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Volume 50 Number 4
Self-Help Interest Group
Written by Tehseen Noorani, email@example.com
Self-Help and Mutual Aid: Greetings from the New Chair and Looking Ahead
As the incoming Chair of the Self-Help interest group, I wanted to write to introduce myself, update those who could not make it to the 2017 Ottawa Biennial on the lunchtime interest group meeting, and offer some reflections intended to stimulate discussion over the coming term. Alicia Lucksted and Greg Townley have served as co-Chairs of the interest group for the past 4 years, and on behalf of the group I want to thank them for their leadership and the smooth running of the group. Under their stewardship the group ran quarterly phone meetings and a regular column in this periodical, which I plan to keep going.
A bit about me: I have interdisciplinary training in the humanities and social sciences, with a PhD in Law and Society from the University of Bristol in the UK where I conducted research with two mental health self-help/mutual aid groups: the Hearing Voices Network and Bipolar UK. From 2013-2015 I was a postdoctoral fellow at Johns Hopkins in Baltimore, leading a qualitative investigation into a novel psychedelics-assisted psychotherapy for addiction cessation. From 2015-2017, I taught in Science and Technology Studies at New York University, on psychoactive drugs, medical attention and the pharmaceutical industry, the politics of knowledge and the changing authority of experience.
This summer I left New York when my partner got a job in London, and for the present time I will be chairing this interest group from the UK, taking the opportunity of location to build up trans-Atlantic links and look out for funding streams that promote international and interdisciplinary initiatives.
As I emigrated for the UK, the SCRA biennial took place in Ottawa. The interest group meeting was reportedly a great success, with as many new attendees as familiar faces and enthusiasm for extending and deepening our activities. The discussions raised important and timely issues covering the focus and scope of the interest group, the mission statement and obstacles to funding, which have inspired some reflections on my part. In the rest of this column I will highlight key issues that were raised, together with some of my own reflections, in the hope that they may contribute to ongoing dialogues in our group and the wider Division.
Firstly, attendees discussed the difference between self-help and mutual support. I find this to be an illuminating though tricky distinction. The difference could be defined, for instance, through a group's activities, its functions, or the kind of community or sociality a group brings into being. Contrasting the act of helping oneself with that of helping another is useful, but this is not a neat distinction in practice. The phrase, 'you alone can do it, but you can't do it alone', often attributed to the American psychologist Orval Hobart Mowrer (1907-1982), instructive in this regard self-help and mutual aid as neither solely helping oneself nor helping another, but both at the same time. How can we conceptualize, study and value this particular form of interdependence? Reissman (1965) coined the phenomenon by which helpers themselves are helped by helping as the 'helper' therapy principle.
Two years ago in this column, Thomasina Borkman drew upon two definitions of mutual help groups in sharing her impressions of clubs of treated alcoholics in post-socialist Croatia. Firstly, Gidron and Chesler (1994: 3) defined it as “the recruitment and mobilization of peers in an informal and non- hierarchical setting, and the sharing of their common experiences”. Secondly, Borkman cited Keith Humphreys' (2004: 14) seven criteria: "members share a problem or status, self-directed leadership, experiential knowledge, reciprocal helping, lack of fees, voluntary association, and include some personal change goals".
A central question this raises for me is what happens when profound personal change and transformational or structural change are inseparable? To draw on the feminist slogan, what if the personal is political? We could then count consciousness-raising group as self-help groups. They are certainly bounded by a shared set of experiences and problems, engaged in collective meaning-making and strategizing, with the aim of transforming both their lives and their environments. An important task would be to trace 'frame-widening' moments, when different mutual aid groups recognize the systemic or ecological commonalities that produced their respective problems.
Also of interest are participatory action research (PAR) groups, such as anti-gentrification housing activist groups, or people who share negative experiences of local policing who are looking to further understand and challenge systemic racism, benefitting from the insights of their particular standpoint (Harding, 1986). And what about collectives that do not see themselves as groups at all - might we want to document the self-help and mutual support of those who gather voluntarily at a youth center, or in a hair dresser, or in a store, or on a street corner? When do these modes of sociality become similar enough to traditionally-conceived self-help groups to fall within our remit? Or does the traditional 'sharing-circle' (Humphreys, 2004) form of self-help make it qualitatively different than all these other spaces and practices?
