A New Way of Teaching "Severe Mental Illness"
Knowing everything we know about human suffering and connection there's no reason to stick to biomedical frames in master's counseling programs
Between the ages of 18 and 33 I was hospitalized in psych wards four times against my will in the midst of manic psychotic episodes, and one time where I technically voluntarily signed myself in during a state of catatonic suicidal depression. I have a lot of experience with clinicians treating me inappropriately and frankly just not knowing how to relate to me as a fellow human being. Most clinicians are not trained to understand how to relate compassionately to people struggling with what gets called “severe mental illness.” It’s confusing, especially if you don’t have personal experience with it yourself. I’m getting close to 50 and those incredibly painful and complicated experiences as a young man taught me so much about how to relate to other humans in the midst of extreme states.
When I was in social work school we spent a lot of time talking about race and class and gender, but we were actively discouraged from talking about our own personal experiences with mental health struggles. It was part of the culture of creating working clinicians, learning how to have appropriate professional boundaries. But there were so many personal stories that we were all just trained to keep in the shadows. Our frame of reference for “severe mental illness” came in the form of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as we learned the diagnostic criteria for all the major mental illnesses. I’ve thought a lot about those experiences getting my MSW, and the culture of becoming a clinician. I’ve thoughts a lot about how I would do things differently, and I’ve put some of those ideas into working with training organizations like the Institute for the Development of Human Arts (IDHA) and my own Transformative Mutual Aid Practices (T-MAPs.)
Last year I was invited to teach a semester long class in the Community Mental Health program at the California Institute of Integral Studies (CIIS) entitled “Severe Mental Illness & Early Psychosis” and I had such a good time doing it. I got really positive feedback from the students and the department even though I only had three weeks to prepare the course. When I was asked to teach again I spent much of this Summer developing the new curriculum. I’m driving up to the Bay Area to teach in person this weekend and it feels like such an honor: CIIS has such a rich history going back to the 1960s Human Potential Movement and the intersection of Eastern spiritual practices and Western psychotherapy. I know a lot of good people that have come out of that place. All the students in my class are preparing for careers in the public mental health system and I get to help them think through what that means. CIIS feels like a great place to be experimenting with a new way of teaching.
Normally a class on “Severe Mental Illness” would be full of psychopathology and biopsych frames, but they’re letting me teach it however I want so I’m bringing 20+ years of working in the Icarus Project and everything I know from living and working in the transformative mental health world, including my last three years as an Internal Family Systems practitioner. I’m particularly excited about introducing the rich history and tools of Systemic Family Therapy to working with what gets called “SMI.” I’ll be posting pieces from class in the coming weeks and months, but in the meantime here’s the course description. Please feel free to like and share this with others if you’re interested and inspired.
Course Description
The primary objective of this class is to prepare you with the confidence and self-knowledge to engage in direct service work with people diagnosed with Severe Mental Illness (SMI). We will learn the major categories of what gets called SMI (e.g. psychosis/schizophrenia, mood and personality disorders) and familiarize ourselves with the political and social landscape that creates the climate for these extreme designations.
This course will introduce students to transformative frameworks, collaborative strategies, and creative practices for working with people labeled with “severe mental illness” and “psychosis.” It is designed to help emerging clinicians draw on their backgrounds and personal experiences with the aim of humanizing those who have received an SMI diagnosis and demystifying their experiences. We will integrate skills and practices from experts by experience and individuals with first-hand knowledge working support roles in and outside the mental health system.
The foundational clinical framework for this class will be the Internal Family Systems (IFS) model created by Dr. Richard Schwartz. IFS has its theoretical origins in the Systemic Family Therapy movement, which initially grew out of working with people diagnosed with SMI from the 1950s through the 1980s. It is a theoretically rich and creative model that is currently growing in popularity and offering a non-pathologizing framework to use in the mental health system. Other theoretical models we will cover in this class include Narrative Therapy, Somatic Trauma Therapies, Process Oriented Psychology, Neo-Jungian/Humanistic models, Open Dialogue/Dialogic Practice, and Compassion Focused Therapy (CFT.)
COURSE GOALS & STUDENT LEARNING OUTCOMES
Students will be able to recognize what constitutes SMI diagnoses and how to think outside the diagnostic labels.
Students will be aware of etiological theories of SMI including psychosis/schizophrenia, mood and personality disorders, their historical context, and the structural and cultural factors that influence their diagnosis.
Students will be familiar with evidence based practices for approaching SMI diagnosis and clinical treatment planning that is person-centered.
Students will become familiar with creative and practical frameworks for understanding and engaging with people diagnosed with SMI, including peer support networks and activist movements developed by and in solidarity with people labeled with SMI.
Students will create and compose a vocabulary and a set of practices for doing “inner work” with the understanding that the more we know ourselves, the better we will be able to genuinely engage with others.
Mad love, y’all.
Let me know if you’re interested in seeing any of the video lectures, I might post them for paid subscribers and send them to anyone who wants to see them.
Amazing work, Sasha! I would definitely like to see any videos to learn more. It is so refreshing to see this much needed approach. I would very much like to find practitioners who take this approach willing to work with my family member who lives with schizophrenia.