Opening the Dialogue: Can Families and Survivors Heal Together?


This is the million-dollar question. One that elicits many strong responses and opinions from every quarter: survivors, families, providers, researchers.

It is important to acknowledge, at the outset, that there are those who don’t even bother to ask the question. Perhaps for lack of resources (why bother?) or false or narrow beliefs about the causes of mental health challenges.

If we believe that emotional problems are primarily disorders of the brain, then perhaps taking a “fill-in-the-blank” medical history is sufficient.

However, if we believe that emotional crises and dis-ease are problems that exist between people, in our sticky or not-so-sticky web of relationships, then whether families, survivors and those in crisis can heal together is a much more relevant, if still complicated, question.

Perhaps the most honest answer to this question is: “It depends…”

It depends on a willingness to enter into dialogue; a ability to suspend judgment, to be open and curious; an attitude of mutual respect; a safe environment where every voice can be heard and held with reverence; and, perhaps, the alignment of the stars just so.

But when it works, it really works, as programs like Open Dialogue in Finland have proven and our new online Family Recovery Education classes are beginning to prove in interesting ways.

In fact, research has shown that  family psychosocial education and support has the potential to dramatically improve recovery outcomes, decreasing relapse and rehospitalization rates by up to 75%.1

But easily accessible recovery-based family education is in very short supply. And by “recovery-based,” we mean family mental health education that focuses on hope, strengths, empowerment, empathy, possibilities, compassionate communication, respect, mutual aid, personal responsibility, choice — all the things that are vital for individual recovery, transformation and growth. We know these attitudes, skills and approaches transform lives.

The challenge has been how to share these recovery principles with more families (who seem to be the last to know that mental health recovery is possible).

Last fall, Mother Bear: Families for Mental Health, along with our program partners Family Outreach and Response and, embarked on a grand experiment to provide mental health recovery education for families everywhere using web-based technology.

By everywhere, we do mean everywhere and anywhere there is access to an Internet connection and/or smart phone reception.

By family, we mean the human family. Which includes family members and individuals with lived experience from a variety of vantage points —those in recovery, psychiatric survivors, friends and allies, care providers, community members, educators. Anyone willing to create and support family healing communities based hope, strengths, mutuality, respect, curiosity, and a diversity of perspectives; anyone willing to commit to working on his or her own personal growth.

Sounds good in theory, right?

Except for some long-standing and deep divides between the consumer/survivor/ex-patient movements, family mental health organizations, and mental health care providers. Not to mention the perfectly valid argument that it is not always safe to heal with your family of origin. Sometimes that healing is best done at a distance. A great distance.

Honestly, What Were we Thinking?

“Emotional distress is held in relationships.” 

“Nothing about us without us.”

“That Open Dialogue approach sounds mighty good.”

And many other less-polished but equally compelling thoughts.

Truth be told, we were as nervous as we were convinced of the merits of our more inclusive and trialogical family education approach. There were many unknowns.

Could we transcend not only geographical but also cultural and language barriers? Could we create an intimate and safe online community? Could families and survivors and providers fumble alongside each other with enough compassion to allow and forgive mistakes as we all learn new and healthier ways to relate to and support ourselves and each other?

We are grateful for everyone who has joined us on this new and exciting recovery journey. It has been an amazing ride so far.

To date, our 8-week facilitated online classes have included participants from 22 United States, 8 countries and 3 continents. One family member from Poland used Google translator to participate in class discussions. Class participants have included family members, those in recovery, survivors, peer workers, and service providers. Our class facilitator and family recovery coach gracefully incorporates her experience with pretty much all of these categories (another source of inspiration).

Participants have joined us from different places on the mental health and recovery continuum. While our last class was in session, families had relatives in the hospital, living at home, in college, and living and working independently. We’ve had participants who identify themselves as in recovery, fully recovered and/or psychiatric survivors—a number also worked as mental health care providers. We’ve even bridged the age gap with participants in their early 20s up to their mid 70s.

Together, we have explored the mental health continuum (and our constantly shifting places on it), the importance of hope, how to create healthy boundaries, empowering language and attitudes, compassionate communication skills, dark emotions and techniques for working with them, the meaning(s) hidden in psychoses, identifying strengths in ourselves and in our relatives, and recognizing and addressing our own emotional needs and feelings.

We have not learned how to diagnose each other or discussed the merits of various medical or pharmaceutical interventions.

Our focus, instead, is on the healing that can happen in the “in between” spaces. Those healing places that exist between our fears and our hopes, our current realities and future possibilities, between this moment and the next, and between each other in all of our relationships. This has proven to be very fertile ground for family healing and personal growth. More than enough to fill a lifetime, much less an 8-week online course.

Can Families and Survivors Heal Together?

We believe the answer is yes. And that there is room and value in opening the dialogue as widely as possible to create healing communities with diverse perspectives and numerous opportunities for support —freely chosen, respectfully offered and with the highest expectations for well-being.

We’d love to hear what you believe.


(1) Office of Mental Health Research and Training, School of Social Welfare at the University of Kansas.


 For more information please go to Families Healing Together.


  1. Jennifer,

    Thanks for this refreshing counterpoint to some uncomfortable discussion regarding NAMI posted recently. I love what you’re doing and think it is truly the way to move toward a new paradigm. Institutions can’t answer these questions – people need to answer them together and tell the institutions what is needed. I find myself feeling much more hopeful after reading your blog. We can do this! All of us who care can do it together.

