Bipolar, ADHD, CPTSD and other acronyms that have been tossed my way over many decades. After decades of therapy and medications I am finally feeling healthier than I ever have. I was the one that brought up possibly trying to go off some of my medications extremely slowly under supervision, not my psych, because behavioral health providers seem to have a "if it ain't broke don't fix it" mentality. I was very lucky because several of my case managers started out in peer support. They encouraged me to question my treatment and taught me how to advocate for myself. And because they also dealt with mental illness I felt much more comfortable working with them. Now on the cusp of 70, I never thought I could feel this mentally healthy.
What comes through so strongly here is the moment of collision between language and lived reality. The word recovered shifts from abstraction to something embodied once it’s witnessed in community, not theory. That transition from diagnosis as identity to recovery as practice feels like the hinge of the piece. The way peer support is described reframes expertise in a way our systems still struggle to tolerate. Lived experience isn’t positioned as anecdotal or secondary; it’s operational, relational, and stabilizing. The refusal to reduce people to diagnoses, and the insistence that hope is not naïve but structural, exposes how limited the biomedical lens can be when it treats instability as failure rather than part of being human.
Thank you, Sarah. I really appreciate these insights.
This resonated with me: "Our symptoms are part of what it means to be human—maybe not for everyone but for us. Psychiatric disorders are extreme occurrences of basic thoughts, emotions, and behaviors." I have clients and loved ones who have various diagnoses. I have often thought that their symptoms are examples of living life as a human but I have worried that this opinion may minimize their experience and suffering. Their symptoms, sometimes extreme, at their core seem like the human experience. I don't express my observations because I don't want to minimize or negate their lived experience. But sometimes I'm sad because I see them as so much more, and so much more whole than their diagnoses.
Thank you for these insights and thank you for being part of the movement that provides these resources.
Dear Julia, …But sometimes I'm sad because I see them as so much more, and so much more whole than their diagnoses.” Yesss. Thank you for those words and your comment! As an impatient patient, I can attest to the feelings on both sides of the table. It saddens me greatly as well because I was stuck in that thinking pattern for too long. IMO our problems today and for centuries stems from all of our ancestors who were responsible for designing a Society to adhere to a system of entitlement, a belief in perfectionism, grossly unrealistic expectations with deceiving pretenses. Our society was intentionally centered around power, wealth, greed with an ideology that only the loudest, powerful, most popular, and wealthiest and healthiest people could possibly be accepted and supported to succeed. Curiosity, compassion, empathy, courtesy, patience, respect, and kindness towards others were not intended to be integrated into the “system”. Hence, we have an enormous amount of work ahead of us to change our medical care system for those who suffer from mental illness. (IMHO) I believe no one escapes being affected by a mental illness to one degree or another. It comes with being a human being.
My apologies for over sharing my personal opinions on how we got here in the first place causing millions of people unnecessary harm to their overall wellbeing.
May we all get better together and support one another when possible. No one should ever be left behind. 🙏🏼
This essay about peer to peer support in mental health recovery is compelling in many ways. Nuance rather than all or nothing thinking and the use of peer to peer help rather than sole reliance on profit-motivated institutions can be seen as moves away from unbridled rationalism.
At the risk of sounding ignorant… as a person in mental health recovery (almost 50 yrs in treatment, 8 dx, just six months off the last of 22 different medications) my observation is that care systems require peer specialists to be meds cheerleaders. Sounds like this may differ in some locations. What are others experiencing?
Hi Carlene, I’m not a medical professional—just a woman in my late 60s with decades of experience as a patient. Here’s my very personal reply strictly based on many years of being prescribed a lot of different medications by different doctors.
Medications are often necessary and most certainly have their time and place. How long we stay on our different meds depends on a lot of factors, which make it confusing for both our prescribers and us, their patients.
