“Being a Windhorse Housemate – ordinary living of extraordinary importance”
by Lori S. Heintzelman
Perhaps the most powerful experience of my adult working life was being a therapeutic housemate to a client with extreme mental health challenges. It was an opportunity that not many have, and even fewer may desire. One might ask, “Who would do this?” I want to answer that question by sharing aspects of my experience. But first, it might be helpful to give a sense of that role’s structure and its uniqueness within the mental health world.
In conventional mental health services, a client or patient meets with a therapist or host of providers in an office or facility. In contrast, the Windhorse approach to mental health is home-based; a team is tailored specifically to a client, with home as the locus of the work. For some clients, within that team constellation there is a Housemate: a person who actually lives with them. This is not in a group home or residence owned by the agency but the actual client’s home, in a one-to-one pairing. A Housemate’s purpose is to be a consistent companion and stabilizing force for that person—not a caregiver, per se—building a relationship of trust and genuine friendship. Living alongside a client in such a situation, and helping them find their own sanity, is a matter of example rather than instruction—modeling healthy rhythms of eating, sleeping, exercise, upkeep of the space, social activity, as well as time to oneself. The Housemate must inhabit the house in such a way that it feels like home, and go about other aspects of their life, such as a part-time job or school. That includes having friends over to the house occasionally (with the client’s consent). A 6-month commitment is requested, and that may last longer if all parties agree it is beneficial. By design, a Housemate is not a therapist. Some Housemates do have a counseling degree and/or training, but this is not what the role calls for. In fact, Housemates who have such a background can find it difficult to refrain from “therapizing” the person they live with.
Two factors need to co-occur for someone to become a Housemate. One, that person must be available. That is, they can’t be tied to other housing—via a lease or mortgage—or have obligations to a partner, child, or parent. At the same time, a successful Housemate must be strongly internally anchored.
And this is where my story begins. I had recently finished many years of graduate school (a PhD, no less) and was looking for work in my field (Linguistics) in a terrible economy. This was after the Great Recession of 2008-09. Other aspects of my life were in transition too. My dad died after a lengthy illness, and I had put my belongings in storage and moved back to the Midwest temporarily to support my mom. After 6 months there, I felt I had been helpful to her in settling into life without her partner of 50+ years. And I had gotten valuable time with family that I hadn’t realized I needed. I was ready to come back to Boulder—my home base of many years—but didn’t have a place to land. I knew I was a responsible, reliable and organized person who actually liked the rhythms of home life. I had also grown up with many siblings and had had roommates as an adult, thus I was comfortable sharing living space. I was already linked to WCS, having provided administrative support there during grad school. I had long been curious about the Housemate role, so I made this known explicitly and was put in touch with Team Supervisor Chuck Knapp, who was organizing a new team for a returning client.
In conversations with Chuck, I came to understand the situation of this client: a young woman (mid-20’s)—whom I will call ‘Carly’—whose predicament he characterized as “strong and persistent psychosis.” She had a particular delusion: she thought she was on a reality TV show—one I had heard of but never watched—and her life was being filmed. She had shown incredible impulsivity—with accompanying risky behaviors—and there was also suicidality in the mix. The type of Housemate she needed was less typical: one who could hold strong boundaries and watch out for her safety rather than being a peer and a buddy. Further, Chuck noted that—even with a large team—they were considering that two Housemates might be necessary to hold this situation. (The configuration of 2 Housemates was more common in the early days of Windhorse and is rare in the present.) Finally, he said he was about 70% sure this support structure would work.
This was sobering. Although I was mature and believed myself to be psychologically sturdy, I had doubts and fears. Could I hold my own living with a person in such intensified states of mind? The level of responsibility around the client’s suicide risk felt especially daunting. And although I didn’t share details with my family, they expressed concerns about my safety. Also, a prospective Housemate and a client typically meet before there is actual commitment, to see if they have a sense of fit. This was not possible, given my distance and Carly’s state of mind at the time.
