Building a Bridge to Hope

Lisbeth Riis Cooper
13
201

Hope Heals.

This incredibly simple statement seems too good (or too naïve) to be true, particularly when talking to families and individuals who are experiencing deep emotional anguish.

When we are fighting desperately to hang on to life, “hope” may feel like too much to hope for.

And yet, the truth remains: hope heals.

It was true when Dr. Karl Menninger held doctors accountable for enhancing patients’ hope in his 1959 address to the American Psychiatric Association.

It was true when Victor Frankl, Auschwitz survivor and one of psychotherapy’s founding fathers, emphasized the link between (wo)man’s “courage and hope” and “the state of immunity in his body.”

Hope heals.

While the healing nature of hope has been the subject of philosophy and religion for thousands of years, hope has even made its way into the mainstream medical model. Over the past 40 years, there have been numerous attempts to quantify its healing impact through a variety of formal measurement scales from Gottschalk Hope Scale (GHS) to Erickson’s Hope Scale (HS) to the Beck Hopelessness Scale to the Snyder Hope Scale (SHS) to the Hope Index to the Miller Hope Scale (just to name a few). It would seem that many social scientists are staking their claims on hope.

With all of this emphasis on the importance of hope, from early philosophers to present-day “hope researchers,” why does hope seem so remote for families who are experiencing extreme emotional distress?

It is understandable why individuals and families feel hopeless when they are struggling alone.

But why do we continue to feel hopeless after we reach out for help?

It would seem that hope is one of the best-kept secrets in the mental health care system.

There is credible, longitudinal research by the World Health Organization and Courtenay Harding that demonstrate even the most “intractable” mental health challenges aren’t so intractable. The majority of those diagnosed with schizophrenia do go on to experience recovery. Innovative early psychosis approaches like Open Dialogue in Finland continue to prove this to be true. There is reason to hope.

So what is going on here? Why do families keep reaching out to us in despair?

It is hard to remain hopeful when we reach out for help and our family members are instead given medical diagnoses and all that often comes with them—prognoses that often lead to lifelong illness, disability, stigma, social isolation and overreliance on medications that pose significant health risks and side effects.

The mental health statistics that accompany this approach are even more dismal. Exponential increases in disability rates, worsened overall health impacts, and alarming increases in the rates of diagnosis for our most vulnerable populations including children (especially those in foster care) and the elderly.

And yet, hope still heals.

All that hope research tells us so. More importantly, the experience of those who have recovered from psychiatric diagnoses tell us so.

Mary Ellen Copeland, PhD, has asked thousands of people who have recovered from mental health challenges, “What helped you get well and stay well?” and found that hope is central to recovery.

So, how can we get to hope from here?

How can we build a bridge from hope-stealing physical and emotional pain, hopeless diagnoses and prognoses, and hope-numbing side effects?

Bridge to Hope

How can we look within own families and communities, acknowledging the full depth of suffering and confusion, including the losses of those most precious to us, and be able to say and believe, “hope heals”?

Perhaps we can’t in the face of overwhelming evidence to the contrary. Perhaps we start by building and being bridges to hope.

We may need to make sure our own hoping self is alive and well so we can hold hope for others until they are ready and able to hold it for themselves.

But what if we, as family members and supporters, are feeling hopeless? Who can hold the hope for us? This is when the support of other families with lived experience is not only helpful, it is crucial.

We are discovering first-hand how hope can be nurtured even in the midst of crisis when families come together to learn and practice hope in a recovery-oriented community.

Mother Bear has recently launched an online family mental health recovery course in partnership with the Family Outreach and Response Program in Toronto. Thirty six of us are learning how to support our family members and ourselves using principles championed by the peer recovery movement—the importance of fostering hope, focusing on strengths, understanding mental health and distress on a continuum, and the healing power of community.

During our 8-week pilot program, we have all taken turns encouraging each other as we learn to practice new recovery attitudes and approaches. We recently completed several lessons on hope and worked with a concept called “reasonable hope” developed by Kaethe Weingarten, Ph.D.

Reasonable hope can help us build a bridge to creating more authentic hope in our lives even in the midst of challenging circumstances, uncertainty and even despair.

