Unravelling ‘peer imposter syndrome’ and coming to understand the experience of mental health distress

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It doesn’t rear its ugly head much (anymore) for me, but it did for a while. So, let’s start with a full disclosure: I was never medicated. I was never diagnosed. I was never locked up in a “mental health unit”. So, I’m not a survivor of systemic or psychiatric abuse. I was “only” suicidal for a couple of years. In Ireland around a third of  suicides are people with no history of service use, 76% are male. 

Would we consider these people to have had a mental illness/disease? Particularly when we may reject the concept of labelling human suffering by ascribing it subjective diagnostic codes. We can probably agree they were in extreme distress.

Mental health or mental distress is a nuanced area. What holds true for one, doesn’t necessary hold true for another. That should possibly be held as a golden rule for all discussions in the area. A diagnosis and/or medication may have been a breakthrough for one person and a curse from beyond Hades for another. I’ve made peace with my own past and present. I’m not seeking validation for being a peer and don’t care if you think I’m one or not, if I’m honest. But it’s a topic I think worth exploring. Who arbitrates who becomes a peer? Should we have a peer/lived /living experience council/collective who “decide” if your suffering was intense enough or of long enough duration. Must you have had a diagnosis; must you have been medicated? 

Its axiomatic that you must have experienced these things to be a “survivor” of psychiatric abuse but what will we define as a peer, or should we have a definition? After all, most everyone probably has times when they don’t feel great or potentially feel life is not worth living. Do we measure either duration of distress, intensity of distress or attempts at suicide? Are all thoughts and attempts valid or only those which we almost completed or that had a provable physical manifestation? While most of the people reading Mad in Ireland probably ascribe a trauma-based explanation for the aetiology of mental health distress, where things really get confusing is why this leads to depression in some, suicidal ideation in some, hearing voices in some, disassociation in some and a myriad of others.

Some thinking propounds that the peer will most likely have undergone a Damascene moment or a paradigm shift where we changed the direction of our life as a result of the distress experienced. This could be a reasonable measure, or probably it just seems so, because it’s been my experience. My paradigm shift came from my negative experiences. While I wasn’t quite set on becoming Gordon Gecko from the film Wall Street, I was focused on “winning at life” as I saw it, #bestlifeever, before hashtags were even a thing. I was focused on business, on my own business and having the trappings that are associated with wealth. I was vice-president of the local chamber of commerce and saw myself as a “man about town”. My naive attitude was that people out of work, people that were homeless, were there because of the choices they made. I’m quite embarrassed to recount that now. My eyes have been opened so to speak. 

So, what opened then? To keep it short, a series of unfortunate events. Within the timing of the financial crash, I had the sheriff calling from revenue several times to the business. I had to scramble to find monies to keep the shutters open, pay staff, put food on the table etc. I hadn’t been making mortgage repayments or payments on other loans. Serious illness arose with a close family member, and another passed away, all within a short time frame. The marriage went by the wayside and, perhaps most crushingly of all, I was now only able to see my daughter as someone who no longer lived with her, instead I was a regular visitor. Life was in a spin. Life didn’t seem like it was worth a lot. In my opinion, at that time, I didn’t seem to be worth a lot. A darker road beckoned and on one occasion I followed it. 

 A series of “unfortunate” events in a short space of time pulled out my foundations and tumbled me into the abyss. Yet the depths and beauty of the water was also where I sometimes found my solace. Enraptured by its silence; the ocean cast its spell. I was bound to be a part of it. In retrospect there can hardly be a clearer analogy of life, nor the ending of it, at your own hand. On some occasions I stood or knelt on the ocean floor gazing at the way back up. Glancing at my watch that indicated my time at this depth. I knew roughly how long I could stay there on a single breath. If I stayed for longer……it would look like an accident. Suicidal ideation or the rapture of the deep? Jacques Mayol a famous freediver once said, “you need a good reason to come back up”. 

I had so many good reasons but not for an instance did I contemplate them.  I honestly can’t answer what brought me back each time as this “experiment” was repeated in various formats for a while.  Another venture to the ocean had me swimming far, far out, swimming until I was enveloped in a cloud. I couldn’t see the shore anymore, just cloud and the ocean. Then the rain came. It bounced on the surface and melded my tears with the sea. I couldn’t but admire it, couldn’t be, but awestruck by the beauty. Then a break in the clouds and a visible shore to return to. What concatenation of thoughts conspired to bring me back can hardly be described, yet at some level, I know it to be the humblest of things, love of- and from others. Potentially, if that was not there, even in the subconscious, what was there to come back for? One other conspirator perchance, that of curiosity. I do recall being curious of how much more one could take? What could or would happen next?  A lover of life, a hermit or a right awkward bastard? 

So, if you can, stay curious. 

Again, my naivety showed, I thought that must have been rock bottom. Instead for several years I wallowed and wandered in this darkness, engaging in what clinicians would describe as risky behaviour. It “helps” if your pastimes are regarded as extreme sports, so many instances could have been perceived as accidents.

Several things had a buffering effect, and while I’m thankful for them now, I was unaware of them at the time. I had a good social network and family that, due to my headspace, I never availed of but was there nonetheless. One that I’m most thankful for is that my daughter was never used as a bargaining chip. My access to see her was never restricted. I was still able to get one or two days work a week. At the time there was precious little social supports for the self-employed, something that has been changed somewhat since. 

Eventually a contact got me into volunteering with a phone service and I heard first hand of the immense strength of some humans. While we can’t accurately measure a person’s trauma, the stories I heard put my difficulties into some context for me. In this role I also got to do some training in a prison and heard stories from the guys that simply said to me, “If I had experienced that, I’d most likely be in the same place”. This self-reflection, this shift of perception is probably one of the key components of peer work or at least is for me personally. For some survivors, it may have been this shift from the dominance of the medical model, for some it may not have been, refer to the “golden rule” above. Several years later I saw the advertisement for the role of peer support worker but internally queried whether my experiences had been severe enough to warrant the position. For about a year or so in the role I still reflected upon this with some trepidation. There was no shift in perception this time but rather a perspective of perhaps having gradually earned it at this stage or potentially (with advancing years) I just stopped caring what people thought of me.

As the role expands in both statutory, non-statutory and other services, we will be faced with ongoing problems. Namely keeping the fidelity or the ethos of the peer movement and avoiding becoming more of the same or co-opted, particularly within the statutory services. Plenty will say the horse has already bolted on this, those of us in the system will say we are still working on it. At some point you need to decide if you’ll attempt to change things by being inside the system or by existing outside of it. Here’s a book about exactly that. We’ll get some of that expansion right and some of that wrong. Hopefully we will correct as we go and maintain a critical self-reflection.  The job specifications for lived experience roles often cite “the experience of mental health distress” rather than an actual diagnosis – or experience as someone who has used mental health services. If and how we discriminate for that distress will never be black or white, but like much of life, will be in the many shades of grey in-between.   

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