Again, from my experience, I’ve been prescribed the wrong meds at different times. One example, I was on a mental-health prescription for three years that didn’t help and i believed were worsening my symptoms. When I finally had to insist my doctor wean me off, just as soon as the drug left my system, I felt like a human again! I felt so good! Even my tween kids noticed the difference in me. As someone else mentioned, sometimes it’s appropriate for us to push back on a treatment plan if we believe it’s not in our best interest
I grew up believing doctors knew everything. They seemed almost—well—like gods. I didn’t start questioning diagnoses or my treatments until I had two bad experiences. Whenever I am on more than one med, I will always ask my medical prescriber about potential counter interactions. Of course, most do not like patients questioning them. Many times doctors quickly dismiss my questions and assume I am worrying too much…until I sometimes later return and present them with a verbal report from my pharmacist who I go to whenever I would like them to review my meds with me. Pharmacists are more than happy to look at our meds and answer any questions we have. (It’s a big part of their job.) They will often point out things to me that I would never have known otherwise and at a level that I can understand and report back to my healthcare provider if appropriate. If I don’t understand anything they share with me, I won’t leave until I do. I am a big believer in asking questions until I receive clear answers. If I need someone to put it in writing for me, I’ll ask them to please do that as well. Doctors are essential, but they don’t study pharmacology. They don’t have a Doctor of Pharmacy degree (PharmD). Pharmacists have deep knowledge of medications and why they’re often prescribed for different diagnoses reflecting a different, valuable perspective.
My number one priority today is my overall wellbeing across all aspects including my physical, emotional, mental, and spiritual health. I want to stay as healthy as possible and well informed about everything related to my health.
If my reply didn’t address your concern, my apologies.
Thanks, Carlene. Not sure what a "meds cheerleader" is. But I doubt they are trained to be "meds cheerleaders". Maybe you're referring to peer supports who blindly promote your prescription without question. I'd steer clear of those individuals. When I Sponsor people or provide peer support, I just try to help them make realistic, cautious decisions; to self-educate on the best science; and to connect with a trusted provider who specializes in their diagnosis, an M.D. Psychiatrist or licensed psychotherapist. BTW, some do not know that it's pretty rare for a Psychiatrist to be a trained Psychotherapist.
Loved your post. Especially the ending. Thank you for sharing your authentic self with your readers with evidence and compassion. We are in this together. Peace. Christopher and family
There is so much to this piece. So much for us to learn, to appreciate, to think about. And I love your tangents (did Siddhi catch the fly?) which reflect how you speak, how you think. And while their connections to your point aren't always initially obvious, after a while, they are (if you accept, for instance, my interpretation that the fly represents recovery).
In any event, to me what makes a piece worth reading is whether a) I make it to the end, b) whether I learned anything about human existence and c) whether it changes my thinking.
You hit your abc's. With me at least.
I am not someone who has had to open the door to mental health care. I have been fortunate. My only real episode was many years ago with a friend and co-worker who dramatically entered into a world of his own, a world of intense paranoia and fear ... and anger. I woke with him sitting in a chair by my bed (I never lock my doors) telling me that the Mafia was after him. And me. And that we needed to flee. What followed was three hours of living in his delusion and discovering that he'd had a near violent episode at our favorite breakfast place in town, that he had written a deranged news story about how he and I had discovered this great conspiracy and the Mafia had been hired to take us out. I learned that he'd written all this in a story he'd put on the wire that connected our small chain of newspapers. We were at our satellite office at that point and my boss called and was apoplectic. When my friend was in the bathroom, I was able to find out who his doctor was, was able to call him, was able to get his advice on how to get him to safe care. 'You are the only one who can get him here. He trusts you.'
As I slowly progressed him to help, at one point going to his home and discovering he had left a pan of water on the stove and the water had evaporated and the pan, cheap aluminum, had melted and was dripping molten metal onto the wood floor, which now was spotted with glowing embers.
I finally got him to help. It was a long and twisted journey. When we arrived, when the orderlies gathered him, I remember the look he gave me -- haunting, like I was the enemy, that I was in league with the Mafia.
In the decades since, I have never seen him again. At the time, his doctors refused to let me see him, to talk to him; they refused to discuss him with me, refused to even tell me where he had been taken. His parents would not return my calls, nor the calls of other co-workers. All of us were closed out of his life. All we knew was that he'd been placed in an institution. Somewhere.
He was a brilliant writer and journalist. You would read his stories in wonderment. His humor, his wit, his ability to notice details that no one else saw were his markers, were what set him apart, what made him special. He was a friend. But now he was gone.
A decade later I heard that he had returned to work at a newspaper; he did not return my call. Another mutual friend said the same thing. At that point I had come to the belief that I had been demonized, perhaps with help from the mental health professionals because I had, in essence, manipulated him within his made-up world (at his doctor's guidance) in order to get him to medical help. Or, perhaps, he had been guided to forget all parts of that past life.
