Communication Model Manifesto

The Communication Model Manifesto

When I was a young adult I was in Utrecht, the Netherlands. I took one year out of a four year degree, called Integrated Communication and Management. It was here that I learn about the cycle of communication from sender to receiver. The process of sending a message seemed relatively easy except, components such as encoding and decoding. Both had sub-components in them that allowed or did not allow for the message to be received. Not being able to decode a message, for example, meant that the message from the sender could not be received correctly by the receiver. This very intricate process is a complex process but even the most cleverest communicators can miss the fact that their message is not being received. For example, if someone sits in front of you with a completely blank face, while you are talking, it may seem that the individual is listening to you, when in fact they are not.
One can carry on a long dialogue with the idea that the other is listening attentively and storing the information for the next conversation, however if one has a problem deciphering a message, by means of not being able to decode the message, then the actual message cannot actually be received.

For example, what I noticed in individuals with schizophrenia is that the emotional message cannot be received. This emotional message is in the intonation, the eye contact, the body movements, the clothes that one wears, it is also in word choice and in movements, such as rapid eye-movements – and it is also in the pupils. For example if an individual likes you, this can be witnessed by looking at the size of the pupils. If they are fully dilated then they like you, however if they are small pin-points then I would guess the opposite is true.

So if one looks at the intricate ways of emotional communicating, then I believe that the communication model really is the key to understanding schizophrenia.

Individuals with schizophrenia are not really different then the rest of humanity. The only difference is their way of communicating on an emotional level. That is why using a triangle method, through the way of drawing an abstract drawing while communicating with a person with schizophrenia is the solution. The act of drawing while engaging in emotional discussions with an individual with schizophrenia is like have a third party on the scene. The abstract line motions, that travel through the body of the practitioner to the paper and which create lines and forms and designs works in three different ways. First it helps the individual with schizophrenia understand that he/she is being taken seriously, because the communication is flowing and there is a visual reality-based physical drawing of the emotions – which works as an anchor-like force, which provides the person with severe distress a reference point in which to concentrate on. This reference point distracts away from the psychological distress and changes into a curiosity into what is being drawn on the paper. Second, the abstract drawing works to help the practitioner express the counter-transference feelings he/she feels while communicating with an individual in severe mental distress. This expression of abstraction, through drawing lines on the paper, contributes to two components, first it contributes to understanding the mental distress of the other, and second it is a concrete form of empathy. This concrete form of empathy is the intermingling of the individual in severe distress with the practitioner. This intermingling is a combination of individual and combined, emotional therapeutic connection. This unique integrated connect also helps the individual with severe mental illness by receiving the warmth and the safety of another trained individual. This feeling of safety grows over time. As the communication model is not a quick fix. On the contrary. The communication model is a method that is used throughout a life-time. There is no time limit to when it is not used any more. Instead, when someone is in extreme distress and comes for help, out of their own initiative, then the communication model technique can be applied. There are also no time slots – for example, one could apply the communication model for ten minutes or for five hours, depending on the needs of the individual experiencing distress. It is recommended that the communication model be used in a private setting, like in a private office space, or anywhere where privacy can be safeguarded.

The idea is that that communication model be implemented in the field of Mental Health and Addictions, by family-members and by probation officers when trying to help individuals, clients and/or inmates re-integrate back into the community.

The communication model is a non-judgemental communication device. It is impartial. There is no good or bad in the creation of the lines, forms and the design. There is no right or wrong. There is no angels or devils – instead there is true acceptance of the whole person.

What usually happens when the communication model is in place, is that the emotional distress subsides. It gets transformed into something beautiful – something tangible and real, based on a therapeutic human connection.

The communication model is like an interaction. Like two people playing ping pong. It is an equal interaction in the form of a dialogue and the ping pong ball is like the abstract drawing. It is the momentum. It is the connect.

