths than to condenm our weaknesses. It is impossible to posess the full truth when we speak about what has become to be known as 'mental health'. However, it is becoming more and more clear that the illness model is causing much more harm than good. It does not appreciate us as round human beings. It sees us as flawed objects in need of a fix.
Our bodies, minds and spirits need good food, water, shelter, love,companionship,freedom, self control and fun to survive and thrive. Psychotropic drugs have caused and are still causing untold harm to millions of people worldwide. Many people have become legal drug addicts and cannot become drug free when they want to lead a drug free life. Marion Aslam and Elemental will be a Godsend to many who want to lead a drug free life.
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Thrive is refreshing and empowering
From: Tony Regan, outreach community worker, UK
Date: January 25, 2010
I have had the pleasure of reading the materials on the “thrive” concept and believe it offers an inspirational and spiritual concept in true recovery.
I don’t for one minute believe Marion thinks any less of another human being if their recovery does'nt mirror that of her own. On the contrary, its about respecting and supporting hope for individuals who believe they are much more than a mental health "label”
We do have services in place for acute episodes and services which maintain and support. What we don’t have is a recovery model like “thrive” that is totally refreshing and empowering and is available to individuals who would like the choice and support to be free of all services. Not everyone wants to own a mental health "label”, but in my experience it does serve well when some people are renewing their claim for DLA! The comment that Marion made about DLA was not a cheap shot as you say but it obviously hit a nerve and when a nerve is hit, it could be that we need to look within as to “why”? it is a long hard journey back to reality when one has become institutionalised in the system for many years and Marion and many others who have made that journey are just trying to express and offer support to those who choose to face their fears and take full responsibility for all their feelings and emotions because it is when one is able to do this that the light switch is on.
On ending my reply, I have the upmost empathy for people who are unwell and need the support of services. But come on guys we know the ones who are playing the system don’t we?
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Elitist to say those on medication can not thrive
From: Peter Campbell, former Mind champion of the year, London, UK
Date: January 25, 2010
I am very opposed to the way ideas about "recovery" and, it seems "thriving", are being used to categorise people. It is one thing for people to declare themselves recovered, quite another for people to classify them as recovered or , equally as likely unrecovered.
I thought "recovery" was a unique and individual journey. If this is so, I don't think it is helpful or necessary for a group of experts to spring up who lay down stages of "recovery" and "recovery outcomes" and to judge people by them. Leave it alone, I would say.
I don't know much about the "thrive" approach but do feel it is both absurd and elitist to say that people who are still using medication and mental health services cannot be "thriving". I have been receiving services for more than forty years and am doing not too bad. I don't need a group of "recovery" or "thrive" enthusiasts to come along and make me feel inferior.
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In defence of Pembroke
From: Rósa Corcoran, journalist, Dublin, Ireland
Date: January 25, 2010
I write this in a state of amused horror at Amy Smith's assertion that Lou Pembroke 'does not know her history'. Has she any idea whom she's addressing?
Lou Pembroke is one of the most informed, insightful, compassionate, intelligent, democratic and fiercely political thinkers I have ever encountered.
I struggle to find her equal in many respects and would place her on a par with the equally extraordinary and sadly missed activist Judi Chamberlin.
I would suggest it is you who does not know your history, Amy.
The idea that Lou supports bio-psychiatry is simply not worth engaging with it's so ill-informed and ludicrous. I'd imagine if she\'s read this she's equally tickled!
It is wonderful you feel yourself to be thriving, but Aslan's dogma smacks of the type of fascist rhetoric we have come to expect from the worst type of orthodox psychiatry.
Far more worrying to my mind than issues of recovery/thriving is that this entire debate alerts us to a growing prevalence for what could only be described as service user/refuser/survivor cannibalism.
To attempt to shame, dismiss and discredit a group of people who have already suffered horrifically at the hands of psychiatry on the basis that they don't fit your prescriptive paradigm is deeply unhealthy.
To mention in the same breath notions of 'spiritual movements' afoot leaves me speechless. I suggest you sit down and read a little Will Hall if your interested in exploring issues of compassion and spirituality in the US in relation to people who've had experience of emotional/psychological distress and are building communities that are truly radical and egalitarian.
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Thriving on Lithium?
From: Shannon O'Neil. "somewhere between recovering and thriving", London, UK
Date: January 25, 2010
The concept of thriving is an ideal for many service users. But the path to recovery is often a painful journey - from victim to survivor to thriver. For me the journey is as important as the end goal - just as well as I dont seem to fit is with Ms Aslan's interpretation of thriving!