The Ottawa meeting also discussed how the term self-help doesn’t fully convey the importance of the peer role. This seems very important to me. What do these different terms evoke, what do they exclude, and how are they being deployed strategically? The term 'help' has been mobilized in discourses of empowerment that gloss the complex intertwinements of care and violence. Of course, not everyone needs to be helped, and not all those who need help are capable of asking for it. Adding 'self-' to the term does not necessarily make things easier, unless one believes in the very sovereign liberal subject that relational approaches and the prism of 'interdependence' troubles in the first place. The turn to peers, including perhaps the sponsors of the 12 Steps groups, allows us to think differently, about what it might mean to know more or know better, to see self-help and mutual aid groups not just as building community but generating structures of knowledge and wisdom too.
Others at the Ottawa meeting noted that self-help support groups are distinct from peer support specialists. I think of the former as evoking bounded, protected spaces with ground rules that ensure non-hierarchical practices, while peer support specialists are modeled upon professional service provision. How are they different? What happens when attendance of self-help support groups is made compulsory, as if to incorporate them into a service provider structure as specialists receiving referrals? And what challenges and opportunities do peers working within wider systems of service provision encounter?
The Ottawa meeting also acknowledged that groups don’t have to be entirely professional or entirely mutual assistance, but that there is middle ground - for instance, when peers are employed by a mental health center. There are already so many practices that populate the middle ground, perhaps due to practicality, funding or administrative stipulations. How does this change the nature of the care provided? As researchers we can easily dismiss 'non-pure' practices as having sold out, when this may be more a function of the inability of academic modes of analysis to get a grip on what is happening via naturalistic study (see Kennedy et al., 1993) than it is a failure of the practices to stand up to the demands of 'ideal types'.
Some individuals noted the value of also focusing on youth peer paraprofessionals - the youth occupying a special category in relation to questions of temporality. What are the different issues that face youth peer paraprofessionals? What are other social categories that get excluded from self-help research and literature, and how might that affect how we understand the capacities of experience? In feminism when women of color and poor women began mobilizing instead of white middle class feminism, the language of choice shifted to a language of reproductive justice. What other ways can we shift our gaze from the individual to the collective and the bureaucratic to the political?
Experiential knowledge was identified as a crucial focus of the group. This may lead us to wonder what happens if we choose to foreground experiential knowledge. Is experiential knowledge inherently a good thing? Following the accumulation of experiential knowledge means following problems as they gather people, resources and practices together. While so often liberating, what happens when experiential knowledge rein scribes dominant knowledge’s, in form if not in content? The centering of such knowledge is perhaps less about the resolution of problems than their capacity to produce new communities and new psyches.
Broadening our lens, self-help work is particularly important in the contemporary context due to the lack of statutory investment in helping people sustain themselves. The Ottawa meeting noted that self-sufficiency is, in some ways, more important now than ever. Several people suggested that our mission statement expand to embrace activism and/or advocacy. We face a difficult time with a populist call to "deconstruct the administrative state", and new challenges to a welfare consensus that has persisted for seventy years, including increasingly explicit assaults on social security. And yet, across the US and elsewhere, the response to recent events has been not just to contest these encroachments on the role and scope of the public, but to build new communities of care. This is happening at a time when we have access to peer-to-peer technologies and digital platforms that both presuppose, and offer novel opportunities for sharing, skills and knowledge in the building of new commons. And self-help and mutual support groups can be understood as exemplary commons.
Finally, and despite the relevance of self-help, mutual aid, peer support and the potentialities of experiential knowledge, it was noted in Ottawa that it remains difficult to obtain funding for self-help research. Two exceptions are the Patient Centered Outcomes Research Institute and selected National Institute of Mental Health grant programs, which offer research monies that could be used for self-help and peer specialist research. What then are the challenges in communicating the importance and relevance of self-help and mutual aid research to funders? Is it inherently hard to study self-help using social scientific tools - and if so, why?
Any of these could be fantastic topics for a submission to TCP's self-help column!
Borkman, T. (2015) 'Impressions of Clubs of Treated Alcoholics in Post-socialist Zagreb, Croatia', The Community Psychologist, vol. 48(4), 26-28.
Gidron, B., & Chesler, M. (1994). Universal and particular attributes of self-help: A framework for international and intranational analysis. Prevention in Human Services, 11(1), 1-44.
Harding, S. (1986) The Science Question in Feminism, Ithaca, NY: Cornell University Press.
Humphreys, K. (2004). Circles of Recovery: Self-Help Organizations for Addictions, Cambridge, UK: Cambridge University Press.
Kennedy, M., Humphreys, K., & Borkman, T. (1994)'The naturalistic paradigm as an approach to research with mutual help groups', in T. J. Powell (ed.), Understanding the Self-help Organization: Frameworks and findings, Newbury Park, CA: Sage, 172-189.
Riessman, F. (1965) 'The ‘Helper' Therapy Principle', Social Work, vol. 10(2), 27-32.