HIERARCHY – Power struggles

Within every single system structure in Canada, there is a hierarchy structure. It really does not matter how one looks at an organization, a family and a city. Each one follows a hierarchy system. Even the Mental Health system structure follows a hierarchy structure. I believe that this hierarchy structure contributes to tensions which can contribute to Mental illness. One of the main factors within a hierarchy system structure is the notion of coercion. Coercion is a very old method that probably found it’s way into the human system structure by means of analysing the animal kingdom, where the strongest species survived and the weakest died off, yes, the Survival of the Fittest. The notion that the strongest and the most capable survived the test of time, while the altruistic beings died off. Looking at the current Mental Health system, this hierarchy seems to be still alive and well. To me, it seems that the psychiatrist is the patriarchal  head of the family, everyone else – either employees or clients with mental health problems – all fall under the psychiatrist. This system is one that is a false system. It is a false system because education, career and status on a hierarchical system structure are not the only components that make a good system. For example, I believe that respect, integrity, ethics, empathy, equality, social justice and understanding are really the personality traits that should be valued in contrast to the business connections that a professional psychiatrist carries with him into a hospital setting.

Looking through the lens of the hierarchical system structure, one can see holes in it. It is simple, let’s say for example that Mental illness is caused by the environment only. I am not saying the mental illness is solely caused by the environment – however, let’s say that it is caused by an injustice within the family structure. Let’s say that, at a very young age, that an individual is born into a family, automatically gets maltreated, for what ever reason, let it be poverty, power struggles between mother and father and perhaps Mental illness in the mother and father (or one of the parents) – whatever the case may be – the child ends up developing Mental illness because of these factors.

The source is, in this hypothetical case, is the patriarchal system. The family structure, where the child is born more or less powerless into a household where he / she does not  have any defences against the parents. They are both the boss over him/her. Let’s say that the individual with severe mental illness tries to make sense of his/her environment, and tries to make sense of the maltreatment, by going to school and copying the behaviours that he/she was taught at home, such as coercion above the weak – like how his/her parents displayed when he/she was younger. This maladaptive treatment starts to repeat itself at school. This individual starts to bully other weaker kids. He/she could also get aggressive with teachers – which could result in the individual being kicked out of school. The parents in this case, somehow seem to have such a low threshold of tolerance, could then throw the child out onto the streets, as the parents, hypothetically have never seemed to have been able to build up their own sense of safety and hence could never provide it to the child.

The next step, would be that the child/teenager lands on the streets. With no school. The chances that this individual develops serious mental illness is highly probable. He/she has never known a stable home, has never received justice and never received a fair chance at life. He/she was born into a world with virtually no coping mechanisms for survival.

At this time, if an Outreach worker would try to communicate with him/her, the individual may experience a vast distrust in other human beings which could result in paranoia. Paranoia meaning that, for example, the whole world is evil and out to get him – in a very personal way. This symptom of mental illness, has, hence its source in the hierarchical system in this specific hypothetical case. Who is to say that this male/female is delusional? Is it not logical that this human being would feel threaten by the world and see it as hostile?

Let’s say that the next thing that happens, is that this individual is hungry and cold and vandalizes a downtown restaurant in order to get something to eat and in order to stay warm in the night, and as a result gets arrested and taken to jail. In jail he/she falls into another hierarchical system where coercion is strong. The police officer is the authority figure, they need to be treated with utmost respect – based on their status – just like in the original family structure. This triggers the individual, who has had such a hard time in that patriarchal structure in the first place, and he/she becomes violent as a reaction to the threat of incarceration. This creates an even tougher sentences. When the individual is in jail, no one comes to visit him/her because his/her parents have already written him/her off and the school system already asked him/her to leave. So he/she is all alone in a hostile jail environment which seems to feed into his/her vision of the world being hostile.

