Recovering the Person in Treatment

This article was authored by Wellspring co-founder Richard Beauvais, PhD for publication in Mental Health News in January of 2013.

Download a copy of this article in PDF format by clicking here.

Person-centered recovery could well be reframed as recovering the person; for isn’t that what treatment is ultimately about? At Wellspring we base our relational approach to treatment and education on a multi-dimensional concept of the person. We also organize our multi-modal residential programs for children, adolescents and young adults to address precisely that.

In many treatment settings, an individual is provided with a psychiatric diagnosis and objectified as a particular disorder. While useful for clinical practice, a diagnosis with its symptoms easily becomes a label, defining the individual as an “it” or object, rather than a “thou” or subject. (Buber, 1957) I can’t tell you how many clinical summaries I’ve read that are devoid of any sense of a person.

The cornerstone of Wellspring’s relational approach is that inherent in each individual is a wellspring of personal being that is unique, unrepeatable and imbued with spirit. Respect for the sacredness and dignity of each individual proceeds from this belief. As the foundation of our relational approach, personal being is understood as a particular expression of all Being, which implicitly connects us with one another and all other creatures. We emphasize this as a core treatment value, because there are forces within our culture and society that would blur this awareness.

The word person originated with the Greek term, phersu, which depicted the mask used in ceremonies of the cult of Persephone, a goddess who symbolized the seasonal aspect of fertility, because she spent half the year above ground in the light and the other half below ground in the Underworld. Thus, the nature of person was thought to be partly manifest and partly hidden – both apparent and mysterious.

In Roman times, the word evolved to designate the mask through which an actor spoke his lines – hence, dramatis personae. Persona stood for the character represented by the mask, as well as the voice speaking through it, per-sonare, i.e. through sound. Person in this sense is a quality of being communicable through expression. The late Fritz Perls, originator of Gestalt Therapy, agreed saying that the truth of the person – the authenticity of communication as personal – is in the sound of the voice, not the content of the words. This ring of truth – of the truly personal – is what we listen for in our Emotional Expressive Groups.

Historically, the concept of person evolved from religious and theatrical contexts into civic life. Here, its meaning was altered to convey a special dignity associated with social stature and civic rights. Women, children and slaves, for example, were not considered persons. However, with Cicero, the great Roman poet and orator, the meaning of person was transferred from the exterior social sphere to an interior and metaphysical meaning, which pertained to all individuals regardless of status or function. Person was used to denote that which is essential and distinctive in each individual, in contrast to the humanity shared by all. As a quality of being inherent and intrinsic to the individual, person was no longer reducible to utility or number. (Schmitz, 1997)

Finally, another Greek term, prosopon, was also incorporated into the meaning of person. It emphasized the human face and the experience of intimacy with self and other through face-to-face encounter and exchange; hence, the source of the familiar phrase “up close and personal.” (Schmitz, 1997)

Each of these five lines flows into the meaning of person, and each informs how we engage our clients in a process of person recovery:

1) Both apparent and mysterious;

2) communicable through expression;

3) of dignity and deserving of respect;

4) essential and inherent to each and every individual;

5) a quality of intimacy shared between individuals.

What we need to become aware of is that a fundamental shift of emphasis occurred historically, which tended to disconnect the meaning of person in each of these five senses from its depth.

This shift was first expressed by Descartes’ philosophical cornerstone – “I think; therefore I am.” The statement signified an increasing introversion, which circumscribed the meaning of person in terms of subjective self-consciousness, while disconnecting that meaning from participation in the larger mystery of Being. Our own field of Psychology reflects this orientation: Psychoanalysis is a case in point. Since Descartes, the sense of person and of personality has become increasingly elaborated and made more and more complex. However, complexity is not the same as depth or authenticity with respect to human being.

Along with this increase in subjective complexification was a corresponding tendency toward depersonalization. Whether defined in terms of ethnic stereotyping or social utility, the individual has tended to become more and more emptied of personhood and reduced to mere matter or number, to which the visible carnage of bodies on the movie screen attests. The same tendency is mirrored in our clinical reporting.

The challenge for us at Wellspring, and for anyone serving in mental health, is to consciously extend our caring and healing mission against this increasingly pervasive I-It orientation. If only because, as Martin Buber points out, any time our consciousness reduces the other to an it, we diminish our own sense of I. It’s what, I believe, this issue is attempting to address.

At Wellspring, we think of the work of person recovery as having two complementary thrusts. One is to change unhealthy patterns of relationship to self and others that distort or block who this person in essence actually is. The second is to reveal and affirm this core personal self, so the individual can align with it and build on it as the basis for a personal identity.

What our multi-modal and holistic treatment programs provide are different windows for seeing, mirroring, affirming and supporting the emergence of the person in the context of clinical work. Because persons are many faceted and differently gifted, no single treatment modality or approach can serve all, but each modality contributes to the work of person recovery in its own particular way.

What staff bring to the process of person recovery is an alertness and receptivity to individual differences and the uniqueness of individual gifts. Because individuals cannot see their own nature, they take for granted what they do and how they do it. What they need is to be seen, acknowledged and affirmed within an interpersonal framework that is focused on person recovery, so that they can begin to align with a sense of who they are.

A person thus emerges only in the context of relationship: The two are inseparably linked. Individual therapy provides face-to-face intimacy and exchange, which is amplified in turn by relationships with staff in the milieu. Interactive group therapies provide a context for the individual to see and be seen as a person among peers, exploring individual differences and commonality with others through engagement. Family therapy can work through problems in primary relationships that open ways to person recovery. A child or adolescent may have been oppressed by the parents’ vision of who he should be, or he may have been unseen altogether. In the treatment of addiction, parents can recognize the re-emergence of the essential person of the child they had lost sight of but had known before.

Emotional Expressive Group is another important context for person recovery. By working through blocked emotions of anger, sadness, grief and joy, the individual can stand clear of defenses and be more vulnerable and real. With creative-expressive modalities that encourage self-expression – art therapy, puppetry, dance and sand-tray work, for instance – the creative product stands as a signpost of the personal.

At Wellspring, we maintain the presence and care of animals in all of our residential programs, because relationship with an animal simply makes us more human. It is why the non-verbal, land-based, experiential therapies of work, animal care, horticulture, and adventure program receive special emphasis, because nowhere is the essential nature of an individual more clearly revealed than in the instinctual responsiveness of body activity. Sally’s process of person recovery began with discovering a deep love for animals that opened a career path as a veterinary assistant and possibly as a vet.

The same personal approach holds true in education, where different learning disabilities and learning styles must be approached individually. This is truly the art and the heart of “special education.” Debbie, for example, was motivated to learn only when she was able to adapt her entire curriculum to the needs of cooking, after we discovered how passionate she was about food, and had been so, her mother assured us, since she was 4 years old.

Finally, the disorder itself can provide a window for person recovery. Symptoms, simplistically, can be understood as substitute ways to meet previously unmet needs – for attention, affection, appreciation and acceptance. But the personal can also be expressed through the symptom, whether in the artfulness of a defense or the style of a manipulation, the ways in which an individual strives to be special or to disappear. When Sara, a twelve year-old, hacked into our computer system to read her chart, some were outraged at her behavior as symptomatic of a budding character disorder. Others noted her audacity and technical aptitude, and lauded her innate drive to uncover “secrets” as a born detective. The “disordered” act became the basis for her emergence into health.

To the degree that we as a therapeutic community direct our efforts toward the process of person recovery, we provide an environment where treatment, education, and the healing of the person are enhanced.

 

 

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