Montag, 1. Juni 2020

Steffen Roski: Corona crisis and peer support work



This paper owes a lot to the weekly video conferences of UPSIDES peer support workers from Hamburg during the Corona crisis, which Rebecca Nixdorf initiated. I would like to expressly thank her for that!


The Corona crisis makes something fundamental clear: what individual life crises and risks represent for peer support workers and the people they accompany has collectivized and socialized in the shadow of the pandemic. Those affected know very well what terms such as stigma, exclusion, trauma, irritation, isolation, fear, depression or exclusion mean, because they have already perceived and experienced these conditions in their own everyday life, regardless of the pandemic. Just four months ago, it was unimaginable that society as a whole, whose self-image was expressed in the triad of growth, success and increasing options, could suddenly find itself in a fundamental crisis of this magnitude.


For me, recovery and empowerment are the core concepts from which I would like to view this fundamental crisis from the perspective of peer support. Recovery and empowerment are interdependent, recovery always includes empowerment, and the same applies: empowerment strengthens recovery. As I understand it, peer support work means: dealing with one's own life crisis in a way that is ready to learn and using this process of self-reflection to develop potential and capacities in order to be able to empower people who are in acute life crises. Anyone who has ever had a depressive episode - and I know what I'm talking about! - may have experienced the Corona crisis in perhaps two ways, an alternating mix of the two being possible.


First, it is obvious to assume that existing life crises will deepen. Restrictions on contacts and closed or only partially open psycho-social meeting places further thin out the already limited possibilities of social interaction. Cinemas, theaters, museums and public libraries are only slowly starting to reopen, but for example the opportunity to watch a film will only be granted to the few who can secure a ticket from the then very limited contingents. Anyone who does not want to move about in public space as a matter of course will have to overcome even more hurdles in order to enable a minimum level of social participation. The pandemic restrictions of everyday life reinforce the tendency to withdraw, which consequently means isolation - with the few exceptions to essential purchases and other errands. In extreme cases, this state of poor contact and loneliness can be life-threatening: no important doctor visits, the dependence on material and non-material addictive substances (alcohol, drugs, medication, social media, online gambling, etc.) increases, domestic violence, suicidal and self-destructive thoughts are circling in the head.


There is - secondly - a completely different experience of the Corona crisis. When I think about myself, I come to the following interim conclusion: Yes, I do miss some things from the pre-Corona period: simply going to a café, visiting cultural events, being able to meet people spontaneously - all of those things that I would seldom have given my thoughts to before the pandemic. But I was also able to see positive sides of the pandemic and come to terms with myself. In fact, social contacts have diminished, but I experience them all the more intensely when they come about. I inform myself thoroughly, read a lot, listen to music, give a lot of myself to people I love and at the same time receive at least as much good from them. This also includes the weekly video conferences with colleagues from UPSIDES, which I am always looking forward to. I would like to generalize the following context as a hypothesis: Precisely because people with crisis experiences prior to the pandemic must have painfully learned to somehow manage to cope with themselves and their life history, to value their individual potentials and not to raise efficiency and success as the sole maxim, it could be that from crisis experience something like a crisis resilience emerge. The requirement to keep your distance physically has not only negative sides: Sophrosyne in pandemic times.


I often read the request:》 Let us see the crisis as an opportunity!《It seems important to me to be precise here. The Corona crisis may actually offer opportunities for each and every one of us and for society as a whole. Still, I have to warn against such imperatives from the perspective of peer support. They can be overwhelming. Crisis-experienced people know very well how stressful it is to be accused of not having done one's own life what corresponds to conventional societal norms. An example: On Facebook, a good friend expressed her pride at having used the Corona time to clean up the apartment. I think that's good and I also wrote to her that I am delighted. At the same time, I know all too well about myself and my own intrinsic psychological intertwining, but also about people whom I accompany on their life paths, how difficult it is to implement what is apparently banal and necessary. My apartment is clearly different from that of my Facebook friend! Of course, I know too well that I will hardly be able to avoid cleaning up. At the same time, however, I am just as aware that it is harmful for me to want to force it. If someone advised me to see the crisis as an opportunity and to clean up the apartment during the lockdown, this would probably block me. The corona crisis may offer many individual small opportunities, but against the background of each individual experience, it is important to think carefully about which of these opportunities should be seized at what time and in what way!


The motive of the crisis as an opportunity brings me to another key concept of peer support work, namely empowerment. Just like recovery, empowerment is not so easy to translate into German. What is meant is something like strengths and potentials to be found and felt in the individual as well as in collectivities, to be developed and then used to attain meaningful goals. Empowerment ranges from the very concrete to the visionary and utopian. For me, the meaning of the empowerment concept is to be ready to cross the boundaries of the individual, to organize collectively and to fight for better social inclusion, integration and fair life chances in the political-institutional framework. For me, UPSIDES is one thing above all: an empowerment project!


The pandemic stimulates many considerations about the possible character of a post-coronal society. While some are optimistic about the future, others see the dark. I cannot make any predictions, but I can develop scenarios for empowerment in the light of a new, responsible and risky normalcy against the background of my knowledge. A caveat seems appropriate to me right at the beginning of my explanations. The author of this text is an active peer support worker and at the same time academically socialized. As a sociologist, I am used to operating with distinctions. To make a conceptual distinction does not mean to strictly separate terms and concepts from each other. In terms of rigidity, apparently clean terminological separations cannot be maintained in everyday life, they mix in many different ways and thus produce hybrid color transitions and gradients instead of strong contrasts. But at the same time I want to emphasize the heuristic value of distinctions. Although they cannot simply depict social reality, they nevertheless allow a certain mental structure to be brought into an event like the Corona crisis that appears complex, confusing and difficult to understand and whose endpoint is far from being foreseeable and cannot be described. I therefore expressly do not proclaim any truth, but simply want to make a modest contribution to reflection in these pandemic times.


