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Peers as Dignity Workers Nora Jacobson September 22, 2012

Peers as Dignity Workers Nora Jacobson September 22, 2012

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Page 1: Peers as Dignity Workers Nora Jacobson September 22, 2012

Peers as Dignity Workers

Nora Jacobson

September 22, 2012

Page 2: Peers as Dignity Workers Nora Jacobson September 22, 2012

Today's Agenda

A model of dignity

Peer support as dignity work

The dignity audit

Page 3: Peers as Dignity Workers Nora Jacobson September 22, 2012

Dignity in the Literature

• Human Dignity– The inherent and inalienable value that

belongs to every human being simply by virtue of being human

• Social Dignity– Dignity-of-Self– Dignity-in-Relation

Page 4: Peers as Dignity Workers Nora Jacobson September 22, 2012

• Human Dignity– “to be recognized for my real worth as a

human being”– “it’s just something that should be there

regardless of who you are or where you are, you know”

Page 5: Peers as Dignity Workers Nora Jacobson September 22, 2012

• Social Dignity/Dignity-of-self– “dignity is the positive feelings that I have for

myself”

• Social Dignity/Dignity-in-relation– “it’s just the way I’m treated and spoken to”– “a sense of personal and kinda individual

control over one’s circumstances and um respct by others of your own, um, space and your, of who you are”

Page 6: Peers as Dignity Workers Nora Jacobson September 22, 2012
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Processes of Dignity Violation

• Rudeness• Indifference• Condescension• Dismissal• Disregard• Contempt• Dependence• Intrusion

• Objectification• Restriction• Labeling• Discrimination• Revulsion• Deprivation• Assault• Abjection

Page 10: Peers as Dignity Workers Nora Jacobson September 22, 2012
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Courtesy

He speaks to me, uh, with respect so that I feel he values my, my, uh, humanness…the way he talks, not talking down to me, but talking directly to me and, you know, and if I don’t understand something then taking the time to explain it.

Page 12: Peers as Dignity Workers Nora Jacobson September 22, 2012

Recognition

I say…“What color eyes has the [homeless] person that you meet on the street every day?” “Oh, I don’t know. I just know he wears a grey coat”…When you see somebody on a regular basis and you don’t ever look in their face…. So they’re usually, “Oh, should I give money?” I say, “No. Give a hello. Because you’re probably the only person who will have said hello, will have acknowledged that person, and just saying hello makes that person feel human, because it’s so much, so many of us walk right past them, as though they were a rock.”

Page 13: Peers as Dignity Workers Nora Jacobson September 22, 2012

Acceptance

I am not here to judge them. I remind them of that. I really try, uh, and strive towards not imposing my own values and judgment on people.

Page 14: Peers as Dignity Workers Nora Jacobson September 22, 2012

Empowerment

Sometimes I do see with a client that it does seem like, uh, an act of dignity to say “No, I don’t, I don’t want to take the meds. I don’t want to do that. I’m going to do this instead.” And, uh, you know, that’s hard for me to see that or understand that as dignity, uh, but that’s, I think, what it is in a lot of cases…that was the most important choice for the individual to make and that’s the choice that the individual felt best about and, you know, at the end of the day whether he is receiving treatment [or not] he still is an autonomous individual who has to live with his choices.

Page 15: Peers as Dignity Workers Nora Jacobson September 22, 2012

Independence

[If you’ve got] a key to a door, which is your home, a place to live, that’s your own, all that is dignity…I’m not going to tell you anything―you are the queen of your castle. You know what I mean? You can do anything you want.

I really see income and employment as going a long way in restoring dignity. That it's something a person does for themselves and they feel they've done it for themselves, 'cause in fact they have, they gotten up and gotten there.

Page 16: Peers as Dignity Workers Nora Jacobson September 22, 2012

Contribution

“Giving something back”

“Making a difference”

Page 17: Peers as Dignity Workers Nora Jacobson September 22, 2012

Discipline

“Doing chores”

“When I tell someone I'm going to do something, I do it.”

