This came about as a response to a very rich and intense discussion on Facebook about whether or not to include cutting oneself as a Wellness Tool in a group setting.
There are controversial things that some people see as Wellness Tools for themselves, like drinking or using substances, eating certain kinds of foods, cutting, or smoking. I have found myself at the center of such controversies from time to time. People will want to list things like having a beer or smoking a cigarette as a Wellness Tool. This is a private personal list. It is up to the person developing the plan what they want to put on it. And it is up to them to decide when they want to let go of something like smoking or drinking that others might see as bad or negative. Sometimes incremental steps in letting go of certain things are Wellness Tools, like “I will have only five cigarettes a day instead of the usual fifteen, or “I will drink one beer instead of a six pack”, or “I won’t cut myself as deeply this time”. Mary Ellen Copeland from WRAP Plus (Copeland, M. 2010. Dummerston, VT: Peach Press, p. 55).
From Mary Ellen Copeland:
The topic of Controversial Wellness Tools first came up for me shortly after WRAP was developed in 1997. I was leading a facilitator training in Great Britain. We were listing Wellness tools on the newsprint pad. One of the participants suggested cutting herself as a Wellness Tool. Others in the group said that cutting was not a good idea and should not be added to the list. As a result of this discussion, I realized that I needed to take a closer look at the issue of controversial wellness tools.
Over the years I have talked to lots and lots of people about Controversial Wellness Tools like cutting, drinking alcohol, using illegal substances and smoking. More recently it has become a topic in our WRAP Facilitators on-line group. The responses ranged from:
- Don’t put controversial Wellness Tools on the list [and chastise the person for suggesting it–never a good idea]
- Include them with discussion about other possibilities to include them with no discussion and move on.
One person said, “Who am I as a facilitator to say what belongs or doesn’t belong in a WRAP?” Another said, “Facilitators aren’t supposed to classify/define anything. This is a difficult one. There are the other participants and continued agency support to consider.”
I believe that every participant and every response needs to be honored and respected. While I continue to be open to other opinions on this important topic, I have come to believe that these tools that some see as harmful needed to be respectfully validated. And of course, no one should ever be shamed in a WRAP group. However, since people who don’t understand the values and ethics of WRAP, perhaps even the agency that sponsored the program, may see the listing and not understand what it is, it is best to not include tools that might be easily misunderstood on the list on the newsprint pad. Of course, anyone can include in their personal WRAP anything they want to include.
Following are some responses to this issue from the dynamic WRAP Facilitator group to whet your appetite:
- Wellness Tools are what we do to achieve and maintain wellness. Who am I to say what is not your Wellness Tool? Include all items on the flip chart and participants can write the ideas that resonate with them in their own plans. At one time I would have included a specific medication as one of my Wellness Tools, now that medication would be on my Trigger list and one that I avoid in order to support my wellness.
- Cutting is a way to relieve pain or distress, just like heroin, alcohol, books or any addiction. It makes a person feel better. I would write it down and at the same time encourage the person to come up with other tools also… what works for one may not necessarily work for another or be the healthiest way, but it’s what works for them in that moment…. I’ve heard smoking a joint, masturbation, farting and various other things as wellness tools is what works for folks. I just write them down…. And then sometimes have a discussion on humor as a wellness tool
- For many people who engage or engaged in the past in self injury do so to stay alive. For me, self-injury was a tool when I had very little in my wellness toolbox to help me stay well. Gradually as I found other tools that worked, self-injury was no longer on my list because it had moved from helping to hurting my recovery. If individuals are to be the person in charge of their recovery, the person who knows what’s best. Their choices honored and validated.
- The criteria for Wellness Tools are that they are supposed to be simple, safe, inexpensive or free. If a person in a group says that a Wellness Tool for them is to get drunk every day, or someone else says that for them, cutting is a coping skill, it can become a challenge for the group to validate and honor those choices no matter what their personal feelings may be. This usually becomes an “Aha!” moment for most as it harkens us all back to the Values and Ethics of WRAP, where there is no judging and where each individual is the expert on themselves. In a group setting, it helps to refer back to the Comfort Agreement, and if necessary, add to it to account for everyone’s feelings.
- This becomes more of an issue in a group setting where a person suggests something like cutting as a Wellness Tool. Then these controversial Wellness Tools can become a point of great debate, contention, and discomfort. It can be upsetting and embarrassing for the person who suggested the Wellness Tool. I would prefer that a WRAP group was a place where a person could share cutting as a Wellness Tool and have that be the basis for a conversation about what helps and what doesn’t with the understanding that what may seem to be harmful to one person may actually be helpful to another, and that a person’s wellness tools may change over time as the recover and move on with their lives. I personally feel that every wellness tool needs to be validated.