What I did learn, though, was he was nothing like who he had been, who he was. Someone I knew -- who also had known him before -- said he talked slower, thought slower, was on lots of medications that changed his personality entirely. He had lost his sense of humor, his gnawing need to find answers, his brilliant writing style. His work was dull and awkward and often absent answers to the most obvious questions and – the biggest change of all – were filled with errors. The person was not sure how long he would stay with the paper, how long he would last, for journalistic reasons if nothing else. As it turned out, it was not for long. And again, he dropped out of sight.
Your post made me rethink all this. Made me realize that yes, he had inside him a medical, chemical imbalance, something that affected his mind in a most tragic way. But your piece also made me rethink how the mental illness medical community works, how someone like my friend could never recover, could never be cured, would be a slave to medication that changed him entirely and, in essence, chained him to a life of disability. 'Don't forget your meds.'
Your post made me think that there could have been a better way. That we, as friends, could have been seen as assets, could have been welcomed in to support, to listen, to help.
Your piece also made me think of our own perceptions, how even you were not fully aware of the details of a movement to use peer support as a vehicle to recovery, how recovery was even possible, how 'recovery' can be and should be in different terms than the lack of or persistence of symptoms.
And your piece made me think of my friend's parents who put up a wall and saw their son's problems as a stigma, an embarrassment, something not to be discussed, referred to only as 'our son suffers from mental illness.'
I thank you for bringing all this to my mind, for helping me to rethink the experience, to see it in a different way.
As a final thought, I appreciate your willingness to expose your own vulnerabilities, your own own journey to knowledge. You make a commitment and keep to it. Your strength is in your willingness to try, to explore something new, to empathize, to rethink.
We could all do well to follow that practice in everything we do.
So well-written, Ms. Fay. Both technically and from your heart & soul. Thank you. As a person recovering for 38 years from the Dual Disorders of Substance Use Disorder and Complex Developmental Trauma, I appreciate what you're doing. Thank you.
I always appreciate your articles. I am 60 was medicated over 30 years ago because I was labeled when it fact it was just trauma and loss. I having been trying to wean off my last antidepressant since 2019 . I was pollydrugged and abused by too much medication. Now down to approximately 20 mg. I am finding it hard to come off. It makes me sick to think about taking it. However, I must or I get serious withdrawals.I am angry that this has happened. I have still terrible anxiety and depression but it is no different from when I was emotionally blunted on the meds. Initially they put me on these drugs for PMDD. Ridiculous. I feel it has ruined my life. I dont think I can ever be truly happy because truthfully I dont know what that feels like.
It is somewhat surprising that you don’t mention AA in this conversation, given that it has been recognized as many times more effective in the treatment of alcoholism than any other pharmaceutical or other treatment by legitimate research organizations, and that it has been doing peer group counseling for 90 years.
Alcoholism, as treated by AA, is a mental disorder. AA does exactly zero to help its participants deal with the second drink, only the first, because the need to drink is a disease of the mind, not the body. Alcoholics are plagued by narcissism, grandiosity, bipolar disorder, depression and more, yet many achieve the ability to function normally and stay sober.
One distinction is that there is no certification, though there is clearly a process.
It is the granddaddy of all of approaches you list, and it certainly deserves respect and credit. It derived from the Oxford Group and certain religious traditions like Quaker Friends, and peer group counseling derived from it.
I could be way off in my thinking about your comment so please be sure to take what you want and leave the rest. Or, leave all of it!!
I spent at least 12 years an Al-Anon because of someone else’s drinking. We were very close. Fortunately that person is now 29 years sober and continues going to AA. I am so grateful they found sobriety and reclaimed a large portion of their life. From my personal observations in seeing and speaking with them from time to time, I can still feel an uneasiness they carry inside of them and have since I’ve known them for well over 40 years. I couldn’t help but think of them while reading this article. I was thinking how they might have benefited from having a recovered alcoholic as their Peer Support Specialist along their journey in addition to AA. I may be mistaken but I thought Sarah mentioned that the trained Peer Support Specialists have a personal history with the diagnosis of those they are already or hoping to be supporting. I have said to myself way too many times that the specialists I see have absolutely ZERO idea what I am going through because they haven’t personally experienced it. Everything they prescribe or recommend (IMO) comes straight out of the textbooks they memorize. It’s frustrating as hell.
Maybe you might like to write to Sarah directly to share your perspective and thoughts based on your personal experience. I’ve done that a few times with different people on Substack and I was always heard. What they do with my personal experience and/or opinion isn’t anything I can control; but it always makes me feel better because I know I tried. Wishing you peace.
