Using Empathic Therapy as a foundation for Peer Support for Suicide Bereaved in Melbourne, Australia
by Tony Gee, "Life Is…" Foundation, www.lifeis.org.au         

This brief article is about a Pilot Outreach Peer Support Program for families bereaved by suicide that we have run in Melbourne, Australia for about 18 months now.  It is a small program (we have had contact with around 30 families) and the support is offered on a voluntary basis (in the home or elsewhere) by Peer Volunteers all of whom have lost someone to suicide themselves.

Why an Outreach Program?:
The loss of a family member, relative, friend or colleague to suicide is devastating. Many speak of the ‘ripple effect’ of such a tragedy, but for those closest it is more akin to a tsunami.

After a suicide occurs, many people struggle to access the support they need, both in the initial stages and longer term. While it has been found that the earlier a ‘connection’ can be made, the more likely suicide bereaved persons are to access appropriate help, it has also been found that grief surrounding suicide is complex and the bereaved are often numb, traumatized and overwhelmed. Many find their grief de-energizing and confusing and, over time, find little motivation to seek assistance. Some become isolated, their own well being at risk.

We therefore decided to set up a service that will take the ‘intervention’ to the persons and where appropriate, we actively continue to follow through on referrals and keep ‘touching base’ with persons we support.

What is Peer Support?
“Peer support is a system of giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful. Peer support is not based on psychiatric models and diagnostic criteria. It is about understanding another’s situation empathically through the shared experience of emotional and psychological pain. When people find affiliation with others whom they feel are “like” them, they feel a connection. This connection, or affiliation, is a deep, holistic          understanding based on mutual experience where people are able to “be” with each other without the constraints of traditional (expert/patient) relationships.” (Mead, 2003)

I would also emphasise two further elements:
1) that it is this deep connection through the lived experience (of loss through suicide) that offers a healing quality that is unique.

2) it is the connection to a ongoing community of peers that empowers, supports and sustains both in the immediate and longer term. For many it is the joining of a common experience community that ‘holds’ someone through the most difficult times. 

Recently in Melbourne, a number of Peer Support organisations  who represented people from a diverse range of backgrounds impacted by mental health issues or traumatic life events, developed a Charter of Peer Support. There are 7 Principles noted in the charter which summarize the benefits and efficacies that Peers Support can offer. These are:

1. Opportunities to benefit from collective wisdom, providing:

• access to accumulated knowledge, from multiple perspectives.
• new insights, widening the basis of understanding of their mental health issue, and building meaning in their life.
• an unmatched source of support and inspiration and empowerment, reducing the burden of living with a mental health issue.
• self-respect, knowing that their collective wisdom is valued.

2. Opportunities to understand and destigmatise mental health issues (including loss from suicide), enabling them to: 

• have the freedom to be themselves without fear of rejection, ridicule or humiliation.
• gain an understanding that their lived experience is accepted and valued.

3. A renewed sense of self-respect, understanding and belonging through being part of a circle of a caring community, providing: 

• knowledge that they are NOT isolated.
• strength gained from realizing that they are an important part of both a group and the community.
• opportunities to make authentic connections that increase well-being socially, mentally, physically and spiritually.
• means to alleviate stress and improve well-being for carers.

4. Opportunities for people to re-discover and activate their own personal, hidden resources, enabling them to: 

• share their life challenges with those who understand.
• grow in confidence and be encouraged to share and explore their issues in increasing breadth and depth.
• believe that they can and do have control over their own life, well-being and happiness.
• take on responsibility for their own journey towards recovery and health.
• gain and share knowledge of skills, treatment pathways and tools that have proven useful.
• be strengthened, and take that strength out into the community.

5. Opportunities to receive hope, inspiration and empowerment for recovery, providing: 

• proof that recovery is possible, gained from hearing the recovery stories of others.
• encouragement from others.
• an understanding that recovery and health is a lifelong journey.

6. Opportunities to give help to others, as equal-to-equal, through:

• sharing their own story.
• encouraging listening, as well as being listened to.
• offering support to others from their lived experience.
• experiencing the personal strength and healing which comes from helping others and making a contribution to the greater good of the community.

7. A unique pathway to help which is:

• non-threatening.
• affordable to all (low cost approach).
• either complementary to existing clinical services or stand-alone.
• open to freedom of participation, when and where required, without waiting lists or limitations on number of visits.

See:  The Charter of Peer Support  -  www.peersupportvic.org

The ‘Conversational Model’:
In putting these principles into practice, we are clear that we are not offering therapy or counselling and are not working within a defined ‘professional’ or ‘expert’ context. What we offer is Peer Support - a kind of mentoring which has its own unique context, connectiveness and healing quality.

As stated, we have found that the ‘expertise’ of lived experience, constructively applied in conversations with appropriate boundaries and focus, offers an ‘empathic attunement’ that is unique in its ability to connect and assist. In developing our ‘Conversational Model’ of Peer Support we have also found, in general, the principles articulated in Empathic Therapy (Breggin, 2011) to be highly consistent with and helpful to our process development. We also draw upon several other influences including Collaborative Therapy (Anderson and Gehart, 2007) and indigenous, narrative/healing approaches (Mehl-Madrona, 2010). 

Overall we are guided by Breggin’s (1997) notion of creating a ‘healing presence’. He states: “Healing presence is a way of being that by its very nature tends to reassure and encourage people, to lend them moral and spiritual strength to provide confidence that they can overcome suffering and continue to grow”. 

References:
Anderson, H. and Gehart, D. (2007): Collaborative Therapy: Relationships and Conversations that make a difference. Routledge, New York

Breggin, P (1997): The Heart of Being Helpful. Springer Pub. Co. N.Y.

Breggin, P. (2011): Guidelines for Empathic Therapy – online article from www.empathictherapy.org

Mead, S (2003) Defining Peer Support - online article from www.mental healthpeers.com

Mehl-Madrona, L. (2010) Healing the Mind Through the Power of Story: The Promise of Narrative Psychiatry Bear and Co., Rochester, Vermont.

Tony Gee, BA, Grad DipEdPsych (Monash), M. Suicidology (Griffith)
 
Tony is a Psychologist and has worked with families and individuals in the family law field for many years, employers including the Family Court of Australia, Relationships Australia and Victoria Legal Aid. He continues to be involved with these organizations on a sessional basis. Following the death of his daughter Nellie in 2005, he has worked to establish "Life Is..." and develop programs aimed at harm prevention and well being. He currently has a private counselling practice, as well as developing and managing LIF programs and activities. He is a Board member of the Coyote Institute and also on the Board of Compassionate Friends.   

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