Compassion and Mutual Identification in Peer Work

By Patrick Roff

The mutuality created between “one alcoholic talking to another” has been the cornerstone of recovery since 1935.  Webster’s dictionary defines “mutuality” using the following words: “the quality of being mutual” and “a sharing of sentiments; intimacy”. The word “intimacy”- “something of a personal or private nature” may provide some insight. When we drop hierarchy at the onset of a helping relationship, equality can flow naturally through it. Yet, how can we be intimate with some we consider our equal and still act as professionals with that person? These are thorny questions.

One pillar of a Peer Recovery Philosophy (PRP) is the creation of mutual identification in the context of a peer-to-peer relationship engaged in “the matter at hand”. One person helping another with a drug and alcohol problem in a way that is non-clinical. However, it is also important to remember CPRS work is always contextual, particular to “the matter at hand”, as well as founded on a non-directive approach; sometimes reducing harm is our best option.

At CARES we now work on the streets, giving out kits for safer use, dignity bags with hygiene products, clean socks, and underwear. Our staff is trained to always be compassionate, kind, and pragmatic, even when being cursed out, even when all they want is a pair socks. Sometimes not bringing up drug and alcohol use allows the person we are helping to bring it up themselves, thus empowering them to identify they have a problem and to choose help, whatever kind of help they want. These interactions of mutual identification can sometimes begin with the trained CPRS sharing their own story to help a fellow human being suffering through addiction and/or recovery.

However, it can also happen in reverse, depending on the context and/or physical location – the ER, the jail cell, the courtroom, in a recovery or treatment center, on the sidewalk, on the phone or face to face. This relationship must be peer-to-peer and equal in nature, built on trust, equality, respect, and intimacy. How does it work? The CPRS must try to create some sense of “I am like you and you are like me” – even just a kernel of mutual identification will do at the start. That is the mission. It could be as simple as I am a human being and so are you, liking the same music, or the CPRS sharing their own past experiences of being in the same or similar situations, or relationships with particular substances or in a relationship with a particular type of person (family member, partner, using friends). For the trained CPRS, this is not simply the telling of war stories; this is creating mutual identification, professional intimacy, the sharing of sentiments within the boundaries established by the CPRS curriculum. Research has empirically shown the power of shared story telling in helping to heal addiction. Then, through using the knowledge, judgment and skill sets learned from becoming a CPRS, help might emerge in a way that is practical, possible and, most importantly, the choice of the person needing help.

The job of the CPRS is to meet a person where they are, and as who they are, and just listen, perhaps considering which Stage of Change the person is in over a period of time and considering possibilities on how and when to try and help them “move the needle” from one stage to another and perhaps even another. However, at no point should a CPRS show any signs of judgmental behavior, we should always be attentive to our own verbal and non-verbal cues of bias, distaste or even disgust. We are all flawed human beings, first and foremost. Acts of basic human decency and kindness, built upon the principle of mutuality, should always come before offers of help.