    — Steve

  2. “…by “recovery-based,” we mean family mental health education that focuses on hope, strengths, empowerment, empathy, possibilities, compassionate communication, respect, mutual aid, personal responsibility, choice — all the things that are vital for individual recovery, transformation and growth…”


    I’m one (amongst, surely, more than a few) who’s becoming increasingly wary of this word “recovery” — as it now means so many various things, to various people, in various walks of life.

    For those involved in Twelve Step groups, the phrase “I am in recovery” has long been a somewhat indirect reference to their presumed *abstinence* from certain debilitating habits (perhaps, unspecified); and/or, it’s been their acknowledgement of what they may consider to be a life-long process of striving to rise above such habits (a.k.a., “addictions”).

    [Note — as occasionally pointed out, previously, in my comments, on this website: I myself benefited *hugely* from attending certain Twelve Step group meetings, more than two decades ago. That was back when I was ‘withdrawing’ forevermore, from psychiatric drugs (and, from psychiatry). I am deeply grateful to have had those meetings, back then; but, “recovery” was a relatively short-term project only; I attended meetings for little more than a year, just to get me through that ‘withdrawal’ period (which was, at first, grueling). The quality of my experiences with psych ‘med’ addiction were such that, once I was through the worst ‘withdrawal’ period (which passed in the first couple of months), I’d never become even momentarily tempted to consider going back to psych ‘meds’ of any kind. From that point, forward, there was no temptation to go back to psychiatric drugs; for, they’d initially been *forced* upon me, and I’d been *coerced* into taking them thereafter. (Though, I was not legally coerced, ‘just’ coerced ‘socially’ — with the looming threats, of loss of family support and constant, nearly unyielding ‘social’ pressures… of being talked by family back ‘re-hospitalization’ if I was to seem ‘non-compliant’ with doctors’ orders.) I.e., never had I really wanted them in my life, but psychiatrists had done everything in their power to convince me and my family that supposedly I ‘needed’ them to survive.]

    For many “patients” of psychiatry, “recovery” refers to the potentially quite limitless period and/or process of following “doctors’ orders,” after some personal and/or interpersonal crisis led to psychiatric “hospitalization”.

    Hence, as you are aiming to promote family ‘mental health’ whilst deploying the word “recovery” repeatedly in your post, I’m attempting to glean what it is exactly that “recovery” means for you, not only by considering your definition of “recovery-based” (in that sentence of yours, which I’ve quoted, in italics, above) …but also by studying the context in which you are using it, elsewhere.

    You state,

    We have not learned how to diagnose each other or discussed the merits of various medical or pharmaceutical interventions.

    Our focus, instead, is on the healing that can happen in the “in between” spaces. Those healing places that exist between our fears and our hopes, our current realities and future possibilities, between this moment and the next, and between each other in all of our relationships.

    That’s a wonderful statement and and excellent focus…

    So, IMO, at last, this whole post of yours is very promising, and it leads me to wholeheartedly agree with Steve (above), as he’s called your post, “refreshing counterpoint to some uncomfortable discussion regarding NAMI posted recently.”

    What your organization is offering is apparently so very different from (and even contrary to) the messages one gets from NAMI literature!

    Check out, for example, the following link:

    There (in an article titled, “The First 48 Hours: Telling Your Family and Friends About Bipolar Disorder: Whether or not to tell your friends and family about bipolar disorder…”), one finds the following advice,

    Hopefully, your family will turn into your greatest asset. Your illness can often bring you closer — your shared hardships forging a stronger bond. But the experience can also drive you apart, leaving you feeling unloved, unwanted and embittered. You may have no choice in the end but to break off a bad relationship, but please let this be your last option, rather than your first.

    So far as I can tell, NAMI is not primarily about keeping families together, nor is it primarily about the attainment of recovery, as in the eventual ‘curing’ of any so-called “mental illness” that’s ostensibly been “diagnosed” within a family; it is mainly about making the “patient” of medical-coercive psychiatry comply with psychiatry’s views, practices and dictums.

    Your organization, on the other hand, is encouraging what I’d call “healing” within families, that face ‘mental health’ crisis. From how you express yourself (and from checking out that link of yours, to your online course), I believe you’re doing a great job.

    Though, were I you, I’d go one step further: I would tell families to discard any and all psychiatric so-called “diagnosis” that any family member has ever received.

    I would say, “Just trash the psych labels!” …and/or, at the very least, I encourage family members to ‘deconstruct’ the labels (which may require carefully studying the those “diagnoses” which the psychiatrists are offering, until it’s well-realized that they are nothing more than self-fulfilling prophecies).

    In all other ways, so far as I can tell, your message does do enough, it is great; and, that online course you’re offering looks very promising.

    (What a really a tremendous use of Internet-as-liberating-technology!)

    More power to you and to those whom you’re working with…



  3. “We’d love to hear what you believe.”

    What I think is that if healing and recovery are possible, it should become a High Priority to ensure that it will occur. I also think it should be made known if and when a situation is beyond “salvation”, or recovery or healing. It should not be left in doubt or question or wonder.

    What I know is this:

    Human Beings often drag on in dysfunctional relationships because they do not know HOW to end them, and sometimes lack the ability to state clearly and with certainly that they actually would like a relationship to end. If a person is being irresponsible, lacking the ability to respond appropriately, the tied strings stay strung and continual suffering, struggle and strife are the result. People, in my experience, do not articulate but will “drop hints and clues”, so confusion is the result. So much “diagnostics” (establishing facts of the matters) goes into it all, does it not?

  4. I like to think of families and psych survivors healing together and your post raises some interesting points. The problem is though that, of all interested parties, families might have the most invested in the biochemical theory of psychiatric distress. And, in some tragic circumstances, psych survivors actually need to heal FROM their families.

  5. “Can Families and Survivors Heal Together?”