You bring up two related issues that really matter:
1. It is possible in AA to have long sobriety that is not great sobriety. I know many long-termers who have not gotten to the bottom of their underlying issues, and who tend to "survive" through sponsorship and fellowship more than inner stability.
2. There are "Peer Group Specialists" who have a personal history and those who don't, and there are AA (NA, ...) sponsors who are shallow and those who are deep. It seems there is real power in having a personal history, a power that accrues to the sponsor and the sponsee. I also think that some sponsors follow the book, and others understand its underlying message.
I am not sure whether I resolved anything!
When I sponsor, I am very clear that we are not going through the steps as Kabuki, but as a sincere way to unburden the self and leave behind bad thinking patterns. I believe strongly in curiosity and "double-clicking" on assumptions, meaning don't stay with the first thought, but process what might be hiding behind it.
Thanks, DiAne. Perhaps what you're observing is someone in Dry Drunk. That's the term for someone who's stopped alcohol and other drugs, is technically "sober", but who's not following the AA/NA suggestions for building a Recovery LIfestyle. That's what "in recovery" means. The person in Dry Drunk relies more on their own willpower than on a Higher Power, so they retain the anxiety, shame, depression and irritability they always had. On the other hand, in recovery we're expected to always have a Sponsor, who is our peer Spirit Guide. The Sponsor helps us to continuoulsy work the Steps for continuous healing and growth. We make progrress, lifelong, but none of us gets "recovered" because the disease of addiction is incurable; we keep the disease in remission by maintaining a Recovery Lifestyle. BTW, we now have about 45 years of neuroscientific research that identifies the process of addictive disease. "Disease" is not a metaphor or a theory. I hope this helps. Blessings for you, and your friend who you clearly care about.
♥️♥️♥️ I can’t tell you how much your kind words means to me. What you explained makes so much sense! I feel as if there is a still a very dark hole my friend hasn’t tried to resolve. The skeletons are still in their closet bothering them. I sense a real lack of self awareness, understanding, self compassion, deep inner healing, self love, agency, equanimity, spirituality, mindfulness. Unable to talk deep about anything personal.
Learning about guided mindful meditation, practicing regularly, reading and learning about Buddhism has helped me in my own recovery and journey…What a wonderful sponsor and role model you are!!
Thank you Matt, for directing us to AA and its radical approach to becoming human. AA has been effective worldwide and is still expanding... an impressive scope. Now ponder this: AA, NA, CA have no formal leaders. None. Have any Organizational Behavior Scientists researched this? And a bit more history on the roots of AA... the first ever self-help groups for people with Alcohol Use Disorder in North America were started in 1800, in Tonawanda, New York, a Seneca village of the Haudenosaunee Iroquois Nation by a shaman, Handsome Lake. He wanted to restore the traditional spirituality of their culture, which was being destroyed through genocide. Handsome Lake knew the colonists were plying the Haudenosaunee with alcohol as a way to exploit and exterminate them. AA's oldest antecedents were our indigenous peoples' spiritual peer support.
True, DiAne... Bill, and Bob, and Lois and a few other friends in recovery created AA and it's 12 Steps process in the mid-to-late-1930s. The point is that the very first peer support groups for alcoholics, called Circle Groups, were started by the Seneca tribe of the Haudenosaunee Iroquois Nation. The Circle Groups were intentionally spiritual, as are AA and NA, but the Circle Groups are not 12 Steps Groups like AA-NA.
Yes. Even esteemed experts don’t even know everything. Constructive observations, shared firsthand experiences and healthy feedback can potentially make an important difference. If we are lucky.
Thank you, Dr. Mirkin. My take on this is that recovery is a process of healing and growth. In the recovery process, I claim my diagnoses as useful for now, but I will not be labeled by them. I'm never a schizophrenic, but I'm a person with many strengths, some common human needs, and with schizophrenia. Perhaps my most important need is for mental health; for reliable reality-testing; and the need to accept specilaized help. As I heal and grow, I meet these needs more effectively and my recovery focuses more on exercising and enjoying my strengths. But I do not expect to be recovered; I'm always recovering.
Bipolar, ADHD, CPTSD and other acronyms that have been tossed my way over many decades. After decades of therapy and medications I am finally feeling healthier than I ever have. I was the one that brought up possibly trying to go off some of my medications extremely slowly under supervision, not my psych, because behavioral health providers seem to have a "if it ain't broke don't fix it" mentality. I was very lucky because several of my case managers started out in peer support. They encouraged me to question my treatment and taught me how to advocate for myself. And because they also dealt with mental illness I felt much more comfortable working with them. Now on the cusp of 70, I never thought I could feel this mentally healthy.
