Chapter

Peer Support and Mutual Aid

Mutual Aid Groups and Listening Spaces (as used by The Icarus Project)

Breaking through the walls and making a connection can mean all the difference in the world.

Mutual aid and support groups are a way to bring down the walls that isolate us. No one in the group is above anyone else: mutual aid means we listen to and support each other as a community of equals, without paid professionals or staff to define who we are. Each of us is an expert on our own experience, and each of us is the center for our decisions— and we are not alone.

When we gather together with people who’ve been through what we’ve been through, people who share some of the mysteries and suffering that get labeled “mental illness,” we discover new maps through crisis, learn new tools to stay healthy, and weave communities of solidarity to change the world. We discover something at the heart of the dangerous gift of madness: caring for others is often the best way to care for ourselves.

Listening Spaces

There is a wide diversity of group models to draw on, and we encourage you to experiment to find the best fit for you. All these approaches, however, share the same essential principle: create a space for listening.

In nature, stillness, silence, and sky create a vast container for what is essential to emerge. Step into wilderness and you encounter a hushed patience and gentle holding rare in the noisy, sped-up clash and clamor of our lives. Corporate monocropped culture suppresses true listening and imposes labels, rigid habits, and preconceived notions. Real support and caring means breaking down habitual ways of interacting, and meeting each other in spaces of true, effective listening.

Key elements of listening spaces

= Don’t talk over others or interrupt. If someone interrupts, gently ask them to stop. Take turns. Raise hands, or go in order.

= Don’t rush through or go too fast. Create a calm, quiet space without interruptions or distractions.

  • = Allow periods of silence while we find what to say.

  • = Let the person decide when they are done. Don’t jump in. If time is an issue, the group should decide on what’s fair and stick to it.

= Don’t react or speak up automatically. Watch how your reactions to what others say reflect your own experience, not the person speaking. Give yourself time to respond from a deeper place.

= Ask permission before giving advice or responding directly to what someone said. Sometimes people just want to be listened to.

= When someone responds to you or gives advice, allow yourself to take what is helpful from options presented, and leave the rest, rather than defending yourself if you disagree.

= Listen as a receiver, not as a critic. Imagine different perspectives and experiences, rather than assuming they’re just like yours.

Facilitation and Self-Facilitation

With their roots in effective listening, groups can nurture healing and community through facilitation. Facilitators help the group listen more effectively, and pay specific attention to the overall needs and direction of everyone involved, not just their own individual needs. The facilitator should avoid bias, and if they are too involved with a particular group topic then someone else might be better in the role. It helps when two people facilitate and when facilitators reflect group diversity such as gender, age, and race. It is also good to pair more experienced and less experienced facilitators, and to offer new people a chance to learn facilitation skills.

Importantly, everyone should keep overall group needs in mind, and everyone can assist the group through self-facilitation.

Key elements of facilitation and self-facilitation

= Create a clear agenda or plan on how to spend your time together.

= Keep track of time so people can “wrap up” their feelings without feeling cut off or not heard. Closing the meeting respectfully is as important as beginning it.

= Remind everyone to respect group confidentiality, so sensitive information does not leave the room.

= Check in with the group’s energy level and focus, and redirect the conversation if it is becoming scattered or bogged down. Suggest breaks, exercises, games, or agenda and time revisions when necessary. If conversation is lagging, ask questions, tell a story, or get up and do some stretching. Sometimes if the group is stuck, the facilitator can ask a clarifying question, reframe an issue, or connect points to earlier discussion.

= Offer choices, especially if people want feedback or not after they speak.

= Consider using “I” statements when speaking, such as “I feel” and “I want,” to stay focused on your own feelings and needs. Talking about other people or gossiping takes focus away from your own experience.

= Encourage defining problems within the concept of “dangerous gifts” and unique mysterious talents rather than seeing ourselves as flawed or diseased.

= Use a common vocabulary and minimize jargon.


= Be on the lookout for repeating patterns in each other’s lives to identify root causes.