    I believe the answer is NO, unless families understand that a survivor is, well, a survivor. That is all I ask that my own family understands to have any hope of healing. And an apology for having ruined my life with involuntary so called “treatment”. Until that happens, the chances of me making peace with my family are non existent.

    • You have a point cannotsay, I think of friends who are quite understandably ostracized from their families because their families were the cause of their distress through abuse, neglect etc, healing with them would never have been possible, in fact they needed separation in order to survive. Then as you point out there are families who have instigated commitment/sectioning – how would you feel about a ‘truth and reconciliation’ process like they did in South Africa whereby victims of Apartheid had the opportunity to detail exactly what was done to them and the perpetrators answered to their actions. Some forgave, some did not, but overall attempting the process appeared worthwhile to me even if there was no reconciliation, even if it only offered the victim the opportunity to say it how it felt.

      • Good point about the South African Truth and Reconciliation process – in many respects I think both processes are analogous. If TaR worked (when it worked, which was by no means always) it was because the abusers had a chance to understand and admit the harm they had done and ask the forgiveness of those they had abused – obviously for the process to work there has to be an admission of guilt or responsibility; it does not work if those responsible for the abuse turn around and say to the victim: “we didn’t do anything wrong – we just did what was best for you”

        I think all too often people forget the greatest difficulty of the theory of trauma as the cause of “mental illness” (which is also the greatest strength of the biological model): 9 times out of 10 it places responsibility (I think correctly) on the family environment. So I think Cannotsay is just basically stating a minimum requirement for any “family therapy” to work: family members must be open to the fact that they might have been part of the problem to begin with. Ironically this was much better understood in the 50’s (right before Big Pharma came to the rescue of families with guilty consciences) when people like Gregory Bateson were talking about “schizophrenic families” rather than individuals.

        I think the kind of work Jennifer is doing is the way forward, but this uncomfortable aspect of it must be clearly understood or else it won’t really work.

  6. I’m a recent “graduate” of the online course. I wish it had been around ten years ago when our family fell into the trap of psychiatric labelling and trusting the doctors to sort it all out. A heartfelt thanks to Mother Bear and practicerecovery for this wonderful course.

    Francesca – it was interesting to me that some of the family members (usually mothers) in the course had adhered to the biochemical model, but willingly took the course because their sons or daughters were still a source of great concern after many years. To my recollection, the topic of the pros or cons of medications was never brought up, either by the moderator or by the participants. And, yes it is true that some people need to heal from their families, but can still benefit from the healing wisdom that the course teaches. Just a point of clarification re peole healing FROM their families: In the course I took, everybody was there on their own, not enrolled with another family member. We learned how to better understand what we or our relative was going through, we learned about grief and letting go, boundary issues, etc. We can then take these skills and understanding and practice them on ourselves and share them with other family members if we choose to do so.

  7. Thanks Jennifer for a positive, inclusive, hopeful post which encourages families and survivors to work through the pain and stay together.

    I’m a survivor and carer, a dual role from when I was a teenager and my mother experience altered states of minding resulting in psychiatric locked ward treatment. We’ve always stayed together, united against the system when it tried to separate us completely from each other. And it did try. Not sure why. Maybe the system thinks it can do a better job of parenting or managing. I was never convinced of this.

    And so I stood with my sons as they went in and through the psychiatric system, advocating and giving peer support. The system would have preferred for me to stand back. But I wouldn’t. Why should I? As a mother I have every right to be included. I suspect the schizoaffective label they pinned on me had something to do with it. And the schizophrenia label they pinned on my mother. They are good at labelling and drugging, not so good at getting alongside, supporting, keeping families together.

    So it’s good to hear about the Families Healing Together course through the leadership of Mother Bear and partners, available online. I live in Scotland so will promote the course through my websites and networks. All the best, Chrys

    • me too Chrys, my family were always united with me against the system, but they had no support, no bench mark, it was really hard for them and at one point we probably could have done with space and not been together for a while, and with maturity I made sense of just how hard it must have been for them. I so wish there had been something motherbear around for them because the only relative org was the ‘National Schizophrenia Fellowship’ and they were cold shouldered in the only meeting they attended after being asked why I wasn’t medicated and in hospital..

  8. I’m more than wary of ‘recovery’ I’ve come to detest it in a visceral way because I’ve seen too much of it here become a stick with which to beat people after it’s been wrapped around a medical model of mental health. That’s what [at the worst] can make it so insidious, how it can be wrapped around ANY ideology, any agenda, by anyone with ‘prescribed’ descriptions of what it ‘should’ be from – you must walk away from psychiatry/cease meds to accept your ‘illness’ and be compliant – polar opposites!
    For me walking away from psychiatry and ceasing daily meds hasn’t equalled automatic ‘recovery’ for me, and some of us can be left feeling that those of us who define ourselves as experiencing enduring difficulties are somehow second class citizens or an embarrassment, as though we somehow degrade the concept of recovery by our existence and failure to live up to the mark. Within services it’s a horrible hybrid of the two – learn about your illness/take your treatments AND you must damn well recover = getting out of services asap and get employed.
    Political divide & rule where only full employment and no receipt of any state support is valued [I’m including in-work support] has infiltrated survivor activism with survivors being judgmental and even abusive towards their peers who either use services long term, are not in paid work, are in receipt of disability benefits or in-work benefits [because of low pay/hours]. I’m really ashamed of this because I guess I held us to higher standards, that we would be more accepting of each other, and indeed IMO we were accepting in previous decades, it didn’t matter who was taking meds/using services/employed/unemployed/doing voluntary work etc, we seemed to accept each other’s contributions and positions better.

