Soteria Vermont: A Practical Guide to Peer Support In A Residential Setting

The following is excerpted from a chapter that appears in Humane Alternatives to the Psychiatric Model, edited by Eric Maisel and Chuck Ruby.

There is a long history and extensive literature justifying the isolation, objectification, and of course incarceration of people labeled “mentally ill.” What we need to understand is that when we build prisons we imprison ourselves, when we isolate others we isolate ourselves. If we want to free ourselves we must free each other. Moving from “doing to” to “being with” is about liberation and relationship. Soteria Vermont is an experiment in mutual liberation and an invitation to collective healing.

Peer support emerged from the natural camaraderie experienced among the institutionalized and those labeled as mentally ill. It is a movement to reclaim our experiences from powerful institutions that have worked to define and control our minds and bodies. Peer support advances the perspective that our lives and experiences are not illnesses to be cured but challenges to be met with creativity and courage, as well as opportunities for personal growth. Furthermore, we propose that intentional and compassionate communities of peers are most supportive for individuals in crisis.

Although the origin of peer support is rooted in the community of psychiatric survivors, Soteria Vermont has differentiated between “peer” as an identity and “peer support” as a practice. The insights and direction provided by those with lived experience and psychiatric survivors can inform all who provide care. All those who choose to adhere to the practice and values of peer support may work as a peer. We can all connect with one another through our shared human experience. Much of the human experience is universal, we all want to survive and even thrive in a challenging world. The desire to understand ourselves and others and to use this understanding to move toward empowerment and self-mastery is a shared human project. Everyone’s experience is valuable. As peers, we meet each other with respect and compassion. As peers, we ask one another, “What do your experiences mean to you?” As peers, we do not pretend to know what is best or right or possible for others. As peers, we work together to move forward with a deeper understanding.

Soteria Vermont is one of the first organizations to offer Intentional Peer Support as the primary support in a residential setting with an extended time frame of three to six months. At Soteria, there are no clinicians or clinical oversight. This has given us an opportunity to explore more fully the potential of these relationships as well as identify specific challenges that emerge.
As peer support practitioners, we are not therapists and we are not friends. We have defined a relationship that is mutual and genuine but maintained within specific professional boundaries. Staff engage residents as equals. Staff share from our personal experiences with the intention of offering narratives of wellness and resilience. Staff do not share personal contact information or social media. Staff do not spend time with residents outside of their scheduled work hours. Our goal is to have focused, short term relationships that have lasting impacts.

A clearly defined and limited relationship can become a reliable container for inquiry and exploration of difficult material. Relationships that are circumscribed in time and free of the obligations and complications of friendship or romance open a new space for sharing and exploration of self and other. It is critical that we are clear and explicit about what we are offering because we want people to take advantage of this opportunity and avoid drifting into a casual relationship or one of authority. Peer support places relationship, human connection, and community at the forefront of working with crises.
We build relationships through shared experience. We identify with each other’s experiences and we share experiences in real time together. It is important to be able to communicate who we are and why we are here, both on the organizational level and on the personal level. We are joining people in an intense and intimate moment in their lives. Mutuality can not be achieved without sharing about ourselves. We share about ourselves with these intentions:

Peer support asks us to form a very specific relationship. This relationship has professional boundaries that are closer than those found in most traditional clinically defined settings. There is a distinct and significant difference between the peer relationship that intentionally provides human connection and a more distanced clinical relationship defined by professional boundaries that can leave all engaged in them feeling isolated and disconnected.

This intimacy is not self-indulgent nor is it something that only psychiatric survivors have the capacity to offer. This intimacy and genuine human connection offers a direct mechanism of support to people in crisis. It is also evident that these relationships provide a value and quality to staff that supports their ability to do this demanding work in a sustainable way. Healthy, positive relationships are supportive to all engaged in them. There is in fact an element of self-care for the practitioner embedded in the peer relationship. We ask staff to engage in a passionate participation with a resident’s experience. We want to become a part of a resident’s experience and collaborators in it.

The four priorities of peer support at Soteria are:

1. Respectful, equal relationship. It is extremely important that we meet people with respect and acceptance. The respect of others directly supports self-respect and self-acceptance. We strive not to just “meet people where they are” but to join in their experience. We want to collaborate in a truly shared experience, which is the genesis of relationship and connection. Positive, authentic relationships are healing.
2. Defining and ensuring success. Success is getting what we need. Everyone needs to be accepted and valued in our relationships and community. We can do this for one another in a consistent and reliable manner. Our goal is to provide residents with interactions that support self-respect and self-esteem. This will mean providing encouragement and compassion as well as drawing clear boundaries and firm expectations. The goal of peer support is to move through difficult experiences toward joy, meaning, and transformation. An interaction or relationship is successful if it connects us to one of these. Adversity and powerful experiences offer us powerful opportunities for personal growth.
3. Normalization. Extreme states are within the “normal” range of human experience and do not make us weird or scary.
4. Personal empowerment. Exploring our experiences with the intention of fostering self-awareness and self-mastery. Engaging in important conversations about identity and narrative. Exploration of relationship to self and others. What patterns of behavior and thought are we perpetuating? What narratives are we maintaining? Where can we assert ourselves and replace damaging behaviors and damaging narratives with behavior and narratives that serve us?

It is difficult to be a witness to suffering. This difficulty is exacerbated by the fact that suffering may not always look the way we expect it to. People in crisis may appear to be in a place of arrogance or callousness to others. People in crisis may be dishonest with us. People in crisis may insult, offend, or even physically attack others. It is our job as peer support practitioners to see beyond the immediate situation and understand the context of difficult behavior as an expression of suffering.

It is also important to see beyond the suffering and recognize the whole person that resides in all of us. Whatever behavior is expressed in a crisis may be understood as a person’s reaction to and attempt to cope with an overwhelming experience. Being present with suffering without becoming overwhelmed by it or alternatively becoming callous to it is a difficult balance. Suffering is not alleviated by pity. We can have compassion for others without the condescension of pity. Suffering is a part of the human condition and can be dignified if those around us offer that dignity.

To learn more about Soteria Vermont, contact [email protected].