From the Desk of Russell Pierce

August 20-21. 2014

A Message of Recovery for Psychiatric Residents

Worcester Recovery Center and Hospital

Russell D. Pierce, Director, Office of Recovery and Empowerment

If there is one thing that I want to accomplish today that is to counter the notion of ‘otherizing’ one another so nicely described by the poet, Langston Hughes:

I, too, sing America.

I am the darker brother.

They send me to eat in the kitchen

When company comes,

But I laugh,

And eat well,

And grow strong.

Tomorrow,

I'll be at the table

When company comes.

Nobody'll dare

Say to me,

"Eat in the kitchen,"

Then.

Besides,

They'll see how beautiful I am

And be ashamed—

I, too, am America.

What this poem means to me and perhaps to some of you who have experienced recovery in your own lives—from failures, divorce, bad relationships—or just circumstance, is that we often felt alone, but my purpose here at the moment is address in some small way recovery as a part of historical process and

how people who have been marginalized over time have gained voice.

Let us begin:

Through all the sorrow of the sorrow song, there breathes a hope in the ultimate justice of things, so said the great thinker W.B. Du Bois. What this means to me is that suffering can be endured through song and dance, that distress can be endured through the mystery of music, but perhaps more importantly, that wrongs will be righted and justice instituted. I am proud to be a carrier of a rich tradition of reform movements across our nation’s history including the mental health reform movements that dates back in this Commonwealth to the nineteenth century with the work of Dorothea Dix

Let us note at the outset that “recovery” does mean something more than “getting better”—it does involve a fundamental shift in how we define ourselves in communal life with the full range of rights and responsibilities of citizenship. In this regard, we are not only talking about symptom abatement, normalizing, and the provision of housing and employment supports. No, we are talking about and must talk about people reclaiming their lives, dream and aspirations.

See, Slade, M., World Psychiatry, Uses and Abuses of Recovery, Vol. 13. Issue 1-pgs 12-20, February 2014.

To share a personal note: I am often asked how have I overcome so much, so much hardship, pain and loss. I think the answers lies in childhood experiences and I had a good childhood. I can recall my mother saying ever so sweetly to me that life ‘ain’t easy’—which I interpreted even then that ‘rejection’ is part of the life course, not so much because you were black, even though that would certainly contribute to it, but because difficulties and adversities affect everyone. When I was young I would listen intently to both sermons and gospels that would inspire me with truths, if not satisfaction, songs that had words to the effect, “God bless the child that got his own, that mama may have, papa may have, but God bless the child who has his own.’ So powerful.

So today I am not going to discuss or render comments in the typical way that some people do—amounting to a ‘working of the wounds’—not instead, I am going to offer some reflections that actually may benefit those of you—and us who are involved in the day-to-day strivings of ordinary lives, sometimes complicated by misfortunes and specifically conditions related to well-being and health.

But my aim today is not to delve deeply into the consumer rights movement. I will leave that for anther time—perhaps another invitation.

I am delighted to join with you today—in fact, over the last two days, in a discussion of recovery and how this innovative approach to clinical practice can cash out in the therapeutic alliance between persons with lived experience and those of you who are—or about to enter the caring professions. In some ways, I view psychiatry and counseling in much the same way I started to view law as a student—as something akin to caring, a form of ministry if you will to the afflicted, the suffering. I viewed the law as a form of ministry, helping the soul, helping those to witness the majesty of the Lord in action: to health and to repair and to restoration. Perhaps, this grew out of traditions and childhood, but it was the centerpiece of my early studies—the influence of the church and community, and even the philosophies of Augustine and others, including Thoreau and Emerson.

