Our project deals with one of humanity’s most ancient but ongoing social problems: treatment. We believe, as R. D. Laing said, “Treatment is how we treat each other.” The innovative nature of this program lies in never giving up the idea that life might be better if we treat each other in a better way.
The goal of the Soteria Shelter Program is to sustain a temporary home where people experiencing extreme states can live undisturbed, with the potential to go through their crisis without medication. Our program is unique in Hungary as it is neither a hospital, nor a medical institution, but a loving and friendly home. We aim to offer an alternative to the state psychiatric care system, providing physical and emotional shelter for those who are struggling with existential crisis.
Currently, our program is without a physical house. We are working hard to raise funds to procure a new one, but in the meantime I would like to tell you more about the philosophy of our project, its history and activities, and how I came to be involved.
How I found Soteria
I joined the volunteers of the Soteria Shelter Program in 2012, after being in personal therapy with the former leader of the shelter (what we call “the House”). Through that experience — feeling the quality of the therapeutic connection, the ‘thusness’ of the presence and the treatment — I realized how alienating and dangerous, in contrast, my previous encounter with a psychiatrist had been. All my life I had thought like the psychiatrist had: that the problem is within the individual, and the professional helps to fix it. That there is a blueprint of the normal, the expected, and there are illnesses that disturb us and we (or parts of us) need to be fixed. Maybe not cured, but at least have our diseases under control.
I remember how the psychiatrist said, after ten minutes of talking, that I had serious depression and some kind of personality disorder. She gave me a brochure called ‘Depression,’ prescribed an antidepressant and gave the number of a psychotherapist whom she said I should only call one or two months later, after the medication had had an effect on me.
Luckily (and this was the biggest luck in my life) I was so terrified by my experiences in those months — by the panic, the fear of losing touch with reality forever, the fear of death, etc. — that I continued to search for help and was directed to my therapist. In the first session we agreed on leaving the antidepressant behind, and I was introduced to another philosophy and way of being in the world which radically changed my mind, my way of thinking, my life.
My therapist, in every encounter, transmitted to me with her full being: I am here, I am with you, I am present. I act as myself, I’m not in a role, I don’t pretend to know anything, I am not advising you on anything, I don’t want anything from you. I encourage you to do what you think is the best for you to do. I don’t push you, I am not afraid of you. I give you the space and company to find your own rhythm, voice, desires. I accept you and I love you. I am not rushing you.
And so, one day, the unimaginable happened to me: I put down all my defenses and started to sob. I realized that nobody is suffering who hasn’t been treated badly or who hasn’t been treating someone badly. I discovered that the problem was or is always between us — and so is the possibility of ‘healing.’
I found out that mental illness is a bad metaphor: either we have a brain disease or we have problems in living. All the various diagnoses in the DSM try to describe ways we react to our traumas. But everybody is immensely different and unique, so there is no use in diagnosing someone — it is harmful, alienating, traumatizing and degrading. I realized that there is no Us and Them, there is only Us, so nobody has to look up to someone or look down on someone. And it’s better to do nothing if we don’t know what to do.
With this shift of paradigm I entered the House for the first time, as a new volunteer, where this way of thinking was already common and practiced.
About the Soteria Shelter Program (Soteria Menedék Program)
We consider crisis as a condition not to run away from but as the possibility for rebirth: excruciating and inescapable change. We believe that if we do no harm, crisis is not only danger but opportunity. Those who have lost contact with consensus reality — those who suffer from the pain of fear and despair, the horrors and weariness of one’s traumas — are offered a chance to live and rest in a safe place in their own rhythm, with autonomy, without pressure or coercion.
The lives of the residents are assisted and helped by the volunteers, the leader of the Shelter House and the supervisors. We do not “treat” anybody or force anyone to do anything. We are together in order to help the people in crisis by means of our presence. Our ethical motto is: “It can happen to you, too.” This change of aspect puts our thinking in a new light: What if we were to get into trouble? How would we feel? Who or what would be good for us? Some volunteers have already belonged to the target audience in the past and might belong to it in the future. Like anyone can. Because we are human beings.
The Soteria Shelter Program is modeled after the work of R. D. Laing and his associates, who developed this method based on scientific research dating back decades in Europe and the United States. The method of Soteria has been tested in accordance with rules and principles of the strictest clinical examinations (Mosher, Menn, Matthews, 1975; Mosher, Menn, 1978; Straw, 1982; Kiesler, 1982; Mosher, Vallone, 1992; Ciompi, Dauwalder, Maier, Aebi, Trütsch, Kupper, Rutishauser, 1992; Mosher, Vallone, Menn, 1995; Mosher,1996; Mosher, 1999; Mosher, 2001; Bola, Mosher, 2002; Bola, Mosher, 2003; Ciompi, Hoffmann, 2004; Calton, Ferriter, Huband and Spandler, 2008, etc.) and turned out to be cheaper and more effective than traditional psychiatric treatment. And to top it all off, it is more humane.
