{"id":4161,"date":"2015-09-16T17:09:51","date_gmt":"2015-09-16T23:09:51","guid":{"rendered":"https:\/\/disabledangel.ca\/?p=4161"},"modified":"2019-01-28T23:56:16","modified_gmt":"2019-01-29T05:56:16","slug":"peer-assisted-open-dialogue-pod-transformation-mental-healthcare-system","status":"publish","type":"post","link":"https:\/\/disabledangel.ca\/?p=4161","title":{"rendered":"Peer-Assisted Open Dialogue, POD:  A Transformation for the Mental Healthcare System"},"content":{"rendered":"<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/11755217_1006549796043621_7164642305579562642_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/11755217_1006549796043621_7164642305579562642_n.jpg\" class=\"alignright wp-image-4166\" alt=\"11755217_1006549796043621_7164642305579562642_n\" width=\"555\" height=\"370\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/11755217_1006549796043621_7164642305579562642_n.jpg 880w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/11755217_1006549796043621_7164642305579562642_n-300x200.jpg 300w\" sizes=\"auto, (max-width: 555px) 100vw, 555px\" \/><\/a>I happily put on the hat of roving Reporter within the world of Mental Health\u2026 again.<br \/>\n<strong>Breaking News! POD<br \/>\n<\/strong>can build bridges between Caregivers and Patients in Psychiatric Care<strong>.<\/strong><\/p>\n<p>Paraphrasing from the <strong><a href=\"http:\/\/opendialogueapproach.co.uk\/\" target=\"_blank\">POD website in the UK<\/a><\/strong>:&nbsp; <span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em>Many people \u2013 service users, carers, and staff of all disciplines \u2013 have a strong sense that we can do better in the services we provide for people with <\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/circle.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/circle-1024x681.jpg\" class=\"alignleft wp-image-4269\" alt=\"circle\" width=\"443\" height=\"295\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/circle-1024x681.jpg 1024w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/circle-300x199.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/circle.jpg 1050w\" sizes=\"auto, (max-width: 443px) 100vw, 443px\" \/><\/a><\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em>mental health difficulties, and the current way of working can be improved upon, towards <\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em><strong>a more holistic and collaborative approach to mental health care<\/strong><\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em>&#8230;. It is a <\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em><strong>less hierarchical approach, where everyone is seen as a partner in the process from day one<\/strong><\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em>.<\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em> &#8230;<\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em><strong>peer support has been made integral to service delivery<\/strong><\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><em> &#8230;<\/em><\/span><span class=\"size12 Helvetica12\" style=\"color: #000000; font-family: Helvetica,Arial,sans-serif\"><br \/>\n<\/span><\/p>\n<p>I attended a POD, Peer-Assisted Open Dialogue, Conference March 2015, in London, England. Relatively new to my awareness yet The <strong><a href=\"https:\/\/youtu.be\/HDVhZHJagfQ\" target=\"_blank\">Open Dialogue<\/a><\/strong> aspect has existed for over a decade in Finland. To sum up the Finnish experience: 74% of the acutely psychotic patients were either working or educating at two years. Ten times higher than the British results in a more traditional Biomedical Model of care. The Conference was a gathering together of six teams from different National Trusts, subsections of English&nbsp; National Healthcare System serving their geopraphic portion of the population. A Research Project to explore the POD model involving nearly twenty Psychiatrists is now underway.<\/p>\n<p>&nbsp;<\/p>\n<p>A multidisciplinary team of Health Care Workers is assembled around each acute case. This could be four or more people: A Psychiatrist, A Nurse, a Psychologist, an Occupational Therapist,&nbsp; or any Mental Healthcare worker from <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/npa-slim.