CKC - Clubhuis KennisCentrum -WHY WORK WORKS


Created: 2013-11-26 Last modified: 2013-11-27 Published: 2013-11-26

By Robby Vorspan

Robby Vorspan was until 1990 Assistant Director of the National Clubhouse Expansion Program, Fountain House, New York, and now lives and works in Brooklyn, New York.

Fountain House has recently received a grant from the Robert Wood Johnson Foundation to support partially a major project that we are calling the National Clubhouse Expansion Program. The project has many goals, but one of the biggest is to allow us to offer intensive two and a half day consultations to any interested programme in our Directory of Clubhouse Programmes.

Since we began the project last year, we’ve had the wonderful opportunity to get an in-depth experience of many of the clubhouses around the country. Before beginning the project, a group of us put together a long document that we call The Protocol, which consists of dozens of questions meant to help the consultants order their observations of the house and to help them focus their attention for potential growth and improvement.

The questions cover all aspects of club functioning, from special arrangements to Clubhouse relationships. To begin with we didn’t really attempt to weight the questions as to which ones were the most crucial to the making of a strong, vibrant Clubhouse. But as we have experienced more and more different Clubhouses, and have attempted to arrive at an understanding of what really are the most fundamental elements of a Clubhouse, we see one major ingredient rising to the surface over and over again.

Many of us have had the experience of going into a Clubhouse and immediately sensing a breath of life, a feeling of vitality and activity and growth. There is an immediate sense of health and hope when one can’t tell the clubhouse members from the staff, and they are all buzzing around together in a constant cloud of clubhouse activity that is taken with the utmost seriousness by the whole house. Many of us have also been in Clubhouses which, though they may have all the external trappings of a Clubhouse, still exude the stale mustiness of hospital day rooms or stagnant day treatment programs. The more we re-live these two experiences, the more we understand that the radical difference between these two kinds of programmes comes down to one fundamental issue, and that is their investment in a genuine work-ordered day, or a day that gets its momentum, meaning, and life from the work that structures it.

Most groups that set off to start a Clubhouse do understand on some level that the club day involves a work, or vocational, component. But for some or many reasons, it seems to be extremely difficult for many of us to conceive of the work as the heart of the Clubhouse, rather than as one of its peripheral limbs. I can use myself as a probably not too atypical example of someone with this kind of stubborn resistance. I came to work at Fountain House after spending many years as a patient myself, in and out of psychiatric hospitals and intensive therapy. Before coming to Fountain House, my professional career had been in inpatient psychiatric settings and in traditional therapy-oriented day treatment programmes. I had become deeply entrenched in the view that the “way out” of the pain and bottomless despair of mental anguish was only through insight, therapy, confrontation, and introspection. To me, attacking the pathology in a person meant grappling with it constantly. If one, two and three hours of therapy a week were of value, then wouldn’t 24 hours of therapy a day be that much valuable?

When I came to Fountain House and was thrown into the lively chaos of our clerical unit, and the structure of my day suddenly revolved around having our funding statistics up to date and our research projects accurate, I was uncomfortably jarred. It felt to me as if Fountain House were giving up, resigned to the belief that people would never get better, so that the least the programme could do was to get people to “function,” to stop being a burden to those around them, and to pay their taxes. I felt that the members were being cheated of the opportunity to change their lives in a radical way, and instead were being patched up to return to the world, and to hell with whatever turmoil, confusion, and anguish underlay the prized “functioning.”

At the same time that I was experiencing all of this, I was still climbing out of a very deep, dark and painful period in my own life. Every morning I would wake up feeling terrible, with the overwhelming temptation to crawl deeper under my bed covers and turn off all of the pain. I would remember that two of the other staff members in the unit were out on transitional employment placements that day, and that the attendance statistics were already 3 days late, and that I still hadn’t written a social security letter for Lucille.

I would drag myself reluctantly out of bed and go to work, where the high pitch of activity and obvious investment of those around me in the work of the house quickly caught me up into its own rhythm and order. All of the difficult and conflicted realities that I was dealing with in my therapy would of necessity have to temporarily sift down out of my conscious experience, and I would have to “function.” When I walked into Fountain House every morning, a whole net of very real relationships spread itself out beneath me, based on the reality that we needed each other and appreciated what each of us could bring to our shared work. Despite the chaos and confusion that threatened to paralyse me, every day as I entered the busy, vibrant, work-driven environment, I was carried into something greater than myself. Since the work I had to accomplish in my unit was far too much for me to handle myself, I had no choice but to engage the assistance of clubhouse members and other staff members. I experienced a connectedness in those relationships based on shared work that I had been unable to experience in other contexts. For hours at a time I was no longer alone, I was part of a living organism that was bigger than I was.