    Within MH services, we have a ‘Recovery Star’ in our ‘recovery focussed’ meds/CBT/no choice services – the star offers more points to paid work than voluntary work, why?

    Recovery has become an industry, a brand, and in saying all this please don’t think I dismiss all survivor or professional efforts in this area, I really don’t, but I do remain overall critical of the swathes of poetic descriptions I read of recovery being this nice journey and our choice – because it isn’t! Not socially, not politically, not in healthcare, and even within professional critical thinking/survivor circles taking a critical stance in relation to recovery can mean being ostracised from people who once respected who you were and what you offered, that makes me sad.

    I resent the fact that it’s pretty difficult for survivors to have a platform at a conference unless they can offer a ‘recovery story’, that’s the expectation now. I worry about those who we will never see here, never see at any ‘alternative’ event, I don’t want to see an underclass of survivors..

    Recovery as a word and concept IMO has been bastardised here by politicians, policy makers, NHS commissioners, managers, MH professionals, academics, and even from some survivors and allies who profit from it, for me personally it’s now too corrupted a word for me to entertain. Some of us even describe ourselves as unrecovered, failed voice hearers etc, we’re making a point [as opposed to ‘sitting in our sick role’].

    If *some* recovery approaches dictate what people should be/do then it simply replicates biological psychiatry, for me true freedom is about being able to be who I am and for others to accept alongside me my limitations as well as my strengths.

    I’m horrified by service “Recovery Colleges” with their like coach phrases and pictures of flowers, it’s as though someone must be employed to look up ‘inspirational’ phrases and pool them together for recovery leaflets. So people are taught how to manage their ‘illness’, put together a CV, do some mindfulness and off you go..

    Ok rant over, Open Dialogue, Jen that’s a fascinating topic, I’ve watched some of the Youtube video’s and it certainly grabbed my interest and made me wonder what if..what if I’d experienced that approach when I was 16-17, how might things have turned out for me? There’s definitely something within that we could learn from, but maybe we also need to understand the wider socio-political and cultural context within which that approach operates. I say that because many decades ago I went to Japan and became aware at one point of survivors hanging onto my every word wanting the ‘blue print’ for change for them and I stressed that whatever ‘worked’ [however we define that because it’s subjective] in the UK context wasn’t necessarily transferable to their country with a completely different history and culture.
    Also I try to picture Open Dialogue and how it would deal with current socio-economic pressures here, I’m thinking of low income families and service users struggling with housing benefit and working tax credit cuts, maybe subject to sanctions/food banks – no amount of talking makes that more palatable or takes away the distress it induces. Can Open Dialogue address social causations [and maintenance] of distress?

  9. I know this is not strictly on topic but I really wanted to make US survivors aware of this because it does have a bearing on [UK] activism and development of innovative services – leading politicians have recently described disability activists/groups/petitions and reports as “extremist” and “extremism”. Also political point scoring using our Citizens Advice Bureau [which is taking up the slack of Legal Aid having been cut] and now the only charity available to many people for help with housing/debt/welfare forms. Given anyone addressing social injustices are openly attacked in parliament, how would any MH service be commissioned if it assisted it’s users with those very issues which as we know are significant triggers of mental distress?

  10. My hope is that some day the conversation about recovery will no longer be based on the false distinction between “families” and “survivors.” I hope for the day when we realize that we are all equally survivors and family members and are no longer pressured to identify ourselves (and others) as one or the other.

  11. Jennifer,
    We are looking for something exactly like this to support family/friends. Our Board (funder) would likely make funding available if it’s consistent with our mission, vision, values.

    Is there any way I can review a summary of the content for each lesson? While I’m fairly sure we would agree with the information, it’s something I’m going to have to do before making a recommendation to our Board. Please contact me [email protected] if this is possible.

    Our need came about because we were not at all satisfied with the NAMI ‘Family to Family’ curriculum. We offered to work to change the information to be more accurate but our offers were not accepted. I’m not sure local NAMI chapters have the latitude to change key portions of the curriculum.

    If we can move forward on this and start with the next cycle in September, I’d be more than happy to do a report out via my blog on how things went in Ashland County.

    Thanks Jennifer,

  12. This has been a very interesting thread to read. As a parent of young ault children who have chosen medication and one who we chose to put on medication, and as a psych survivor and Mental Health worker in the past I applaud your efforts since it is so needed. We never had any family support. I found NAMI not to my liking since they at first seemed nice but where not open to dialogue about alternative views on treatments and alternative views on mental health professionals and medication.
    We have done our own work as a family by ourselves.
    It has been hard for me since I had bought into the system after graduate school then with my own awful hospitalizations changed my perspective. My family is not into exploring information and this and other websites and books. So I have been starting the dialogue on my own with them. They are aware their medication is a choice and there can be negative consequences. They know I have chosen not to medicate myself. They acknowledge the healthy difference in my physical and mental experience.
    I would like to see a support for families like your online course for my children. They need to express what it was like to have a mother who was psychotic and who OD’d unintentionally.Secrets and unheard family history is not healthy.
    We survivors need to listen to their lived experience as mental health professionals need to listen psych survivors lived experiences. Neither situation is easy to handle. Thanks for beginning this step!

  13. I represented one of the survivors who just took this course and I found it exceedingly worthwhile. I recommend it to other survivors to check out. It is organized and run by a survivor (of a bipolar diagnosis) named Krista MacKinnon, who also has the same therapist degree in process work as Will Hall.

    The class is geared away from polemics of blame and is instead focused on finding ways to well-being as well as an acceptance of some measure of uncertainty along the way as to how it will play out in any given life story. There are many, many strategies presented and the philosophy is to take what you like, how you like.