My mental wellbeing is about recognising and most importantly accepting when I'm playing victim, surviving or thriving and trying not to beat myself up it. Thankfully I'm becoming more skillful at this acceptence malarky as in the past I would've read Ms Aslan's comments and thought "You're a failure, you're never going to recover as your still taken meds, seeing a shrink etc etc.\"
Does current use of psychiatric intenvention really mean that you aren't thriving? That line of thought seems a bit limited to me. Don't get me wrong and I am all to aware from my own experiences just how awful the psychiatry can be and have spoken about these very publicly. But not using (if you think it helps) the medical interventions available seems like cutting your nose of to spite your face. My friends who are blind have independence with the support of a cane or a guide dog. My friend who has diabetes has independence with insulin and carb counting. My friend who has epilepsy lives an independent life with medication. So why shouldn't I be able to thrive, or shout "I''m in recovery" just because 900mg of lithium each night helps? Maybe it's because I'm another sold out professional service user!
As a lead in user involvement in a national charity and a deputy chair of an NHS trust I'm aware that I'm in a privleged position. I believe that managing these roles in my various fluctuating mental states helps keep the message real. I'm not someone whose totally recovered, imposing my views - and my periods of poorer health can be a timely reminder to colleagues about what they need to do to be accessible to all service users. Sometimes I achieve things at work by being radical/off the wall/ different and sometimes I play a longer seemingly more compliant game. Neither of those are do with with whether I take psychotropic medication or Iam seeing my psychiatrist that week. I am insulted at such a suggestion.
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Why the copyright, Aslan?
From: Jan Wallcraft, honorary fellow of University of Birmingham, England, UK
Date: January 25, 2010
I am not sure who it is Marion is aiming at in this piece. She throws out judgemental statements at every turn - having a go at service user representatives who don’t fit with her arbitrary model of ‘thriving’; at the model of recovery itself, which most service users now agree has been badly, maybe even fatally, damaged by being linked to Government employment targets, and along the way slinging a cheap Daily Express-type shot at people on DLA.
If Marion is truly the kind and gentle soul some of her supporters claim, I'd have thought she would show a bit more temperance than she displays in this opinionated opinion piece.
Marion didn’t invent the concept of thriving, which according to her website she has the nerve to claim a copyright over! Since she is making a living through her ‘thriving’ industry, perhaps she has a vested interest in claiming her way is the only right way?
For most of us, however we earn our living, our main concern as survivors and service users is living our life in the best way we can, and the way which makes most sense to us, whether that is with or without a ‘mental illness’ label and medication. And along the way doing what we can to work together, help and support each other, not criticise, judge and dismiss each other’s choices.
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Stop this survivor cannibalism
From: Louise Pembroke, 'unrecovered' service user, London, UK
Date: January 22, 2010
Nothing is black and white. I don’t subscribe to a religion but I unreservedly respect anyone’s faith and would access it for someone if required. I have never promoted or subscribed to a medical model of mental health but I have to respect survivor’s different frames of reference including medical and I refuse to merely blank them out. None of us can gain say what a person’s needs are to get through the day even if it’s something we wouldn’t choose for ourselves. I don’t promote medication, I’ve always vigorously argued for BNF level of information to be given and individual’s choices respected, for chemical sovereignty of our bodies to not be violated, but I refuse to blank people who do take daily medication. I don’t care what a person’s definition of recovery is, so long as it’s THEIR definition, equally if recovery is meaningless to a person that’s ok too, but I would still hold the hope for a better life which is about meaning, self worth and living as well as we can. It doesn’t matter whether a person chooses to take medication or take support from services.
As for benefits, again this isn’t black & white. People who are in paid employment can also receive DLA, not everyone on DLA is not working, it’s not a benefit purely for people not in work, it also applies to people in work to help them stay in work. Some people on DLA do not qualify for Income Support, housing/council tax benefits so are not on high levels, people’s circumstances vary considerably. Some people try really hard to get into paid work but find part-time means getting into debt but full-time means stress beyond their ability to cope and yo-yoing back and forth from work-benefits isn’t always a good thing for some people as it can mean spiralling debt and humiliation, even with decent support. It’s not always a case of people are not trying hard enough or don’t have the right support, it’s a complicated picture, but if we say that recovery work is only for those who reject illness/medication/service support and chastise people for being on benefits then what happens to those people? So we just blank them? We’re in danger of creating a two-tier system here of recovered/unrecovered, deserving/undeserving.