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/npa-slim-300x113.png\" class=\"alignright wp-image-4256\" alt=\"npa-slim\" width=\"422\" height=\"158\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/npa-slim-300x113.png 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/npa-slim.png 648w\" sizes=\"auto, (max-width: 422px) 100vw, 422px\" \/><\/a>the team. A person experiencing their first case of Psychosis, although is used effectively to treat acute and non-acute cases alike, first or subsequent acute episodes, would benefit from the collaboration with the team and any friends\/family members that would like to be involved (always with the Patient\u2019s consent). Lastly, a Peer with their own personal experience of crisis within the system, is a part of this <strong>Non-heirarchical Circle. <\/strong>It is not always possible but the aim is&nbsp;<strong>not<\/strong> to prescribe medications until at least three meetings have occurred and with the collective agreement from the group. The Patient\u2019s belief about medications is important and relevant in this decision. The meetings occur as frequently as deemed necessary. In acute cases this could be daily.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Psychiatric Upgrades of the Peer-Assisted Open Dialogue.&nbsp; Key points of how POD is different.<br \/>\n<\/strong><\/p>\n<ol>\n<li><strong> Psychiatrists Listen to Patients \u2013 Essential to Develop a Trusting Therapeutic Alliance.<br \/>\n<\/strong><\/li>\n<\/ol>\n<ol start=\"2\">\n<li><strong> Psychiatrists and Mental Healthcare Workers: Develop Awareness <\/strong>of themselves through <strong>Mindfulness Training<\/strong>.<\/li>\n<\/ol>\n<ol start=\"3\">\n<li><strong> Non-Heirarchichal Healthcare Teams<\/strong><\/li>\n<\/ol>\n<p>A Circle: no one above, no one below. Each takes their place in the Circle.<a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11174810_10205911753944839_2445000942812031115_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11174810_10205911753944839_2445000942812031115_n.jpg\" class=\"alignleft wp-image-4258\" alt=\"11174810_10205911753944839_2445000942812031115_n\" width=\"444\" height=\"295\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11174810_10205911753944839_2445000942812031115_n.jpg 498w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11174810_10205911753944839_2445000942812031115_n-300x199.jpg 300w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/a><\/p>\n<ol start=\"4\">\n<li><strong> Peers \u2013 an Invaluable Resource.<br \/>\n<\/strong>By Peers, I mean a person who has had a similar crisis within the Psychiatric System. Also known as a former Patient.&nbsp; I consider as a possible translator &#8211; my own speculation.<\/li>\n<\/ol>\n<p><strong>&nbsp;<\/strong><\/p>\n<p>To repeat, the key elements are:<br \/>\nPhysician Wellness and Evolution via Mindfulness Training.<br \/>\nMultidisciplinary, non-heirarchal team approach.<br \/>\nListening to the patient. Yes! Listen.<br \/>\nToo Simple to be True?<br \/>\nIt is Simple. And it is True.<br \/>\nInclude a Peer.&nbsp; Someone with experience as a Patient in Crisis.<\/p>\n<p>&nbsp;<\/p>\n<p><strong><a href=\"https:\/\/youtu.be\/EQgAorQpxGc\" target=\"_blank\">Russell Razzaque on Breakdowns and Spirituality<\/a><\/strong>. 30 minute talk from the London-based Psychiatrist, <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11745931_898150390249572_1800154488861445171_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11745931_898150390249572_1800154488861445171_n-300x169.jpg\" class=\"alignright wp-image-4259\" alt=\"11745931_898150390249572_1800154488861445171_n\" width=\"444\" height=\"250\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11745931_898150390249572_1800154488861445171_n-300x169.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11745931_898150390249572_1800154488861445171_n.jpg 850w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/a>Russell Razzaque.&nbsp; He leads the Research Team in England.<br \/>\n<strong><em>Open Dialogue is a System Transformation. <\/em><\/strong><br \/>\n<strong><em> It is a Whole System Change. <\/em><\/strong><br \/>\n<strong><em> It is about Everyone coming together in a Different Way.<\/em><\/strong><\/p>\n<p>Transcribed, partly Paraphrased:<\/p>\n<p><em>Rather than try to get the Patient back to where they originally started, &#8230;perhaps there is somewhere this experience is taking the Patient.<br \/>\nBe open to the variation of each individual.<br \/>\nWe do need a different attitude to the Suffering we have. Because it is ubiquitous to the way we run ourselves as a <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10176013_759121377470793_1007766850218024494_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10176013_759121377470793_1007766850218024494_n-300x300.jpg\" class=\"alignleft wp-image-4260\" alt=\"10176013_759121377470793_1007766850218024494_n\" width=\"344\" height=\"344\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10176013_759121377470793_1007766850218024494_n-300x300.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10176013_759121377470793_1007766850218024494_n-150x150.jpg 150w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10176013_759121377470793_1007766850218024494_n.jpg 600w\" sizes=\"auto, (max-width: 344px) 100vw, 344px\" \/><\/a>Society today.