    There are two lessons a week of the same theme for the week. The lessons include intro youtube video of the instructor, the lesson itself, visual art, worksheets to print out, as well as links to audio files, youtube files, articles, and recommended books for further reading. I doubt anyone in the class had the chance to read/see everything as there is such a wealth of material, but since the lessons come to one’s email inbox they can be referenced even after the class ends. Finally, there is the wonderful alchemy of the class participants making sense of the material in applying it to their own lives in the threaded discussions.

    As someone who has been an avid reader of Mad in America for a year, I wasn’t sure beforehand that I had all that much to learn. Well, I happily had that wrong! I learned very much and was really inspired by the pioneering format. Good stuff!

  14. Jennifer, thank you for addressing this topic with hope and optimism that we can heal with our families.

    While I do feel it is true that many of us have had to heal *from* our family dynamics–in my case, for dissenting from enabling the abuse going on by calling it for what it was, and in the process enraging other, more fear-based, family members (which resulted in multiplying the abuse and shaming which came flying towards me)–I believe that once we heal ourselves from the negatively skewed self-images that family abuse ignites within us, then our roles in the family shift from family victim to family healer/teacher.

    I used a combination of forgiveness, separation, dialogue, and ultimately making a film, in order to have my voice heard in the family. Before launching the film on YouTube, I sent it to my mother and siblings (my dad had already passed away), for their input and reactions. I was very lucky that my mother, while shaken by how I was telling my story, told me when I first shared with her that I was going public with my story for the sake of inspiring self-understanding in others, to ‘stay the course,’ that she could handle this and knew it was important for me to tell this story. I was grateful, but also a bit nervous about how this would ultimately affect her. But I knew that I would only be feeding into the original dynamic if I were not to allow her to take responsibility for her feelings (guilt, mostly), rather than my ‘taking care’ of her, and therefore sacrificing my voice and my heart’s truth. Most fortunately, it paid off beautifully, and we all grew from the experience.

    It was amazing (and jarring, at first) the resistance they put up over the years to my healing from these issues, as it only could mean for them that they had to share in the responsibility in what we all created as a family, and which I most overtly embodied–that is, chronic anxiety, mental chaos, and emotional distress. It took a lot of patience on my part–with which I didn’t always connect, but to which I always eventually came back–and knowing when to engage and when to allow them space for their own process. But over the years, I learned how to navigate this with my heart, as I was healing it from chronic wounding. They can easily resist direct dialogue in many ways, but communication happens in many forms, so I learned to respect how it was most comfortable for them, without sacrificing my own voice and process.

    At present, it appears to have all worked out. It was touch and go for a while, and I was not sure whether or not my family would ever recover from my healing and having found my voice and personal power, but they seem to now be humble to my example. I’m grateful for their own willingness to grow in the direction of family unity, rather than holding tight to their denial.

    In short, I learned that our individual healing can serve to spiral outward, like a radio signal, if we keep the fire of hope alive, even when it looks a pretty tenuous. The ups and downs of healing with any community can, indeed, be both fascinating and very moving. Most certainly, it is a powerful spiritual opening, and I believe we are all benefitting from our ownership, humility, and trust in our processes.

    Best wishes with your program, as it seems to me to be a most worthy and enlightened endeavor. In essence, it is how we spread our own healing light into the world at large.

  15. This was my experience when my older son had a breakdown and nearly took his own life here in the UK. My family fell apart and no help whatsoever was offered to us. My son was sectioned and forcibly medicated. I tried to tell the psychiatrists what happened but no one listened. My husband sided with the doctors and made himself scarce. My daughter and my second son who tried to support me developed insomnia and collapsed physically after a bout of flue. Son number 3, who had stopped his brother from jumping, failed all his university exams and went spare because he couldn’t stop blaming his brother for this failure etc. As you can see everything fell apart and a lot of healing, forgiving and forgetting had to be done. We are half-ways there. I hope we will get there but no, we didn’t get any help at all from the Mental health services. All they were interested in was that my oldest son continued to take his medication. He didn’t: the medication was only harming him. The attitude of his father and the resentment of some of his siblings weren’t helping either. Ultimately he had to get away to allow himself to heal.

  16. Great essay Jennifer, and as others have noted, very hopeful. I’m just wondering though how the real-life experience of many in this community, relates to the notion of supportive and loving families? In my own experience, there is a non-recognized need to move away from (over time) any member of the family group, who is not seen as a source of support and protection. A movement that is “physical” more so than psychological, and rarely verbalized, by any of the group members. As Murray Bowen pointed out, in his seminal ideas on Family Therapy, our underlying e-motive reactivity, is managed by emotional cut-off, usually involving physical distance.

    Is the family, the very crucible of madness, and are we back to previous ideas, about our emotional functioning, like Bateson’s “double-bind?” As you write, by family, we mean the human family;

    “By family, we mean the human family. Which includes family members and individuals with lived experience from a variety of vantage points —those in recovery, psychiatric survivors, friends and allies, care providers, community members, educators. Anyone willing to create and support family healing communities based hope, strengths, mutuality, respect, curiosity, and a diversity of perspectives; anyone willing to commit to working on his or her own personal growth.”