If I feel I’m being dictated to as in this picture is what constitutes recovery and nothing else measures up then I’m going to dig my heels in even if it were a picture I liked. I sometimes take medication, I take service support, not because I’m a weak dependant idiot but because I find it helpful. Not everything in life can be resolved or healed. I live with the uncertainty of transplants, will they survive as long as me? Shall I have further surgery if this trial fails knowing just how long the recovery period is, just how grim the complications are and how this can trigger spiralling distress even with the best support in the world.
Nothing can take away the uncertainty, I can’t ‘think’ my way out of that all the time. Some people adapt to temporary or permanent changes/disability and others do not. Are those who don’t cope as well weak, not trying hard enough? Can we just have a bit more kindness and humanity because these days it feels so very judgemental. Are we recovered, are we recovered enough, are we on medication, are we using services, are we working, are we working enough, are our beliefs radical enough…for some people this means shit to them. They’re just trying to make it through the next 24 hrs without any fanfare, glory in their user/survivor status, illness, diagnosis, seat at a committee table. It seems to me that recovery is tearing more people apart than uniting us. Is it worth it?
And yes Amy, I know Walter Freeman did the ice pick lobotomies, I know what damage physical treatments can wreak having a close friend with Tardive Dystonia. But words and the non physical also damage. Some people are crushed by a diagnosis, judgement, behavioural regime or being sutured with no anaesthetic in an ED, these things can kill the soul too. If one person says you’re hopeless and the other says you’re not but ‘only if’…what is the difference? The development of recovery in the UK has not been the same as in the US and, yes, I’m aware of some US work. I greatly admired Judi Chamberlain and I remember an email conversation I once had with her about survivor cannibalism and she told me this happened as much in the US as it does here. None of us are perfect. Let’s just please stop telling each other that ‘this way is the only way’. Can we please draw our own pictures
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Beware the wolf
From: Amy Smith, service user and 'Thriver'. USA
Date: January 25, 2010
Gee, you guys are so mean to each other! Here in the United States if we get radical in any way, the organizations attack us, we get fired from our jobs or lose our benefits or services, things like that, but the peer community generally respect each other’s right to their own point of view.
I have heard Marion present many times and read most of crazydiamond’s material, and I just don’t see these mandates or expectations that you all are complaining about. What I see is another way, a different, a voice that suits ME, and to tell you the truth, a voice and a community I never had before. I am grateful for it, believe me! Nevertheless, I would never suggest to anyone that my way should be his or her way, and I have never heard Marion express that idea in any way, either.
I drew a little cartoon last night, scared sheep in a huddled mass in the middle of a corral, staring anxiously at the wide-open gate, muttering anxiously together about who should be brave enough to go over and shut the gate, to protect themselves from the evils of the world outside. And never noticing the lip-smacking wolf that is inside the corral with them! Well, folks, you can have your corral, welcome to it, I am out the gate with Marion! Adios from the USA!
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Suppression of alternatives
From: Catherine Clarke, carer, England, UK
Date: January 25, 2010
I did not hear Marion ‘having a go’ at those service users who were still being medicated with psychoactive drugs. She was clearly stating that people who want to remain on psychoactive medication would not be suitable for the self-help “Elemental” group.
The tragic thing is that many people, and that includes mental health practitioners, service users and carers, are being brain washed by the Department of Health about ‘schizophrenia’ and its treatment. I think this situation results from the suppression of alternatives way of caring for people in distress together with the harm psychoactive medication causes.
In my experience there are far too many service users and carers who because of their salaried position will just toe the line with all the dogma ozzing out of the NHS - for fear of loosing their service user/carer professional status and salary. I also recognise how difficult is for some service users to be physically present at NHS meetings because of the resurgence of bad memories due to the hand of practitioners who have been either physically and psychologically abusive.
It is fact that many service users receive financial benefits, which in some cases might well be abused, and on the other hand some will not be abusing the benefit system. I also recognise how difficult it is as people begin to recover/thrive who experience their financial benefits dwindle.
What I heard Marion say was to give her own subjective account of her experience in mental health and what she was doing about it. And I find it sad when a positive progressive situation instigated by Marion can potentially turn into a slagging match.
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This hatred for each other is sickening
From: Louise Jones,, lecturer, UK
Date: January 27, 2010
The alternative is just to walk away completely...from the service user/survivor community as well as mental health services. All appear to offer very little, kindness to the soul and spirit. I find the current culture of survivor cannibalism and survivor celebrity (as well as the canalisation of some service users) ..((as witnessed here))...as repulsive and sickening as biological psychiatry.