Knowing that there would be a team to support me, I said YES. I drove back to Boulder in mid-November to start. I was pleased that the client’s home was actually a house—not an apartment, which is more common. It was simple and small, but it had a lovely back yard, with flowers and fresh herbs still growing even as winter was approaching. I first met with the Team Leader in the living room. The shades were drawn, and the décor was sparse. I learned that the client was just being released from a recent hospitalization because of a suicide gesture. The gravity of the situation was palpable. After that meeting and before Carly arrived, I went out to get some lunch. As I picked at my food—my appetite had disappeared—I wondered aloud what I had gotten myself into. Still, I trusted Chuck and this team approach, and I told myself to just breathe. Also, there would be an experienced temporary Housemate with me for the first two weeks.
As I met Carly and settled into the house, I realized that her courage in allowing me into her home and her life was no less significant than my leap of faith moving in with her. I gave her a lot of space in those early days, which felt respectful and safe for both of us. Several weeks later, the second Housemate, Julie, was brought in, and we began our journey together. I knew that sharing the intensity and responsibility with another Housemate also meant I had to forge a second relationship. The challenge in this triad was to not exclude the client or make her feel marginalized by the “sane” people. Julie was very likeable and closer to Carly’s age, and I thought that was a good thing for all. I was actually of the same generation as Carly’s parents, but I never felt motherly toward her. And I don’t think she saw me that way either. I felt like we both understood my place as a caring person who landed in her life to help keep her safe.
Time in the house “on duty” was scheduled, and we proceeded to cook meals, eat, do chores (Carly was delightfully tidy!) and lightly converse—getting to know each other. There were safety measures in place, like sharp kitchen knives being locked up, and no alcohol in the house. Stimulants were considered risky too, so caffeine and cigarettes—which Carly unfortunately craved—were rationed, with Housemates and other team members as gatekeepers. Julie reminded me recently of the “endless cigarette negotiations.” Indeed! We navigated the physical space and relational dynamics at weekly house meetings—a wise Windhorse requirement—facilitated by our Team Leader.
Other members of the team would come and go—mostly Team Counselors as Carly’s companions in 3-hour shifts. At times, we as Housemates would join in, especially around meals. Cooking was a skill many on the team had, and the kitchen seemed to become the hub of sanity in that household. Our whole team’s emphasis on healthy regular meals, and the act of cooking together, was our strongest way of inviting Carly to sanity. Another layer of that was having her dad over pretty consistently for weekend dinners. We (Carly, Housemates and whatever Team Counselor was on the schedule) had to plan a menu in advance, shop for the food, divvy up the cooking tasks, and be ready to eat and socialize at a particular time.
There was also often a puzzle in process in the living room, the subject and design of which Carly would choose. This was a low-pressure way to be together around a shared activity, or for Carly to focus on something when alone. On some Team Counselors’ shifts, they took Carly out for errands or social/recreational activities. She liked the nearby Rec Center for exercise, especially yoga and swimming. This also gave the Housemates a welcome break from the intensity of Carly’s presence.
The most intense but intriguing part of Carly’s mental health challenge—and living with her—was the depth of her delusion. The “relational medicine” aspect of Windhorse was difficult to achieve because Carly was absorbed in a complex inner world. She truly believed her life was being filmed for a reality TV show. She talked about cameras being everywhere, even in our cars. She heard voices regularly, and they were not kind. They belittled and badgered her. They suggested things about her identity and place in the world—so important for a young adult—which were often quite bizarre. And I know this because she not only spoke to them—a group of about four by name—she spoke as them in whole conversations, changing pitch and intonation for distinct voicing of each character. It was fascinating to me as a linguist whose dissertation focus had been life story and identity formation. How was it even possible for the language centers of a brain to accomplish such a thing? What life experiences was she working out in such a process? Still, it was difficult to be exposed to on a regular basis. Carly’s dialogues with her internal tormentors were a more delicate matter when we were out in public together—say, at the grocery store. The voices might flare up unexpectedly, and Carly’s engagement with them was sometimes full of rancor, profanity, and explicit sexual content.