Weingarten identified five characteristics of reasonable hope, which we are understanding and interpreting in the following ways:

Relational. Hope happens between things and in relationships. It is held, shared, communicated, birthed. It shifts and moves, waxes and wanes, as we interact with ourselves, each other and our environment. It can be likened to the African concept of “Ubuntu,” which Archbishop Desmond Tutu described as “being enveloped in the community of other human beings, in being caught up in the bundle of life.” Hope is like this, caught up in bundles of shared experience.

Is something to be practiced. Hope is a verb more than a noun. Rather than an internal feeling we have or we don’t, hope is a quality we can actively cultivate through the choices we make. Hope is an ongoing process, something we practice in the here and now—not something we passively wish for in the future—that makes us more “hope” prone.

Sees the future as open, uncertain, influenceable. An uncertain future creates space for change, growth and transformation. It opens the door to possibilities beyond our current expectations. Hope is a process where “the soul turns toward a light which it does not yet perceive, a light yet to be born,” as is eloquently described by the French philosopher Gabriel Marcel.

Seeks goals and pathways. Reasonable hope is both practical and fluid. It looks for what goals can be accomplished now (and identifies ways to get there) and adjusts as new possibilities and pathways become available.

Accommodates doubt, contradictions and despair. When understood as a dynamic, moment-to-moment practice, hope can be messy and spacious. It can hold the whole of our lives with all of its losses, joys, setbacks and surprises. Instead of closing our eyes and making a wish, we can open our eyes wider and turn toward a light that may not yet be born.

Reasonable hope is only one of many ways we can bring hope into seemingly hopeless situations. A bridge from what is true now to a place where we can dream and hope again.

But maybe, in the end, any kind of hope will do. And someone to share it with.

Wishing you all hope and healing in this holiday season,

—From all of us at Mother Bear

For more information about our online Family Mental Health Education program, please contact Jennifer Maurer at [email protected]

References:

Copeland, M.E. Wellness Recovery Action Plan overview, books and resources, http://wrapandrecoverybooks.com.

Frankl, V.E. (1963). Man’s search for meaning: An introduction to logotherapy. Oxford, UK: Washington Square Press.

Harding, C. (1987). The Vermont Longtitudinal Study of Persons with Severe Mental Illness, II. American Journal of Psychiatry, 144, 727-734.

Jablensky, A. (1992). Schizophrenia: Manifestations, Incidence and Course in Different Cultures. Psychological Medicine, supplement 20, 1-95.

Leff, J. (1992). The International Pilot Study of Schizophrenia. Psychological Medicine, 22, 131-145.

Marcel, G. (1951/1962). Homo viator: Introduction to a metaphysic of hope. New York: Harper Torchbooks.

Menninger, K. (1959). The academic lecture: Hope. American Journal of Psychiatry, 116, 481–491.

Parse, R. R. (1999). Hope: an international human-becoming perspective. Sudbury, MA: Jones and Bartlett Publishers.

Weingarten, K. (2010). Reasonable Hope: Construct, Clinical Applications, and Supports. Family Process, 49, 5–25.

13 COMMENTS

  1. Lisbeth,

    Thanks for your work and clear writing about the important practice of hope. I especially appreciate your comment that “hope can be messy and spacious”.

    Personally, I like to zoom right past “reasonable hope” and into hope beyond reason. This is the hope I like in my daily practice.

    All the best,
    Alice

  2. Lisbeth, This is a terrific post, and a vitally important one. I know for myself I was so fortunate that my friends always held hope. In fact, one friend gave my wife to be great hope. I had been going out with Tish for about a year. She knew I had a history of extreme mental states, which psychiatry calls psychosis. I was very stressed by medical school and started to retreat again into my own reality. My young girl friend was terrified, having never seen me in that condition. We were so fortunate, a good friend, who had seen me go through such periods before told her, “don’t worry he comes out of these states better than when he went in.” Those words of hope enabled her to stay with me, which enabled me to come through the extreme state. We have been married 34 years and have two wonderful daughters. I never retreated like that since, and we have my friend’s hopeful statement to thank.

  3. Hope?

    Tell me, what’s a saving grace?

    Crows.

    The way birds are messengers ~ symbols ~ representatives; storks deliver babies, pigeons deliver messages and crows deliver conflict.

    I noticed that crows seemed to be “following” me. Their presence was so attention getting that I began researching and studying them. I learned that crows are thought to be highly symbolic and their meaning has a wide range. Just as anything else, it becomes a problem – a “mental” problem.