= Investigate how past experiences shape present realities. Did something from childhood happen this way? From an early work or school experience? The past can help explain the present, but stay focused on present problems.

= Reflect upon the political dimension of personal problems, and reframe problems within a framework of a crazy-making society instead of blaming the person suffering.

= Hold people accountable for behaviors but don’t criticize who they are as people.

= Focus on the things we can control and let go of things we can’t, but don’t give up on visions of change and revolution!

= Keep an experimental attitude and a willingness to explore new perspectives and options.

= Learn what triggers you and how to cope with them. Recognize the buildup, escalations and de-escalations in crisis periods.

= Remember that the group is not a promise that problems will be solved, but a space to address problems safely.

= And finally: know when to bust out! Nature isn’t always neat and orderly. Sometimes wild conversation, spontaneity, and “breaking all the rules of facillitation” is exactly what the group needs in the moment. A skilled facillitator and skilled participants can feel when the chaos and cacophany that erupt are refreshing and true to the group spirit, and when to go with it. Then comes the time to reel it all back in and return to the basic structure of taking turns and listening carefully.

 

Inclusion and Self-Determination

Groups need to be welcoming and inclusive, where diverse perspectives and life choices are respected and honored according to the principles of harm reduction and self-determination. For example, people who take psychiatric drugs and people who don’t take them are welcome.

People who use diagnosis categories like “bipolar” to describe themselves, as well as people who define themselves differently, are also welcome.

 

Ways to create group inclusion

  • = Invite newcomers to introduce themselves if they want to.

  • = Practice “stepping up, stepping back” so we can each contribute to equal participation.

    = Give priority to people who haven’t yet spoken.

    = Encourage quiet people to speak, but don’t require them to or put them on the spot.

    = Be careful to not dominate the discussion, speak in capital letters, restate what others say, or speak for others.

    = Allow each person to define their problems the way they want. Don’t label or judge others.

    = If you disagree with someone, ask questions to understand their point of view better. This is not a time for arguments or trying to convince others you’re right.

    = Respect different views and choices, such as diagnosis, medication, recreational drugs, nutrition, medical care, holistic health, exercise, spirituality, lifestyle, and other decisions. Change is difficult! People grow at their own pace, and you may not really know what is best for another person, because you are not them.

    = Accommodate limitations and access needs, such as mobility accessibility and sign language interpretation. Be aware of how choices of where to hold meetings might affect people, such as institutional settings like clinics or health centers that can trigger painful memories, or places with toxic substances (fresh paint, new furniture or carpets) that people might be chemically sensitive to.

    = Identify and discuss how power and privilege play out by understanding how white supremacy, patriarchy, classism, heterosexism, ableism, and all other forms of oppression affect each of us.

    = Intervene in situations where people are making oppressive comments. Re-focus on the agenda, and remind everyone of the need for group safety. Recognize the intention behind someone’s word choice, and give them an opportunity to correct themselves or recognize how their words might be offensive. It can help to say, “When I just heard you say that, some people might feel you used an inappropriate or disrespectful term. Can you reword that statement?”

    = Remember that including marginalized voices and overcoming oppression helps everyone’s liberation.

    When we listen to each other effectively, we begin to understand our needs and how to meet them. Icarus groups can become places to nurture community networks of mutual aid and advocacy, help each other through crisis, deal with the mental health system, and learn about new options and resources.


Meeting Agreements

This gathering has some basic agreements to ensure inclusion, safety, and open dialogue:

  • We “listen like allies.” We respect a wide diversity of choices and perspectives, even when we disagree, and we don’t judge or invalidate other people’s experiences. We try not to interrupt. When it’s our turn to speak, we can ask others for feedback and advice, or just have people listen without responding. All responses are in a positive spirit of support and respect.

  • We also practice “step up, step back.” People who are quiet are encouraged to speak, and those who talk a lot are encouraged to give others a chance. We invite new people to introduce themselves if they want. And silence is also always ok.