This individual is still not diagnosed with having a Mental illness, however a lot the symptoms of mental illness seem to be there, such as delusional and paranoia. Often what occurs, is that these symptoms do not go away and if not treated, they do escalate into more extreme symptomatologies. This individual could hypothetical experience a psychotic break in jail, which could land him/her in an isolation cell, instead of in a humane treatment setting. Once he/she is in the isolation cell, he/she is still not receiving treatment and no forms of the surmounting mental illness symptoms are being addressed. This cycle of abuse is called recidivism. It is the escalating cycles of abuse within the hierarchical system structures.

In this particular, hypothetical case, this person never received the chance to rehabilitate him/herself. In a sense this person was the victim of a hierarchical system structure (namely the environment). In this particular case of coercion, this individual only experienced the dark side of the hierarchical system. And even though the hierarchical system structure is ideally meant to work well, in the case of helping  an individual with mental illness, that is in some cases not the result.

In this situation, it would seem that a Mental Health practitioner would need to intervene. It would probably be best if the Mental Health practitioner intervened once the individual entered the school system. It would have been at that time when symptoms would have started to present themselves. If the parents were not able to emotionally provide safety for the individual, then it would become the responsibility of the school system to keep an eye on the circumstances and behaviours of individuals. If a Mental Health practitioner is able to identify traits that resemble mental illness, then the first step would be to invite the individual to talk about their life in a safe setting.

The initial talk would lead to clues as to what is going on in the individual’s life. The answers to questions would lead to possible interventions and precautioning measures. The initial talk would also be a way that the individual could actually start to trust another individual based on mutual respect, integrity and ethics in contrast to the hierarchical power struggles and coercion.

This connection would lead to rapport and this could become a foundation on which to build. This restorative reconciliation could provide the individual with hope, the building of coping mechanisms, self-determination and perhaps start to build on the idea of free-will and free-thought.

If there was a Mental Health practitioner on site at schools, and could freely intervene, then this could possibly help an individual who was heading towards absolute self-destruction and self-annihilation.

MORALS & ETHICS

The existing field of Mental Health is really one of coercion. It exists based on the hierarchical system structure, where it is stereotyped that the strongest, most intelligent and the most capable is the leading force – in this case the psychiatrist – is still – within the Mental Health system – that most powerful professional in the field. The psychiatrist is the one that can diagnose an individual with severe mental illness and the psychiatrist has the authority to involuntarily admit a mentally ill individual. This power over an individual is something that is very terrifying.

The Mental Health system has been built to help an individual who is mentally ill, but at the same time, the Mental Health system is also used to contain individuals that may cause harm to themselves and to others. The role that a psychiatrist has within the mental health system is not only to take care of the individual, but also to protect society from individuals who are mentally ill. This dual role is a conflict because is creates a lack of trust. For example, a mentally ill individual needs support, trust and safety – however when the individual with mental illness would go to see a psychiatrist, I believe that some individuals can pick up on the dual roles that a psychiatrist has, and hence would have a problem trusting the psychiatrist.

This suspicion could result in paranoia – which is a symptom of severe mental illness, however officially distrusting a psychiatrist and questioning if he/she is really impartial and supportive is not acceptable behaviour and this would result in the confirmation that the individual has trust issues and is hence mentally ill. In short, on the one hand the individual with severe mental illness is considered sick and needs care from a psychiatrist and on the other hand, the psychiatrist’s role is not only to help the individual but also to protect society from any potential harm this individual may or may not do. To me, it is a double edged sword. With no right and wrong answers. Just feelings of confusion. An incongruence. An ambivalence. A symptom of Mental illness in itself.

