Relationships and Mental Health : Relational Experience in Distress and Recovery

This interdisciplinary edited volume examines the complexities of relational life in the context of psychological distress and recovery. It is well documented that supportive, close relationships are central to wellbeing. This volume explores how connectedness is shaped by mental health settings, interventions and mental health experiences - and vice versa. In doing so, this work provides important insights for adult mental health care, where systems and settings can often struggle to take account of the relational context of distress and recovery. This is the first book to address the emerging shift towards a relational account of distress and recovery through a focus on people's experiences. Chapters explore community and statutory service settings, privileging the voices of those experiencing distress, their loved ones and the professionals who work with them. It also extends recent interest in the role of loneliness and social isolation in mental health, to consider themes such as belonging, connection, care and intimacy. It will appeal to mental health practitioners as well as academics in the fields of psychology, sociology, psychotherapy, psychiatry, social policy and social work. Acknowledgements Contents Contributors List of Figures List of Tables Part I: Relationality and Relatedness in the Context of Distress and Recovery: Key Foundations 1: Introduction: Why Relationships Matter for Mental Health References 2: Conceptual Foundations: Relational Thinking for Mental Health Contexts Being-With as a Fundamental Aspect of Personhood Understanding Relational Experience from a Developmental Perspective The Contrasting Experiences and Consequences of Intimacy and Loneliness Social Disadvantage and Mental Health Conclusions References 3: Clinical Foundations: A Brief History of Relational Practice The Relationship as Therapeutic The “Independence Imperative” in Adult Mental Health Services A Paradigm Shift? Towards a Relational Practice Relational Alternatives and Innovations Conclusions References Part II: Relational Trauma; Relational Recovery 4: Family Relatedness for Māori Survivors of Familial Childhood Sexual Abuse Whanaungatanga and Doing Family Kaupapa Māori Methodology Survivor Experiences of Whanaungatanga Whanaungatanga Iho Supports Movement Through Distress into Recovery Enacting Whanaungatanga Iho to Create Long-Lasting Change Conclusion Glossary References 5: Relational Contexts as Causal and Curative Pathways in Recurrent Suicidal Distress and Repeated Police Mental Health Act (Section 136) Detention Introduction and Research Context A Note on Terminology Suicidality Personality Disorder Diagnoses A Relational Model of Recurrent Suicidality Relationships: The Critical Scaffold to Psychosocial Development Distress as a Relational Disorder Conclusion: The Reparational Potential of Relationships References 6: Working Through Relational Trauma: An Exploration of Narratives of Lived Experiences of Trauma and Recovery Understanding Psychological Trauma in Adulthood Methodological Approach Case Studies Challenge and Struggle Connection Power and Loss Independence and Perceived Helpful Coping Strategies Awareness and Making Sense of Memory Hope Reconceptualising Relational Trauma and Recovery Through a Relational and Existential-Phenomenological Approach Relational-Centred Principles Integrating an Existential-Phenomenological Approach Recommendations for Working Through Relational Trauma References Part III: Peers, Family and Community: Care and Companionship Through Distress and Recovery 7: Understanding the Value Base That Supports the Development of Peer Support Relationships What Is Peer Support? Evolution of Peer Support in the Global North The Peer Support Relationship Sharing Experiences of Mental Health Challenges Taking an Interest in One Another’s ‘Whole Lives’ Considering One Another to Be Equals Boundaries Pooling Expertise Based on Lived Experience Has a Different Feel to the Relationships Peers May Have with Friends or Family Not Time-Limited Benefits of Peer Support What Is the Value Base That Underpins This Relationship? How Do You Create the Conditions in Which Those Relationships Can Flourish? Facilitation Types of Leadership Focus of Peer Support Sessions Membership Type Organisational Support Paid Versus Unpaid Roles Conclusion References 8: Exploring Family Experiences and Relationship Dynamics Where One Member Experiences Psychosis: “We’ve Been on That Journey Together” A ‘Whole Family’ Study Data Collection and Analysis Adapting Through Learning and Communicating: From ‘Not Talking’ to ‘Trying to Understand’ Unity, Sharing and Delegating: Facing Difficulty Together Damage, Repair and Revisit: Maintaining Balance in the Family System Reflections Family Resilience Connections References 9: Relatedness and Connectedness Over Time: How Young People Make Sense of Their Relationships During Their Recovery from First-Episode Psychosis The Developmental and Relational Context of First-Episode Psychosis Relatedness, Connectedness, and Recovery from First-Episode Psychosis Relatedness and Connectedness Over Time Relationships Can Thrive or Wither Re-constructing the Self in Relation to Others Shifting Between Dependence and Independence Relationship Re-appraisal and Re-evaluation The Evolution of Others’ Sense-Making Re-engaging with a Reciprocal Network Reflections References 10: Hunger Trauma, Relational Care and Emergency Food Support Hunger, Suffering and Care Ethics The Research Findings The Unavoidable Desperation of Hidden Hunger The Constant Crisis The Shame of Hunger Food as a Relational Commitment The Indignity of Food Support Relational Opportunities for Dignity Gendered Hunger Concluding Thoughts References Part IV: Love and Sex: Negotiating Intimacies in Mental Health Settings 11: Implicating the Institution: Who Is Responsible for Sexuality-Related Silence in Mental Health Settings? Sexuality in Mental Healthcare: What and Why? Sexuality in Mental Healthcare: Current Practice and Research Sexuality-Related Silence: Implicating the Institution Moving Forward: Beyond the Clinician’s Skills and Deficits Conclusion References 12: Romance in the Context of Psychosis: A Risky Business or Are Mental Health Services Just Risk Averse? Psychosis Risk How Are Risk Averse Attitudes Regarding Romantic Relationships Formed and Maintained? Are Relationships Really that Risky? Potential Benefits of Romantic Relationships Recommendations Conclusion References 13: “You Don’t Even Get a Hug”: Sexuality and Relational Security in Secure Mental Healthcare Outside-In: Relational security Relational Security in Forensic Mental Healthcare Relational Security and Recovery Inside-Out: Patient Experiences of Intimate and Sexual Relationality in Forensic Mental Healthcare Brianna Jake Intimacy and Sexuality in Relational Security References Part V: New Directions: Building a Relational Approach to Distress and Recovery 14: The Development of a Relational Practice Movement Introduction Rationale Contextual History A ‘Relational Practice Movement’ Definition of Relational Practice Research and Evidence Supporting Relational Practice Recognition of Relational Practice Theoretical Framework Underpinning Relational Practice Levels of Relational Practice Personal Qualities One-to-One Relationships Group Culture Organisational Culture Conclusion A Manifesto References 15: Concluding Thoughts: Relational Hopes, Relational Realities References Index