    In my own need to master psychosis, self-education and a self-reliance, which involved giving up the “group-think,” in my need to belong, has set me free from the subconsciously “projected” needs of others. In a family, emotional systems view, the “sensitive one” (me) in our family group, no longer soaks up, the dumped negative affect’s of other family members. In that strange twist of fate, which people find “unbelievable,” the “apparent” weakest link in the family chain, turns out to be the most independant and strongest link, in the generational nature of emotional coping. In the history of the family therapy movement, it is understood, that the “sensitive” one, carries the burden of healing generations of emotional pain. Please consider an excerpt from my generational journey;

    “The Family: The Foundational Cell of Society?
    The family systems perspective contends that the most effective way to work with individuals is in the context of their families. In their groundbreaking book, The Family Crucible (1978), Napier and Whitaker wrote, “Working with the totality of the forces that influence the individual is such a logical idea that it is hard to deny its validity” (p, 59). Excerpt from Creative Family Therapy Techniques

    In 2006, when I made my right of passage observation to that young woman, I’d been reading books like The Family Crucible for my Differentiation of Self assignment, researching three generations of my family tree. Trying to understand why the existential themes of abandonment and rejection, seemed to run, river like, through both sides of own family. My ex wife, myself and my four sons. Which, right now, brings me to a recent post about, affect, family faces and the generational nature of our very human madness. Please consider;

    Subconscious, reactions to the transmission of “affect”
    Recall from: Family Attachment Affects & Mental Illness. Pt 1
    “I have three lovely handkerchiefs here, choose one.” Then Monica left the house and my mother never saw her mother again. My mother was just five years old when this rather brutal act of abandonment took place. Already the focal point of a family projection process, which sought to dump feelings of guilt and shame onto an unwanted “other.” My mother, who no doubt had already begun to form her hard-core defense against the transmission of “affect.” A tendency to distance and isolation which has had its ripple effects through the continuing generations of our family tree. Please consider;

    Is traumatic experience a factor, in the generational nature of, emotional coping?

    “It is the nature of trauma to elude our knowledge because of both defense and deficit … To protect ourselves from affect, we must, at times, avoid knowledge. We defend against feelings of rage, cynicism, shame, and fear by not knowing them consciously. Trauma also overwhelms and defeats our capacity to organize it.”

    Psychoanalysis, psychiatry, and developmental traumatology are all now converging on dissociation, the bottom-line survival defense against overwhelming, unbearable emotional experiences. Longitudinal attachment research demonstrates an association between traumatic childhood events and proneness to dissociation, described as “detachment from an unbearable situation,” “the escape when there is no escape,” and “a last resort defensive strategy” (Schore, 2003b, 2009). Although Kohut never used the term dissociation, in his last book (1984) he characterized an early interaction in which the traumatized child “walls himself off” from traumatizing experiences.”

    Excerpts from “The Science of the Art of Psychotherapy” by Allan N. Schore.

    “Dissociation, detachment, and a wall” of indescribable distance, certainly resonates within me, when I think about the traumatic experience of birth, shared by my mother and I, and its ongoing generational affects. Indescribable, by way of the (surface, verbal, conscious, analytic explicit-self) described above. An emerging understanding of the human condition, which seems to resonate with that divided sense-of-self we all feel, when we notice the discrepancies between our explicit-self, and a very private, implicit-self, deep within us. Our taken for granted maturity, signified by an ability to make the appropriate noises and gestures, while simultaneously holding sometimes opposite, private thoughts and feelings. Yet these words, explicit and implicit, are not exactly part of our common vocabulary of self-description and social interaction, leaving me wondering if I’ll ever resolve a family estrangement, now seemingly set in concrete. “Is it really, all my fault,” I’m wondering. Should I let sleeping dogs lie and not question the roots of my own and my mother’s trauma history, for the sake of an emotional equilibrium, maintained by physical distance and psychological denial. Should a child ever question the sanctity of motherhood, or explore the foundations of this most fundamental of relationships? Did traumatic experience affect my mother’s ability for emotional empathy? Consider;

    “If the mother’s empathic ability has remained infantile, that is, if she tends to respond with panic to the baby’s anxiety, then a deleterious chain will be set into motion. She may chronically wall herself off from the baby, thus depriving him of the beneficial effect of merging with her as she returns from experiencing mild anxiety to calmness. Alternatively, she may continue to respond with panic, in which case two negative consequences may ensue: the mother may lay the groundwork in the child for a lifelong propensity toward the uncurbed spreading of anxiety or other emotions, or by forcing the child to wall himself off from such an overly intense and thus traumatizing [experience, she] may foster in the child an impoverished psychic organization, the psychic organization of a person who will later be unable to be empathic himself.

    NOTE: 1, In this chapter we equate “unconscious” with “nonconscious”; that is, implicit functions that occur beneath levels of awareness not because they are repressed but because they are too rapid to reach consciousness.

    2. Throughout this chapter, we refer to “mother” interchangeably with “primary caregiver(s).” We are referring to the primary attachment figure, although we recognize that the infant’s primary attachment figure may not be the mother.”

    Excerpts from “The Science of the Art of Psychotherapy” by Allan N. Schore.

    Two interesting facts spring to mind as I read the above explanation of the generational nature of trauma’s “affect” on our individual ability for empathy. 1. My father and my grandmother were the primary caregivers, in the early childhood I remember. 2. I cannot remember a single occasion in my life when my mother has initiated contact with me, certainly not once in my adult life, including the periods of illness I‘ve suffered. There was a period in my early 20’s when I tried to broach these fundamental questions of family relationships with both my parents, only to meet the “double-bind” response of a subconscious “shame” reaction, rationalized as an assumption that I was blaming them, for my own weaknesses.

