What's going on for me?
You’re not mad, crazy or ‘missing’ something that enables others to cope with life and all that it brings. And things can be different; you won’t always cope in the way that you do, you won’t always be subject to a merry-go-round of assessments, admissions, blame and scrutiny for being unwell.
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There’s other ways of understanding and responding to mental-ill health and distress outside of a medicalised psychiatric model of diagnoses, ‘treatment’ and clinical frameworks. Take a look at non-medicalised understandings and resources below.
Resources & Training
Beacon House
Instead of the 'brain gone wrong', we can look at mental health illness as being the 'brain gone right'; a brain responding to circumstances or environments where we have no control but we still have to live through it. There's may ways that the brain's survival strategies appear as 'abnormal' or 'disordered' to the outside world; sometimes when people self-harm or suffer from an eating disorder, it is rooted in ways of coping when our brain and bodies are in survival-mode. You might be experiencing dissociation and are perceived by others as shutdown, depressed, or you might have human needs that are not being met, and your way of communicating distress is not effectively being responded to.
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Image or information courtesy of Beacon House Therapeutic Services & Trauma Team | 2022 | www.beaconhouse.org.uk
Beacon House
When we (as human beings) understand what might be driving seemingly 'ill' or 'deviant' behaviour, we then adjust our response to meet the needs of the individual and meet them with compassion, not blame. To do this, language matters.
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Image or information courtesy of Beacon House Therapeutic Services & Trauma Team | 2022 | www.beaconhouse.org.uk
Beacon House
Are you, or your child, the quiet kid, the head-in-a-book kid, the independent-highly-intelligent kid? What if, instead of this being an indicator that you or your child are 'fine' and thriving, it means you're blending in to survive and cope with life?
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Image or information courtesy of Beacon House Therapeutic Services & Trauma Team | 2022 | www.beaconhouse.org.uk
'[Boyce] writes that certain variant genes can increase a person's susceptibility to depression, anxiety, attention deficit hyperactivity disorder, and antisocial, sociopathic, or violent behaviours. But rather than seeing this "risk" gene as a liability, Boyce, through his daring research, has recast the way we think of human frailty, and has shown that while these "bad" genes can create problems, they can also, in the right setting and the right environment, result in producing children who not only do better than before but far exceed their peers. Orchid children, Boyce makes clear, are not failed dandelions; they are a different category of child, with special sensitivities and strengths, and need to be nurtured and taught in special ways. And in The Orchid and the Dandelion, Boyce shows us how to understand these children for their unique sensibilities, their considerable challenges, their remarkable gifts.' Watch Boyce talk about his work here.
Open Dialogue UK provides training programmes, workshops and resources across the NHS, private sector and internationally in the hopes to embed the Open Dialogue Approach into our current mental health systems.
Through utilising her lived and professional experience, Carolyn Spring makes the complexity of trauma and its lasting impact simple. Her work centres around a fundamental belief that recovery from adversity and trauma is possible but, to do that, we need other people. Professionals, providers, and survivors alike, Carolyn shares her breadth of knowledge through her online training, resources, blog and podcast.
Forming part of an international movement calling for non-coercive and humane mental health services, Soteria Network (UK) are a UK-based collective of professionals and survivors of psychiatric services that promote the use of medication-free and drug minimal therapeutic environments as an alternative to conventional psychiatry.
Naomi Fisher provides a different perspective on neurodivergence, parenting and living in a world that fails to accommodate the needs of autistic people. She gives a breadth of knowledge, professional insight and lived-experienced through online courses, webinars and training.
Compassionate Mental Health is a network of people across the UK calling for a radical shift in how mental health is viewed, understood and responded to. They provide online and in-person training on a variety of topics from a compassion-based and psychiatry-alternative perspective.
Models, Frameworks &Approaches
Originally founded in Western Lapland, the Open Dialogue approach is centred around engaging in compassionate, empathic, and secure dialogue with a network of people (not professionals). Rather than relying on medicalised treatment practices and hospitalisation in response to acute risk, the Open Dialogue approach works not only as a form of therapeutic conversation, but a whole-system approach to acute distress and crisis.
Living Well emerged in 2018 to create new systems of community mental health across the UK. Since its inception, outcomes for people struggling with mental ill health have improved in areas that have adopted and incorporated the Living Well system and approach. Read more about their case for change here.
Born out of Italy in the 1980s, the Trieste approach takes a relational and community-focused view of mental-ill health, underpinned by a culture throughout community mental health services that recognises the autonomy and inherent rights of all who need support. The Trieste approach centres itself around mutual trust and respect of those in their care; there is no restraint and no alienation or ‘othering’ by diagnoses, compliance and risk-averse practices.
Peter Stastny / Peter Lehmann (Eds.)