<br \/>\n&#8230;Epic scale of inequality we are seeing everywhere.<br \/>\n&#8230;Recalibrate our Relationship with Suffering.<br \/>\nNot something to push away or deny, try to remove and get rid of. Look at it as something that contains some Real Healing for us, as well.<\/em><\/p>\n<p>Pain equals \u201cAttention Here\u201d.<br \/>\n&#8230;Wherever possible, try to find the message in pain \u2026 to learn about our True Nature.<br \/>\nTrue Nature is different for Everybody.<br \/>\nEnabling Everyone to have their Journey: find their Reality through their Pain. We can All Learn from each other.<br \/>\nMy Pain takes Me to My Understanding.<br \/>\nYour Pain takes You to Your Understanding.<br \/>\nWe can Respect Each Other&#8217;s Understanding.<\/p>\n<p>We, as a Society, can start Learning from each other.<br \/>\n&#8230;Respect Everybody&#8217;s Individual Wisdom.<br \/>\nThere is not One Truth that we are going to follow.<br \/>\nAllow everybody to have their Truth.<\/p>\n<p>Practically: What to do about this?<a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1511119_963907496967400_5334317344579024679_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1511119_963907496967400_5334317344579024679_n-300x300.jpg\" class=\"alignright wp-image-4261\" alt=\"1511119_963907496967400_5334317344579024679_n\" width=\"388\" height=\"388\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1511119_963907496967400_5334317344579024679_n-300x300.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1511119_963907496967400_5334317344579024679_n-150x150.jpg 150w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1511119_963907496967400_5334317344579024679_n.jpg 960w\" sizes=\"auto, (max-width: 388px) 100vw, 388px\" \/><\/a><\/p>\n<p>He describes research findings: two groups of people with OOE, Out of the Ordinary Experiences. One got into the Psychiatric System ending up on Antipsychotic Medications and remained in the system for decades. The other managed to Integrate their experiences and stayed out of the Psychiatric System. Biggest difference between the two groups was that the second was surrounded by a system of Acceptance &amp; Validation. They were Listened to and Respected.<br \/>\nShould not be about whether something is Real but whether it Serves a Compassionate Purpose.<\/p>\n<p>Dr. Razzaque sees a day when Psychiatrists will stop being the Reality Police.<\/p>\n<p>Open Dialogue, originating in Finland, is a good Avenue to start to change the way Mental Health Services are delivered.<br \/>\n74% of the Patients who suffered an Acute Episode of Psychosis were back to work or study at two years. And Out of the System. Ten Times higher than the results of the British Mental Health System.<br \/>\n<a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11391163_853943481308633_6625926699414335305_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11391163_853943481308633_6625926699414335305_n-300x300.jpg\" class=\"alignleft wp-image-4262\" alt=\"11391163_853943481308633_6625926699414335305_n\" width=\"388\" height=\"388\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11391163_853943481308633_6625926699414335305_n-300x300.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11391163_853943481308633_6625926699414335305_n-150x150.jpg 150w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11391163_853943481308633_6625926699414335305_n.jpg 720w\" sizes=\"auto, (max-width: 388px) 100vw, 388px\" \/><\/a>The Experimentation occurred on the backdrop of some of the worst Mental Health Services in the World, Finland. Set an environment of being willing to try something completely different.<br \/>\nEverybody sits together to find meaning in what is going on. Anyone who wants to be involved is welcomed to the Process.<br \/>\nOpen Dialogue has started to setup in various places around the World.<br \/>\nFour Locations starting Pilot Projects within the U.K. 50-60 Clinicians. 10-15 Psychiatrists.<\/p>\n<p><strong><em>Most Important thing we are teaching people is to become an Expert in Not Being an Expert. To Unlearn What We Have Learned.<\/em><\/strong><br \/>\n&#8230;We can grow as much as anybody else through this <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10313796_735320503156631_8176489037303703467_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10313796_735320503156631_8176489037303703467_n-300x225.jpg\" class=\"alignright size-medium wp-image-4272\" width=\"300\" height=\"225\" alt=\"10313796_735320503156631_8176489037303703467_n\"><\/a>process.<br \/>\n&#8230;There is no \u201cThem\u201d and \u201cUs\u201d. \u2026 All of us have Our Wounds.<br \/>\nWe all benefit from sharing the process rather than pretending to be the Fixer: the Healer and the Wounded. It is more a relationship of Equals.