Looking back at that first year or so at Fountain House, it seems amazing to me that I could have been so blind. My reproach to Fountain House-that its unwavering commitment to a work-ordered day was a result of its not believing in the potential of its members-oddly was never shaken by my own experience of growing stronger and healthier and happier through the vehicle of shared work. I was too close to the situation to realize that the standard that I was applying to myself was very different from the standard I held for the members.

As I’ve thought more and more about why the clubhouse seems to work as well as it does, I’ve had to look at what “work” is, and what it means to people in general, and to people who are mentally ill in particular. On the surface, it is true, working is something that we do to keep ourselves from being burdens on other people, and to pay our taxes like good citizens. But work goes way beyond that. We always say that in the clubhouse we don’t do therapy, and maybe that was part of my initial resistance to this way of working. By saying that we don’t do therapy, I had inferred that therefore we are no longer looking toward the radical integration and growth that we usually think of as the goals of therapy. But what we are really saying, I now believe, is something very different from that. We are saying that in the medium of shared work, in the very special context of a clubhouse community, we are discovering an extremely effective means of achieving the kinds of thing we have always sought solely in traditional therapy.

No matter who you are, work has a profound meaning in your life. It gives you a sense of who you are among other people. Working pushes you to come in touch with your own very unique strengths, talents and abilities. As you discover and rediscover these things in yourself, you gradually begin to define a more and more consistent representation of who you are to yourself and how unique you are and how you are the same as those around you. This consistent sense of yourself, I think, is the absolute prerequisite to self-esteem and to the ability to develop real relationships with others.

In the natural chaos of our minds and our inner worlds, work provides a stable focus. It lays down a firm groundwork beneath us upon which we can direct and organise our days. Without the external structure of our work, any of us would have a much harder time keeping our heads above the swirling chaos of our thoughts and feelings. Also, our work gives us a handle on the future. The future is a vast unknown, full of potential pitfalls and dangers, but our work is something that gives us a bridge between our lives as we now experience them and our imaginings about tomorrow. We are better able to imagine ourselves as part of the future when we can reasonably predict the work that we will be engaged in. Although the specifics of each of our individual work paths may differ, they do put us into immediate relationship with one another. Whether or not we are actually working at the same job or on the same project, the very fact of our working gives us a common ground with each other. The most common question we ask when meeting someone new is inevitably, “What do you do?” Having an answer to that question gives us immediate entry to the normal flow of life.

Through work, we learn that we as human beings are multi-layered. We learn that we operate on several planes simultaneously, that we can be crushed by the break-up of a relationship or overwhelmed by moving to a new house or any other emotionally fraught situation and at the same time might be able to undertake complicated work assignments. We learn that we are

not as fragile as we might feel ourselves to be, as we bring our pains and stresses into our work and somehow manage to stay afloat.

Work gives us an opportunity to develop relationship in which we can immediately feel good about ourselves. When our relationships develop out of shared respect for the unique talents we all have, it is much harder to sink and destroy them with feelings of not being worthwhile enough, or of having nothing to offer to the relationship. We know deeply that we are being taken seriously and respectfully by someone who is depending on us to help accomplish a job. People who have mental illnesses are first of all people and can benefit from work in all of the same ways as everyone else. But what I have been discovering through my journey through the clubhouse experience is that work has the potential to be even more integrating and powerful for people whose lives have been shattered by mental illness than it is for other people.

All of the issues that I mentioned-the need to combat the natural chaos of the mind, or the need for a structure to help us move towards an unknown future, or the need for a common ground on which to develop mutually respectful relationships are needs which are at the very heart of the anguish of any mental illness.

It is not the illness itself that hurts the most, but the effects of the illness-the panic at the thought of the future, the ever widening chasm the person feels between himself and everyone else, the dread of drowning in the intensity of one’s thoughts and fantasies. Once a person experiences the trauma of mental illness, he or she inevitably feels snapped off from the tree of normal everyday life. Social interactions become more and more difficult as the common realities you used to share with others slide away from you. It is not that people who are mentally ill simply lose their ability to socialize but that they lose their sense of connectedness with others in a very deep and frightening way. Becoming engaged in the valuable work of the community immediately provides a re-entry point into the mainstream of life. It provides a sense of belonging, being valued, and being needed. The work a person is engaged in also becomes a very basic starting point in making conversation, something which can be very difficult for people who have become isolated in their illnesses.