    I began to review my history. I easily found the first instances of crows that I can remember: the Crow family, a foster home. My first day there taught me all I needed to know about where I was.

    I was 15 years old when I was placed with the Crow family. My daughter EmmaGrace is 15 years old and lives with the DeMarco family. My landlord’s last name is DeMarco. The crows are back and they get an awful lot of my attention. It all becomes a “mental” problem.

    What’s a saving grace?

    EmmaGrace emailed me last week. My mind enters an alternate dimension where all a mother’s *valid* worries and questions are contained. The crows are back, what do they want, Emma emailed me – DeMarco DeMarco – and it all becomes a “mental” problem. I’m left with the mental concept: does EmmaGrace need saving?

    Side note whispering, Hope is the Mother of my grand-daughter, who died at three weeks old. Hope and my son lived on Church Street, where their baby was conceived. Hope’s twin sister is Faith. Hope and my son are not together anymore – Hope is now gone from the family.

    Hope. What’s to Hope for? Baby daughters? Baby girls? Their mothers? Families, ripped and torn apart? Solutions to mental problems?

    I’m not exactly sure what to Hope for.

    saving grace
    n.
    A redeeming quality, especially one that compensates for one’s shortcomings

    1. saving grace – (Christian theology) a state of sanctification by God; the state of one who is under such divine influence; “the conception of grace developed alongside the conception of sin”; “it was debated whether saving grace could be obtained outside the membership of the church”; “the Virgin lived in a state of grace”

    grace, state of grace

    state – the way something is with respect to its main attributes; “the current state of knowledge”; “his state of health”; “in a weak financial state”
    Christian theology – the teachings of Christian churches

    2. saving grace – a redeeming quality or characteristic; “her love of music remains her one saving grace”; “her sense of humor has to be a saving grace”; “the saving grace for both developments is that they are creating jobs”
    characteristic – a distinguishing quality

    saving grace
    adjective redeeming feature, asset, good point, advantage, blessing, boon, ace in the hole, mitigating feature, feather in your cap, ace up your sleeve

    Here’s a Hope:

    let “psychiatry” include a MANDATORY “diagnosis” of each and every individual’s SAVING GRACE. It makes perfect sense to Me and I say it is a great idea.

    • Dear mjk,

      It sounds like “saving graces” are your bridge not only to your divine *state* of grace but also your hoping self.

      Thank you for sharing your process of working toward hope or grace. As you strung words, images and thoughts together, I imaging you were stringing pearls together, perhaps for you and your daughter to wear to remind you of your beauty and wisdom, perhaps a bejeweled lifeline to each other and to grace.

      It is interesting how and who defines things as problems. When you mentioned crows, I thought back to my own time living on an Native American reservation, the Makah nation (“Makah” is pronounced the way the crow calls, a bird always present on the rez).

      In Native American legends, crow is the keeper of the sacred laws, Great Spirit, and also has the ability to travel and see past, present and future simultaneously. She is a shape shifter. She brings the possibility of sacred transformation. Which sounds very much like your concept of saving grace.

      I love your suggested diagnoses. I would, in fact, prefer that over the other kind.

      Wishing you and your daughter peace and lots and lots of grace,

      Jen

  4. Lisbeth,
    Thank you for questioning the on-going disparity in hope between the medical model of the illness (bleak diagnoses and dismal stats) and the negative message that families take away from the model. In order for us to be strong enough to be there for our relatives, we must develop our own positive “hoping” mechanisms, instead of just coping mechanisms. It can be learned. While I feel I’ve come a long way myself in developing helpful attitudes, there’s always something more to learn. I’m looking forward to taking the on-line course beginning in January.

  5. Thanks for promoting hope as a cornerstone of human life. After reading your beautiful text, I tried to reformulate/mix it through my own mind and language (I hope I did not stray too far from what you meant):

    It is good practice to not promise more that we can deliver. But hope is what bridges on one side the lack of any guarantee, a possible history of setbacks, and on the other side the need to always continue to try to move forward anyway (at our own pace), and to choose to promote life. We should be cautious when doing promises, but we should hope in a unbounded way.

    There are a few laws of nature that are firmly established, but for the biggest part, our future cannot be predicted, and when confronted with the mystery of what will be, when no science can provide a firm answer, promoting unbounded hope and reasonable optimism should be a moral imperative.

    Hope is the feeling that no matter what we are confronted with, our mind can still be OK.