Shifting from poiesis to praxis

Tomorrow will be the fourth session for what I fondly refer to as Suicide Group. There’s a formal title for this closed group and it doesn’t actually have the word “suicide” in it, but saying a lengthy name is tiresome in everyday conversation. The particular one I (was drafted into, but I digress) am enrolled in is focused on students in college/university settings.

What makes this program stand out is that it’s specifically for those with a suicide attempt on record.

Why is this significant? Much of mental health information that I’m presented with is centred on a few key ideas:

  • Preventative: Taking care of your needs before crises, and Relapse Prevention.
  • Supportive: Guidance before and during crisis.
  • Rehabilitation: Re-entry into society, tied into Awareness.

The issue with suicide that I’ve noticed is that it’s extremely in Preventative mode. It isn’t talked about normally until tragedy strikes. We implement programming such as safeTALK and ASIST. That’s wonderful, but that’s for Preventative and Supportive modalities with some dipping into Awareness.

I used to let Keinnayi wear her safeTALK sticker with pride. But the discrimination is so powerful that I removed the sticker and tossed it into the garbage. There’s a discussion going on that I can’t engage for fear of further self-isolation, and it flies in the face of the Canadian Mental Health Association’s (CMHA) efforts to recognize the dignity of all persons, regardless of state or trait.

“We’re beautiful in our brokenness,” says some. “There’s beauty in the breakdown,” says Frou Frou in the song Let Go. But then there’s other lyrics in that song that contradict that message, but sure. It’s okay to challenge another’s thinking, provided that person is fine with this. (That last sentence? It’s the cause for a LOT of tension between me and some peers.)

On one hand, CMHA hires individuals with “lived-in experience” – also known as people who are/were involved with the system in some observable way. The reasoning behind this, as demonstrated to me, is that a peer connection can be more valuable for another person than the traditional roles of psychiatrist or therapist. (Yes, there are psychologists, but I haven’t met a single person who can afford those fees outside of institutions.) The peer is still in a position of authority, no mistaking that, but their own journey is relatable on a level that’s easier to grasp.

Now compare this to the other discussion. Well-meaning folks troubled about harm to clients and triggering of therapists … I fell for this trap too. Despite encouragement from the professor who’s stuck with me since Fall 2007, I came across the word incapacity and there went my marbles. I lost passion for my program. I’m still struggling to find my space.

Still, if I have one gift that means anything, it’s endurance. Lately, that IQ of 142 has been a hassle. My mind doesn’t want to shut the hell up. Even during sleep, I’m lucid, so I’m always analyzing and poised to intervene when the dream turns into a nightmare.

I dropped the CBT-DBT course, feeling guilty after I’d just secured permission to do the assignments on a level closer to doctoral work than the requirements of my master’s. Guilty after actively taking the material and trying to apply it to myself in an effort to fully appreciate the model. I used to hate CBT after exposure in a hospital setting. I hated it more when an untrained person with no formal psychological education crafted a regime based on CBT to fix me, and blamed me for failing to produce the desired results. The first class of Seminary adventures, I directly challenged the model out of sheer spite, calling upon positivism and empiricism.

The professor? He smiled. He didn’t agree with my labelling of radical behaviourism, but then a bomb dropped. His theoretical orientation is grounded in psychoanalysis, and here he was, teaching CBT and DBT.

After that first class, I approached him with great hesitation. “I’m going to have real trouble in this course, but will you have patience with me?” This is a man who uses few words in class to get his point across. You could take him at face value or go deeper into the way lectures are structured. You could spout a novel at him, and he finds a paragraph – if even that much.

“Of course,” was his very simple, yet meaningful reply. Even when I dropped the course and composed a letter of explanation, I got two sentences back. “Do what is best for you. I will be always pleased to have you as my student in the future.” Yeah, I was bawling for a while in gratitude.

My venture into facilitating a group, fondly known as Quadrifolium, fell apart due to issues in group dynamics. It was ugly and rough even when I confessed about it (without identification, or I could be reprimanded for privacy violations) and criticized myself in my Ethics essay. I was expecting the reaction I could hear from other directions. Proof that I was incapable of psychotherapeutic work. My skills and strengths would be best serviceable in a more strict research approach. Dangerous to clients, a danger to myself.

Look at how we treat people who are currently struggling with certain and specific mental health issues. And who, someone asked me, would want a therapist that’s sick herself? It’s the same reasoning I use to not complain about the constant pain my body deals with everyday. As long as I can motivate myself to walk to the grocery and buy enough food for the week, then wheel it all home in my little cart, then it’s okay. I don’t take pain medication for many reasons, most important being the fact that my body hates medication with a passion strong enough to destroy me. I do wear medical ID for good reason, you know.

My Ethics professor delivered another shock to me. Geez, all three of them, it’s almost like they planned this. The idea cracks a smile on my face. What do faculty discuss at those mysterious meetings anyway? LOL. Not only did I earn an A+, but I received individual feedback as promised to all the pupils. That feedback had very little to do with writing (hello APA, bane of the psych student – but hey, I did spend four hours with the Sixth Edition Manual and still screwed up with a specific about references) and more about guidance for next steps while attending to my experiences and journey this far.