Amazing, Roberta. So amazing.
Same here Roberta!! Bravo to us!!! I shared a little of my own story in my comment below.
What comes through so strongly here is the moment of collision between language and lived reality. The word recovered shifts from abstraction to something embodied once it’s witnessed in community, not theory. That transition from diagnosis as identity to recovery as practice feels like the hinge of the piece. The way peer support is described reframes expertise in a way our systems still struggle to tolerate. Lived experience isn’t positioned as anecdotal or secondary; it’s operational, relational, and stabilizing. The refusal to reduce people to diagnoses, and the insistence that hope is not naïve but structural, exposes how limited the biomedical lens can be when it treats instability as failure rather than part of being human.
Bravo!🙌
Thank you, Sarah. I really appreciate these insights.
This resonated with me: "Our symptoms are part of what it means to be human—maybe not for everyone but for us. Psychiatric disorders are extreme occurrences of basic thoughts, emotions, and behaviors." I have clients and loved ones who have various diagnoses. I have often thought that their symptoms are examples of living life as a human but I have worried that this opinion may minimize their experience and suffering. Their symptoms, sometimes extreme, at their core seem like the human experience. I don't express my observations because I don't want to minimize or negate their lived experience. But sometimes I'm sad because I see them as so much more, and so much more whole than their diagnoses.
Thank you for these insights and thank you for being part of the movement that provides these resources.
Dear Julia, …But sometimes I'm sad because I see them as so much more, and so much more whole than their diagnoses.” Yesss. Thank you for those words and your comment! As an impatient patient, I can attest to the feelings on both sides of the table. It saddens me greatly as well because I was stuck in that thinking pattern for too long. IMO our problems today and for centuries stems from all of our ancestors who were responsible for designing a Society to adhere to a system of entitlement, a belief in perfectionism, grossly unrealistic expectations with deceiving pretenses. Our society was intentionally centered around power, wealth, greed with an ideology that only the loudest, powerful, most popular, and wealthiest and healthiest people could possibly be accepted and supported to succeed. Curiosity, compassion, empathy, courtesy, patience, respect, and kindness towards others were not intended to be integrated into the “system”. Hence, we have an enormous amount of work ahead of us to change our medical care system for those who suffer from mental illness. (IMHO) I believe no one escapes being affected by a mental illness to one degree or another. It comes with being a human being.
My apologies for over sharing my personal opinions on how we got here in the first place causing millions of people unnecessary harm to their overall wellbeing.
May we all get better together and support one another when possible. No one should ever be left behind. 🙏🏼
Thank you, Diane. You've touched on many truths.
This essay about peer to peer support in mental health recovery is compelling in many ways. Nuance rather than all or nothing thinking and the use of peer to peer help rather than sole reliance on profit-motivated institutions can be seen as moves away from unbridled rationalism.
Amen.
Hi Sarah. Is this the last post in the Cured series, or are there more?
At the risk of sounding ignorant… as a person in mental health recovery (almost 50 yrs in treatment, 8 dx, just six months off the last of 22 different medications) my observation is that care systems require peer specialists to be meds cheerleaders. Sounds like this may differ in some locations. What are others experiencing?
Hi Carlene, I’m not a medical professional—just a woman in my late 60s with decades of experience as a patient. Here’s my very personal reply strictly based on many years of being prescribed a lot of different medications by different doctors.
Medications are often necessary and most certainly have their time and place. How long we stay on our different meds depends on a lot of factors, which make it confusing for both our prescribers and us, their patients.
Again, from my experience, I’ve been prescribed the wrong meds at different times. One example, I was on a mental-health prescription for three years that didn’t help and i believed were worsening my symptoms. When I finally had to insist my doctor wean me off, just as soon as the drug left my system, I felt like a human again! I felt so good! Even my tween kids noticed the difference in me. As someone else mentioned, sometimes it’s appropriate for us to push back on a treatment plan if we believe it’s not in our best interest
I grew up believing doctors knew everything. They seemed almost—well—like gods. I didn’t start questioning diagnoses or my treatments until I had two bad experiences. Whenever I am on more than one med, I will always ask my medical prescriber about potential counter interactions. Of course, most do not like patients questioning them. Many times doctors quickly dismiss my questions and assume I am worrying too much…until I sometimes later return and present them with a verbal report from my pharmacist who I go to whenever I would like them to review my meds with me. Pharmacists are more than happy to look at our meds and answer any questions we have. (It’s a big part of their job.) They will often point out things to me that I would never have known otherwise and at a level that I can understand and report back to my healthcare provider if appropriate. If I don’t understand anything they share with me, I won’t leave until I do. I am a big believer in asking questions until I receive clear answers. If I need someone to put it in writing for me, I’ll ask them to please do that as well. Doctors are essential, but they don’t study pharmacology. They don’t have a Doctor of Pharmacy degree (PharmD). Pharmacists have deep knowledge of medications and why they’re often prescribed for different diagnoses reflecting a different, valuable perspective.