  • As a community, we try to use “owl vision,” the ability to listen closely to the speaker while also having a feeling for the needs of the whole group. Keep in mind that others might be waiting to speak, or when we all might need to take a break.

  • We recognize that overcoming oppression helps everyone’s liberation; it is the group’s responsibility to challenge racism, classism, sexism, ageism, homophobia, and other forms of prejudice. We educate each other in the spirit of solidarity, and hold others accountable for their behavior without criticizing who they are as people.

    • We respect spiritual beliefs, altered states of consciousness, and definitions of reality that fall outside the mainstream material view.

    • In order to be as clear as possible, we try to use “I” statements when speaking to the group. This helps us avoid misunderstandings, and invokes trust and sensitivity.

    • We try to pay attention to repeating patterns in each other’s lives, in order to identify root causes. We try to notice common themes and roles that we play out together as a group.

    • To create trust we respect confidentiality. The group decides on what level of disclosure and openness outside the group we want.

      This is a work in progress. We need everyone’s feedback and ideas of how to improve our efforts and strengthen our group. And as we meet, keep in mind that there are many other people gathering like this to build community support networks with a vision of a new world.


Mutual Aid

= Ensure people can make their own best decisions by having solid facts about the drugs they take, their diagnosis, and options. Psychiatric drugs are toxic and have huge dangers pharmaceutical companies don’t talk about, and diagnostic labels are often misleading and disempowering. At the same time, holistic health doesn’t work for everyone, and going off drugs can be risky. Share lists of books, websites, and articles that have information correcting mainstream misinformation.

= Compare experiences with herbs and holistic health, medications that are helpful, and different treatments.

= Share advice and knowledge on how to reduce and go off medication safely if people want to.

= Put together a resource list of area low-cost/sliding scale health care practitioners who are open to non-mainstream views of mental health and recovery: use the Icarus Provider Guidelines and listing.

= Help people advocate for themselves with their doctors and health care practitioners; accompany them to appointments.

= Advocate for people struggling for justice: publicize human rights violations, connect people to patients advocate organizations, visit hospitals, contact area media, write letters to the editor.

= Connect each other with legal aid resources, housing, community gardens, free food and other needs.

= If a person is disruptive or needs a lot of attention, consider pairing them up with someone one on one, so they can get the focus they need and the rest of the group can continue.

= Set aside issues or conflicts taking a lot of group time to deal with outside of the group. Sometimes interpersonal mediation one on one is better than a group trying to solve a problem between two people.

= Share info about activism, community events, and recreation so people can meet outside the group.

= Learn ways to help people when things start to come crashing down. Consider creating a crisis plan where people name their early warning signs and describe the support they want if they start to go into crisis.

 

Different Forms of Peer Counseling Groups

With the principle of listening as the foundation, groups can take many forms. Once weekly, once a month? Is it a drop-in group, or are people committed for a series? Is it open to anyone or does the group select its members? Looking at and learning from different group models can give you a broader sense of what is possible and how to structure your group.

= 12-Step Programs such as Alcoholics Anonymous. Group members tell their stories drawing on years of shared wisdom, and follow a stages model of recovery through specific personal and spiritual goals. More experienced members coach newer ones through one- on-one sponsorship.Timers divide up speaking time equally.

= Council Process (“Talking Stick” model). Members take turns speaking on a theme or topic without interrupting or responding.

= Co-Counseling Dyads: People take turns with equal time in pairs, where one person is the speaker and the other just listens, then they switch.

= Skill-share, Resource Sharing, Such as Medicine-Specific, Holistic- Specific, or Advocate-Specific.

= Reading / discussion group.The group chooses an article or book to discuss each meeting.

= Emotional Support Groups: participants gather because they share a particular problem/theme, such as chronic pain, being a veteran, or suffering grief and loss.

= Hearing Voices groups: Small gatherings across England and Europe where people discuss the experience of hearing voices and share ways to cope in a non-judgmental atmosphere.

Empower yourselves to explore different options and create your group the way that works best for everyone

 

Confidentiality

Revealing intimate information makes people vulnerable. Groups build trust when this vulnerability is respected and cared for. Your group should agree to a confidentiality policy and make sure to practice it.