On the DLA debate, to be fair to Aslan I actually think she was referring to the array of disability benefits above rather than just DLA. (i.e ESA, IB, IS, free prescriptions and Freedom passes etc). But that’s a game of semantics, who ‘earns' or receives how much, when and for what. The welfare system, like the mental health system is not a caring one, it's there’s to deliver an ‘outcomes’ based on certain pre-determined criteria. It’s certainly not the fault of people who become ‘stuck’ within either system; likewise, the system is not the place to lay all the blame. It has to be about the relationships that are created and maintained and the meaning that are attached to those relationships. All in all its a system which will never be perfect or meet all the needs of all the people all the time...At the end of the day though, we all got to eat and find a way to pay the rent!! At times I have ‘earned’ more being on benefits than in paid employment. At other times, people on benefits clearly receive more than I do from the state than I have from a current employer. (That’s not a new conclusion, Marion, to figure that sometimes some people are better off on benefits/find it easier for a whole array of valid reasons to stay on them aka ‘better the devil you know!!!!)
Debates about the ‘have's and have nots’ are not helpful as at the end of the day I’m just grateful I live in a society where the majority (in most cases) of adults/children , dogs and cats don’t end up living and dying on t he streets.
I think in the end it comes down to choices. We all have choices to make. I know I make some bloody awful ones sometimes. The choice I made to be a psychiatric refuser was the best one I ever made as all in all I think I am doing better since I got all the doctors out of my life. That does not mean I am ‘recovered or ‘thriving’ or any less distressed that I may have been last week or last year .... Seeking ‘the answers’, some ‘truth’ in someone else, or some ‘alternative’ theory or group is not the answer either.
Speaking as someone who has not taken an anti psychotic in 10 years, takes the occasional sleeping tablet, but still has (distressing) periods of active self harm and hearing voices, is on a low income (but not dependent on any disability benefits).. I certainly don’t think I am ‘thriving’... and I certainly don’t think any one person, has the answer or ‘truth’ within any theory or classification system or any Elemental ‘approach’... Maybe the only ‘truth’ (or perspective) is that life is sometimes f***ing hard. .. and no one said it was meant to be ‘nice’, or ‘fair’...
What I guess is really sickening in reading all this above is the degree of hatred we appear to have for each other. Not defending Aslan, and certainly not in support of her ‘thriving’ version of recovery, I think a few key quotes have been taken out of context by the person who wrote the article above to generate a debate such as this...almost for the sake of debate’s sake because as much as Marion is not offering any ‘radical’, ‘new’ , ‘alternatives’ to what has gone before ..... It seems the debates always end up back at the same place, and as much as I’ll happily rip apart the medical model I’m starting the belief that the real enemy is within.
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Thrive in the hope
From: Chris Evans, company director, UK
Date: January 27, 2010
Having read a copy of Marion’s book, “The Art of Thriving,” I fully agree and support her views and methodology for recovery from mental stress/trauma. However I can understand why some people are upset by some of the statements in it.
In the foreword the phrase written by Olga Runciman, “…those service users/consumers who seem satisfied to be the lap dogs of the psychiatric system.” is harsh and will be offensive to such people.
There is so much anger and frustration in the way pharmaceutical companies have undermined and dictated the way human stress conditions are dealt with and inevitably some of the language used by people involved will reflect this.There is a shocking history of abuse, chemical and physical that has affected past and present service users and many campaigners are determined to right the wrongs and protect future sufferers.
There is incontrovertible evidence of failure to disclose or deliberately manipulate drug trials to favour psychotropic medication. Why should you ingest substances that have horrendous known side effects when the trials show they perform no better than placebo? A paper by Irving Kirsch states: ”Meta-analyses of antidepressant medications have reported only modest benefits over
placebo treatment, and when unpublished trial data are included, the benefit falls below
accepted criteria for clinical significance.”
Anti-psychotics have a similar history and have only served to delay and subvert recovery. How could there ever be a pill to cure a stressful life situation? People need time, sympathy, love and understanding. As a society we cannot afford not to afford this.
Marion has turned her experiences around from anger and frustration to a message of hope that she wants to share. Hope against a background of fear, repression and stigma.
Please embrace that hope and maybe you too will thrive.
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Aslan's fearless spirits took my campaign to new level
From: Grainne Humphrys, Elemental Lead, Ireland
Date: January 27, 2010
I would like to invite Rosa Corcoran to raise awareness of 'The Incarceration of John' and 'Free John' campaign here in Ireland, that Elemental UK and Marion Aslan have taken to a whole new level. Marion's fearless spirit has given me renewed energy to fight for John when I was losing hope.