More seriously, the voices commanded Carly to do things that were self-harmful. This manifested once in a late-night suicide gesture. (I hadn’t realized that someone might attempt suicide for any reason other than depression and despair.) Julie, in the bedroom across from Carly—my bedroom was downstairs—was attuned enough to know that something was up that night. She alerted me to join her to intervene, and a catastrophe was averted.
My time as a Housemate lasted 18 months, with Julie ending after 7 months, another Housemate coming in for 6 months, and the final 4 months solo. Carly’s family chose then to end the team. There is so much more I can say about my particular experience, but I want to circle back to a broader question. How it is possible for a person to take on and succeed in such an unusual role?
First, there is the structure of a team. No one person holds all of the responsibility. A Windhorse team is a group of really intelligent and caring people in various roles, led by a senior clinician—all bound in a serious endeavor. This configuration allows for collective wisdom as well as lightness and humor – mostly at the foibles that inevitably arise from such a deeply human enterprise. The Housemate spends the most time with the client but has the least amount of clinical expertise and relies on the team for guidance and insight. The collaboration is realized most explicitly through a weekly meeting of the entire team.
Secondly, and related, there is required regular supervision. Housemates have a weekly one-to-one meeting with the Team Leader which encourages honest admission and discussion of all challenges of the work. Stoicism or denial on the Housemate’s part is actually quite dangerous; a feeling of drowning in the “soup” of a client’s extreme states can sneak up on a person who is not acknowledging their own internal experience and processing it in healthy ways. Also, because speaking to outsiders about the experience would violate client confidentiality, this is the place to freely share observations and ask questions.
Another essential ingredient—for all Windhorse staff—is some kind of contemplative practice that keeps one aware of their own experience. Watching one’s own mind is imperative, along with a willingness to work with the psychological material that will inevitably be unearthed, particularly in an immersive role like Housemate. This process of healing for all team members—parallel and intertwined with the client’s process—is what Windhorse speaks of as mutual recovery. I was not from a formally contemplative background; my meditative practice, then, was being out in nature. The Housemate experience sharpened my senses in relating to myself and others but also around my existing hobby of outdoor photography. I came to really see the detail and the beauty in small, simple things around me (including weeds – just ask me about teasels and milkweed pods!).
Another aspect of do-ability is the shortness of a Housemate stint by design. Intensity is more tolerable in small doses and with a known end point. I was in my late 40’s at the time, and compared to the span of my life, 6 months or so was not that much in the scheme of things. Also, the restrictiveness of this particular situation (which included not being able to have friends/guests over—not typical but necessary here) was manageable because it was temporary.
A genuine desire to be of benefit to a struggling person is also what makes this possible. Along with that, a curiosity to understand the workings of a disturbed mind close up is enormously important. The experience for me was an opportunity to challenge my own preconceptions about “mental illness” and realize that we are all vulnerable to patterns of thought that cause us suffering and stuckness. The line between sanity and insanity is blurry, if it exists at all. I felt compelled, after that, to confront mental health stereotypes held more broadly in our culture and educate others about them.
Being a Windhorse Housemate is both ordinary and extraordinary work. It pairs simply living one’s daily life with the constant awareness that another’s mental health and stability depend on it. The experience was profound for me; I wouldn’t trade it for anything.
Lori Heintzelman’s work background is in Human Services, Education, and Communications. She earned a PhD in Linguistics from the University of Colorado-Boulder in 2009. During graduate school, she provided light administrative support to Windhorse, and joined the staff as a Housemate in 2011. In 2013, she transitioned out of the Housemate role and into an administrative position while doing part-time basic attendance on 2 clinical teams. She is currently Windhorse’s Human Resources and Facilities Administrator, as well as a member of the Journal team. In her spare time, she is often out wandering around in nature with her camera, capturing the incredible beauty of Boulder and beyond. She is also an earnest amateur singer and guitar player.