<\/p>\n<p>Conference March 11, 2015 in Central London 600 people registered. A lot of interest in this.<br \/>\nIf we can Change the way we Deliver Our Mental Healthcare, it can have a Fundamental Ripple Effect on the rest of Society as a whole.<br \/>\nWe can start to all Listen to Each Other rather than consider this is Normal, this is Not Normal.<\/p>\n<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/IMG_5664.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/IMG_5664-300x202.jpg\" class=\"alignleft wp-image-4280\" alt=\"IMG_5664\" width=\"444\" height=\"299\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/IMG_5664-300x202.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/IMG_5664.jpg 1002w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/a>If someone says that a Mental Illness is just like a Physical Illness, just ask: What is the Physical Test to know that someone is Mentally Ill?<br \/>\nThere isn&#8217;t one. There never has been one.<br \/>\n&#8230;There is no way of discerning that somebody has this physical change going on.<br \/>\nThere is a huge debate as to whether there are actually things that are happening.<br \/>\nDifferent Schools of Thought on this. There is no clear cut answer.<\/p>\n<p>Recently heard a talk from a Neuroscience Expert. There are Theories of various Chemical Imbalances. They are just Theories \u2013 Reverse-Engineered by the fact that certain drugs had effects on the Symptoms. Lots of debate on this.<br \/>\nSome people find some comfort to think of the Biological Illness Construct. It helps them. Then it can work.<a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/welcome-to-acceptance-sign-29027897.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/welcome-to-acceptance-sign-29027897-300x225.jpg\" class=\"alignright size-medium wp-image-4254\" width=\"300\" height=\"225\" alt=\"welcome-to-acceptance-sign-29027897\"><\/a><br \/>\nBut other people vehemently reject it. They find that it doesn&#8217;t help them.<br \/>\nWorking with People in a way that Allows them to Lead, working on a way to Understand their Experiences \u2013 very Important.<br \/>\nWe have to admit with some Humility that we do not have the same level of Technical Certainty that other Branches of Medicine have.<br \/>\nWe can be in that Uncertain place and allow others to offer their input.<br \/>\n&#8230;This is a Grey Area. I think it is Important to Treat it as Such.<\/p>\n<p>WHO, World Health Organization 10 years ago<br \/>\n&#8211; outcomes of Psychosis compared between Undeveloped Countries and Developed Western Countries. Relapse Rate lower in the Undeveloped Countries.<br \/>\nTaught in Medical School. Kind of brushed under the Carpet. Kind of Embarrassing.<br \/>\nWhen you go to those undeveloped Countries, they are doing these kinds of things (similar to Open Dialogue). &#8230;<br \/>\nIf it works, it works. I am for anything that works for whatever person.<br \/>\nIt will be that Person and their Belief System that helps them Define that.<\/p>\n<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10984148_799186546797609_1886391516074864132_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10984148_799186546797609_1886391516074864132_n-300x252.jpg\" class=\"alignleft wp-image-4252\" alt=\"10984148_799186546797609_1886391516074864132_n\" width=\"444\" height=\"373\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10984148_799186546797609_1886391516074864132_n-300x252.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10984148_799186546797609_1886391516074864132_n.jpg 960w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/a>Recounted working with Patients with Violent Tendencies. Varied results: sometimes settled in 2-4 weeks, other times 2-6 months. Dr. Razzaque would ask Patients, what do you think got you better? About half of them at least said: it&#8217;s the Spirits, they are gone now. \u201cWho am I to say that is wrong? What do I really know?\u201d Dr. Razzaque asked himself.<br \/>\nTo Know that We Don&#8217;t Know is the most Important Thing \u2026 in terms of the Clinician.<\/p>\n<p>Described Ram Dass asking his Teacher about LSD. The Teacher sampled it and felt nothing different. Even a handful of LSD doses had no impact. Was felt that he always existed in the place that LSD can<a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10305064_287667608060214_7548345697493554868_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10305064_287667608060214_7548345697493554868_n-300x300.jpg\" class=\"alignright wp-image-4273\" alt=\"10305064_287667608060214_7548345697493554868_n\" width=\"404\" height=\"404\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10305064_287667608060214_7548345697493554868_n-300x300.