You may have read the interview I did with Keith Falkiner 'Give John a Chance to be Dad' in the Daily Irish Star on Sunday. This is a human rights issue. John has to date spent 4 years locked up. He has been drugged into oblivion on exceeded doses of dangerous psychotropic meds, so much so, that he sleeps most of his days, vomits, has turned yellow in the past from liver (or kidney) damage, developed tardive dyskenisia, akathasia, his teeth have rotted due to continuous use of largactil, if he expresses anger he gets a clopixol depot shot, he's on four meds plus sleepers at any given time. He gets barely any fresh air or exercise and his appearance is shocking. They have done nothing to rehabilitate him because there is no rehabilitation team in place for long-term residents (psychiatric prisoners). The Carraig Mor centre (where John is incarcerated) was highlighted as part of state inspections into the country's 68 psychiatric units which found some wards in some facilities "unfit for human habitation". The inspection of the Cork institution (Carraig Mor) by the Inspectorate of Mental Health Service found it did not have a rehabilitation team in place to help long-term residents.
Marion has shared the burden and outrage I feel at the 'treatment' of my partner and the injustices he is enduring. Along the way, I have encountered a wall of fear, prejudice, discrimination and lip service. But not with Marion and Mike.
Marion Aslan puts her words into action. 'The Incarceration of John' video she has made John on youtube has already had 1,277 hits or thereabouts.
I would like to end my comment with a quote from Al Galves' (an American psychologist) wonderful paper 'The Health of Psychosis': "The way in which our society treats people who experience the symptoms of schizophrenia (or altered states) is sickening, horrible. We immediately pump them full of powerful antipsychotic drugs. The drugs get in the way of the healing process in which the psyche is engaged and turn people into zombies and chronic mental patients." (This is what has happened to my partner, John ). What we should do is provide such people with a safe place in which they can live without any pressure to "get better", "stop saying those things" or "straighten up". A place in which the staff will just be with them as they go through the healing process in which they are engaged. A staff that will help them go through the experience, make some sense out of it, ultimately learn from it and come out the other side healthier, more balanced and more whole than when it started.
To my mind, this is what wellness models are promoting; the Thrive model and the Renew model.
Marion and Mike, as a team, deeply understand this way of working and are encouraging others to move away from the traps of the traditional illness model. Their work is profoundly important and refreshing and real. To my mind, this kind of approach saves lives.
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Perhaps the USA works through differences better?
From: Jan Wallcraft, honorary fellow of University of Birmingham, England, UK
Date: January 27, 2010
This debate has got polarised in a weird way, with people like Louise and myself and others who object to Marion's assertion (that she is entitled to judge who is 'thriving' and who is not) being characterised as pro-medical model.
Anyone who has read anything I or Louise have read would know that is the opposite of the truth.
I have been totally opposed to the medical model since my own experience of ECT and abuse by a shrink many years ago. I don't take medication of any kind and I am not on benefits. But I consider I've been fortunate in some way (not quite sure what way that was, I don't feel very fortunate) and I am not arrogant enough to make judgements about others who do take medication or who have not escaped the psychiatric system yet.
As to knocking people on DLA, - what IS that about? People who get DLA have to go through a strict assessment, and usually get it because they actually need it to pay for necessary support. End of story.
If Marion's system works for some people, that is well and good. I have no problem with that. But I object to her passing judgements on everyone who doesn't see things her way, and to those of her 'disciples' who echo her words whilst knowing nothing about the people they are criticising. We are only responding to Marion's quoted words, if she wants to retract those, cool, if not we have a right to reply.
It is a shame that people who should be working together to transform the system end up name-calling, and I do think you guys in the USA have a better way of working through your differences, perhaps some of you could come over and help us learn how you do it?
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Mental health politics was not always like this
From: Louise Pembroke, 'unrecovered' service user, London, UK
Date: January 27, 2010
So people are either employed users toeing their trusts party line in order to keep their salary or playing the benefits system or institutionalised campaigners refusing to face reality and opposing Marion’s version of recovery means you’re pro medical model and too afraid to recover?
Mental health politics has become aggressive and excluding, it never used to be like this [and NO I don’t place that at Marion’s feet - this has occurred over a period of years].
I can see why some people have walked away from it, I think I need to do so too it’s not why I ever got involved within survivor activism and mental health politics, I wanted to contribute a difference and I promoted self management. I’m not perfect, I often wish my life was quite different and I don’t know how to action that so my position is not one of threatened institutionalised ease, it’s one of how can I live within my skills and limitations to the best of my ability? Sometimes I think I’m doing really badly at it, sometimes I think I’m doing the best I can, but that’s for me to judge, and for others who know me well and care about me.