Note for students wrestling with APA: Yes, the Bloody Blue Book from Hell (aka the Manual) is annoying to deal with. But trust me when I say this, using Internet sources and templates do NOT replace the Manual. I spend more time fighting my frustration with applying the Manual to my work than you know, actually WRITING THE GOSH DARNED REPORT. But guess what. The Manual has all these things that the Internet sources do a poor job of explaining. I refuse a model outright unless I can perceive how it was constructed. Don’t give me the reasons, let me explore HOW the thing was designed, then we can talk. The scary thing? Professors will know if you used an Internet source versus the Manual. It’s not a magical formula. In undergrad they let it slide a little, but in grad school, d’aw hell no, the Manual is a required purchase.

Yes, I like to ramble and it might seem unrelated, but my mind is like a radial web that keeps spreading. It’s connected, seriously. I’m not actually off-topic.

Do you see where I’m going with all this chatter? Here it is: People within the field of psychotherapy are placing more emphasis on the Aristotelian praxis. The easiest way I can describe praxis is to quote my current theology professor, “Doing something for the sake of doing it well without an end goal; an act without an objective result.”

Here is an example of my first conscious encounter with Aristotle’s three forms of knowledge, because apparently going to see Myra’s Story on October 4th was an exercise instead of watching a play and confronting our feelings regarding the homeless.

Professor: Theoria, praxis, and poiesis can be applied in this way.

Poiesis: Brian wrote the play.
Praxis:
Jennifer performed as Myra, the homeless woman.
Theoria: Audience viewing of the play.

Professor: Now for your experience. How would you describe Myra’s Story?
Me: I think I’m starting to understand what reflection and reflexivity mean. My partner’s mentioned it before, and it came up in this week’s readings. Here’s my experience.

Theoria: Viewing the play and being open to my reactions, allowing it to permeate through, within, and without me.
Praxis: Reflective, acknowledging my reflection; reflexive, seeing myself as part of the mirror.
Poiesis: Explaining to Andrei about why I kept thinking of The Little Matchstick Girl.

And this, I think, is why psychotherapy is heading where it is – at least in Canada. Psychotherapy is often held as poiesis, the point being to assist a person into recovery. This shift to praxis is evident in my continued struggle, the question is being asked of everyone, “What does recovery even look like?”

CMHA is taking on a different approach with peer support workers, community based treatment, and so forth, even down to Suicide Group am I seeing this paradigm testing its wings. Of course this won’t satisfy everyone. Some people just want to get better and be done with it, and you know what? They’re right to want that. It’s vital to address all sides, or we lose people through the cracks.

It’s a major problem with introductory statistics courses. That pretty bell-shaped Normal curve? Yeah. Do more than memorize formulae, actually understand what those formulae are doing. Watch the subtle differences in terminology. Semantics may be complex but as researchers, you have the ethical (though not always legal) responsibility to be aware of how you’re collecting, manipulating, and interpreting raw data. So you can’t stop the media from bastardizing your study and twisting the words of interviewees, but that doesn’t mean you do research and hide away in the ivory tower. People who aren’t as familiar with how scientific inquiry actually works can and will run away with speculation, because of the lack of understanding. People take your work seriously. Your work is implemented into society or at least discussed on some level. Take care how you portray what you’ve learned!

Father: I read one report saying that coffee’s good for you. Then I read another saying that coffee’s bad for you. Which is it? Which one is right? Why can’t scientists make up their minds?
Me: It’s not one or the other. Both are correct, and scientists “can’t make up their minds” because there’s a difference between theories and hypotheses. Hypotheses can be falsified, but a theory cannot. As to how both can be correct, that requires some knowledge of how statistics work. If you want to dig deeper, we’d have to delve into epistemology.
Father: All I want to know is if coffee is good or bad for people. Not that shit.
Me: Then don’t rely on reports for information. Go find out for yourself.

That, too, is a form of praxis.

So what does recovery look like? My answer is this: It’s a journey, not a destination. I sometimes refer to myself as Endless Wanderer for this observation (note the way I structured that title, it’s very telling). It may sound cliché, but it’s a reality for me. No, you’re free to make your own decisions about my perception. I make two more appeals:

Aristotle: It is the mark of an educated mind to be able to entertain a thought without accepting it.

A textbook on world religions: Real understanding is not a matter of agreement or acquiescence, but a quest for a patient and appreciative relationship that can persist despite disagreement.

And now to find some food. 🙂


REFERENCES

Amore, R.C., & Hussain, A. (2015). In W. G. Oxtoby, R. C. Amore, A. Hussain, & A. F. Segal (Eds.), A concise introduction to world religions (3rd ed.), (p. 27). Don Mills, Ontario, Canada: Oxford University Press Canada.


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