My number one priority today is my overall wellbeing across all aspects including my physical, emotional, mental, and spiritual health. I want to stay as healthy as possible and well informed about everything related to my health.
If my reply didn’t address your concern, my apologies.
Wishing you good health!
Thanks, Carlene. Not sure what a "meds cheerleader" is. But I doubt they are trained to be "meds cheerleaders". Maybe you're referring to peer supports who blindly promote your prescription without question. I'd steer clear of those individuals. When I Sponsor people or provide peer support, I just try to help them make realistic, cautious decisions; to self-educate on the best science; and to connect with a trusted provider who specializes in their diagnosis, an M.D. Psychiatrist or licensed psychotherapist. BTW, some do not know that it's pretty rare for a Psychiatrist to be a trained Psychotherapist.
Sarah,
Loved your post. Especially the ending. Thank you for sharing your authentic self with your readers with evidence and compassion. We are in this together. Peace. Christopher and family
Sarah,
There is so much to this piece. So much for us to learn, to appreciate, to think about. And I love your tangents (did Siddhi catch the fly?) which reflect how you speak, how you think. And while their connections to your point aren't always initially obvious, after a while, they are (if you accept, for instance, my interpretation that the fly represents recovery).
In any event, to me what makes a piece worth reading is whether a) I make it to the end, b) whether I learned anything about human existence and c) whether it changes my thinking.
You hit your abc's. With me at least.
I am not someone who has had to open the door to mental health care. I have been fortunate. My only real episode was many years ago with a friend and co-worker who dramatically entered into a world of his own, a world of intense paranoia and fear ... and anger. I woke with him sitting in a chair by my bed (I never lock my doors) telling me that the Mafia was after him. And me. And that we needed to flee. What followed was three hours of living in his delusion and discovering that he'd had a near violent episode at our favorite breakfast place in town, that he had written a deranged news story about how he and I had discovered this great conspiracy and the Mafia had been hired to take us out. I learned that he'd written all this in a story he'd put on the wire that connected our small chain of newspapers. We were at our satellite office at that point and my boss called and was apoplectic. When my friend was in the bathroom, I was able to find out who his doctor was, was able to call him, was able to get his advice on how to get him to safe care. 'You are the only one who can get him here. He trusts you.'
As I slowly progressed him to help, at one point going to his home and discovering he had left a pan of water on the stove and the water had evaporated and the pan, cheap aluminum, had melted and was dripping molten metal onto the wood floor, which now was spotted with glowing embers.
I finally got him to help. It was a long and twisted journey. When we arrived, when the orderlies gathered him, I remember the look he gave me -- haunting, like I was the enemy, that I was in league with the Mafia.
In the decades since, I have never seen him again. At the time, his doctors refused to let me see him, to talk to him; they refused to discuss him with me, refused to even tell me where he had been taken. His parents would not return my calls, nor the calls of other co-workers. All of us were closed out of his life. All we knew was that he'd been placed in an institution. Somewhere.
He was a brilliant writer and journalist. You would read his stories in wonderment. His humor, his wit, his ability to notice details that no one else saw were his markers, were what set him apart, what made him special. He was a friend. But now he was gone.
A decade later I heard that he had returned to work at a newspaper; he did not return my call. Another mutual friend said the same thing. At that point I had come to the belief that I had been demonized, perhaps with help from the mental health professionals because I had, in essence, manipulated him within his made-up world (at his doctor's guidance) in order to get him to medical help. Or, perhaps, he had been guided to forget all parts of that past life.
What I did learn, though, was he was nothing like who he had been, who he was. Someone I knew -- who also had known him before -- said he talked slower, thought slower, was on lots of medications that changed his personality entirely. He had lost his sense of humor, his gnawing need to find answers, his brilliant writing style. His work was dull and awkward and often absent answers to the most obvious questions and – the biggest change of all – were filled with errors. The person was not sure how long he would stay with the paper, how long he would last, for journalistic reasons if nothing else. As it turned out, it was not for long. And again, he dropped out of sight.
