15 May 2019

Lessons learned from Dr. Thira's "The Community is the Medicine" Wellness Training

I recently attended a two-day training with Dr. Darien Thira, a clinical psychologist based out of BC, but also an expert in using community based interventions for wellness, particularly in Indigenous communities.

I wanted to share some of the main insights that I gained from the training. Some of the insights are lengthy, some are short one sentences.

Post Colonial Thinking
One of the first pieces he addressed was the importance of thinking in a non-colonial fashion. It sounds easy, but it is really difficult to do. Colonialism has impacted everyone is some shape or form.

Good Enough Parenting
It's not everyone's favourite term, good enough parenting. But if you are a "good enough" parent, your child will have the foundation to reach 90% of their potential. If you are a perfect parent, if that even exists, that will make up the remaining 10%. This is an important message that you can still be good enough to raise a successful child, you don't need to be perfect.

Successful Helping Relationships
There are three things Dr. Thira identified that helpers can bring to the table to make an effective helping relationship: who you are, being useful, and being safe.

He later presented a different interpretation of what makes a helping relationship work. In the past it was identified as 40% extra therapeutic factors, 30% the helping relationship, 15% hope, and 15% technique. Dr. Thira said 40% is the clients readiness to change, 30% is the therapeutic relationship, 15% is the counsellors readiness, and the remaining 15% is technique.

Re-framing Depression
Dr. Thira presented a different definition for depression, that it is a realistic view that lacks imagination for hope.

Trauma Braid
Our Survival Instinct to Traumatic Event Coping to Colonization Terms
Flight to Anxiety to Addiction
Freeze to Depression to Suicide
Flight to Rage to Violence

This is an interesting flow of how our natural instinct may correlate with a response to trauma, which then has a colonization impact.

Successful Circles Created for First Responders
Dr. Thira emphasized that circles should be small to contain the safety.

Circles should go through four phases or steps: past, present, future (individual), future (community).

Many circles, in my experiences and Dr. Thira's stop at the second step. We talk about the terrible thing that has happened and how it impacts us presently, but we never talk about what we are going to do about it on an individual and community level.

Counselling is Spritiual
Dr. Thira said that counselling is spiritual. It is a placebo, a non-medical effective intervention.

Don't Say "Stop It"
When it comes to addiction or problematic behaviours, there is a tendency to say "just stop it." However, as any addiction counsellor knows, the behaviour needs to be replaced with a healthier habit.

Replacement Technique
Building upon the replacing a habit with something healthier, Dr. Thira outlined the following steps:
-Identify the Problem Behaviour
-Purpose of the Behavior. The answer to this question "What would I lose if it stopped?" is the purpose of the behaviour.
-Problem Behaviour Advantages.
-Problem Behaviour Disadvantages
-Replacement Behaviour

As you begin to understand the advantages and disadvantages of a behaviour it becomes easier to identify a customized replacement behaviour. The new behaviour may not have the same advantages, but the costs of the disadvantages should be greatly reduced.

Balance Respect & Care
It is a delicate process for helpers, who want to help, to show appropriate respect and care for clients. If we do things for them, we are caring but not respecting. Balance needs to be found when supporting individuals.

No Respect Responses create Low Self-Esteem
Dr. Thira encouraged us to be careful with our words, and what we may be unintentionally telling someone when we try to give them advice.

As some examples if we try to give advice to protect them, we are in way telling them that they are vulnerable. If we give advice to solve, they have a problem. If we want to use advice to be fast, they are slow. To help, they are helpless. Because we have they answer, they are stupid. Because we are strong, they are weak. To fix, they are broken.

Low self-esteem is then expressed in two ways according to Dr. Thira. Despair or Arrogance. Despair then tends to create a victim state of being, and arrogance a bully state of being.

Dr. Thira said that the antidote for advice is a question.

Post-Traumatic Growth
Wounds have the ability to become gifts.

Importance of Creating Safety 48 hours after a traumatic event
Dr. Thira gave a timeline that if safety is created within 48 hours of a traumatic event, it lowers the chance that the emotional fallout of the event will create the symptoms of post traumatic stress.

This for me personally emphasized the importance of walk-in counselling clinics to be available to create an emotionally safe environment for individuals. However, keep in mind that 40% of counselling success is client readiness, and a client may not be ready to deal with a traumatic event 48 hours after ward.

Validation-Invitation 2-Step
First, validate the person or the situation. To validate the individual consider validating the person themselves, their social connections, culture, or principles. To validate the situation, validate emotions, thoughts, observations or needs. Personally, I tend to do more validating of the situation.

Second, invite. Seek information, and then create steps to change.

I Do, We Do, You Do. Can also be considered as modelling.

Four Branches of the Wellness Wheel
The primary model driving Dr. Thira's interventions is the Four Branches of Wellness:
-Caring Connection
-Respectful Empowerment
-Contributing Purpose
-Cultural/Spiritual Wisdom

When the four branches are in unison, it creates self-worth and a worthwhile life.

For more information about Dr. Darien Thira visit Thira.ca

Picture at top: Myself with Dr. Darien Thira