    In line with new understandings from neuroscience research, it was not me they were really defending themselves against, as it appears at the surface of our conscious sense of self. Our explicit-self. It was their own core, non-conscious self, in an avoidance of negative sensations, such as our internal sense of shame. “Shame-Humiliation” understood within Family Therapy, as the social emotion, of our rank and status, family and society, groups. My parents subconscious reaction was one of anger, as mother nature’s antidote for sensations of shame. We can’t feel shame and anger at the same time, it’s literally a physiological impossibility, yet this non-empathic and defensive response, affects sensations of shame in the other. That was the double-bind trap of this traumatized, and unwanted child, and later experience of an “affective disorder.” (Bipolar Disorder Type 1) And the subconscious reality, of this strange an very uncommon phrase, “the transmission of affect.” Please consider;

    “Nervous Entrainment, as a Mechanism for the Transmission of Affect/Emotion:

    If “contagion” of affect/emotion exists (and the study of crowd/group behavior, says it does), how is it “effected?” If one walks into a room where one “could cut the atmosphere with a knife,” and that “affect” contained within the room is a profoundly social thing, how does it get there? There are indications of social science interest in research on “electrical” or nervous entrainment, “the driving effect one nervous system has on another,” affected by touch, sight, smell and sound.

    Nervous entrainment may also depend on bodily movements and gestures, particularly through the unconscious imitation of rhythms. In understanding the aural rhythmic component of the vocal interactions of a parent and child, Richard Restak suggests we attend to “prosody” the melody, pitch, and stress of speech, where auditory cues have priority over visual ones. Rhythm is a tool in the expression of “agency,” just as words are. Rhythm, literally conveys the “tone” of communication, and in this sense it unites both word/symbol and affect/emotion. Rhythm also has a unifying or dys-unifying regulation role, in affective exchanges between two or more people.

    The rhythmic aspects of behavior are critical in establishing a collective sense of purpose and common understanding. In addition, there is a sense of well-being which comes with a rhythmic entrainment with one’s fellows (in dancing for instance) . By contrast, non-rhythmic or dissonant sound also separates. It leads people to stand apart from one another and generates unease.

    While the auditory has priority over the visual, the visual has a place in this process of nervous entrainment. Firstly, registering an image is rooted firmly in brain physiology. The registration of an image in the minds eye is part of such nervous entrainment, yet the image has been transmitted as sound waves or valence register physical effects on the ear drum. Words and images are matters of vibration, vibrations at different electrical frequencies, but still vibration. In addition, the social, physical vibrations of images are critical in the process of nervous “electrical” entrainment, even though they lack the rhythm of auditory entrainment.”

    Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

    What Teresa Brennan is alluding to, is passive and active “energy states,” and how they are subconsciously stimulated. For example, when I asked my father “what’s wrong?” Because his habitual explosive temper, has been subconsciously triggered by a small insignificant incident, and I’m trying to understand why his response is so outrageously out of proportion to the offence. His response “your breathing aren’t you!” Stimulates an extreme “passive” energy state within me, because of the sense of contempt, not just in the words used, but the “tone” transmitted by facial gesture, staring eyes, and prosody of his voice. Please consider;

    “Human beings rely extensively on nonverbal channels of communication in their day-to-day emotional as well as interpersonal exchanges. The verbal channel, language, is a relatively poor medium for expressing the quality, intensity and nuancing of emotion and affect in different social situations … the face is thought to have primacy in signaling affective information. (Mandal & Ambady, 2004, p. 23)

    In the developmental attachment context, right brain– to– right brain auditory prosodic communications also act as an essential vehicle of implicit communications within the therapeutic relationship. The right hemisphere is important in the processing of the “music” behind our words. When listening to speech, we rely upon a range of cues on which to base our inference as to the communicative intent of others. To interpret the meaning of speech, how something is said is as important as what is actually said. Prosody conveys different shades of meaning by means of variations in stress and pitch— irrespective of the words and grammatical construction (Mitchell, Elliott, Barry, Crittenden, & Woodruff, 2003). These data support suggestions that the preverbal elements of language— intonation, tone, force, and rhythm— stir up reactions derived from the early mother– child relationships (Greenson, 1978).”

    Excerpts from “The Science of the Art of Psychotherapy” by Allan N. Schore.

    * * * * * * *

    What I’m trying to convey here, is the subconscious, emotional foundations of what we consciously, and defensively, presume to be a mental illness in others. What is becoming increasingly understood from all the recent neuroscience discoveries, is how the foundations of our sense-of-self, is laid down in, “subconscious & sensory,” emotional interactions, between caregivers and the child, in the first years of our lives. Those crucial early years when our brain-nervous systems are maturing by way of interactions with a social-emotional environment, and all taking place at the subconscious level of an implicit-self. A subconscious, implicit-self, which guides motivation throughout each individual’s life-span, and drives the generational nature of family relationships. From this “subconscious” perspective on human behaviors, there is no blame or shame, this is simply the real-life nature of being human. Unconscious functioning, so little understood, and only now, with the aid of technology, beginning to see the light of true reason.

    Chaos theory is playing a huge role in understanding just how complex chemical systems within the human organism, stabilize in defense of our survival. In practical terms, this can be seen in the chance and circumstance of my birth. In the real-life circumstance of time and place, bad luck affected such a pain fueled void between my mother & I, that we’ve never managed to resolved it. We’ve suffered from the generational nature of pain/shame fueled emotional cut-off too. If my mother had had an optimal birth experience, which had allowed her to bond in the “subconscious” sensory nature of emotional attachment, it more than likely would have helped to heal her abandonment by not only her own mother, but an entire family. I would have ended up with a different “implicit-self,” which would not have needed the subconscious process of psychosis, to stimulate a new and more positive sense of self. Psychosis, as a need of re-wiring those early forming neural networks within my brain-nervous systems. Euphoric psychosis, which was a need of mature orientation to the world of reality, as it is. I needed, at a subconscious level, to dissolve the conditioned, “autonomic,” nature of my predominately “negative” internal states. Internal states, stimulated by my hearts reflex orienting responses to reality, along with my brain and nervous systems, of course. I needed to grow beyond, an implicit “freeze” reaction to any new challenge, in the social environment. (As explained here)