Your post made me rethink all this. Made me realize that yes, he had inside him a medical, chemical imbalance, something that affected his mind in a most tragic way. But your piece also made me rethink how the mental illness medical community works, how someone like my friend could never recover, could never be cured, would be a slave to medication that changed him entirely and, in essence, chained him to a life of disability. 'Don't forget your meds.'
Your post made me think that there could have been a better way. That we, as friends, could have been seen as assets, could have been welcomed in to support, to listen, to help.
Your piece also made me think of our own perceptions, how even you were not fully aware of the details of a movement to use peer support as a vehicle to recovery, how recovery was even possible, how 'recovery' can be and should be in different terms than the lack of or persistence of symptoms.
And your piece made me think of my friend's parents who put up a wall and saw their son's problems as a stigma, an embarrassment, something not to be discussed, referred to only as 'our son suffers from mental illness.'
I thank you for bringing all this to my mind, for helping me to rethink the experience, to see it in a different way.
As a final thought, I appreciate your willingness to expose your own vulnerabilities, your own own journey to knowledge. You make a commitment and keep to it. Your strength is in your willingness to try, to explore something new, to empathize, to rethink.
We could all do well to follow that practice in everything we do.
Be well.
geoff
Excellent read! And Pathological is going with me on my desert writing retreat! Thank you, Sarah!
You’re such a good writer! I can’t wait to read this.
So well-written, Ms. Fay. Both technically and from your heart & soul. Thank you. As a person recovering for 38 years from the Dual Disorders of Substance Use Disorder and Complex Developmental Trauma, I appreciate what you're doing. Thank you.
I always appreciate your articles. I am 60 was medicated over 30 years ago because I was labeled when it fact it was just trauma and loss. I having been trying to wean off my last antidepressant since 2019 . I was pollydrugged and abused by too much medication. Now down to approximately 20 mg. I am finding it hard to come off. It makes me sick to think about taking it. However, I must or I get serious withdrawals.I am angry that this has happened. I have still terrible anxiety and depression but it is no different from when I was emotionally blunted on the meds. Initially they put me on these drugs for PMDD. Ridiculous. I feel it has ruined my life. I dont think I can ever be truly happy because truthfully I dont know what that feels like.
I am so very sorry for your harrowing experience. 🫶
Thank you.
It is somewhat surprising that you don’t mention AA in this conversation, given that it has been recognized as many times more effective in the treatment of alcoholism than any other pharmaceutical or other treatment by legitimate research organizations, and that it has been doing peer group counseling for 90 years.
Alcoholism, as treated by AA, is a mental disorder. AA does exactly zero to help its participants deal with the second drink, only the first, because the need to drink is a disease of the mind, not the body. Alcoholics are plagued by narcissism, grandiosity, bipolar disorder, depression and more, yet many achieve the ability to function normally and stay sober.
One distinction is that there is no certification, though there is clearly a process.
It is the granddaddy of all of approaches you list, and it certainly deserves respect and credit. It derived from the Oxford Group and certain religious traditions like Quaker Friends, and peer group counseling derived from it.
Becoming Human, Hello!
I could be way off in my thinking about your comment so please be sure to take what you want and leave the rest. Or, leave all of it!!
I spent at least 12 years an Al-Anon because of someone else’s drinking. We were very close. Fortunately that person is now 29 years sober and continues going to AA. I am so grateful they found sobriety and reclaimed a large portion of their life. From my personal observations in seeing and speaking with them from time to time, I can still feel an uneasiness they carry inside of them and have since I’ve known them for well over 40 years. I couldn’t help but think of them while reading this article. I was thinking how they might have benefited from having a recovered alcoholic as their Peer Support Specialist along their journey in addition to AA. I may be mistaken but I thought Sarah mentioned that the trained Peer Support Specialists have a personal history with the diagnosis of those they are already or hoping to be supporting. I have said to myself way too many times that the specialists I see have absolutely ZERO idea what I am going through because they haven’t personally experienced it. Everything they prescribe or recommend (IMO) comes straight out of the textbooks they memorize. It’s frustrating as hell.
Maybe you might like to write to Sarah directly to share your perspective and thoughts based on your personal experience. I’ve done that a few times with different people on Substack and I was always heard. What they do with my personal experience and/or opinion isn’t anything I can control; but it always makes me feel better because I know I tried. Wishing you peace.