I do actually appreciate the hard work Marion would have put in to be where she is, and I don’t doubt that like me and everyone else posting here that the general desire is to make a difference and earn a living. It just saddens me that today’s climate is so very adversarial and accusatory and it seems to get harder to not be drawn into that, I also think the web has its limitations in discourse because it is more likely to get heated in a certain way than in face to face discussion. This is not uncommon with online forums. I think I need to retire from mental health politics for my own sanity as sometimes I think it actually hinders my own ‘recovery’ [whatever that is] or at least can make me feel ‘ill’, I’ve thought that for a while now, so if anyone wants to judge mine then offer some construc tive suggestions as to how I might do it better.
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I'd rather not be a danger - so I take medication
From: Jill Goble, volunteer for Creative Cafe, Brighton, UK
Date: January 27, 2010
You and Marion don’t sound like your thriving, Amy. You sound hypercritical and insensitive calling us sheep and making out your way is the only way. Putting down people on benefits and saying you're better than ‘wobbly service users’. How’s that for delusions of grandeur? You sound like you’ve put on these ‘recovery is
compulsory’ zealot masks but keep saying ‘I’ve recovered. I am thriving’ doesn’t make it true. You're still mad people underneath just like people are still old people underneath face lifts and cosmetic surgery.
It’s still hard to live with being mad whichever ways you try and I’ve tried most ways by now. It was dangerous when I knocked a candle over while manic and my house burned down and I was locked up for over a year afterwards and since then I’ve settled for taking some of these
medications you despise. I’d rather not be a danger to myself and others thanks all the same. And what do you keep saying you’re r ecovering and thriving for anyway?
So you can conform and be like sane people in the unhealthy society out there?
Are you going to recover and thrive enough to run a slaughter house and kill us“sheep” off? Like Eugenics. Because we didn't meet your recovery ideal targets? Except you can’t even tell the difference between sheep dogs and frogs anyway?
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A striver as well as thriver
From: Sylvia Forest, 'Thriver; Stockport, England, UK
Date: January 27, 2010
I have known Marion personally for about 18 months and do not understand the venomous comments made about her in these postings. This is not the woman of integrity that I know. This is not the woman who would not take away someone else’s human right to choice in the ways that her human rights have been violated in so many ways.
Marion has never urged, coaxed or even suggested that I should stop taking my medication she has simply talked about her own experiences and listened to mine. She has been an inspiration to me in her determination to thrive and I am trying to follow her lead in finding my own determination to do well and overcome my own emotional distress. It is sometimes a struggle and I too sometimes pay the price of knee-jerk reactions from those who don’t take the time to look or think beyond the initial impact of the words in order to gain deeper insight and understanding of what I am trying to explain. To think “outside the box” is a risk, to live "outside the box” is a greater risk because you are showing what is possible to achieve.
Marion wants us to be achievers and she has helped me to want to achieve more for myself too.
We have a group in Stockport based on the THRIVE programme and it is a safe place for people who want to find positive ways to improve their mental well being and their whole lives. They support each other in their struggles, they explore new ideas to complement and enhance their recovery journeys, they are kind people and they know how to have fun whilst they are doing all this.
That is the example that the Marion I know has shown. She doesn’t just thrive – she strives too – strives to do the best she can for the people she cares for – that is for everyone who experiences emotional distress whatever form that takes.
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Think twice about judgemental statements
From: Jan Wallcraft, honorary fellow of University of Birmingham, England, UK
Date: January 27, 2010
Since Marion Aslan had a go at survivor workers for not being 'fully recovered' and at people on DLA for playing the system, I think it is no surprise she's getting some flak. Whatever she meant by these comments she might know this is going to be undermining and distressing for a lot of people. Is she suggesting that only people who are, in her opinion, 'recovered' to the extent they don't use any medication or mental health services are fit to do involvement work, otherwise they just prop up the medical model? It certainly sounds like that! And having a swipe at people on DLA at a time when this very necessary and justified benefit is already under Government attack is hardly likely to win her friends.
Marion is entitled to make a living doing what she does and I am sure it helps some people, but she should think twice about making sweeping judgemental statements about other people's coping strategies and about pushing her version of the rather overused word 'Recovery' as the only TRUE WAY.
