Transcript Identifying and Overcoming Mentalism

Identifying and Overcoming
Mentalism
Coni Kalinowski
Pat Risser
Why use the term Mentalism?
• It connotes the systematic mistreatment
of labeled people.
• Analogous to racism, sexism
• The defining factor is a power difference
between the provider and the consumer
• Power differences must be actively
maintained using offensive mechanisms
Systematic discrimination
• inequalities are institutionalized within the social
structure
• imbalance in economic, political, and social power
• pervades social system and all aspects of people's
lives
• generates and sustains misinformation and ignorance
that are translated into attitudes, assumptions,
feelings, and beliefs
• it provides justification for itself
• it affects everyone
Offensive Mechanisms (Chester Pierce, MD)
• Their function is to maintain the power
differential between individuals or groups of
people.
• They are implemented largely through the
aggregate effect of micro-aggressions.
• They are usually unconsciously employed.
• They become institutionalized by
incorporation into policy and procedure.
Macroaggressions and
Microaggressions
Macroaggressions
• Blatant and concrete
o Physical assault during restraint
o Deprivation
• The brutality of the action is hard to deny
o The hostility is blatant
• The impact of the action is hard to deny
o The harm is obvious (e.g., physical injury)
Microaggressions
  They are small, often interpersonal, attacks on the person’s
power, worth, and wellbeing that are not in themselves an overt
threat to the person’s safety, health, or status.
  They are usually unconsciously employed by the offender.
  The person encounters them hundreds or thousands of times
each day and in all settings.
  The aggregate impact is as devastating as a macroaggression, such as physical violence.
  To address power differences, the dominant (“power-up”)
group must assume responsibility for the eradication of microaggressions.
The dynamic process of offensive
mechanisms
They provide justification for the dominant group to remain in
power over the offended group:
o the dominant group is more skilled, experienced, capable.
o the offended group is deficient, inexperienced, controversial.
• They assert the good intentions of the dominant group towards
the offended group, and gratify the dominant group's need to
feel charitable, open-minded, and kind.
• They chastise, punish, discredit, or blame members of the
offended group who are dissatisfied with the situation, especially
in ways that make them appear unreasonable or absurd.
• The offended group is held responsible for ameliorating the
conditions that permit the offense, while the shortcomings and
deficiencies of the dominant group are tolerated and protected.
Examples of Microaggressions
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Language and clinical terminology
The physical environment
Atomization
Pseudo-empathy
Prognostication
Risk assessment
The impact of offensive mechanisms on
people in the “power-down” position
• They are exhausting.
• They reduce opportunity.
• They are internalized in unique ways, and can be
destructive to self-esteem, wellbeing, and selfdetermination.
• They cause people to feel that they are out of touch
with reality.
• They can cause mounting anger and/or grief.
• They cause learned helplessness and depression.
The impact of offensive mechanisms
on people in the “power-up” group
• Loss of valuable human resources and
diversity.
• Loss of personal integrity and compromise of
values.
• Fear and isolation.
• Loss of support from “power-down” group.
• Loss of effectiveness.
• Feelings of depression, anger, bitterness,
despair.
Integration of power issues into
community mental health services
• Acknowledge the presence of prejudice and discrimination as it
impacts people's lives.
• Apply the “would I accept this” rule
• Assist people to identify and defend against micro-aggressions
and offensive power dynamics.
• Confront and avoid offensive mechanisms such as atomization,
tokenism, false compromise, offensive language, and
procrastination.
• Evaluate “ethical” issues as power issues – often the term ethics
is used to describe abuse of power (e.g., sexual exploitation) or
it can be used as an excuse for an offensive mechanism (e.g.,
consumers prohibited from visiting inpatient unit because it is
“not ethical.”)
Integration of power issues into
community mental health services
• Evaluate mental health concerns within the context of
oppression. Avoid pathologizing a person's attempts to cope
with an impossible situation.
• Provide services that support consumer choice and
empowerment.
• Provide constant reminders to staff that the purpose of the
organization is to provide
services, and the organization is
accountable to the recipient of those services.
• Learn to accept and affirm the anger and indignation that people
may feel as a result of oppression.
• Openly confront negative stereotypes and assumptions – be
intolerant of intolerance.
Organizational suggestions:
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Engaging in social change takes time, energy, and resources. It is also
very emotionally draining. Make sure you allocate adequate resources
so that change agents don’t burn out.
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Take time at the outset to define your group values and goals. Talk
about these often, so the group stays focused and grounded.
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Summarize your core values and goals in a few “bullets,” then use
these to evaluate group decisions (e.g., “Does having a membership
fee fit with our core value of inclusion?”).
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Affirm personal accountability rather than power over others.
Stay task-oriented rather than position-oriented.
Organizational suggestions:
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Establish a routine for meetings, communications, procedures – then
rotate the leadership/facilitator role among members.
Establish group achievement as a value, rather than individual
achievement.
Affirm and recognize all contributions by group members, without
judging, comparing, ranking, or competing. This supports a group
dynamic that is inclusive of people of all abilities and means.
Expect that individual members will contribute in different ways, and
that the group as a whole should reflect the attributes of all members
and not just those of the highest achievers.
Find ways to constructively debrief experiences of discrimination and
hostility that help the group to find strategies to cope with prejudice and
oppression.
Find ways to have fun together.
Organizational suggestions:
• Move to Positive Assumptions:
• a. Communicate respect, dignity, and worth.
• b. The person receiving the service and the provider collaborate
to define goals, obstacles, and solutions. (“If we can work
together to come to a better understanding of the problem, we
can devise an effective solution.”)
• c. Move from “knowing” to seeking.
• d. Move from “doing for” to facilitating.
• e. Move from judging to understanding.