- It is a sticky wicket of an issue. I know some people who cut as a way to relieve pain. This activity is not well understood by those who don’t cut. If I were the group facilitator and this came up in this context, it would be important for me to be person-centered and respectful of all the group participants. I would not want to add to the individual’s shame as they shared such a personal thing. I would also not want other members to be triggered. I would acknowledge the individual’s contribution as important to them and thank them for trusting the group. I would probably then disclose a self-harmful behavior that I used to do and overcame…to take the pressure off that one person. Then, depending on the particular group’s level of mutual trust, I would facilitate a discussion on transformation of self-harm to self-love, and ask both the individual and group members to brainstorm this together as they chose. (In other cases, I might ask the group if they wanted to discuss this; but I would have some real concern for the individual’s level of shame if the group said ‘no’.) As facilitator, I might have to take the group back to the comfort agreement…to discuss the values and ethics of mutual respect and no criticism. If the group was not ready for this discussion for any reason, we might consider placing it in the parking lot and identifying it as an important topic for further discussion. I would prefer doing the former option but would need to gauge the group’s comfort level. I would also offer to speak to any group member privately if they had questions or concerns.
- I would not put ‘cutting’ on the flipchart list. I know some here may disagree with this. It is just what I would do. I would also not put suicide or beating on others. If anyone questioned this, I would throw it back to the group, and let my opinion be known along with the opinions of the group.
- Acknowledge. Validate. Express that that may be a wellness tool for the individual at this point in time yet given we are listing (brainstorming) as a group and by wrap wellness tools definition they are anything that is: simple, “safe” etc. I have said ( as have had this scenario and many many others in past 10 plus years of wrap facilitation) that as we are listing a group toolbox (or wellness tool list) that is self-harm of any sort id not “safe” for all and so while it’s something some people find helpful, I cannot list it as “safe” “effective” tool that all may try (same when folks mention pot, booze, etc. etc. as all this and much more comes up).
Also use facilitation skills to present other tools some (or self) have used in times of extreme pain or stress without shaming or discounting this is where the person is at this moment.
If others in group are “triggered” perfect time to stress personal responsibility and folks using (or practicing) their own wellness tools and sitting with their discomfort as if can’t do in this group “controlled” environment, what is the point of wrap as no one will be prepared for outside of group and MH environment (in so-called “real world”) where such triggers happen daily (hourly etc) and wrap is about self-management. without a “facilitator” to step in.
–Wellness Tools are what we do to achieve and maintain wellness. Who am I to say what is not your Wellness Tool? Include all items on the flip chart and participants can write the ideas that resonate with them in their own plans. At one time I would have included a specific medication as one of my Wellness Tools, now that medication would be on my Trigger list and one that I avoid in order to support my wellness.
–One thing that could be brought up is to remind the group what they personally have defined as wellness for them by looking at our list of What I am like when I am feeling well. Ask ourselves, does each Wellness Tool enhance my wellness defined by me or could it detract from it? David Rockwell I had not thought about listing suicide as a Wellness Tool, it has not come up for me in any groups. I don’t think I would want to list suicide as a Wellness Tool since it does not encompass what we have established in our feeling well list as in staying alive to live that list. I guess I would really stress the definition of the list and if they still say it is a Wellness Tool for them, I will add it and stress that each participant is free to make their own list regardless of what is written on the flip chart. I would also bring up how empowering having a WRAP can be to strengthen hope and the other Key Concepts of recovery and wellness. My whole personal goal of utilizing my WRAP is to stay alive and progress on the journey of life. This is a thought-provoking topic.
I encourage you to join the WRAP Facilitator group on-line for further discussion of this and other issues related to WRAP Group Facilitation https://www.facebook.com/groups/175360367306/ If you are not a WRAP Facilitator, you can join the conversation at Mary Ellen Copeland, Mental Health Recovery and WRAP https://www.facebook.com/pages/Mary-Ellen-Copeland-Mental-Health-Recovery-WRAP/137182499646216
You can always email me at firstname.lastname@example.org
I love hearing from you!
Mary Ellen Copeland, PhD, developed Wellness Recovery Action Plan (WRAP) with a group of people with lived experience who were attending a mental health recovery workshop in 1997. She is the original author of the WRAP Red Book, as well as dozens of other WRAP books and materials. She has dedicated the last 30 years of her life to learning from people who have mental health issues; discovering the simple, safe, non-invasive ways they get well, stay well, and move forward in their lives; and then sharing what she has learned with others through keynote addresses, trainings, and the development of books, curriculums, and other resources. Now that she is retired, and that, as she intended, others are continuing to share what she has learned, she continues to learn from those who have mental health issues and those who support them. She is a frequent contributor to this site.