What with Marion's purist version and the Government's 'get a job' version I am beginning to think there's no hope any more for the real concept, which is people defining their own journey to recovery. People who follow the purist version of Recovery are totally misreading the Recovery 'guru' Pat Deegan. Look again at what Pat actually wrote, purists, she has a very open-minded approach, but now everyone seems to want to redefine it to suit their ends. Pat never suggested people had to be 'fully recovered' in the sense of not needing any medication or support systems!
Marion is saying that recovery is being hijacked by NHS trusts, which is true. But then she makes a sweeping statement about unrecovered service users who are failing to challenge the medical model and making it easier for trusts not to change. Given her definition of recovery, very few people would fit this, and the fact is many service users do challenge the medical model and take on PCTs daily for no pay at all. I feel insulted on their behalf by the erroneous, judgemental statement Marion made about service users who get involved. Perhaps she was quoted out of context and would like to clarify this statement?
I don't doubt that trusts often select people who don't challenge them too much but that doesn't apply across the board in any case, I have friends who regularly go to PCT meetings and fight their corner with very little satisfaction in terms of outcome or visible change but keep on going because they believe they just have to try their best. How helpful is it to label them as 'naive'?
And how on earth are people ever going to 'recover' and 'thrive' if the work they can do, e.g. survivor activism and user involvement and voluntary work is invalidated by Marion and her friends because they aren't perfectly recovered, and disallowed and penalised by the Government because it looks as if they have recovered because they are doing it!
What a can of worms!
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Work together for change
From: Virginia Pulker, Mental Health Worker and Elemental Lead, Australia
Date: January 27, 2010
As someone who has had the great pleasure of working alongside Marion in both personal and professional capacities I am deeply saddened to read such unkind things about her from people who clearly don’t know her.
Just because she has made a few comments in this article doesn’t make her the person some of you want to make her out to be. Anyone who has met Marion knows, like I do, that she is an incredibly warm and loving woman. Positive, patient and non-judgmental. She accepts and supports anyone who asks for her support, wherever they may be in their recovery journey. She does this tirelessly and at only a cost to herself. In fact one of the things that I so admire about Marion is that she values everyone’s story equally and doesn’t see her recovery as exceptional or “better” than anyone else’s.
Despite what some of you may believe she doesn’t rub her own recovery story in people’s faces or look down her nose at anyone. Is it not dangerous to make such strong judgments about someone based on an article where their comments can be taken out of context? Or make assumptions about their character based on what you think they’re saying? I don’t believe that Marion claimed anywhere in the article to be a radical. I don’t believe she has tried to “force” the concept of thriving on anyone or see her recovery journey as superior to anyone else’s. I believe Marion's criticisms were largely directed at services rather than the people who use them. And she may have said some challenging things about service user representation in general but I don't believe that anywhere in there was a attack on anyone. I feel the response is a little disproportionate to the original statements. I don’t believe that Marion has made any criticism of other people's struggles and I don’t believe she is “judging who is thriving and who is not”. What she does provide, however, is a powerful example of how someone can emancipate themselves from the system and come out of mental distre as a stronger person. She is putting her energy behind a philosophy that gives people hope and I for one find that refreshing and delightful.
I don't think that anyone who has responded to the original article is pro-medical model and I think if you looked at what Marion has written about Thriving and about what Elemental stands for you would find it interesting and probably not so different from your own beliefs. Imagine if we could all work together- we would be an unstoppable force for positive change.
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I've seen many tokenistic service users
From: Fay Saunders, mental health worker, Birmingham
Date: January 29, 2010
I was truly shocked at some of the replies to Marion's article and how many of you seemed to take this as a personal insult .
Having worked within the mental health system for the last 9 years, I have come across many service users who are employed by trusts in a tokenistic manner often having no political insight into anything alternative to a psychiatric model of care. I have attended meetings where people who are often too unwell to gauge insight into anything other than the powerpoint presentation that has been dictated to them. Reading Marion's work the only thing I have to add is Thrive on, maybe one day others will truly realise what their capabilities are and dare to step outside the conventional methods of treatment and fully take on board that it is us who make our own recovery not a pill or a meeting with a therapist. Yes these treatments can be helpful but they are only a stepping stone to self actualisation/fullfillment.
Marion your work is inspirational and at least you have not sold out on your own personal beliefs unlike others who may not even have them, just a dictation and diagnosis. At least you have an opinion many others are too institutionalised to believe there is an alternative . Shine on you Crazy diamond.
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Aslan supports my charity
From: David Clarke, Chair of The Kerala Partnership, England
From: February 4, 2010
The news headline at the top of this discussion advised readers that a storm was brewing. But I did not expect it to centre so personally on Marion Aslan. Disagreement on concepts, tactics, and approaches is one thing but attacks on the individual seem inappropriate.