The concept of Mental illness is simple. An individual with serious mental illness has a psychotic break. This psychotic break leads the individual to the hospital emergency ward and at the emergency ward an individual with severe mental illness gets injected with medicine. The medicine sedates. The individual gets a DSM label, for example, schizophrenia. Schizophrenia is a label that stays with an individual for life. This label entitles one to disability monthly payments. Schizophrenia is a chronic illness with no cure. On release back into the community the individual can receive psychosocial care, however this is totally up to the individual. If the individual does not want psycho-social care, then he/she will not receive psychosocial care. Psychosocial care is a system which focusses on what is known as Recovery, however, Recovery here has a very specific context, as it is linked specifically with schizophrenia and schizophrenia is chronic and there is no cure – so how can one really recovery from the illness? This is an incongruence. An ambivalence. Recovery within the context of being diagnosed as a person with schizophrenia means the opposite of the original meaning. In the context of schizophrenia, recovery means accepting that one is mentally ill, that the individual will be mentally ill for life as the disease is chronic, and that medications will contribute to the ease of psychological distress however the medications will never cure the illness. In a sense recovery means accepting having a psychiatric disability, accepting one is sick and accepting that ones’ life will probably not be the same as it was prior to the psychotic break.

To take this notion of recovery one step deeper, in recovery from schizophrenia, one can often not make their own decisions because of a fragile mental state. An individual needs to let other people, such as nurses, psychiatrists, family-members or loved-ones make decisions for them – this is a contradiction with, let’s say when an individual breaks a leg, heals and recovers from the broken leg – and can run fast again. That is a type of medical recovery that is the opposite of the recovery from schizophrenia. The term recovery within the context of schizophrenia has an incongruent meaning – as, according to medical treatment, one cannot recover from schizophrenia.

Schizophrenia is such an individual mental illness. To me, schizophrenia is the most personal emotion, expressed in the most personal way. My idea of schizophrenia, from the outside looking in on to schizophrenia through the lens of a Mental Health and Addictions practitioner, is that schizophrenia is like a quartz with many sides to it, and when the sun shines through the quartz, those many sides seem to multiply exponentially. Schizophrenia cannot be contained into words of every day language. Instead it needs to be expressed through abstract art. Abstract art is the only medium that can capture all the dimensions of emotion, feeling, transferences, counter-transferences and ideologies. To classify schizophrenia in a single book would be like capturing a free-spirit, clipping an angels wings and locking up an einzelgänger.

Schizophrenia is understood in the traditional model of care –  the bio-medical model – a model filled with DSM diagnoses, medications and treatment – as a chronic disease.

Can a chronic disease have a recovery? In simple terms, a chronic disease cannot have a recovery, however in terms of schizophrenia, where slipping in an out of psychosis can happen, like a door opening and closing, there is always moments when working towards improvements is possible, however consistency is really the key to recovery – consistency versus ambivalence – however when communicating and working with people with schizophrenia, a practitioner needs to work with consistency and ambivalence at the same time.

HISTORY

In the 1950’s many mental institutions started to get really full. At that time in history, two situations occurred. First, human rights started to protest about the inhumane treatment that individuals with serious mental illness were receiving in the crowded mental institutions, and at the same time medications for serious mental illness seem to lessen symptoms.

The next event that occurred was the closure of mental institutions and the application of medications was implemented. This decision-making lead to homelessness and full jails in the Western world.

The medications were not fool-proof. Having medications did not rectifying serious mental illness instead it was like trying to contain an overflowing dam. The threat of the walls of the dam collapsing was ever-present and the threat of the water surging over the walls of the structure of the dam was a very real danger.

Individuals with serious mental illness no longer had proper and adequate medical attention. In a sense that is still how it is. Individuals with severe mental illness receive medications and they return back into the community. Most decisions are done by asking him/her what he/she wants. If an individual says that he/she wants to live under a bridge – then that is respected and the individual can go and live under a bridge. If the individual with severe mental illness goes and lives under a bridge, that individual will most likely have problems getting good food, and having a good storage area for his/her medications – which will effect the mentally ill individual’s state of mind. This state of mind could end up deteriorating, which in turn could lead to street drug use and this combined with having no home, not taking the medications as prescribed, plus the street drugs, not having supports – could all lead to suicide.

This cycle of care is very odd. It seems that the human rights that this individual has backfire. The human rights that were there to protect individuals from injustice seem to contribute to injustice. As it is not right if an individual dies without knowledge as to why his/her life is spiralling out of control.

