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Abstract: Stages of Recovery in a MASK group
Presented at NEFESH Israel 2003
Judy Belsky, PhD
Clinical Psychologist Private Practice
Clinical Supervisor Lman Achai, Ramat Bet Shemesh
MASK (Mothers and Fathers Aligned Saving Kids) a support group for parents of Kids at Risk was begun in 1997 in New York and in 2001 in Jerusalem. MASK is often the first entry point for families who have a child or children at risk. Problems may include but are not limited to: substance abuse, eating disorders, self mutilation, behavior problems, school adjustment issues, relationship problems, history of physical and sexual abuse. The group functions as a self-help group facilitated by a psychologist. Thus it has features of a therapeutic process group, as well. Participants report that benefits include empowerment, sharing of critical information, new skills attained in an atmosphere of support. This presentation seeks to outline stages of recovery experienced by members of the support group over time:
  • A. And B Taking off the MASK of rejection, shame and isolation in the community. Much heard comment: I see I am not the only mom or dad with these feelings. First time participants are often quiet and often surprised. Others tell such a similar story and express such similar pain. Learn to Telling the story and finding consensual validation.
  • B. Grieving in good company. The loss of the ideal family.
  • C. The nature of mutual support: empowerment is good for the pain of helplessness.(Help new participants, volunteer for tasks such as email announcements, sharing info, and a deeper level of help, befriend a new part, make calls or receive helpful phone and email contact between meetings.
  • D. Learning new skills. In this surrogate family, The group models skills of communication and empathy that are taken home. These differ from type of communication that had been occurring at home in frustration and desperation, as parents keep trying harder to help their kids to motivate them but it is not working. They have to repair the relat with more empathy, more love, new definitions of love,
  • E. Finding Effective Help: through the shared resources of the group, members find effective rabbis, educators, therapists, rehabilitation programs, support groups for kids, Twelve Step programs, etc.
  • F. Outreach activism. Group members advocate for needs of kids at risk and their families, help shape educational and preventive outreach in the community.Apply pressure for follow up treatment, half way houses after rehab, appear on radio programs and conf to help educate the public,
  • G. Therapists Role: It is impossible not to be moved. Not to change. PATIENCE… spend a few therapeutic moments with each participant at each meeting. Feel like a Ten minute therapist. Frustrated but reminds me to remind myself and them about the benefits of building upon each awareness each step. It reminds us to believe in gradualism. No meeting completes the work, no interaction ends the communication in a anything like a comprehensive way. Of course we end with Tehillim, we remind ourselves that we await the salvation of Hashem.
    The next three topics are DENIAL, DENIAL and DENIAL, my own and everyone else's. I will start in a personal way: When I was a small child, our neighbor just across the street, a Shomer Shabbos Jew drank. Before he drank himself into cirrhosis of the liver and an early death, his wife was alternately cherished and battered, his daughters escaped similar pain by using drugs, which in those days meant a descent into the depravities of the African American drug culture.

    When I turned 11 my parents decided it might be a good idea for us to move away, to a new neighborhood, in order to shelter me from this novel form of education.

    They had my best interests at heart. But it was too late to shelter me. I had seen and experienced it already. Later when I heard the myths, there are no substance and alcohol abusers in our community, there are no battered wives or abused kids, there are no teenage pregnancies, I knew them to be untrue. I had already glimpsed the deep pain that accompanies these phenomena. I experienced one family in deep trouble. I knew if there was one family visible to me there were others who were invisible to me, who were not my neighbors, who were in hiding.

    I lost this piece of my innocence long ago. As a community, we are just beginning to awaken at last. But there is always a great reluctance to give away one's innocence.

    A year and a half ago I assumed the leadership of MASK in Jerusalem. I am a trained. I know how to keep appropriate boundaries in a group, how to join with the group members but how to keep the necessary distance. I know they need a strong ego that can contain the pain and not drown in it. I know what transference issues to look out for. I know when new members are in denial. I know what to do. But unlike any prior clinical and addictions experience I had in general, non-Jewish mental health settings or veteran's hospitals in the US, these people are my people. They could be ME. Any of them could be my friend. Now the professional distance is harder.