So when we insist on a clubhouse day that springs from real and meaningful work, we are not ignoring the profound reality of the pain of emotional illness. We are addressing it head-on. We are saying that work can become a potent tool in dealing with the deepest life issues for our members. In my own experience, I have also come to realise that it is genuine involvement in our work that allows therapy to become the very valuable asset that it can be. If therapy is conducted in a vacuum, in the absence of real work and life experience, then it turns in upon itself and leads deeper and deeper into the pain and confusion, with no toehold to find a way out. Therapy is completely dependant on the real things, work, relationships, obstacles and successes- that make up our day. Spending ones whole day being a patient for endless expanses of time can only result in one’s becoming more and more of a patientI mentioned earlier the experience that many of us have had of immediately sensing that a clubhouse is working, that people are growing and laughing and changing and very busy there. And I also said that it was becoming increasingly clear that the core that generates that kind of culture is a firmly established work-ordered day. The reality of the clubhouse workday, though, is very often misunderstood. This has resulted in many clubhouses around the country that are clearly centred in work, but also very clearly are not the fertile soil of growth and spontaneity that the strongest clubs are. The misinterpretation seems to be that the clubhouse ceases to be work-ordered, and becomes work-dominated. Instead of not valuing work at all, which is the other extreme distortion in many clubhouses around the country, these clubs make work and productivity the reason for the program. Work becomes a god that we serve, instead of us having work serve our needs.

Common characteristics of clubhouses that have elevated work to such god-like status are things like requirements for member participation and productivity, insistence that members spend a certain number of hours working each day, requests that members leave for the day if they can’t or don’t want to work that day, and structured “work unit” hours during which members are told that they must be in their units. Even pre-arranged, structured break times and lunch times seem to me to come out of a misconception that the clubhouse should attempt to mimic the workplace as much as possible.

The clubhouse is not a workhouse or a business, it is a clubhouse. Work comes from the daily needs of the community and is taken up voluntarily with a sense of ownership, investment, and pride. In the extreme case of a work-dominated club, the work becomes joyless and meaningless, the relationships between members and the staff become stiff and supervisory and ultimately the clubhouse is drained of its life-blood.

The clubhouse is first of all a community. Clubhouse-generated work acts to gather together the staff and the members and to shape them into a living community. Work as the motivating factor immediately restructures relationships, so that what used to be guarded, professional, and distant relationships are transformed into spontaneous, personal and mutually appreciative ones.

The living, lively clubhouse knows itself to be a community driven by the work it needs to accomplish in order to continue to fulfil the needs of its members. Staff members are invested with the bottom line responsibility to make the clubhouse function, and the energy that drives the work-ordered day comes out of their pressing need to engage clubhouse members in every aspect of the house’s work. The clubhouse work has to be taken deadly seriously by the staff, and it is their passion, not some abstract prevocational rehabilitation goal that inspires and entices the members into action. The nature of the work of a clubhouse is paradoxical. The work is only meaningful and healing when it is genuine work, work that has urgency and purpose. Yet if the urgency and purpose override the even deeper reasons for the work, which are to provide growth opportunities and mutually respectful relationships for the members, then a clubhouse is missing the point. There needs to be a finely tuned balance between the genuine urgency of the work being undertaken and the needs and interests of each of the members involved in that work. The community and the work have to feed each other, not detract from one another.

When work is approached in this way, it is the soul of the clubhouse. In a real clubhouse, work can never simply be a component of the program. It is the life-blood of the healing and rehabilitation that the clubhouse offers. If we try to delegate work as one element of a program, the entire picture shifts out of focus and the program becomes something other than a clubhouse.

We as the clubhouse community have to begin to understand and appreciate what we have created. The work-ordered day is not a way to keep people busy. Together with traditional verbal therapies, it is the way for people whose lives have begun to feel like a bottomless pit of pathology and patienthood to begin to allow their health to express itself. It is an invaluable handle back into reality, into relationships, and into the experience of satisfaction, self-esteem, and appreciation. It is the jewel that illuminates the entire clubhouse structure, and we need to see to it that we continue to value it and to keep it always in the centre of our vision for our future.

This paper was originally presented as an address to the Sixth Plenary Session of the Fifth International Seminar on the Clubhouse Model, St. Louis, Missouri, 1989.

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