I understand empowerment as the self-production of individual and collective action. In the face of the pandemic, one thing is particularly clear to me in a frightening way: pure helplessness, to be dependent on decisions over which no influence can be exerted. Shortly before the contact restrictions were imposed, peer support workers met at the Hamburg University Hospital in Eppendorf for UPSIDES training. Many ideas for peer support have been developed and followed up. At the same time, the first tentative contacts to those affected who had decided to take part in the project began. I was in good spirits: something started to move, recovery should become concrete, empowerment processes should be started. Then the incision: the pandemic.


I would like to differentiate between two phases of the Corona crisis. In the first phase, the so-called lockdown phase, the virus represented one thing above all from a sociological point of view: a danger! Social life almost came to a standstill, shocking pictures from Italy or New York City, for example, went through the media. The expertise of virologists and epidemiologists and their institutions formed the framework for political decisions and administrative measures. Time was used to correct the inability to adapt hospitals to unexpected illnesses. The mass media provided extensive information about the virus, the possibility of infection, the diseases that occurred and the expected mortality.


It does not seem presumptuous to me to speak of a sub-policy of the experts that knew how to claim the position of the political. From an empowerment perspective, this sub-political constellation creates a real dilemma: on the one hand, to adopt a rather skeptical attitude towards experts, but in the face of the pandemic, on the other hand to blindly trust them. In this phase, I was primarily concerned with arranging myself with the new circumstances: being careful, perceiving my own feelings, coping with everyday life, maintaining contact with people in my immediate vicinity, informing me, track media coverage - and with all of this: to find enough rest. Since I was mostly at home, I felt relatively protected in the face of the danger, which I could not influence.


A new phase in the corona crisis has only recently begun: The change from phase 1 to phase 2 in combating the pandemic is a change from describing a SARS_CoV_2 disease as a danger to describing the same disease as a risk. The short and medium-term danger of overwhelming the hospitals is averted. Time was used to correct the inability to adapt hospitals to unexpected illnesses. The most visible sign of the replacement of virological sub-politics by normal political decision-making was that the regular press briefings of the Robert Koch Institute, the government’s central scientific institution in the field of biomedicine, were suspended. At the same time, this process of re-normalization, which is now underway, means that, to a certain extent, everyone is now left to make decisions themselves instead of being dependent on decisions by third parties over which there is no influence. An example: The Hamburg UPSIDES peer support workers want to meet again on June 18, 2020 after a long time. Risk assessments have to be made: do you prefer to meet outside in a park? Are masks to be worn? If you do meet indoors: is physical distance guaranteed? Would the room be well ventilated?


When sociologists speak of a risk society, this theoretical description can be experienced very concretely in everyday life in the shadow of the pandemic. What are the prospects for empowerment and peer support in the normality of pandemic society? What was true before the Corona crisis now applies even more to it: scope for empowerment and peer support do not fall from the sky, they have to be fought for! In this context, too, the call to see the crisis as an opportunity proves to be double-faced. Whose life chances were limited before the crisis will now experience social inequality as even more depressing.


An example: even before the pandemic, state benefits in the area of ​​basic security (e.g. unemployment benefits, pensions, etc.) did not meet the minimum requirements, were too low to actually enable social participation. The corona crisis has further exacerbated the social situation of people affected by poverty. The Federal Government has so far rejected legitimate demands to raise these minimum government benefits, at least due to the crisis. The minister responsible for labor and social affairs argues as follows: The demand for an increase in state social benefits had already existed before the pandemic and the Federal Government was not willing to decide a topic that was controversial even before the Corona crisis, in favor of those who bring an old issue on the table again. This argument seems cynical to me. From the perspective of empowerment, I can only say that it is worthwhile right now to argue that long-standing social injustices will be put on the political agenda. Political restrictions have to be overcome: Those affected are entitled to participate and get full social inclusion!


How many times have I had to hear and read the sentence:》 All people and society as a whole are equally affected by the corona crisis.《This statement is only true insofar as the SARS_CoV_2 disease actually affects everyone, regardless of the individual socio-economic status. In the Corona crisis, however, it seems to me that social inequalities that have existed for a long time, like in a magnifying glass, appear to be more pronounced. Social participation and full inclusion - for all these progressive topics and demands you need strong and active voices!


The Corona crisis should be seen as an opportunity. This is a hope and at the same an activating appeal. In conclusion, I would like to formulate a few questions that could be important in view of the upcoming restart and the future of the UPSIDES research project:


  1. What needs to be done to make recovery and empowerment an integral part of professional mental health services for people in life crises?

  2. How can peer support be institutionalized in mental health services without losing the character of peer support work as a critical impulse in existing professional institutions?

  3. What role will social media play for peer support work in the future?

  4. What lessons can be learned from the Corona crisis for peer support work?

  5. How will physical closeness and distance be determined in the future?

  6. What does the Corona crisis mean for social and cultural participation? (Should it turn out that there will be further restrictions in participation: how would you work against it?)


















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