Topic Thursday ** 28/01 7-9pm** OPEN DIALOGUE: Supporting your loved through crisis and beyond

[Flick]

Yeah, it's a really interesting question - how to be dialogical with people who are "doing things to you". It's a question that people often ask about Open Dialogue. The answer that I hear experienced Open Dialogue professionals share is that if you yourself speak and listen in a dialogical way - trying to listen to the other person's perspective, without trying to change them and speaking your own truth - this supports everyone to become more dialogical. It's that old idea of "being the change you wish to see" except that in this case, I've seen it work to influence change. Does that make sense?

[CherryBomb]

I think it makes sense @Flick.

Can you give us some day to day practical example of how people might change their behaviour?

One thing that I might be helpful to discuss is the alternative perspective Open Dialogue provides as adjunct to understanding mental illness in terms of the medical model. I think knowing the idea behind this may help others to integrate this into their own approach. 

[Flick]

Hi Cat64. I'm really sorry to hear how hard things are at the moment.

One of the things I'm coming to think about through my studies of Open Dialogue is the idea of networks being important. It sounds like it's really hard for you and your husband to navigate this crisis, and what Open Dialogue would suggest is to ask "who else might be useful to involve in discussions about what's happening?" 

The idea is partly that crises occur because there are not enough resources in the network - if there were more people holding the crisis together, it would be less overwhelming, and so more options become available. 

I've seen Open Dialogue meetings with a young man experiencing psychosis, his best friend, his mother and his mother's best friend (!) The mum's best friend had some really valuable perspectives to offer, although someone like that would rarely be included in our current system (in fact, mum might not even be involved). Does that make sense? The idea is to increase the resources of the network, by inviting in more voices, more people who might be able to be part of moving out of crisis.

[CherryBomb]

@Flick you kind of answer my question with this:

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@Flick wrote:

The idea is partly that crises occur because there are not enough resources in the network - if there were more people holding the crisis together, it would be less overwhelming, and so more options become available. 

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To clarify, Open Dialogue see that social networks are invaluable and crucial in maintaining wellness as well as seeing some through a crisis? Would that be right?

[BeHappy]

@Cat64

I can relate to feeling isolated. It's like no one gets it.

@Flick - is the principle like a community coming together to care for someone?

[Flick]

@CherryBomb I'll try to think of a practical example.

I do know of a friend who brought together her own network of support to have an Open Dialogue-style network meeting - Open Dialogue is structured around a series of meetings of the whole network.

A more detailed example is that I remember watching a family come to an Open Dialogue network meeting where the son was experiencing psychosis and smoking a lot of marijuana in his room. His father was adamant that the son needed to stop smoking pot, and the son wanted the father off his back. They were at an impasse and were both really frustrated.

In the network meeting, the clinicians who were facilitating the meeting were able to ask the son what his experiences were, and the father and the clinicians listened really carefully, trying hard to understand his experience. The clinicians also asked the father what his experience was, and listened really carefully, trying to understand his experience. No one was judged as "wrong" (ie. for smoking or for being pushy, although I personally found the father quite aggressive at first). 

Listening to everyone, it became really clear just how much the father cared about his son, and the son was able to hear that. The father was able to hear about the son's high anxiety, and how when his father pushed him to come out of his room and not smoke, he felt more anxiety and struggled more.

There was a really palpable shift in the family, as they moved away from "pot smoking is the problem" or "dad harassing me is the problem" to let's listen to each other. They came away not trying to change each other's behaviour, but understanding each other's perspective more. I truly believe that the father would have stopped being so aggressive (I felt so much softer towards him by the end!) and the son would have had second thoughts about his behaviour too. 

I believe it's possible to have these kinds of conversations, but best with people involved who are "less involved", if that makes sense? I would struggle to facilitate a meeting with my own family, but I imagine someone else could support us (perhaps a cousin or neighbour or colleague)...

[LivingAdl]

I wish I had the opportunity to offer to my son 9 years ago but it was so hard on the family at the time, and noone understood, the psychiatrist just pushed for antipsychotics & I kept asking for him to have CBT or counselling - was told until 1.5 years ago 'he wasn't ready yet'....  painfully slow process in the public health system - I am taking him to a Hearing Voices group at Christies Beach tomorrow, finally working out the best strategies.  Would love to know if anyone includes functional medicine / dieticians as part of the therapy incl. in open dialogue...?

[Shaz51]

Hello @BeHappy, @CherryBomb, @Flick, @Cat64

I can relate to feeling isolated. It's like no one gets it. --- @Cat64

[Flick]

@BeHappy Yes! That's exactly it. There's acknowledgement amongst Open Dialogue people that this is how humans have responded to each other when our communities are strong and robust - some people would have been skilled at facilitating the community coming together to discuss and really listen to everyone's perspective, believing (like that story of the elephant) that everyone has something valuable to contribute.

It's funny - Open Dialogue is both a deeply considered approach, grounded in Russian philosophy, systemic family therapy, narrative therapy and more, and also something humans do naturally.

[CherryBomb]

It makes sense to me. Thanks for taking the time to write up that example. 

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@Flick wrote:

I believe it's possible to have these kinds of conversations, but best with people involved who are "less involved", if that makes sense? I would struggle to facilitate a meeting with my own family, but I imagine someone else could support us (perhaps a cousin or neighbour or colleague)...

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It sounds like having an extra pair of ears - without any biases because they are 'less involved' is helpful to mirror back what it is said so people can hear.