If one does not have any real knowledge as to why their decisions contribute to destructiveness, then how can one be held responsible for their actions? How can they be held accountable?

Human rights laws can contribute to the liberties and freedoms of people with schizophrenia and at the same time strong human rights also lead to homelessness and jail incarceration of the seriously mentally ill. I would suggest a compromise. How the current Mental Health stands is detrimental to the extreme vulnerable, while at the same time it enables a portion of serious mentally ill individuals to start re-building their lives.
There never seems to be enough funding for the Mental Health industry. Homelessness and jail incarcerations seem to be ever increasing. The general public pays for these services through taxes – it is not just homelessness and jails – but also the police force and the medical system which the Canadian general public pays for. Could it be that all of these systems contribute to Mental illness? The actual disease. For example, instead of looking at schizophrenia as a chronic disease, would it not be better to listen, comprehend and understand an individual with serious mental illness, in order to understand their side of the story. Would not communication and better communication within all layers of society – enable individuals to express their emotions, feelings, thoughts and words through a constructive summarizing of events.

The Communication Model really is intended to be a model that enables an individual with serious mental illness to express him/herself in a constructive way. The expression of emotion and the expression of words is the first step to learning to communicate clearly what is going on internally.

For example, a person with schizophrenia may feel very misunderstood – however this idea could be incongruent with reality. It is the expression of emotion of ambivalence which provides an individual with serious mental illness relief.

Often what happens is, an individual with serious mental illness could have a lifetime of keeping their emotions and thoughts bottled up – and this could cause a breakdown. This breakdown, when treated at a hospital setting is treated by using medications. However, the root-cause of the emotional distress never gets discovered. Instead it gets covered up with medications, which are sedating, numbing and used to make the psychological distress less.

It is like applying a band-aid to a broken leg and hoping it will get better on its own accord. This is wishful thinking and at the same time individuals with mental distress continue to walk around sedated on medications like hierarchical soldiers who need to follow the instructions from their psychiatrists in contrast to finding their own voice. In contrast to finding their own voice – based not on synthetic medications and re-programming but authentic emotion and reality.

The triangle method of the communication model is intended to cultivate the communication between practitioner and individual with serious mental illness. It is meant to provide relief for the individual with mental distress and it is intended to help an individual verbally express themselves in a very open, free flowing and emotional way.

The act of a Mental Health and Addictions practitioner drawing an abstract pen drawing, while listening to an individual with psychological distress contributes to the slowing down on the emotional processing. The movements on the paper allow for both parties to re-direct their energies not on trauma on the inside, but recovery and progress on the outside and in reality.

This therapeutic process is creation. It is recreating from the individual’s own perspective versus a standard medical model or standard hierarchical system structure. The communication model advocates individualism and existentialism – finding ones own truth through self-discovery versus medical symptomatology.

The communication model is unique to each individual willing to be part of it. There is no one-size fits all attitude – instead it is based on the unique feelings and ideas inside the individual. The communication model offers a form of freedom of expression – this freedom of expression leads to relief. It leads to contemplation and it leads to discovery.

The communication model helps individuals connect to beauty within mankind – it is about seeing beauty in all situations despite the apparent set-backs. For example, one could have schizophrenia and it is a chronic disease, however individuals with schizophrenia are as human as everyone else on this planet.

Having a chronic disease does not render one stagnant. On the contrary – having a mental illness means that an individual is going to have to fight to exist and the communication model is intended to help those individuals that will not give up on life despite their personal setbacks.

The communication model is intended to help the mentally ill individuals who are in the jail system, who are homeless and in contrast to that main category is the secondary category – the intellectual who has serious mental illness and who experiences mental distress on a regular basis – and who wants to work towards becoming more emotionally in tune with him/herself.