Thank you for the thoughtful response!
You bring up two related issues that really matter:
1. It is possible in AA to have long sobriety that is not great sobriety. I know many long-termers who have not gotten to the bottom of their underlying issues, and who tend to "survive" through sponsorship and fellowship more than inner stability.
2. There are "Peer Group Specialists" who have a personal history and those who don't, and there are AA (NA, ...) sponsors who are shallow and those who are deep. It seems there is real power in having a personal history, a power that accrues to the sponsor and the sponsee. I also think that some sponsors follow the book, and others understand its underlying message.
I am not sure whether I resolved anything!
When I sponsor, I am very clear that we are not going through the steps as Kabuki, but as a sincere way to unburden the self and leave behind bad thinking patterns. I believe strongly in curiosity and "double-clicking" on assumptions, meaning don't stay with the first thought, but process what might be hiding behind it.
Thanks, DiAne. Perhaps what you're observing is someone in Dry Drunk. That's the term for someone who's stopped alcohol and other drugs, is technically "sober", but who's not following the AA/NA suggestions for building a Recovery LIfestyle. That's what "in recovery" means. The person in Dry Drunk relies more on their own willpower than on a Higher Power, so they retain the anxiety, shame, depression and irritability they always had. On the other hand, in recovery we're expected to always have a Sponsor, who is our peer Spirit Guide. The Sponsor helps us to continuoulsy work the Steps for continuous healing and growth. We make progrress, lifelong, but none of us gets "recovered" because the disease of addiction is incurable; we keep the disease in remission by maintaining a Recovery Lifestyle. BTW, we now have about 45 years of neuroscientific research that identifies the process of addictive disease. "Disease" is not a metaphor or a theory. I hope this helps. Blessings for you, and your friend who you clearly care about.
Thank you for this! May peace to be with you one day at a time.
♥️♥️♥️ I can’t tell you how much your kind words means to me. What you explained makes so much sense! I feel as if there is a still a very dark hole my friend hasn’t tried to resolve. The skeletons are still in their closet bothering them. I sense a real lack of self awareness, understanding, self compassion, deep inner healing, self love, agency, equanimity, spirituality, mindfulness. Unable to talk deep about anything personal.
Learning about guided mindful meditation, practicing regularly, reading and learning about Buddhism has helped me in my own recovery and journey…What a wonderful sponsor and role model you are!!
Thank you Matt, for directing us to AA and its radical approach to becoming human. AA has been effective worldwide and is still expanding... an impressive scope. Now ponder this: AA, NA, CA have no formal leaders. None. Have any Organizational Behavior Scientists researched this? And a bit more history on the roots of AA... the first ever self-help groups for people with Alcohol Use Disorder in North America were started in 1800, in Tonawanda, New York, a Seneca village of the Haudenosaunee Iroquois Nation by a shaman, Handsome Lake. He wanted to restore the traditional spirituality of their culture, which was being destroyed through genocide. Handsome Lake knew the colonists were plying the Haudenosaunee with alcohol as a way to exploit and exterminate them. AA's oldest antecedents were our indigenous peoples' spiritual peer support.
Interesting especially because I and most people in AA and Al-Anon are told it was Bill W who founded AA and his wife, Lois, who founded Al-Anon.
True, DiAne... Bill, and Bob, and Lois and a few other friends in recovery created AA and it's 12 Steps process in the mid-to-late-1930s. The point is that the very first peer support groups for alcoholics, called Circle Groups, were started by the Seneca tribe of the Haudenosaunee Iroquois Nation. The Circle Groups were intentionally spiritual, as are AA and NA, but the Circle Groups are not 12 Steps Groups like AA-NA.
A truly necessary conversation with @Sarah Fay. 🐦⬛
Yes. Even esteemed experts don’t even know everything. Constructive observations, shared firsthand experiences and healthy feedback can potentially make an important difference. If we are lucky.
Thank you, Dr. Mirkin. My take on this is that recovery is a process of healing and growth. In the recovery process, I claim my diagnoses as useful for now, but I will not be labeled by them. I'm never a schizophrenic, but I'm a person with many strengths, some common human needs, and with schizophrenia. Perhaps my most important need is for mental health; for reliable reality-testing; and the need to accept specilaized help. As I heal and grow, I meet these needs more effectively and my recovery focuses more on exercising and enjoying my strengths. But I do not expect to be recovered; I'm always recovering.
Same here Roberta!! Bravo to us!!! I shared a little of my own story in my comment below to Carlene.