What I want to talk with you today however is not pure philosophy or even the theory and history of our movement of recovery, for others are more ably to do than I am at this moment. What I do want to discuss with you is my journey as an individual who has been afforded many opportunities to walk through doors of entry and access—and in the process how I have come to view life and the challenges it offers to us,

whether in recovery or not. Far too often we think that only those who have been labeled with a diagnosis can speak intelligently or exclusively on pain and pathos, whereas human beings have been dealing with struggles for hundreds of years. I am just as interested in your stories as well as my own—and perhaps, we will discuss both.

But let me begin with an acknowledgment of those who have influenced me thus far—and of course, that would be my family, especially my mother and grandmother, who always told me to work hard, study hard, learn as much as you can—both formally and informally, and never forget from whence you can because you are going to meet the same people going up the ladder as when you are coming down. I must say they were indeed correct.

They also taught me that you might have to work twice as hard for half as much—and certainly there were no guarantees that life was a rose garden, or that all people would marvel at your talents and celebrate your successes.

The lessons of humility were early taught—and I recognize the lack of it even when I am involved in treatment settings—making me pause again, to consider, whether or not we can actually teach through pedagogy good behavior, manners, respect and overall conduct, that is the basis for a good therapeutic relationship.

My goal here for the moment is not to chastise you or to even instruct you, but to infuse the idea that equal respect and consideration for the person does not happen by accident or luck and chance. It takes purposeful effort and commitment. This dedication to principle is hard and requires us all, in the helping professions, to which you are entering, to engage in frank conversations about race, gender, class and privilege particularly unearned privilege and the micro-aggressions associated with. I have found it instructive to learn about a people’s history, culture and beliefs in my effort to become a friend, ally, or supporter. Without appreciating these frames of references and context, we cannot begin to have a full and authentic conversation with one another. I often say that we do not take introductions seriously—meaning that when we see someone unfamiliar to us, we may say—hi, goodbye and be on our way, not stopping to long enough to possibly witness pain or pleasure or even discuss what lies beneath that veil of identity or mask.

This is more so, at least in my experience, in the treatment setting, where those who are assuming to care for others are pressed by economies and policies, to spend about fifteen minutes figuring out what is wrong with you, as opposed to what is right with you—or even asking what has happened to you to bring you to this point. But my larger point today is not to focus on this. I want my message to reflect a journey of one who lives and thrives in community life, unbounded by

diagnosis, not because I am in denial or even lack insight, but as I hinted at earlier, I was brought up through traditions centuries old to struggle, to endure whatever label—and somehow to summon the strength of the ancestors to carry on. I do not think we can underestimate these protective and resiliency factors in our work together in communities, especially in communities of color.

A strong sense of history has brought me through many a challenge—a diagnosis, unemployment, homelessness, congregate living, loss of friendships—and the death of loved ones. The soul, however, is a complex thing. The soul, the interior of our being and hearts is a wonderful part of each of us. In it we find the rich resources to survive, endure, and as the writers say, to prevail.

I am told that there is something called the ‘idiom of distress’ that a culture and a people practice and believe. The message here is that we all exhibit pain in a certain way—and for those that minister to the spirit and the soul, there is a way of believing and acting that causes that stress to be revealed, let us say for divine or spiritual redress. As an African American, I have sought refuge not only in history or law—or even in a doctor’s office, but also through the songs of Areatha Franklin and Denyce Graves—and the sermons of Rev. Woods, my childhood preacher at the local African Methodist Episcopal Church.

Earlier, I spoke about influences—those people and institutions that impact my life and impart wisdom. I have always been bewildered when interviewers ask the question of ‘who has influenced you’—not because it is an unfair inquiry. I just find it hard to leave anyone out—or anything out. My remarks today have been in the making over a lifetime—influenced by artists, musicians, painters, intellectuals, teachers and friends. I must also at this point say that the magnificent poet Maya Angelou was a major influence with her poem—“Still, I Rise’—as was Langston Hughes when he wrote—‘life ain’t been no crystal stair.’

