Living beyond labels: the example of a therapeutic community

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I am a co-worker at Lothlorien Therapeutic Community in Scotland. Lothlorien provides a temporary home for people with mental health problems and the opportunity to develop their potential through living alongside others who are relatively well, in an atmosphere of friendship, acceptance and mutual support.

The community consists of residents and voluntary co-workers. Staff, known as the Core Group, and day volunteers, come in on weekdays. Residents typically stay in the community for anything between six months and several years. However, there is provision for people to come for ‘respite’ for shorter periods. At the time of writing there are eight residents and four co-workers, and vacancies for others to join.

The community has 17 acres of land, including vegetable gardens, woodland and pasture land. The therapeutic element consists of working together to maintain the land, gardens and buildings, and in being together. It is a place where the usual divisions between the well and the unwell, between staff and service-users, are blurred; where everyone in the community has involvement in decision-making.

For me, this blurring of lines brings into clarity questions regarding the nature of wellness and illness. Can anyone claim to be 100% well, emotionally and psychologically? And is anyone unwell in isolation from the context of the world they live in? I would answer no to both these. This is not to deny that some of us are at times more fragile than others. Suffering is real, whatever its cause.

The experience of living in the environment fostered at Lothlorien enables me to see everyone as intrinsically whole, and not as a problem to be fixed, not as a medical label, a diagnosis.

The structure of the working week is an essential part of life in the community. Routine provides a stable ground, especially the fact that everyone can take ownership of the work, and retain some autonomy regarding which tasks they apply themselves to. Each day starts with a community meeting, followed by homecare tasks (cleaning communal areas), then work outdoors until lunch. The extensive grounds contain vegetable and fruit gardens, a workshop, and native woodland. The whole community shares responsibility for the necessary work of maintaining and developing what goes on in the gardens. The fresh food cultivated on site comprises a large part of the diet. Each day community members volunteer to cook lunch and dinner. There is another outdoor work session in the afternoon. There are around four hours of daily work in total, Monday to Friday.

I have observed that an important part of the ethos behind the management of work in the community is in allowing flexibility. For example, no pressure is imposed on individuals to complete certain tasks within definite time-frames. If someone does not want to do a certain task, they are not pressured to do so. Likewise, if someone is having a bad day, for whatever reason, and does not feel up to working, they are allowed to focus on their self-care. Everyone is trusted to do what they are able to do, for the good of the community, and is also trusted to take responsibility for their self-care. This approach fosters a sense of personal responsibility, and mutual support and encouragement. As is well known to people who suffer from mental health problems, and those who are familiar with the challenges in maintaining psychological stability, stress is to be avoided whenever possible.

What do people with mental health problems need?

While it is not possible to answer this question in detail with reference to an individual at a particular time, I believe it is evident that in general the answer is the same as for people without mental health problems: To have a purpose, to be valued and appreciated, to be known and accepted as a valid member of the human family.

Many years ago I worked as a nursing assistant in psychiatric hospitals, where it became apparent to me that such places cause more harm than good and are far from healthy environments for either service-users or staff. My instinct when working in that environment was that people’s mental health problems are compounded by their enforced isolation from humanity at large. It was obvious to me then that the loss of freedom, restriction of personal agency, and perhaps most profoundly, the denial of the reality of subjective experience, are hugely detrimental. How could it be that a profession based upon the Hippocratic principle Do No Harm, is so harmful? I will not endeavour to answer that here. I am happy to know that viable alternatives are possible. My purpose in writing this piece is to enable others to know that too. My hope is that the existence of Lothlorien will inspire others to consider the possibility that similar communities can be created elsewhere.

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Originally started in 1974 by the Haughton family, Lothlorien has been run since 1989 by the Rokpa Trust, an international charity founded by Dr. Akong Tulku Rinpoche of Samye Ling Tibetan Centre in Dumfriesshire. Although Buddhist values of compassion and tolerance are the basis of the approach, Lothlorien is not a religious community.

1 COMMENT

  1. Great to know these places are still around, I was part of the Cotswold Community a therapeutic community for boys many years ago. No diagnosis but a firmly held Person Centred culture and psychodynamic approach. I have never found anywhere so robustly caring since.