    I mean that it is tempting to flop from one extreme or another. To over-identify. To see addictions behind every tree, so to speak. To obsess about my own family. Or, on the other end, to be horrified by the stories of family pain. And when horrified, to take at least three steps back and say: Not me. Not me.

    So, no matter how well prepared I am, it's high impact. It IS hard to take in. We all have a layer or more of denial to work at. At the heart of the denial is a desire to hide. We can't. At the heart of denial is the idea that problems are bacterial. They're not. At the heart of denial is the belief that nasty things don't happen to nice religious families. They do. At the heart of denial is the need to pretend we are perfect. We are not.

    When we can get away from the polarities, when we move away from both the fear and denial, we can see more clearly. We can be effective agents of change. Whether as rebbeim , teachers, professionals or parents. We will be more likely to see the problems and less likely to be blind-sided by them. We will be in a better position to offer guidance, treatment, and support. To make referrals to addictions specialists, to become addiction specialists, to work against the system that ostracizes a kid or family with problems. As we become more alert we notice problems in their earliest stages, and act to strengthen kids and families, and help prevent problems in the first place. It often occurs in science and in human science that that anew problem under observation appears in its most extreme forms. Later, we begin to see a broader continuum, and where we might intervene most effectively.

    But first of all, we need to accept people in pain rather than keeping them at the end of ten-foot pole.

    What is needed is Compassion.

    Com means with and passion refers to feelings of empathy. To be with, we have to accept not only the person before us. We have to accept our own weaknesses and inner conflicts. We have to look into our own hearts and acknowledge both the jungle and the oasis. In Tehillim 84:6 it says: Ashre adom oz Lo Bach misilos bilvavam. Rav Shlomo Freifeld Z"L said, we all have them. These wild unpaved jungles in the heart. The work of the Jew is to know HaShem, to know that "oz lo bach", our strength is in Him, then He will plow those jungles, to make straight, beautiful pathways that lead to Derech HaYashar.

    But we each have the jungle!

    We have to accept the complexities of being human, how hard it is. Then it will follow that we can widen the latitude of acceptance for those "nasty problems".

    Compassion is not pity. Compassion is defined as a deep feeling of sympathy for someone in misfortune, accompanied by desire to alleviate the pain and remove its source.

    I am grateful for my MASK parents. I am amazed at their courage as they struggle to do the work, As we work together to heal and recover, we are struggling against the tough layers of denial, against the cocoon that the religious community is still wrapped in.

    It is true that in our community our problems have reached epidemic proportions. It is also true that as a community our denial is in epidemic proportions. It is fair to say that addictions and other acute problems are flourishing in a culture of denial. If we were properly awake and aligned, I do not think the kids would get as extreme along the continuum without our noticing and moving in the direction of recovery.
    Organizations such as MASK, Retorno and many other programs for kids at risk and indeed the NEFESH itself opens our eyes so that we can open our minds.
    When we throw wide the windows of awareness, when our hearts and minds are open we can get to work. There's lots to do.
    A broader study is in progress to assess the experience of recovery in a MASK group both here and in the US. As a model, my colleagues DD and MM and I will utilize the work on social action research and participatory action research in self help groups done by Julian Rappaport, U of I Illinois Urbana.
    Participatory action research as a strategy for studying self-help groups internationally in "Self Help and Mutual Aid Groups: International and Multicultural Perspectives", Haworth Press. Borkman, T. (1991) Introduction to the special issue. American Journal of Community Psychology, 19, 643-650. Humphries, K. and Rappaport, J. (1994) Researching Self-Help Mutual Aid groups and Organizations:Many Roads One Journey, Applied and Preventive Psychology, 3, . Rappaport,J. (1993)Narrative studies, personal stories and identity transformation in the mutual help context. Journal of Applied Behavioral Science. 29, 239-256.
     

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    Links and Dr. Belsky's articles:
    MASK
    Introduction to Retorno 2003
    Stages of Recovery in a MASK group
    MASK Parents at Work