These are what are meant by the idioms of distress in my view—the underpinning of a cultural belief system that serve to edify and strengthen people in the toughest of times. I have found the words of preachers uplifting and strengthening even in moments of crisis, which can mark the onset of illness—and it this particular understanding that I can only hope that doctors and psychiatrists apply to their practice, which to me brings recovery to practice, an appreciation of cultural context and milieu.

As I stated at the outset, others can and perhaps already have given you a glimpse into the recovery model, which to me is less a model than an attitude. But I will not dwell on that for now.

What has gotten me to this point in life? It has taken a lot of hard work—delayed gratification, and then some. But I take delight that I am not a statistic. I have a decent job and work in a climate that is extraordinary—as is this opportunity to speak with you here today, and I am grateful to Dr. Sanders, a colleague, who has made it all possible. I realize everyday as I salute the dawn that I am fortunate—fortunate to be here in such a charming city, and to sit in the Commissioner’s Office, as I and my team attempt to give voice to peers across the Commonwealth.

Work has always been a defining characteristic for me—even when I worked in local eateries and restaurants, school cafeterias, and even cleaning out bathrooms, working in filing room, sitting on non-profit boards, all gave me definition and strength. A particular joy and satisfaction was working as a public health advisor at the Substance Abuse and Mental Health Services Administration (SAMHSA) in Maryland, and helping in some way to move mental health systems forward. These assignments provided me sufficient ego-strength, if you will, and cash, to realize the dream of societal integration and participation, that underlies the Olmstead Decision, but yet for many of us, is the unfinished business of years of prolonged advocacy for those with disabilities.

Let me just say a word about ‘disability’—I think it is important that we do not use language to consign people to roles not of their own choosing or making, and for me it has been important to surround myself with people and professionals who do not casually toss around terms without attention to context. I am reminded again of Maya

Angelou—who said ‘I may not remember what you said, or how you said it, but I will never forget how you made me feel’. It has been disheartening to hearing those, even those who minister to the soul and spirit, and for certain those who treat the body and mind, say things like you are sick, you are unwell, you will always be on medications—or that you will always be in our care.

The purpose of a hopeful psychiatry is not to be hope sapping as one of my colleagues described it, but hope-moving and infusing. How we deliver messages to one another is crucial and as I have suggested understanding the idiom or speech of a people is important—as is their history, music and voice tell us. We must understand why the ‘caged bird sings’—it sings because it wants to be both loved and freed, freed from hunger, isolation, trauma and racism. In this realm of thinking, we must to the maximum extent possible understand why choice and relationship are key to the therapeutic alliance. We must encourage healthy risk taking, and understand that all interactions, including the interaction between you as caring professionals and peers entails some risk, but that the potential reward is great. Just like character formation takes time and

responsibility and example, so too does choice take time and cultivation—we can not presume that it will occur just because we desire it or wish it to be—it take hard work, an appreciation for the fullness of the person we are connecting with, and avoiding snap judgments incapable of reversal or refinements.

Even where I sit, I know how it feels to be an ‘outsider’—but this fact alone does not discourage me, for as I learned long ago being the ‘other’ can give one certain advantages—and we must all learn to take advantage of our disadvantages. I point this out not to criticize, but to let you know that the struggle is not over—that it continues, even among those who are allied with us. The ‘other’ has an obligation to teach—to hopefully inspire, hopefully to become part of the solution—and not ‘captured’ as they say in law by structures, or otherwise co-opted. I have said elsewhere that one of the things that I like about my role is to challenge—to challenge assumptions about the aspirations, talents and creativity of a still, perhaps, the last marginalized group in America.

Yet, I see progress. Like the Rev. Dr. Martin Luther King, Jr. said, I may not get to the mountain top with you, but as a people I can promise you that one day we shall overcome. In this vein I too realize, not only with this invitation today and incredibly with my appointment to the position of Director of the Office of Recovery that a greater justice has been extended to those of us in recovery.—your recovery and ours. That, is to

say, it is both possible for individuals and institutions to change..