In their book, Stastny and Lehmann provide a comprehensive account of alternative care and treatment beyond psychiatry. By documenting the voices of over 50 professionals, survivors of psychiatry and their loved ones, Stastny and Lehmann highlight the experiences of psychiatric and iatrogenic harm, and what the alternative might be.
Carina Hakansson
In this poignant interview, Carina Hakansson and Eric Maisel explore the implications of psychiatry and inpatient models of care for society as a whole; within this, Carina shares her experience of working with the Extended Therapy Room Foundation as an alternative to the psychiatric system.
'Over the course of five years a group of senior psychologists (Lucy Johnstone, Mary Boyle, John Cromby, David Harper, Peter Kinderman, David Pilgrim and John Read) and high-profile service user campaigners (Jacqui Dillon and Eleanor Longden) developed the Power Threat Meaning Framework as an alternative to more traditional models based on psychiatric diagnosis. [...] In traditional mental health practice, threat responses are sometimes called ‘symptoms’. The Framework instead looks at how we make sense of these experiences and how messages from wider society can increase our feelings of shame, self-blame, isolation, fear, and guilt.’
(The British Psychological Society, accessed 2023).
With a history dating back to 1971, the Soteria Model is known for its non-medical approach to supporting those dealing with psychosis and schizophrenic-like symptoms. By approaching psychosis without (or with minimal) medication, and making antipsychotic medication a choice, the Soteria Model places emphasis on maintaining personal autonomy, social connections and a safe community when people are in times of acute and extreme distress.
The Polyvagal theory is essentially the 'Science of Safety'; our nervous systems are responsible for both inner and outer cues of safety and threat. If we can understand the subtleties of human experience in terms of safety and threat, we can understand what appears to be a complex plethora of emotion and conflicting narratives of experience. In other words, the Polyvagal theory explains much of what we might call 'mental health problems', and expands our understanding of what trauma is, and the impact of it.
Research, Critique & Analysis.
‘I see each person as the central character in their own play. When I am asked or expected to understand them and to help them to restore some sense of normality and “sanity”, from the chaotic feelings, thoughts, and actions of their madness, I have worked hard to see their world from their perspective. Although the biomedical diagnosis is claimed to reflect a scientifically refined definition of human nature, in fact, it mistakenly oversimplifies the complexity of a person’s state of mind.’
(Robert Murphy, 2023)
An interview with neuroscientist Dr. Stephen Porges on the importance of polyvagal theory in creating therapeutically safe environments and relationships between professional and client.
A narrative review of the shifting definitions of neurodiversity and its implications for therapeutic practice when working with neurodivergent individuals.
In this review article, Dr. Stephen Porges details the need for a paradigm shift in contemporary methods for health and wellbeing that respects and nurtures human beings' biological need for feelings of safety and co-regulation.
Lauren Spiro discusses the strengths of the Soteria House Approach when compared against conventional psychiatric approaches and invites people to be curious about considering alternative approaches to responding to distress and crisis.
This descriptive study looks at symptom repetition and overlap across all 202 diagnoses of adult psychopathology in Section II of the DSM-5. The study highlights that, not only are there distinct limitations of traditional diagnostic systems and categorisation, but further empirical research is also needed to understand the implications of such symptom overlap to improve the validity of the DSM-5 and consequent research and clinical practice.
Research from an experiential perspective of working in ‘The Extended Therapy Room’, an approach utilised as part of the Family Care Foundation.
A conversation with Jaakko Seikkula, co-founder of the Open Dialogue Approach, on what might need to shift in our mental health systems to better understand, respond and care for people experiencing acute distress and crisis.
In this critique, James Barnes outlines and discusses a psychiatric critique of the Power Threat Meaning Framework, a co-produced alternative framework to the conventional diagnostic perspective on distress and mental-ill health.
Dr Lucy Foulkes discusses the current consequences of mental health campaigning and calls for future campaigns to move beyond simply raising awareness and fighting stigma, and instead start highlighting that mental-ill health doesn’t exist in a vacuum; if we’re going to reduce suffering, we need to understand the contextual complexity behind seemingly ‘healthy’ versus ‘unhealthy’ brains.
Networks
INTAR is an open network working to develop a new paradigm of mental health care and promote the use of effective, non-coercive care and treatment. INTAR are currently working on developing an accessible platform to share the breadth of alternative practices, research, and rights-based approaches. Through evidencing what does not work, and why, INTAR works to challenge the traditional models of psychiatric practices and interventions and propose a better, human alternative.
INTAR is an open network working to develop a new paradigm of mental health care and promote the use of effective, non-coercive care and treatment. INTAR are currently working on developing an accessible platform to share the breadth of alternative practices, research, and rights-based approaches. Through evidencing what does not work, and why, INTAR works to challenge the traditional models of psychiatric practices and interventions and propose a better, human alternative.