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10305064_287667608060214_7548345697493554868_n-150x150.jpg 150w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/10305064_287667608060214_7548345697493554868_n.jpg 432w\" sizes=\"auto, (max-width: 404px) 100vw, 404px\" \/><\/a> take a person \u2013 a shortcut. For most people the LSD trip is not longlasting. Other methods get one there in a more permanent fashion. Taking a drug like LSD feels very violent when you exist far away from that (enlightened or expanded consciousness, my addition) place.<\/p>\n<p>Open Dialogue is a System Transformation. It is a Whole System Change. It is about Everyone coming together in a Different Way.<\/p>\n<p>&#8230;Mindfulness also very valuable for Clinicians to own their own stuff and not let it get in the way. Not a lot of Emotional Education in Healthcare. I advocate Mindfulness (if it works for you). Voluntary.<br \/>\n&#8230;Recognizing your Thoughts are not who you really Are. For me, the most Important Part.<br \/>\nDr. Razzaque ran a 15 minute Daily Mindfulness Practice on a Psychiatric Inpatient Ward. Open to anyone who wanted to turn up, staff or patient. The Staff did not <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/481953_10151405872248220_536865979_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/481953_10151405872248220_536865979_n.jpg\" class=\"alignright wp-image-4279\" alt=\"481953_10151405872248220_536865979_n\" width=\"444\" height=\"444\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/481953_10151405872248220_536865979_n.jpg 600w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/481953_10151405872248220_536865979_n-150x150.jpg 150w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/481953_10151405872248220_536865979_n-300x300.jpg 300w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/a>come, but some of the Patients did. Must be voluntary. No one can feel pressured to Engage in the Spiritual Journey.<\/p>\n<p>He recommends Pema Chodron&#8217;s book \u201cWisdom of No Escape\u201d as it helped him.<br \/>\nAlso notes another of her books \u201cThe Places That Scare You\u201d.<br \/>\nTalking about the Messiness etc make us Who We Are. We can&#8217;t be anything unless we are all these messy things too. The Challenge is not to remove these parts of us. The challenge is to find a way to be present with them and to allow them to be as they are. We stop being dominated by the need to remove them.<br \/>\n*********** End Dr. Razzaque video paraphrasing.<\/p>\n<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11040849_954501407928765_5162154729686065288_o.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11040849_954501407928765_5162154729686065288_o-300x300.jpg\" class=\"alignleft wp-image-4270\" alt=\"11040849_954501407928765_5162154729686065288_o\" width=\"388\" height=\"388\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11040849_954501407928765_5162154729686065288_o-300x300.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11040849_954501407928765_5162154729686065288_o-150x150.jpg 150w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11040849_954501407928765_5162154729686065288_o-1024x1024.jpg 1024w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11040849_954501407928765_5162154729686065288_o.jpg 1200w\" sizes=\"auto, (max-width: 388px) 100vw, 388px\" \/><\/a>Author, <a href=\"http:\/\/www.madinamerica.com\/2015\/03\/hunting-woozles-open-dialogue\/\" target=\"_blank\">Jeremy Wallace MD, British Trained Psychiatrist,<\/a> notes, &#8220;&#8230;only by taking an approach which isn&#8217;t focused on getting to the right diagnosis, &#8230; to map the many pathways into and out of psychosis.&#8221;<\/p>\n<p><em>Author states: Within Psychiatry the biggest obstacle to change is the pervasive biological dogma, that is so pervasive.<br \/>\n<\/em>I echo that sentiment as a Canadian Trained Family Doctor.<br \/>\n<em><br \/>\n&#8220;Love is the Force&#8221;. Jaako Seikula, a Psychiatrist and one of the original Doctors in Open Dialogue in Finland. Made this statement while delivering a talk in the Medical Conference setting.<\/em><\/p>\n<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/1907560_707902665991412_1552900935025290980_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/1907560_707902665991412_1552900935025290980_n-300x277.jpg\" class=\"alignright wp-image-4167\" alt=\"1907560_707902665991412_1552900935025290980_n\" width=\"444\" height=\"410\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/1907560_707902665991412_1552900935025290980_n-300x277.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/1907560_707902665991412_1552900935025290980_n.jpg 715w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/a><\/p>\n<p>Enjoyed reading the book Spiritual Psychiatries where Natalie Tobert shared her experiences as a Medical Anthropologist.