In terms of remarks about 'making a living on the back of thriving', may I remind everyone about the message on the back cover of the book. Marion stated: 'The Art of Thriving is sold in aid of the Kerala Partnership registered charity.."
Among other things in life I am chairman of the charity and greatly appreciate the support - financial and other - given by Marion over the years.
Perhaps it might be possible to keep remarks centred on the issues under consideration, rather than on the author.
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We now need Aslan's perspective
From: Rowland Urey, Chair, Oldham Open User Forum, Oldham, Greater Manchester and Elemental Lead, UK
Date: February 4, 2010
May I say in the first instance I am apalled and shocked by the villifacation and character assasination from certain quarters of Marion Aslan.
Do I have to remind them that principles is not a fashion shop on the high street, also is it not the first duty of the seeker after the truth to aim directly at the truth, without looking to the left or the right? Perhaps a quote from Marion will keep things in perspective. We firmly believe mental distress to be a human condition which has been medicalised by professionals who create within society a sense of other and disenfranchise often vulnerable distressed people. This is our statement of resistance. Elemental's core values are: the individual owns their own recovery journey, we reject the reductionism of medical theories of distress, we reject the medicalisation of misery, we network like-minded individuals internationally for mutual support, we support imformation gathering and dissemination of information and research about the concept, process and elements of recovery and thriving, campaigning against medical labels that say little or nothing about actual traumatizing origins of distress.
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We keep trying
From: Peter Relton, Senior Service User Development Worker, Bradford District Care Trust
Date: March 5, 2010
Just read through all the comments - I'm somewhat taken aback at the heat generated by this. I find myself in agreement with quite a lot of what Marion says. I have no doubt that there are real problems with the recovery concept, particularly how it is being interpreted by the government and by mental health services. However, it does seem to me that there is also a danger in trying to replace one model with another, in this case that of 'thriving'.
Surely there are flaws in any model? I do not get the sense from Marion that she has given consideration to possible problems with her model (which, indeed, some people have flagged up). In reality, no one model, no one approach, has all the answers for everyone-and if it is claimed that one approach has all the answers, I think that is where things become potentially dangerous.
This is judging purely from the story -I haven\'t read anything else by her. In relation to her assertion that NHS Trusts are handpicking naive and unrecovered user workers, I'd just say that i'ts very, very difficult to get bureaucratic systems to change, no matter how radical or 'recovered' you are, even with the support of professionals and senior managers. But we keep trying!
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Nothing radical about Thrive
From: Aron Sterk, Ann Lee Centre, Manchester
Date: November 2, 2010
I do not know Marion Aslan personally but I do know many people who praise her and the work she does.
I am sure she is a the empathic, warm and supportive individual people say she is, but that does not put her ideas or statements above criticism.
I remember joking to a fellow activist some years ago when 'recovery' became the new buzz word, that it wouldn't be long before some people were being labelled as 'recovery-resistant'. I little thought that label would be coming from fellow survivors! However inspiring or caring Marian is in herself her words and attitudes belittle and disempower many people who I have immense respect for. Some of them aren't 'thriving', some of them are barely surviving, but they are doing it with immense flair and courage and I for one would be last person who would want to label or judge them for not 'doing better'.
Do those of you being so judgmental not think some people have had enough in their lives without being disparaged as second-class survivors because they cannot face the "hard work that must be put in". Dismissed as earning "wages for their madness", their efforts to put some input into changing the system dismissed because of the derisive expenses they receive as though 'consultancy' services like Crazy Diamond aren't themselves complicit in the system. Let's be honest real radicals don't get paid by the system!
But there is nothing in fact radical about Thrive, because it will simply leave the status quo in place - where else are all those who don't measure up to Marian's ideal of recovery going to go?
Once, as Louise says, it was different, there was a mental health survivors movement, now we have mental health entrepreneurs selling themselves and their copyrighted, branded products; the legacy of three decades of Thatcherite/Blairite neo-liberal individualism. More power to them for making a living, but, no mater how nice and caring they are, when such people are wrong and use their privileged position as survivor celebrities to insult others they need to be told so. Being politically critical means being self-critical as well. Personally I find it sad to see people I respect defending indefensible statements and attitudes.
The project where I work, the Ann Lee Centre in Manchester, has only one understanding of recovery and that is the recovery of as much real control over one's life as possible, and that means the individual controlling if they want help or medication if they decide they need it; how much, when and who they get help from. That is a hard fight for the recovery of their human rights and respect. It is they who need allies, not the Psych system in doing them down.
