Beyond (self) help

“Unmotivated” “resistant” “In denial” “non engager” “non-compliant” “chronic addict/alcoholic” “serial-relapser” “beyond help” “manipulative” “user of the system” “boundary issues”. Terms that were regularly used to describe me on my journey out of addiction and words that still make me cringe whenever I hear them uttered by professionals. Substance abuse services which use ‘readiness to change’ deficit based approaches have developed a million and one excuses for their failures and why they’ve had to ‘close cases’.

Less than 10% of those who are drinking at levels which would be considered harmful or hazardous to health are currently engaging with professional support. I don’t have the figures to hand for how many of those ‘in treatment’ feel it is effective, neither do I have figures to hand for how many people who are homeless (including those in temporary and emergency accommodation)are satisfied with where they’re living and the wraparound support they’ve been offered. From my professional experience, I’d be staggered if the figure was high.

Where does people’s hope come from in a system which blames them if they’re not able to quickly move through it despite all the obstacles along the way? We often turn to ‘self-sustaining self-help’ for this purpose. To put it another way this is something we expect people in recovery to do for free. This may be through an activity associated with the system (e.g. peer-mentoring) or through a peer support group which operates in the community. I don’t wish to be dismissive of all professionals here, there are many who offer hope and consistency despite systems conditions. Also, if long established peer support groups do not wish to receive any funding or influence from outside then I wish to make clear I find this commendable.

We need to ask ourselves where the lack of hope and faith, both in public services or society in general, stems from. People lack access to accommodation they feel able to live in (let alone call a home), and employment prospects which help them see a decent future for themselves. How does the system respond? Allocate money to more ‘navigation’, a cynic might say it will do someone little good to navigate through a system that ultimately offers them fuck-all.

Gaventa (2003) provides a useful explanation for why this happens: the power cube. This cube relates to the different spaces in which decisions are made.

1. ‘Closed’ spaces: spaces which are controlled by an elite group
2. ‘Invited’ spaces where policymakers invite the less powerful to share their opinions. The reason for the invitation can be due to external pressure, an attempt to legitimise their (the policymakers) decisions or reaching a point with a complex issue where they realise new perspectives are needed.
3. ‘Claimed’ spaces are where the less powerful have the opportunity to make their own decisions without control from traditional power-holders.

Gaventa also identified 3 types of power:

1. Visible power: Conventional power negotiated through formal rules and structures, institutions and procedures.
2. Hidden power: The actual controls over decision making, and the way powerful people and institutions maintain their influence over the process and the underhand ways in which they exclude and devalue the concerns and agendas of less powerful groups.
3. Invisible (internalised) power: Ways of influencing how individuals think about their place in society and preventing people from questioning existing power relations.

The final thing to consider when using Gaventa’s cube is whether decisions are being made on a local, national or global level.

To quickly turn the theoretical back in to the practical, I am going to reflect on what the cube means for groups of people with lived experience. The easiest space in which they can claim power has traditionally been to establish a User Led Organisation (ULO) or peer support group at a local level. The level of economic power and resource this will create may encourage one or two people to seize control and escape poverty as paid coordinators of the project. Again I don’t wish to attack, many coordinators of self-help groups and organisations (including myself in the past) are benevolent in their use of power.

Its worth making explicit the privileges (e.g. gender, ethnicity, sexuality, education) which make it easier for people like me to make use of any economic resources created through ‘claimed spaces’. Bizarre claims have been made by some that people can ‘be inspired out of poverty’, there is a need to call Bullshit on any messages such as this. What we can do is offer someone warmth, empathy and understanding. Whilst this has value it sometimes feels you’re pissing in the wind when you see the accommodation people are being forced to live in and their current employment prospects.

In more recent years, the obsession with the term ‘coproduction’ means groups of people with lived experience are being invited in to more decision-making spaces. Again my privileges have allowed me to benefit from the economic resources (or, in plain English, jobs) that have come with this. Again, in the current system these resources are so limited only a handful of individuals will escape poverty through them.

If I cast a critical eye on how my own behaviour interacts with the system conditions then I describe quickly learning how to adapt the skills I gained in addiction (manipulating and blagging) to a new arena. This is being highly self-critical of course, there are legitimate and benevolent actions I have taken and skills I have developed. I have gained an understanding of how to mitigate the hidden power, how to maintain some challenge without getting myself removed from the space. I know how to minimise the suspicion that is created when I enter a new decision-making space. It was the art of deception that taught me about ‘strategic thinking’, but I honed these skills in an entirely different space.

What real power do I and others in similar roles have? We can make pockets of provision more responsive, we can raise awareness of what is actually going on when professionals talk of the ‘hard to reach’ and the ‘non-engagers’. We can push to increase the diversity of the workforce and make it more representative of the communities it is serving. We might be able to help train and support the navigators to make the most of the limited assets and resources which do exist in the community and appreciate how to work alongside someone rather than do ‘to them’.

We may even be able to generate a handful of jobs which we can make sure benefit people who are currently in poverty. We can make the whole process as inclusive as possible and try not to ‘ration’ in a way which most benefits the more privileged. But I still have Neil Kinnock’s warning not to be ordinary ringing in my ears.

But now I want individuals and groups with lived experience to be able to move beyond self-help and learning how to make friends and influence enough people to get themselves a seat in the invited spaces. I want us to gain a seat in the spaces where the most crucial decisions are made. The people who decide whether social housing will be built. Those who design ‘welfare to work’ programmes. The multi-million pound budgets which, decade after decade, fail to transform communities. Because this elite group of decision-makers need to understand the impact of continuing to blame and shame those who haven’t be able to ‘thrive’. They need to see what has happened as the natural consequence of their elitism. Most of all we need the awareness that times will only change ‘when we shake their windows and rattle their halls’ if we are not seduced and corrupted by their elitism. Our ability to be in a conversation means nothing if we are not able to scrutinise on behalf of those still suffering!