<em><br \/>\n\u201cIn India the use of a multiplicity of medical, alternative, complementary, religious and\/or spiritual strategies to address human suffering is not controversial,\u201d Tobert writes. \u201cIt is normal syncretic practice for people to try a plurality of treatments to address their well being.\u201d<\/em> The author also finds that<em> this practice stems, at least in part, from a cultural view that sees mental illness as an almost entirely transitory state\u2014and one that can be overcome.&nbsp; <\/em><strong><a href=\"https:\/\/www.kirkusreviews.com\/book-reviews\/natalie-tobert\/spiritual-psychiatries\/?fb_action_ids=868049939891237&#038;fb_action_types=og.comments&#038;fb_source=aggregation&#038;fb_aggregation_id=288381481237582\" target=\"_blank\">Natalie Tobert, Spiritual Psychiatries<\/a><\/strong><\/p>\n<p>Important to distinguish that Psychiatric Episodes are regarded as a transitory state in India. Alternate viable models exist. Contrasts starkly with the Biomedical Model I have experienced as both a Doctor and a Psychiatric Patient.<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/youtu.be\/8kJ5ufl43Pc\" target=\"_blank\"><strong>Close Encounter with a Bear<\/strong><\/a><a href=\"https:\/\/youtu.be\/8kJ5ufl43Pc\" target=\"_blank\"> <\/a>&#8230;<\/p>\n<p>My Utopic Dream<\/p>\n<p>Be Mindful of the Lesson. Challenge what you Believe to be True.<a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1234076_10152109240398842_831312317_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1234076_10152109240398842_831312317_n-300x227.jpg\" class=\"alignleft wp-image-4255\" alt=\"1234076_10152109240398842_831312317_n\" width=\"400\" height=\"303\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1234076_10152109240398842_831312317_n-300x227.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/1234076_10152109240398842_831312317_n.jpg 715w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a><br \/>\nFear perpetuates Fear. Stay Calm.<br \/>\nWhen you Understand your Fear, you can Act Cooperatively.<br \/>\nThe Result: Harmony &amp; Holistic Health.<br \/>\nUpgrade Normal to Optimal.<\/p>\n<p>In a Nutshell: When you Treat a Bear without Understanding the Bear, it is Dangerous for both You and the Bear.&nbsp; The Bear represents the person in acute crisis presenting to the Mental Health System.<\/p>\n<p>Brings up an important question: What is Normal?<br \/>\nWho gets to decide this?<br \/>\nTo my experience, the lines are many shades of grey. Caregivers in the Inpatient system had a more black and white approach. Language used is extremely biased. New terminology use offers new opportunities for effectual communication. I am a big fan of the use of&nbsp; the terms <strong>shared reality<\/strong> and <strong>unshared reality<\/strong>.<\/p>\n<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth.jpg\" class=\"alignright wp-image-4164\" alt=\"truth\" width=\"478\" height=\"432\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth.jpg 536w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth-300x271.jpg 300w\" sizes=\"auto, (max-width: 478px) 100vw, 478px\" \/><\/a><\/p>\n<p>Concept of Normal: not a fan. I love to consider optimal. Optimal is different for each one of us. Optimal cannot be dictated from someone else. The missing link in the Psychiatric System that I experienced as a Patient is the ability to connect to a Human Being in crisis. Despite the intentions, care feels more like imprisonment. One viable mindset holding another viable mindset captive. It does not have to continue. Excitement always rises when I consider that there are caregivers<strong> right now<\/strong> in different parts of the world creating Therapeutic Alliances with People in Crisis. We can argue over whether that crisis is Spiritual Emergency, Psychosis or other. Integrative Psychiatry, Transpersonal Psychology, Spiritual Emergency. I will not go into any of these terms but love that they exist as a signpost to show there may be more than one way to look at the issues. The terminology <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11064796_10155295093290693_2342638936304612514_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11064796_10155295093290693_2342638936304612514_n-225x300.jpg\" class=\"alignleft wp-image-4271\" alt=\"11064796_10155295093290693_2342638936304612514_n\" width=\"333\" height=\"444\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11064796_10155295093290693_2342638936304612514_n-225x300.jpg 225w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11064796_10155295093290693_2342638936304612514_n.jpg 600w\" sizes=\"auto, (max-width: 333px) 100vw, 333px\" \/><\/a>debate continues. Perhaps there are many different processes under the same name when actually more terms are required. <strong>I do not know.