What is… Recovery?

In this series, I dig a little deeper into the meaning of psychological terms.

This week’s term: Recovery

The word recovery can have various connotations depending on the context.  It began to gain popularity in the context of mental health in the late 1980s and early 1990s, when it was used by the ex-patient/psychiatric survivor movement.  Its usage has become common in mental health services, and various mental health-related government agencies claim to have some degree of recovery orientation.

According to the Mental Health Commission of Canada (MHCC), “‘Recovery’ does not necessarily mean ‘cure’; rather, it focuses on people recovering a meaningful life in their community while striving to achieve their full potential.”  Recovery is unique for each individual, and draws upon strengths.  In the recovery process individuals with mental illness are empowered and enabled to live a meaningful life.  Principles that support recovery include hope, empowerment, self-determination, and responsibility.

The MHCC developed a set of guidelines for recovery-oriented mental health services.  These were built around several key dimensions, including:

  • Creating a culture and language of hope.
  • Recognizing that recovery is personal and unique, and requires consideration of the whole person.  There is a focus on strengths, autonomy, and self-determination.
  • Recognizing that recovery occurs in the context of one’s life, which is impacted by such factors as social supports, social determinants of health, and stigma.
  • Taking into account the diverse needs of all groups within Canada including Indigenous peoples, LGBT individuals and racialized communities.

The MHCC explains that recovery-oriented approaches break down power imbalances between those with mental illness and treatment providers, and recognize the experiences, insights, and expertise of people living with mental illness.

The Mental Health Foundation, a non-profit organization in the U.K., describes the recovery process, which:

  • provides a holistic view of mental illness that focuses on the person, not just their symptoms
  • believes recovery from severe mental illness is possible
  • is a journey rather than a destination
  • does not necessarily mean getting back to where you were before
  • happens in ‘fits and starts’ and, like life, has many ups and downs
  • calls for optimism and commitment from all concerned
  • is profoundly influenced by people’s expectations and attitudes
  • requires a well organised system of support from family, friends or professionals
  • requires services to embrace new and innovative ways of working.

The Mental Health Foundation also identifies a number of factors that support recovery, including good relationships, financial security, satisfying work (it was not specified whether this was volunteer as well as paid), personal growth, the “right living environment” (although it doesn’t specify what this is), and developing resilience.

The U.S. government site MentalHealth.gov identifies four dimensions of recovery: health, home, purpose, and community.  The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies ten guiding principles of recovery: respect, hope, person-driven, many pathways, holistic, peer support, relational, culture, addresses trauma, and strengths/responsibilities.  Hop back across the Atlantic, and the Scottish Recovery Network uses the CHIME acronym to describe common themes of recovery: Connectedness, Hope and optimism, Identity, Meaning, Empowerment, and Connectedness.

Clearly multiple agencies in multiple countries are talking the talk, but does it actually mean anything?  Does the real meaning of recovery get buried under these dimensions and principles and acronyms?  And do the voices of those of us with mental illness get drowned out by the voices of those who want to tell us what recovery is?

I work in a concurrent disorders (mental health and addictions) program, and recovery is built right into the name.  Yet I see precious little recovery in the implementation, and often considerable paternalism.  The program leaders might know the language of recovery, but their decisions don’t show any real understanding.  I think in many ways it’s even worse to be recovery-oriented in name only rather than not claiming a recovery orientation in the first place, because it contributes to misunderstanding of what recovery actually is.  It becomes something that is hijacked by professionals and taken away from those of us living with these illnesses.

In some ways I’d prefer to set aside definitions of recovery entirely and say it’s whatever the individual living with the illness believes it is for them.  I used to think that my own recovery would involve being symptom-free, but I’m not sure that’s realistic, so now I’m looking to be able to engage in meaningful activities that give me a sense of purpose.

What does recovery mean for you?  What do you think of what the various organizations are saying about it?