Within the traditional model / psychiatric model of care, an individual with schizophrenia received medications. The next step, if one wants to, is to join a peer support group. The peer support group is a group that talks about self-help issues. For example, if one has schizophrenia, the individual starts to take medications on a daily basis. These medications has side effects and individuals that have schizophrenia go to self-help groups to talk about their symptoms. They talk about feeling paranoid, feeling anxious, feeling out of sync, etc. Within the framework of schizophrenia, talking about symptoms is a big improvement to only having medications and not really knowing anything about the medications, however, to me, the symptoms all seem so artificial. To me, talking about symptoms seems to just touch the surface of the psychological distress.

I believe that trying to feel better by adjusting ones medications in the realm of schizophrenia is an individual choice – well – not really – because people with schizophrenia are officially involuntarily patients and will remain so throughout the duration of their lives. They must take medications, so talking about medications in a schizophrenia oriented self-help group can be empowering and provide meaning to a person with involuntarily certified schizophrenia – forced medications – life long – however tthose are the DSM diagnosed people with schizophrenia – who seem to build their lives around their illness – on the opposite side of the same coin are the individuals who have schizophrenia – but are not diagnosed, some of whom which are, homeless, in jail or are the high intellectuals, who  present very clear symptoms of schizophrenia but who have never gotten it treated.

The communication model is intended to first help individuals who are not medicated and who present symptoms of schizophrenia, but who do not have a DSM diagnosis. These individuals fall outside of the involuntarily treatment realm of schizophrenia and to me, these individuals are the most resilient and the most oppositional.

Schizophrenia has two classifications – DSM and non-DSM schizophrenia. However, in general schizophrenia is schizophrenia. People with schizophrenia, according to the law, become involuntarily patients, they receive a DSM diagnosis and are patients for life. Why only some individuals with schizophrenia get diagnosed and others do not has to do with finances. That is why the current mental system is elitist. In general the medical model only helps people with schizophrenia when they have finances and means to keep appointments, follow all the rules and regulations of working towards recovery and continue to take medications. When one has a DSM diagnosed label, this means that they are not accountable for their actions due to insanity. One psychotic break, according to psychiatry is a very good indication that it will lead to a second psychotic break – which is why people with schizophrenia are not accountable. If one with schizophrenia would commit violent or sex crimes – the sentence is higher and one does often end up in jail.

However, schizophrenia is a mental illness that effects individuals in severe poverty a lot of the time – and individuals of severe poverty do not get access to good medical treatment. Often individuals with schizophrenia are so traumatized by an event that their coping mechanisms are not working correctly, amnesia sets in and a lack of insight takes over sound judgement – all which explain why there are so many people with non-diagnosed schizophrenia in the world today. The other reason is that most of the general population does not know what schizophrenia is, they cannot identify it and they have no idea what to do to help an individual with schizophrenia. So all kinds of people with schizophrenia fall through the cracks.

All round, if one has schizophrenia, one is screwed. On the one hand, an individual with schizophrenia could get identified as having schizophrenia – which means involuntarily medical sedation for life versus not being identified and living life with no knowledge of a mental problem – yet experiencing profound psychological distress with no understanding as to why that is.

The communication model is intended to change, or shift the understanding of schizophrenia. It is intended to validate the individual with schizophrenia by talking – not only about symptomatology of the mental illness, but also about emotion, feeling and getting to the root cause of the distress in a humane and cautious way. Empathetic listening. Empathy versus sympathy.

However the essence of the communication model is acceptance and non-judgement.

Schizophrenia is complicated and hard to understand. It is mental illness, symptoms and emotions. Emotions are private. For any human being. That is what makes schizophrenia so hard to uncover. If schizophrenia is the most private emotion expressed in the most individual way – how many people will get the chance to witness schizophrenia at it’s best, at it’s worst?

Is it mostly family-members who witness schizophrenia. However, how many family-members comprehend schizophrenia? Do they actually comprehend schizophrenia? How do they really know that they comprehended it? Did they use the communication model to find out what was going on inside the individual displaying symptoms – or did they instinctively understand – like having some kind of a sixth sense? A sense, based on mutual respect and understanding.