<\/strong> I do not know is an empowering statement within any Field of Medicine. When we admit we do not know, we are open to learn. We are more likely to look with fresh eyes, heart and mind. When we wonder what is happening with our patients, we can connect to the best options for care. Medicine lumps patients into large groupings. Pragmatic, yes. Optimal. Likely not.<\/p>\n<p>Lovely that the National Health Service in England is embarking on a large study of the promising POD, Peer-Assisted Open Dialogue, style of delivering Acute Care Psychiatry. I consider what this could mean for the Acute Care System in Canada, my home at the moment.<br \/>\nWe could start to implement aspects of this care immediately. No Research required. I learned in Medical School the importance of listening to my Patients. Somehow, the Psychiatric World felt immune to this important rule in developing a Healthy Therapeutic Relationship. Yes, unshared reality exists with Patients and Psychiatrists. It does <a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11188335_957800340918567_6542675665998504695_n.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11188335_957800340918567_6542675665998504695_n.jpg\" class=\"alignright wp-image-4251\" alt=\"11188335_957800340918567_6542675665998504695_n\" width=\"488\" height=\"603\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11188335_957800340918567_6542675665998504695_n.jpg 736w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/09\/11188335_957800340918567_6542675665998504695_n-243x300.jpg 243w\" sizes=\"auto, (max-width: 488px) 100vw, 488px\" \/><\/a>not negate the essential therapeutic role of being heard. Not simply answering the Biomedical Model questions that railroad you into a corner.&nbsp; I learned about the importance of open questions in Medical School.&nbsp; As a patient in Psychiatry, I am shocked at the high percentage of closed, assuming, judgmental questions I have been asked to answer &#8211; especially when in crisis.&nbsp; POD offers the ability to compassionately review the unshared reality. I challenge the assumption that the Clinician\u2019s view of Reality is the only viable one on offer in this world. Truth looks differently from each perspective.<\/p>\n<p><strong><a href=\"https:\/\/youtu.be\/Ms3s4Boo_3E?t=29s\" target=\"_blank\">Ricky Martin, Cup Of Life. <\/a><br \/>\n<\/strong><em>\u201cHere we Go. Allez, Allez, Allez. Go, Go, Go! Allez, Allez, Allez.\u201d<\/em><\/p>\n<p><strong>Cheers!<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth-300x271.jpg\" class=\"alignleft size-medium wp-image-4164\" width=\"300\" height=\"271\" alt=\"truth\" srcset=\"https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth-300x271.jpg 300w, https:\/\/disabledangel.ca\/wp-content\/uploads\/2015\/08\/truth.jpg 536w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>Addendum September 21, 2015:<br \/>\nThinking about the above picture where Truth as a 3D tube gives off true shadows shaped as either a 2 Dimensional square or circle, depending on the perspective.&nbsp; Imagine Truth originating from the <strong><a href=\"https:\/\/youtu.be\/rG6aIVGquOg?t=7m49s\" target=\"_blank\">4th Dimension<\/a><\/strong>, 5D or even higher?&nbsp; It is quite difficult for our minds to be able to conceptualize.&nbsp; Reality will be perceived within the parameters of our physical and mental abilities to perceive.&nbsp; It is not surprising the grand variety of perceptions that exist among us.&nbsp; Food for thought.<\/p>\n<p><strong>It is not about right or wrong, but many versions of right.<\/strong><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I happily put on the hat of roving Reporter within the world of Mental Health&hellip; again. Breaking News! POD can build bridges between Caregivers and Patients in Psychiatric Care. Paraphrasing from the POD website in the UK:&nbsp; Many people &ndash; service users, carers, and staff of all disciplines &ndash; have a strong sense that we [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[14],"tags":[],"class_list":["post-4161","post","type-post","status-publish","format-standard","hentry","category-psychiatry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.6.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Peer-Assisted Open Dialogue, POD: A Transformation for the Mental Healthcare System - Disabled Angel<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Peer-Assisted Open Dialogue, POD: A Transformation for the Mental Healthcare System - Disabled Angel\" \/>\n<meta property=\"og:description\" content=\"I happily put on the hat of roving Reporter within the world of Mental Health&hellip; again. 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