Are you in a ‘peer’ or lived experience role and struggling to understand how valid your lived experience identity is? Take this short questionnaire* to find out…
(*Before taking the questionnaire, please note that it is satire, and not an actual assessment. There is no intention to imply that certain forms of lived experience are less valid or valuable. Read further to see how the strength of the lived experience movement lies in the diversity of those that make it up. This blog is written with humour; sometimes laughter is the best way of exploring serious ideas.)
How ‘peer’ are you?
- Are you grateful for your job?
a) It pays the bills
b) It doesn’t really pay the bills
c) So grateful
- Have you ever taken psychiatric medication?
a) I know people who have…
b) Some anti-depressants
c) I take a lot of medication, but you couldn’t tell from looking at me
- What are your thoughts on psychiatry?
a) Makes sense to me
b) It has its faults but it’s helped me understand myself and my condition
c) I actively campaign against it whilst being respectful to individual psychiatrists
4. Have you ever completed a wellness plan?
a) A what?
b) Sort of half-done one
c) My wellness plan is my bible, all my friends have a copy
- In the past year, how much activism/campaigning have you been part of?
a) Does complaining about my incorrect Ocado order count?
b) I sometimes show up for a cause, especially if there’s cake
c) I have my local MP on speed dial
- How many hospital admissions have you had related to your mental health?
a) I’ve booked myself into a spa a couple of times
b) They were going to admit me a couple of times but couldn’t get a bed
c) Plenty
- Which of these groups of people do you most easily fit in with?
a) Amanda Holden, The Pope, Freud
b) Stephen Fry, Ruby Wax, Meg Griffin from Family Guy
c) Carl Rogers, the Buddha, Rosa Parks
- How much of your personal information are you prepared to share in supportive relationships?
a) Why are you asking that question?
b) I have some things I keep to myself that are private
c) I’m an open book; if it helps, I’ll share appropriately after asking if it would be OK
- What intentions do you bring to supportive relationships?
a) To help people self-manage and discharge them in good time
b) To support people achieve their goals for recovery and inspire hope
c) To offer a deeply empathic space where two people can learn together and be profoundly changed in the process of shared growth
- What boundaries do you try and maintain in supportive relationships?
a) Professional and caring
b) Achieving that balance between being friendly but not a friend
c) Openly negotiated, emotionally intimate and attuned but respectful and clear
- What does a bad day look like for you?
a) I shout at the traffic, don’t smile much and drink a lot of coffee
b) I can’t get out of bed and when I do people tell me to go home and look worried
c) I tell people calmly that I’m struggling before doing something kind for myself or meditating
- The hardest thing about this job is…
a) Managing risk
b) The crappy pay
c) Feeling so profoundly connected to people and wishing the world was kinder
- People describe me as…
a) Efficient and capable
b) A bit unstable
c) Kooky and creative
- Which statement best describes your career pathway
a) I studied hard to get this job
b) I’m well educated and had a successful career before this one
c) Being a peer is all I want
- My lived experience is…
a) Private, thank you.
b) Pretty much in my face all the time
c) Enough in the past so that it doesn’t affect me, not so much in the past that it’s not a part of me
- When I make a mistake I…
a) Apologise and move on
b) Hate myself for at least a week. Hand in my notice.
c) Reflect with self-compassion and use it to inform my practice
How did you do? Count up the total number of ‘A’s, ‘B’s and ‘C’s you scored.
Mostly A’s: Sub-clinical peer levels
Sorry, you’re not a peer. Much as you might like to think you are, your childhood was probably too normal and your lived experience just isn’t enough to qualify you. It’s unlikely you’ve ever been on benefits or that you take medication, so what makes you think you have lived experience? You are also a little too reluctant to talk about your own personal experiences, as if these are somehow private. You probably buy into the medical model a little too much and your motivation is about helping people rather than something more existential and peer-y.
Mostly B’s: mild to moderate peer
Well done, you definitely have some lived experience, maybe even a little too much. The ways you use it, and how you manage your wellbeing are a little shaky which means you sometimes come across as a bit unstable, and this jeopardises the peer identity. Although you try hard in your peer relationships, you don’t always feel a connection and sometimes your experiences don’t feel relevant. Equally, you might try and be respectful toward staff members but sometimes this ends up as overly angry or placating because you’re not always sure about how to be authentic all the time. At some point, you have probably wholeheartedly agreed with a psychiatrist about a course of treatment, a clear indicator that you’re not quite enlightened enough to make it into fully fledged peer-dom
Mostly C’s: a text book peer
Congratulations, you are a true, gold standard peer. You have lived experience in bundles, meaning you can relate to pretty much everyone. The great thing about your experience though is that it doesn’t affect your self-esteem or your day to day functioning, so you come across as pretty normal which is a relief for the people you work with. You might have dabbled in person centred counselling in the past, and are probably into Buddhism. You believe peer support is part of a spiritual path of connection and deep emotion, and this makes your peer relationships profoundly meaningful. Luckily, you are able to communicate this so psychiatrists can see the value of what you do, and begin to change their own practice without feeling threatened. While you actively campaign against the medicalisation of human suffering, you have empathy for individual doctors and nurses. Namaste.
Well, how did you do? I hope that, if you scored mainly A’s, that you are scratching ‘peer’ from your name tag? Deleting lived experience from your email signatures?
No? Well, good. This was only ever about poking fun at the version of ‘peer’ that seems to be valued, and those that seem to be discounted. I developed this during my PhD, but we’ll come back to that. Let me explain myself, from the beginning.
