By Suzanne Engelen
This seems a really simple question, but when I was trying to find an answer, it became clear it wasn’t simple at all. There are a lot of difficulties with this question.
First: there is no such thing as ‘a hearing voices group’. There are different kinds of groups with different aims and goals, and therefore different needs. So talking about THE hearing voices group, is like talking about THE human being, or being normal… there is no such thing. It’s not as simple as that.
Second: what do we mean by ‘good’? Who defines ‘good’?
‘Good’ is a subjective measurement and depends on who you are talking to. So what I define as ‘good’, and ‘helpful’, can be completely the opposite and even harmful to another person.
So I guess the truth about what we mean by ‘good’ is in the eye of the beholder. Or to be more specific, maybe in this case there is no such thing as the truth, because everyone has his/her own opinion on what ‘good’ is.
There are probably more difficulties with this ‘simple’ question, but for now, I’m going to leave it with these two.
To get an answer to this question I posted the question on the Intervoice Facebook page and asked some Intervoice friends about their opinions.
I basically asked them these questions:
- What does it take to be a good hearing voices facilitator?
- Does it need to be someone with lived experience, or not?
- If not, how can this person be on the same level with the voice hearers?
I got many answers and, not surprisingly, they didn’t all agree with each other! It was just like the real world.
A few people were convinced of the necessity of lived experience. Other people said lived experience wasn’t a necessity but could be a very useful additional skill in understanding the experience of voice hearing. Although the majority of people that responded said it wasn’t a necessity, that doesn’t mean it’s the absolute truth – all opinions are just as valuable!
You can’t be a good facilitator without having lived experience
One person said:
“a true self-help or mutual support group should never want or need someone without lived experience.”
This person had been involved in many support groups over many years and his experiences with groups that were led by people without lived experience were that they had their own agenda that interfered with genuine peer support. So it was not purely about the self-help or the peer support, but there was always another (hidden) reason.
Other people agree that it depends very much on the attitude of the person without lived experience, whether they find them helpful (and therefore good facilitators) or not.
Some people had the experience that in groups that were led by a person without lived experience, the focus was more on ‘the medical model’ – thinking and talking a lot about hallucinations, schizophrenia, psychosis and medication, instead of the personal experience. They could also sense a kind of fear within the facilitators to actually change this and ask about the personal experience. So maybe there was not enough knowledge about other approaches than the medical model, (for example spiritual explanations) or not enough experience in working with voice hearers. This atmosphere felt unhelpful and unsafe to share any personal stuff in, and created a hospital atmosphere although it was outside the hospital.
You can be a good facilitator without having lived experience
Other people stated that in their opinion lived experience wasn’t necessary.
Some said that it would be very helpful to have experience on working with voice hearers, for instance by going through interviews and voice dialogue with voices before becoming a facilitator, so it would be easier to build and develop relationships with the voices and the voice hearers.
“As a facilitator you must be trusting and believing in the process, and respecting the role of the voices in the person’s life. It’s all about your own attitude towards the people and the voices in the group.”
“We all can learn from each other, in how to deal with stressful situations in life, voice hearers or not.”
Many of the non-voice hearing facilitators said that it would be very good and respectful to have at least one voice hearer to co-facilitate the group. It can be inspirational and create self-belief to become the expert. Sometimes that’s not possible for all kinds of reasons. As a starting point it can be more important to just start a group because “it’s more important what you do, than who you are”, but it would be very good to at least try to find a co-facilitator with lived experience as soon as possible to join the group.
Many voice hearers also stated that it would be good to have at least one facilitator with lived experience in the group. One said:
“I think that if in the hearing voices group where I started years ago there had been facilitators with lived experience, I would have opened up more quickly, but it took me almost two years to be 100% open towards the group. If it had all been people with lived experience that would have been easier.”
Some voice hearers said that it wasn’t necessary for a facilitator to have lived experience but that having lived experience made it so much easier.
“You don’t have to explain everything, because the other person knows what you are going through, he’s been there himself. That’s such a relief! Sometimes facilitators with non-lived experience ask a lot of questions. Sometimes it feels like too many questions and more like curiosity then out of compassion. It’s just easier when facilitators have lived experience. That’s the power of peer support, but it’s not really necessary. If a facilitator has the right attitude, it can be ok as well but they should never forget that they are NOT the experts.”
Attitude and Skills
- A facilitator’s attitude and skills make all the difference, lived experience or non-lived experience. But what is this particular attitude and what are some of the skills?
- Being a good listener.
- Being able to listen and not immediately trying to ‘fix’ everything.
- Being open-minded and interested in other people’s experiences/opinions.
- Being understanding, non-judgmental and respectful.
- Having compassion and empathy.
- Keeping the conversation on track and stepping in when necessary to keep the group moving.
- Encouraging the quieter members and calming those that override everyone else.
- Accepting all kind of explanations of the voices.
- Keeping it safe to discuss topics.
- Knows about new developments and research, but also about where to go if you need help in your own area. (Good source of information)
- Can step aside and let other people ‘shine’ when necessary/desirable.
- Keeping harmony within the group and allowing everyone that attends to feel that they have a safe space to discuss whatever it is that affects their life
- Being able to share their story, appropriately.
- Empathy and a general understanding about hearing voices and what that entails.
- Encouraging open discussion.
- Draws people out with open-ended questions i.e.: “Could you say more about that?” “What do you mean when you say…?”
- Injecting humor. (Friendly get-togethers).
- Can clarify and close discussions.
- Is able to handle silence and use this in the process.
In reading all the comments and answers and trying to understand them I came to the following conclusion.
It’s difficult (and maybe even impossible) to say what a ‘good’ facilitator is. There is not a unanimous answer, but there are certain skills that you definitely need to become, and be, a good facilitator. Good listening skills, good people skills, good leader skills etc. But then again, what is ‘good’?
When it comes to the question “lived experience or not?”, I think that we can say that it doesn’t really matter. There are really good facilitators with lived experience and without lived experience – it’s more about the attitude, the skills and the understanding.
One thing is for sure: just the fact that you have lived experience doesn’t make you automatically a good facilitator. You also need the skills to manage/facilitate a group.
I want to finish this article with a quote from a young man:
“If you are a non-voice hearer you should be humble and think that you are learning from the voice hearers and not the other way around.”
I would like to thank everyone who contributed to the discussion and the answers – because I don’t want to take the risk of forgetting anyone, I’ll just make it a general thank you!