TURNING THE PAGE

The communication model is a model that is intended to be used for a life-time. It is a model of helping individuals deal with their emotional distress. There is no start point and there is no end point. The communication model helps an individual with severe distress cope better with their emotional pain – but at the same time it does not solve the emotional distress. Instead it allows the feelings to flow freely and without judgement. This free-flowing of feelings is what the communication model is all about.  Somehow, the communication model has the ability to connect pieces together. It joins individual components together like glue. It temporarily pastes all the pieces together. Creating a congruent whole. This connection between the practitioner and the individual with psychological distress is unique and as original as the abstract drawing that is create. It is a once in a life-time moment in time, that cannot be repeated again.  The abstract drawing marks the moment, like a photograph marks a memory in time. The abstract drawing that is created by the practitioner seemed to somehow capture some deeper meaning which resides in the abstract drawing. The lines, the movements and the connecting of the emotion joins two human beings together in a safe therapeutic bond. This safe bond gets recorded in the outlining of the lines in the abstract drawing just like if two individuals were talking and making clay pots on a spinning wheel. The voices can get recorded into the clay pots and in the abstract drawings, the emotions get stored.

A lot of the time, an individual with distress can experience a negativism, however the abstract line drawings often transform that feeling of dread into something brand-new and uplifting. The negative feelings that are felt inside get processed and transformed into something optimistic and positive. The mood of the individual experiencing an episode slips from negative to positive by means of counter-transference communication. The counter-transference communication transcends verbal words. It connects the unconscious like a soldier going to battle for the first time.  The drawing is like a third party, an impartial party, who allows for bad and good to merge like piano music notes performed by Genesis or Debussy – or like organ music played in the Roman Catholic church during funeral rituals.

The physical drawing becomes an anchor. It grounds emotion and ties it down. What happens as the conversation progresses and the abstract drawing develops – is that the tears of an individual in distress   start to stop flowing and the attention goes onto the drawing. Curiosity is sparked by the movements and the abstraction. Painful psychosis transforms into a playful psychosis. One made up of lines which could symbolize the creation of maps outlining another universe – a universe where there is harmony, peace and safety versus chaos, destruction and ambivalence. The psychosis transforms from locked-in internalization to free-flowing externalization. This is the purpose of the communication model.

Written by Annuska van der Pol, BA, PDD-IMHA
Mental Health and Addictions Practitioner, Victoria, BC

2013 Post Degree Diploma in Interprofessional Mental Health and Addictions, Camosun College, Victoria, British Columbia, Canada

2001 Bachelor of Arts in Arts, Policy, Management and Education, inHolland University of Applied Sciences – Museum Educator

References:

Douglas, K. S., Guy, L. S., & Hart, S. D. (2009). Psychosis as a Risk Factor for Violence to Others: A Meta-Analysis. Psychological Bulletin, 135(5), 679-706. doi:10.1037/a0016311

Fiske, J. (1990). Introduction to Communication Studies, Routledge London and New York.

Pauly, B. (2008). Harm reduction through a social justice lens. International Journal Of Drug Policy, 19(1), 4-10. doi:10.1016/j.drugpo.2007.11.005

Rothschild, D. (2010) Partners in Treatment: Relational Psychoanalysis and Harm Reduction Therapy, Wiley Periodicals, Inc. J Clin Psychol: In Session 66: 136–149.

Vanderpol, L.A. (2013). Moving Forward – A Battle towards positive change / Victoria Police Department BC, Canada Research. Victoria, BC. Camosun College IMHA program research.

Vanderpol, L.A. (2013). Literature Review, Serious Mental Illness and the System of Care: Paradox of Denial or a Congruence of Truth. Victoria British Columbia. Camosun College IMHA program research.

Vanderpol, L.A. (2013). The Peer Model: Based on my experience at the British Columbia Schizophrenia Society, Victoria Branch, in the Recovery and Hope Peer Support Group from January to June 2013. Victoria, BC Camosun College IMHA program research.

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