Some options are

General Experience Only: Members may discuss what they and others say and do with people outside the group, but only generally, without any names, details, or clues about the specific people or events. This is a common policy, used in the NYC Icarus Group and Freedom Center: it supports discussion of sensitive topics such as abuse, criminal behavior, and suicide, while allowing participants to take what they learn to the rest of the world.

Personal Experience Only: “What’s said here stays here.” Participants may discuss what they themselves say and do with people outside the group, but may not talk about, or even refer generally, to what others say or do. This is a more restrictive policy used for groups, such as 12- step groups, that focus specifically on difficult topics such as addiction and abuse.

Full Disclosure: Group participants are free to talk about anything that happened in the group. While common for activist organizations and public events that want to get the word out freely, this approach should be weighed carefully for groups providing mutual emotional support.

Total Non-Disclosure: Anything said or done is not repeated, or even alluded to generally, to anyone outside the group. This can be useful for a closed group focused on a very sensitive topic, where participants want to go very deeply into personal issues over time. This is a common policy used in the RVA Icarus Group.

Every group has different needs, so while General Experience Only is the most common support group policy, the group should set its own policy. Make sure to explain the confidentiality policy at the beginning of meetings, perhaps as part of the preamble.

 

Example Peer Support Facilitator Notes

Keep in mind that each group is different and unique and that it may be necessary to review and revise the format of your peer support group and the level of disclosure that is practiced. These are the notes that the facilitators of peer support groups in Richmond, Virginia’s Icarus Project group use during weekly peer support groups. Feel free to reuse and remix these notes, or make up your own entirely!

  1. Start on time!

  2. Choose a facilitator via consensus decision-making.

If someone is uncomfortable with the person offering to facilitate, that person needs to voice their position and put in a downvote. We will only know your comfort level if you tell us!

3. Introductions: Facilitator explains the role of a facilitator.

A facilitator guides the group process so that it flows smoothly. In this way, the facilitator leads the group efficiently, but does not take leadership responsibility. The facilitator makes sure that everyone has an equal amount of time to speak and that no person is speaking over or interrupting someone else. The facilitator also keeps time.

As our group is non-hierarchical, we like to rotate the position of facilitator for each meeting. If you wish to volunteer to facilitate in the future, please raise your hand now or speak with me after the meeting. Inexperienced facilitators may be able to team up with more experienced facilitators. Please do not hesitate to ask questions if you are unsure of what a facilitator does.

4. Introductions: Facilitator introduces the purpose of the group.

You can read the mission statement if you choose (have a flier with the mission statement available)

5. Introductions: Go around the circle with introductions.

Each person introduces themselves. We suggest giving your name and a story of how your personal experience has led you to be interested in radical or alternative mental health in general, or the Icarus Project specifically.

6. Facilitator explains listening spaces/safe spaces.

7. Facilitator explains the level of confidentiality that we consented to at the first meeting.

We use general experience only: while in peer support, members may discuss what they and others say and do with people outside the group, but only generally, without using any names, details, or clues about the specific people or events. This supports discussion of sensitive topics such as abuse, criminal behavior, and suicide. This is helpful because many of us may frequent the same places or have the same friends. Someone said at the first meeting that “we do not have consent to use someone’s name that is not present.”

We also use total non-disclosure. Anything said or done in the group is not repeated, or even alluded to generally, to anyone outside the group. What goes on here stays here.

8. Individuals start sharing without interruption (<10 people present). Split into smaller groups and start sharing (>10 people present).

If the person has been to peer support in the past, we suggest that they share how they have been feeling since the last time they came. If the person is new to peer support, we suggest that they share how they’ve been doing recently (i.e. the past few weeks/a month). The person sharing can voice whether they would like a response or if they just want people to listen, and would not like a response at this time.

9. Responses and feedback for individuals who welcome it.

10.Closing comments/wrapping up.Encourage members to sign up for email list.

11. Announce the next peer support date!