For the past 15 years, I have been totally immersed in the world of peer support. First as a peer worker – working in the Early Intervention in Psychosis team, on inpatient mental health wards and in community mental health teams – then as a peer trainer, peer supervisor and finally as Peer Support Lead in Nottingham’s NHS mental health Trust. I started my ‘journey’ into peer support feeling unbelievably grateful that I had been given this role, this opportunity for my lived experience to be seen as something other than a catastrophic failure, which is how I felt about it at the time. In 2010, I began working as a peer worker with 6 others, among the first to be employed in the country. At first, I had no idea what a peer support worker should do. I felt celebrated, like I was being employed with some excitement, like the seven of us were going to shake things up, like we had the answers and no one else did. But it is a funny thing to use services and to work in them: on the one hand receiving a message that I wasn’t working hard enough on getting better; and on the other a message that I was the embodiment of hope and recovery for others. And really, neither message rested easily with my own perception of myself, but one being very alluring.
Over the next 15 years, I was lucky enough to meet and work alongside hundreds of peer workers, complete an MSc in Recovery and Social Inclusion, and a PhD exploring how the context of mental health services impacts peer workers who are employed by them. I started grateful and then, as I got to understand more about medical paradigms, capitalist, neoliberal systems and austerity, I got angry. Angry about my own terrible experience in services, and angry at the system more generally for operating in such an unhelpful, damaging paradigm. As Peer Support Lead, I became more aware of the weight of a medical culture and the economic pressures on mental health systems. I sat in more meetings about strategy, budgets and culture and I felt weighed down by it, especially as people began to notice that all the ‘recovery focussed’ ways of working that had been so popular when I was first employed had begun to suffer in the face of shrinking budgets and growing demand for services.
In all of the roles I have worked in, my lived experience has walked into the room ahead of me. I had ‘peer’ on my name badge for 15 years, and have noticed the ways that this changed me in the eyes of others, as well as how it changed the way I perceive myself. During my PhD, I talked to a lot of peer workers about their relationship with the peer title, and their lived experience identities. It was a valuable opportunity to understand how people inhabit the peer identity, and I’ve written a research paper about it, which I’ve also made into a zine. Some peer workers felt liberated by having a peer identity, as I did when I began in the role. They said that it opened up conversations with other staff members about their experiences, and it enabled them to offer their teams a different perspective about how they might go about supporting people. Other peers felt more conflicted. Some hated the way that the fact they had lived experience was all that their teams knew about them to begin with. Their lived experience became this mysterious and eclipsing elephant in the room, and they found themselves wondering what conclusions their colleagues were drawing about diagnoses and psychiatric history. Some peers said that they would rather not have ‘peer’ in their job title, partly because of the stigma they felt it associated them with, and partly because it forced lived experience to be a part of the conversations that they had with the people they supported, when it didn’t always need to be.
What I also found interesting was the ways that peer workers described managing themselves and the way the people might perceive them in their peer roles. A lot of peers said that they avoided taking too much time off, and thought carefully before sharing with colleagues that they’d had a bad day. They didn’t want to be associated with that stereotype of madness; unstable, unreliable, unemployable. In other words, ‘too peer’. Others questioned whether their lived experience was ‘enough’ to qualify them as a peer. For example those that had not experienced an inpatient admission, those that lived with greater degrees of privilege. Again, there was some stereotype, archetype even, that they saw as being a ‘true peer’ and they believed that they were falling short of it. Even in my own diaries, I wrestled with these questions:
One of my fears working as a peer is that my lived experience is not enough. What if when people find out all I’ve actually gone through, they realised that I was never a peer? And yet, when I look at my own experiences, when it’s just me and them, I know that I literally had as much as I could take without dying. I know that I did nearly die. I know that this ‘recovery’ is my goddam life’s work and that it killed me and created me. I know that. But in the face of other people’s seemingly more legitimate stuff, I cower.
The crushing irony is that outside of peer support I feel the opposite. I feel too mad. I would never speak of the ins and outs of admissions and medication and scars.
And so, with all this on my mind, after a particularly thought provoking supervision with a peer worker, I found myself playing around with this idea of working out exactly how ‘peer’ you are using a questionnaire. If there is some archetypal peer identity that we’re all trying to inhabit, and there are definite peer identities that we’re trying to avoid, then why not laugh at the whole thing a little? Why not drag all these ridiculous stereotypes out into the open so that we can see them for what they are? They are the stories that we tell about lived experience, simultaneously a source of wisdom and stigma, simultaneously empowering, restricting and unattainable. Peer workers, myself included, have tied themselves in knots trying to embody the version of ‘peer’ that is implicitly, collectively understood to be the version that services need. This serves no one. It doesn’t serve peer workers, who, in the absence of a supportive working environment, feel obliged to conceal or enhance parts of themselves in order to fit in. It doesn’t serve the people receiving peer support if the people supporting them are strained by the emotional labour of managing their peer identity. It doesn’t serve mental health services, who need to understand that lived experience is a complex and hugely diverse experience, which intersects in myriad ways with other elements of our identities.
We need to move past this idea that a peer worker is holding up the reputation of peer support in all their actions and behaviours, take the pressure off individual peer workers to embody an archetype – it’s crazy making – and instead rethink our understanding of lived experience without essentialising it. Peer support was never meant to be about ticking boxes or proving how “peer” we are. Yes, it’s about shared lived experience, but more than that, it’s about sharing power, being authentic and being open to learning. The strength of it comes in the uniqueness of each peer relationship. If the cultures that peer support operate in reduce lived experience to a stereotype – positive or negative – everyone loses; peers, the people they support, and the system itself. So yes, laugh at the quiz, and use it to take the pressure off yourself and those around you to conform to (or avoid conforming to) these uninspiring, unreal caricatures of peer workers.
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Mad in the UK hosts blogs by a diverse group of writers. The opinions expressed are the writers’ own.