    Just as I am now estranged from my family, my mother was estranged from her family of origin, and entirely dependent on another’s extended family, my father’s. This unbalanced emotional arrangement played its part in the further chaos, chance and circumstance, which resulted in my first episode of bipolar disorder, mania. Essentially, the current estrangement with my family, which is following the same generational pattern as my mother’s estrangement from her family, is based on a subconscious need for movement, both physical and emotional, towards or away from. A subconsciously stimulated movement towards support and protection, and away from a subconscious sense of threat. Like the threat my public airing of mental illness within the family, posses to my mother, my brother and my children, its embarrassing. Embarrassment, being a milder expression of shame, yet nonetheless stimulating a need to move away from the threatening source. Consider Franz Kafka’s brilliant critique of the human family, and our need for support and protection:

    “The Metamorphosis

    “We have to try and get rid of it”, said Gregor’s sister, now speaking only to her father, as her mother was too occupied with coughing to listen, “it’ll be the death of both of you, I can see it coming. We can’t all work as hard as we have to and then come home to be tortured like this, we can’t endure it. I can’t endure it any more.” And she broke out so heavily in tears that they flowed down the face of her mother, and she wiped them away with mechanical hand movements. “My child”, said her father with sympathy and obvious understanding, “what are we to do?” His sister just shrugged her shoulders as a sign of the helplessness that had taken hold of her, displacing her earlier certainly when she had broken into tears.

    “If he could just understand us”, said his father almost as a question; his sister shook her hand vigorously through her tears as a sign that of that there was no question.

    “If he could just understand us”, repeated Gregor’s father, closing his eyes in acceptance of his sister’s certainty that that was quite impossible, “then perhaps we could come to some kind of arrangement with him. But as it is …”

    “It’s got to go”, shouted his sister, “that’s the only way, Father. You’ve got to get rid of the idea that that’s Gregor. We’ve only harmed ourselves by believing it for so long. How can that be Gregor? If it were Gregor he would have seen long ago that it’s not possible for human beings to live with an animal like that and he would have gone of his own free will. We wouldn’t have a brother any more, then, but we could carry on with our lives and remember him with respect. As it is this animal is persecuting us, it’s driven out our tenants, it obviously wants to take over the whole flat and force us to sleep on the streets. Father, look, just look”, she suddenly screamed, “he’s starting again!” In her alarm, which was totally beyond Gregor’s comprehension, his sister even abandoned his mother as she pushed herself vigorously out of her chair as if more willing to sacrifice her own mother than stay anywhere near Gregor. She rushed over to behind her father, who had become excited merely because she was and stood up half raising his hands in front of Gregor’s sister as if to protect her.

    He did not turn his head until he had reached the doorway. He did not turn it all the way round as he felt his neck becoming stiff, but it was nonetheless enough to see that nothing behind him had changed, only his sister had stood up. With his last glance he saw that his mother had now fallen completely asleep.

    He was hardly inside his room before the door was hurriedly shut, bolted and locked. The sudden noise behind Gregor so startled him that his little legs collapsed under him. It was his sister who had been in so much of a rush. She had been standing there waiting and sprung forward lightly, Gregor had not heard her coming at all, and as she turned the key in the lock she said loudly to her parents “At last!”.

    “What now, then?”, Gregor asked himself as he looked round in the darkness. He soon made the discovery that he could no longer move at all. This was no surprise to him, it seemed rather that being able to actually move around on those spindly little legs until then was unnatural. He also felt relatively comfortable. It is true that his entire body was aching, but the pain seemed to be slowly getting weaker and weaker and would finally disappear altogether. He could already hardly feel the decayed apple in his back or the inflamed area around it, which was entirely covered in white dust. He thought back of his family with emotion and love. If it was possible, he felt that he must go away even more strongly than his sister. He remained in this state of empty and peaceful rumination until he heard the clock tower strike three in the morning. He watched as it slowly began to get light everywhere outside the window too. Then, without his willing it, his head sank down completely, and his last breath flowed weakly from his nostrils.” An excerpt from Metamorphosis, by Franz Kafka Translated by David Wyllie.

    No longer a source of support and protection within the family group, Gregor is shunned, even by his sister, who had benefited most from his, father-like support. In Murray Bowen’s seminal ideas on family therapy, this paternalistic nature of the nuclear family group, becomes the structuring force of mainstream society. Hence, we often describe government and other institutions as “paternalistic and condescending.”

    The Motor Act, Is The Cradle of The Mind? Sir Charles Sherrington.
    Hence our implicit, subconscious-self, is based on the survival need of physical movement.

    Just as my mother’s family physically “moved” away from a source of family embarrassment. A family secret my mother had kept to herself for so many decades, until we sat down to review our “family tree,” in 2006. Perhaps she was hoping that those sharing moments together would help to heal the void created between us, in our mutual experience of birth trauma? I’m certain she’d never spoken with my father about our family secret. Such emotional intimacy was not the “style,” on that side of my family tree. Perhaps she’d recalled the mother-child relationship which briefly blossomed between us, in Wallingford, England, when I was the responsible, caring son, on a day when she almost died. Or perhaps my deceased father’s lost presence allowed a more sensitive and open emotional “style,” indicative of our shared genetic heritage, from the maternal side of my family tree?”

    Best wishes to all,

    David Bates.