Goals and objectives of the Hungarian Soteria Foundation
Soteria Foundation was founded in 1995 in Budapest, Hungary by psychiatrist Éva Csom, who was supported and inspired by Andrew Feldmár, a Hungarian-born Canadian psychotherapist. The original goal was to sustain a shelter, a temporary home offering community living as an alternative to psychiatric hospitalization. For 20 years the Hungarian social, sociopolitical and actual political situation did not make it possible to sustain that house. But many other services were born and are still operated by the Soteria Foundation, some of them for the first time in Hungary. These include daily clubhouses for those who live with psychiatric diagnoses, case management and an employment service. In spite of the sociopolitical situation, Soteria Foundation still succeeded in running the Shelter Program (solely funded by the private sector) for two years from 2012 to 2014, led by Ágnes Soltész, the chair of the advisory board and the professional leader of the Foundation.
The Hungarian National Psychiatric Hospital had been operating for 140 years in Budapest and was closed down on December 31st, 2007. The placement of 900 psychiatric patients had been unsolved for years, until the new facility (the National Institute of Psychiatry and Addictions) opened in 2013. There were six years of ambiguity, path-seeking, ambulant treatment and ad-hoc placements of psychiatric patients in different hospitals around the country. Soteria Shelter Program was born during these years as the result of a collaboration of many parties: psychologists, psychiatrists, business people, social workers, academics, family members of psychiatric patients, the Soteria Foundation, the Hungarian Academy of Science, the Hungarian Civil Liberties Union (HCLU) and last but not least, committed and hardworking volunteers.
After raising funds for the first year, in the beginning of 2012 we found a house with the right parameters in a suburban area close to Budapest. The Shelter (‘Menedék’ as we call it in Hungarian) could be a temporary home for a maximum of five people at the same time. Every resident had his or her own room, and there was a big hall for community life. During the two-year period it was open it provided home for altogether nine people. There were residents who lived in the shelter for two weeks, and others who stayed for one and a half years. The business model was as follows: all residents had to pay a previously agreed upon amount of monthly rental fee, which could be a very small amount, depending on their circumstances. Even the maximum amount was about one-third of the actual market price of renting a room. Food and utilities were financed by the program.
During the time of operation we had about 25 active volunteers. We had weekly meetings at the House with all the residents and the volunteers. The meetings were conducted by the House leader and the minutes were sent to our common mailing list (we called ourselves ‘The Ghostbusters’ — see our ‘Ten Commandments’ at the bottom of this post), which was available to everybody in our community.
When somebody was in crisis, we arranged a 24-hour presence in the House. We organized hikes, Christmas and New Year’s Eve parties, barbecues, garage sales, handicraft workshops, birthday celebrations, etc. It was ‘community living’ by definition. We, the volunteers, had to learn that we are not in the House to serve, neither to dictate; we were neither inferior, nor superior. We were in the House just to be present. To be there. To be available. The most desirable mindset was that of no desire: we made a conscious effort of “not wanting” anything from our residents — not even for them to get better. The aim was to provide an environment completely free of all external demands.
Twice a year, when Andrew Feldmár — who supported the program both financially and intellectually — came back to Hungary, he spent two days with the community. We kept daily connection with him via email and Skype. As the apprentice and friend of R. D. Laing decades ago, he saw at close quarters the success of programs similar to our shelter. The success was that the residents could live for the first time liberated, free from the stigma of psychiatric illnesses. The volunteers treated them as people, so they could take off the masks of disease.
Finances and communication
Soteria Shelter Program is a civil initiative without any governmental funding. It intends to be self-sustaining, thus to maintain itself with support from non-governmental organizations along with participation fees, as is done by similar programs around the world. Everyone in the project works as a volunteer. Even though all of us have joined the community to spend time with people who are in need, we also have to deal with fundraising and communication. We have been organizing and co-organizing several events, seminars, workshops and lectures, and are always looking for grants to apply for.
In February 2014, we had to close the House because we were running out of money and there seemed to be no capacity to do serious fundraising. So we decided to take a break to contemplate the two years we had had. Fortunately, two of the residents we had at that time were ready to start a more independent life, and the one who would have preferred to stay longer was able to live at the home of one of the volunteers for some months and then move on.
In 2015, we co-organized one semester of seminars about “madness” and a reading night about personal madness and recovery stories. One of our latest events for collecting donations took place in the Central Theatre in Budapest last November, where pieces of contemporary artworks were auctioned after a charity show. Our second auction event was organized in 2016, at the Summer University that is arranged every year by the Feldmár Institute.