“Staying straight”

Page 18: Peers as Dignity Workers Nora Jacobson September 22, 2012

Accomplishment

I’m thinking about a client right now who, uh, who recently lost his housing and, uh, he’s had a number of other struggles in his life around mental health issues and so forth. Things have really been tough for him lately and, you know, in spite of that, you know, I think what keeps him going is that he sees his past successes, he sees his accomplishments as an individual, twenty years ago and thirty years ago and he understands that he’s not a terrible person because he hasn’t been able to do A, B, or C and that he does have individual strengths…so all of those things make his sense of himself as an individual more intact and I think thereby give him a greater sense of dignity.

Page 19: Peers as Dignity Workers Nora Jacobson September 22, 2012

Enrichment

What I personally do and what I did when I was in the system is I kept my, um. I love literature. I love, um, like real literature--I don’t mean current selling things. I have found that was a real incredibly helpful tool because it was something that I knew on my own would help me preserve a certain dignity. Without that, I became afraid I would then be like the other people and get squashed down even more. So literature for me is like about dignity.

Page 20: Peers as Dignity Workers Nora Jacobson September 22, 2012

Authenticity

You have first to be yourself, what you believe yourself, and you have to have, uh, strong will. You have to be really focused more in yourself than think about other people around you.

Page 21: Peers as Dignity Workers Nora Jacobson September 22, 2012

Love

It lets them know they’re worthy. It lets them know they have value, and it lets them be respected in the end even if maybe they went through their whole life not feeling worthwhile, not feeling any sort of value…by being there, by being able to give people what they need…also just honoring who they might have been.”

Page 22: Peers as Dignity Workers Nora Jacobson September 22, 2012

Perseverance

One thing that I, that I, that keeps me going in this particular area of business is the fact that I, I meet somebody at nine o’clock in the morning. We work very, very hard to get certain things in place, be it a shelter bed, be it a meal, uh, be it access to finances or access to a doctor or any of that…and then at five o’clock I shut my door and I say, “Sorry…I’ve done everything now. I do have to close the door and go home.” And the fact that that person comes back tomorrow morning and has faith and has the internal drive to be able to come back and start all over again, not once or twice but over a really long period of time…. Most of us don’t have the drive to do that every single day. Get up in the morning and know that you’re going to go through the same steps and perhaps at the end of day either end up even worse than you were or at the same place.

Page 23: Peers as Dignity Workers Nora Jacobson September 22, 2012

Control

I know some people, you know, maybe they have a [disability support] issue and so they get on the phone and they’re yelling and screaming. But that never got me anywhere. You try and be, uh, uh. There’s always a million ways to say the same thing, eh? You know, you can yell or you can be too kind or quiet about it or there’s in between, you know? [If] I know I have to call them ‘cause I need something or something, I’m kind of asking them for something so I better be nice about it, or if they made a mistake maybe, there’s no point in getting mad at them. You might stall them in terms of correcting the mistake if they’re mad at me. So you try to be as nice as you can.

Page 24: Peers as Dignity Workers Nora Jacobson September 22, 2012

Transcendence

I cannot really control the actions of other people and sometimes you get a bad reaction from other people and people may have heard it and you don’t want to feel slighted but that’s, you know, and you can’t sit there and focus on it…kind of taking a step back and realizing that hey, this is not really my problem.

Page 25: Peers as Dignity Workers Nora Jacobson September 22, 2012

Preparation

My approach has sort of changed in that I’ve sort of accepted the fact that…there may be medical doctors out there, family doctors in Toronto that would suit my needs, but as of now I haven’t found one…So that I’ll just use him as my once-a-year appointment. I need to go in for some check-ups related to my condition and I’ll just, I’ll just do that. And not expect much from him. And I think that’s going to probably help me with dignity and how I feel about myself, because if I don’t expect much from him…then maybe if I don’ t expect much of him then I won’t be, like I won’t be so upset after the appointment.

