Change is a Constant

Photo description: The word 'IDENTITY' in capital letters using a fingerprint font.

Last week in San Francisco I was honoured to give the opening keynote at the National Association for Dual Diagnosis annual conference. In talking with them as it was being arranged, I suggested that the topic be around the issue of identity for people with intellectual disabilities. I was thrilled when they agreed that this would be a good topic for a keynote.

In the keynote I talked about the importance of identity, positive identity as a disabled person, for people with intellectual disabilities. I related identity to good mental health and to good mental health practice. Separating people, even by language, from their identity gives people the message that there is something shameful in simply being authentically who they are. I was pleased that the keynote was well received, but that's not what I want to write about.

I received an email this morning from someone who had attended the conference and who said that they had been really challenged by the message that disability can be celebrated and be a source of both identity and pride. In her practice with people with disabilities she had never raised the topic of disability believing, somehow, that it was simply unmentionable. She had never questioned why it was unmentionable, it was, she said, assumed to be self-evident that disability was shrouded in silence.

She went home from the conference and in one of her first treatment sessions with someone struggling with depression and suicidal ideation she brought the issue of disability in at a point where it seemed natural to do so. She said that she used the words carefully and fearfully, afraid of the response. Instead, the person she was talking with took a big breath and said, "so, you know?" They then talked about how it had never been mentioned and the fellow thought that he wasn't allowed to bring it up. "I don't have to pretend anymore," he said, with relief.

The rapport that she thought she had had with him was a sham, it was based on his attempts to please her and accommodate what he thought she wanted from him. They were, she said, starting again, this time with honesty and acceptance. "I need to examine my attitudes and my prejudices," she said, "I think I have communicated a lack of real respect for the people I have worked with for so many years."

I am impressed that she was willing to question herself and examine her practice based on what she learned at a conference. I am always amazed when people are willing to embrace a new idea or a new way of doing practice. I try hard, when I'm at a lecture or listing to a presentation, to be open to new ideas - and I know it's hard to do when someone challenges ideas that I hold dear. So, my hat's off to the woman who wrote the email, she clearly understands that we learn as we live and therefore change is a constant.

She told me that I could write about this but she asked that I only quote from the email, not publish the email as written, which is what I've done.