For more than a year now we have been actively working on opening our new House. It became clear very early on that raising sufficient funds for our project will be harder than ever. Our biggest hope was the Open Society Institute’s Mental Health Initiative grant, because they seemed to have a closely shared view of healing in community rather than hospitalization. Unfortunately, they did not accept our application. We will try again this year. Among many ideas, attempts and appeals, last November we started a new campaign, the ‘Letter 100’ in which we are sending letters to the wealthiest people in the country and to the most successful companies in Hungary to support our program.
Our connections with other organizations
Our volunteers have taken part in trainings given by the Hungarian Civil Liberties Union (HCLU) for the fourth time. The trainings were about communication, fundraising, video cutting and practice of law. Apart from HCLU, we cooperate with the Feldmár Institute closely. This Institute works for acquainting more and more people with the way of thinking and “school” which are represented in Hungary by Andrew Feldmár. Following the heritage of Aristotle, Winnicott, Wittgenstein and Laing, the Institute is promoting the spiritual wellbeing that can be experienced through free, honest, and unashamed communication. Since we closed the House, Andrew hasn’t stopped meeting us; last time we spent two days together in the end of November, 2016.
We had also been running a workshop in the Feldmár Institute called “Professional Workshop About Psychosis” for interested and practicing psychologists and psychiatrists for more than a year. This workshop was conducted by Zsuzsa Tar, one of the supervisors of the Soteria Shelter Program. Our main goal was to acquaint the professionals of mainstream psychiatry with the essentials of Soteria.
Current leadership and projects
In the summer of 2015, after half a year without leadership in the Shelter Program, I took the lead of the project, with a deeply rooted commitment to the ethics of Hillel the Elder: “1. If I am not for myself who is for me? 2. And being for my own self, what am ‘I’? 3. And if not now, when?”
Until we can open a new House, we are running a free mobile service for people or families in crisis. That is the so-called “Minishelter” (“Minimenedék”), set up in 2015. The volunteers visit people at their homes. If somebody is afraid or does not want to be alone, we offer our company to the person in need once or twice a week; regularly or occasionally. The volunteers of Minishelter participate in preparatory conversations and groups, and are supervised once in two weeks by a professional. In 2017 February we plan to start a Hungarian crowdfunding campaign to smarten this project and invite more volunteers to participate.
Moreover, Soteria Foundation aims to train a team of three who are already working together at Minishelter in the 2017 Open Dialogue – Full 3 year Training Programme.
Maybe it was only a one-time chance, maintaining a Soteria-like House in Hungary. But still, our community of volunteers exists; we became friends and a self-help group, as we sometimes put it half-jokingly. Now we have fourteen volunteers and two supervisors, seven members of our team having joined after the first House closed. They can only imagine the life we lived around the Shelter, and they are inspired and motivated not just by the stories of the other half of the group, but by the way we think, speak and treat each other in our daily lives.
I hope that if we keep alive our philosophy, it will be possible to create a Shelter Home once again. For ourselves, for our families and friends, for everyone who gets lost in one’s own labyrinth. I completely agree with Andrew Feldmár, who often says: either we all get better, or none of us will.
* * * * *
The Ghostbusters’ Ten Commandments
- Everything is allowed that is not forbidden. At first nothing is forbidden, everything is allowed. Everything is up for grabs. There are no a priori rules. When there is real conflict, decide on boundaries, rules, etc. For example, freedom, autonomy, auto-rhythmia is encouraged, but transgression, taking license is not.
- When there is one or more of us present, or the location is premises that we own or rent, no illegal activities are permitted because that would jeopardize the future of our venture.
- Do not enter into a sexual relationship with those who need us, if you are working with us. It could be exploitative, it is certainly disruptive of morale amongst us, and leads to jealousy, envy, greed and an inability to be of service.
- Best not to have secrets from each other. Privacy is OK, secrecy is not.
- Just listen, keep company, help out only if specifically asked. Do not give advice, even if asked for. Discuss alternatives, leave decision to individual. DO NOT HELP! Live YOUR life in every given situation. You are NOT superior, just temporarily fortunate.
- No coercion, no persuasion, no criticism. All these make feeling loved and cared for impossible.
- Do not become hostage to the other. Guard your own freedom and dignity every bit as much as the other’s.
- Do your own thing, do not focus on the other, do not wait for the other to need you. Read, write, play music, do your own meditation, yoga, or martial art, but DO NOT WAIT. There is nothing to wait for.
- Be careful of your choice of words when you talk to or about the other. Say what you mean and mean what you say.
- Keep your promises. Broken promises destroy trust.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.