Page 26: Peers as Dignity Workers Nora Jacobson September 22, 2012

Avoidance

It’s like a clear glass bell jar around me, but not having a door on the outside and I’m on the inside because, uh, for me―I’m not as, uh, as easily affected as I once was―but that was a problem for me, where like some people could just like open the door, dump their shit in and close it and I’d be like “Oh, what’s all this crap?” and I’d feel overwhelmed by whatever it was…. [But now] I’ve got the door on the inside so I can keep the door shut. But I mean it’s cracked, it happens, and for me dignity is an ongoing battle to, to, to not lose it, to keep it.

Page 27: Peers as Dignity Workers Nora Jacobson September 22, 2012

Concealment

I don’t know if I’m supposed to say this. This is the dignity: I’ve been closeted. I’ve been using drugs since I was fifteen years old. I’ve been closeted ‘cause I raised a son by myself and everything and I had so much to lose. I just could not afford that, you know? So, uh, that’s where, uh, my dignity came. I would do the church thing and hallelujah on Sunday and then call the crack dealer.

Page 28: Peers as Dignity Workers Nora Jacobson September 22, 2012

Advocacy

I would say advocating on behalf of clients, uh, who, uh, may not be well served by their community service provider or who may be facing discrimination of one kind or another…trying to remove obstacles and barriers, uh, to help them live a more full and dignified life.

Page 29: Peers as Dignity Workers Nora Jacobson September 22, 2012

Presence

I may not do anything, but the fact that I am there makes a very big difference…. If I am with my client, my client will feel and be treated differently. If I am not, my client will be treated deliberately poorly.

Page 30: Peers as Dignity Workers Nora Jacobson September 22, 2012

Support

I think it’s pretty hard for someone to conduct themselves with dignity if they don’t get the resources [like food, wealth, opportunities, equity] to do it.

It’s basics [that] give people dignity.

Page 31: Peers as Dignity Workers Nora Jacobson September 22, 2012

Leveling

We call each other on a first name basis and try to, um, minimize the differentials…we try to make sure that as much as we can be seen on the same level in terms of, you know, we’re all people. We try to be real and genuine in our work and not create this huge difference between [the clients] and us.

Page 32: Peers as Dignity Workers Nora Jacobson September 22, 2012

Resistance

Saying “no.”

Saying “no more.”

“Standing up” for oneself

Page 33: Peers as Dignity Workers Nora Jacobson September 22, 2012

Dignity Work

• For self/for others

• By individuals/by collectives

• Transitive

• Affirmative/defensive

Page 34: Peers as Dignity Workers Nora Jacobson September 22, 2012

Dignity work

• Creating dignity

• Maintaining dignity

• Protecting dignity

• Reclaiming dignity

Page 35: Peers as Dignity Workers Nora Jacobson September 22, 2012

Peer support as dignity work

Connecting to resources & info

gathering = advocacy & reducing deprivation

Skill building/mentoring/goal setting & socialization/self esteem building = moving toward positions of confidences and away from positions of vulnerability

Experiential sharing & relationship building & group facilitation & community building = build solidarity & reduce asymmetry

Invisible work = collective dignity work

Affirmative and defensive dignity work

Dignity work at the individual, organizational, and societal levels

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The dignity audit

Using dignity as a lens to assess policy and practice

Examine: structure (position, relationship, setting, and social order); process (processes of violation and promotion); outcomes (objects and consequences)

Identify: types of intervention (affirmative/defensive); points of intervention (person, organization, system, society); logic of intervention; barriers to change

Page 38: Peers as Dignity Workers Nora Jacobson September 22, 2012

Acknowledgments

My thanks to all of the interview participants and to my research assistants, Vanessa Oliver and Andrew Koch.

This research was funded by the Social Sciences and Humanities Research Council of Canada and the Mary Beck Professional Development Fund at the Centre for Addiction and Mental Health.

Page 39: Peers as Dignity Workers Nora Jacobson September 22, 2012

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