 

This post was inspired in part by a recent post by Katie at Stumbling Mind.

Sources:

You can find the rest of the What Is series on my blog index.

24 thoughts on “What is… Recovery?

  1. Revenge of Eve says:

    Recovery, for me with co-occurring illnesses, means receiving support from the circle of support I built, living in a way that aligns with coping instead of using alcohol, being able to offer others support because my condition is in remission and being able to find a common ground between having illnesses and living life to the fullest. Being that I have abused drugs and alcohol and also have bipolar it may not be easy to achieve a full recovery but all I can do is try to fulfill the above and make my recovery my own.

    Liked by 2 people

  2. wingedtrish says:

    Hmmm, yes I feel that our mental health system is not very recovery oriented. A good psychologist or counselor should have the aim of setting their clients free to work on their own, eventually, but it seems that we have set up a system of dependence. While some patients will need life-long care, there are many people who could have independent lives with the right care.

    Liked by 2 people

  3. DV says:

    I think a contributing factor is that medical training is so focused on ‘cure’, at least in the early years, that anything less than cure is felt as kind of a personal failure on both the doctor and patient’s part. Patients who are exposed to others with ongoing problems which can’t be cured seem to be much more accepting of that and to come up with more constructive solutions than doctors, who I think in their heart of hearts are still aiming for cure and in some ways are pushing away those patients who make them feel like a failure – maybe not on a conscious level but I’m pretty sure it’s there underneath. My first exposure to the idea of recovery as opposed to cure was my brother in law’s involvement in AA, and I’ve found the whole idea that you keep trying and that setbacks and relapses are just expected parts of the process quite helpful in dealing with my own mental health problems.

    Liked by 1 person

  4. Meg says:

    This is a great blog post!! Very thorough!! I loved how it traversed the globe!! I also loved the bullet points! And how the concept of recovery encompasses so many different things.

    I guess to me, it’s the whole “Life is a process” concept, which applies even to people who aren’t necessarily recovering from anything. Because it’s like, whatever life is, you keep moving through it and hopefully grow as a person and learn something and have meaningful moments, I hope!!

    I don’t care at all if I never recover from schizophrenia. It’s not on my goals. Many times, it doesn’t act up at all, so if it were a constant source of stress, I’d feel differently. My meds are very useful.

    I do, however, want to recover from the childhood abuse I suffered, so I have that book I told you about downstairs in an Amazon-delivery package. So recovery for me would mean, maybe… no more flashbacks and no sense of low self-worth/shame/degradation/etc…? That would be a worthwhile goal, and it’s currently part of my path through life, so I’m definitely going to read the book.

    Liked by 2 people

  5. Karen says:

    At my last lot of therapy I was told that one aim of therapy was to enable me to live life without the need for therapy (I’m paraphrasing), meaning that I just needed to be sufficiently better to be able to manage my illness on my own. I can see how one could be eternally on the therapy treadmill waiting for a state of full recovery/remission/cure but in the UK the NHS has insufficient funding for many things but especially mental health services so people are discharged before they’re ready and left on waiting lists for a very long time.
    Lost my train of thought, so I’ll just say that for me recovery is:
    – being able to manage without external support
    – being able to function with daily living
    – being enthusiastic about things I enjoy and doing them
    – being able to sleep
    and having a general feeling of contentedness
    If I can have all of these then I’m good, keep taking the meds, keep minimising stress and keep doing all the things that are good for me and my recovery.

    Btw I think your goal of engaging in meaningful activities and having a sense of purpose are great things to aim for.

    Liked by 1 person

  6. Luftmentsch says:

    I also used to think recovery would be being symptom-free, but I don’t think that’s going to happen for me either. And I’m sure the NHS has something on paper similar to the things you quoted, but I haven’t really experienced that. Lots of paternalism, and sometimes being treated as a number, just someone on the waiting list to cross off. And very little hope or optimism.

    Liked by 1 person

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