By David Joel Miller.
We may need to rethink what recovery really is.
Just returned from a really great training titled “Making Recovery Practical.” The most important part of this training was its clear declaration that recovery is possible. Those of you who have been readers here for a long time know that I am a strong proponent of the concept of recovery.
In my professional life, I have seen many people recover. Unfortunately, many professionals still act as if people do not and should not recover. This prompted me to think I needed to write a few more posts about what recovery is and how it is that people do recover.
The presenter of this training was Dr. Mark Ragins, who is medical director of the –MHA Villages Integrated Service Agency. Mental Health America Los Angeles is an affiliate of Mental Health America. The particular training I attended was sponsored by Fresno County Department of Behavioral Health.
Dr. Ragins covered a great amount of material in a very short time. If you ever get a chance to hear Dr. Ragins speak I would highly recommend him. While I won’t be able to say it the way Dr. Ragins did, in this and upcoming posts I would like to explore some of his “Making recovery possible” themes with all of you. What follows are my thoughts on the subject inspired by Dr. Ragins presentation but not specifically the material from his presentation.
The world changed and our approach to mental illness needs to change.
Societal responses to problems are most often about reacting to an immediate critical problem. It is much easier to motivate help for people impacted by flooding or hurricane damage than it is to do projects to prevent flooding. We typically do many things to cope with a recession after it happens, bail out the banks and spend money to create jobs. It is hard to develop the political will to make structural changes that would prevent future bubbles from bursting and creating the next recession or depression. We now know that waiting for a serious mental illness to develop is waiting too long.
Our approach to mental illness has been largely the same. Wait for someone to “get sick” send them to a doctor or hospital and expect that they will “get fixed.” If mental illness is a disease why can’t the doctors “cure” them?
The diseases doctors treat have changed.
The medical model, like the financial model, the employment model and so on is based on treating acute problems, not chronic illnesses. Break a leg and you get a cast, maybe surgery and medications and the leg heals. Medicine is good at treating acute problems. It is not so good at treating chronic problems.
Most medical and mental illnesses these days are chronic problems.
Doctors spend most of their time these days managing chronic illness, diabetes, high blood pressure, obesity and its related complications. Same thing is true of mental illnesses. We are better at treating sudden issues like suicidal thoughts than we are at treating chronic conditions like depression or anxiety. Psychosis is all too often treated by the “put them on meds and then tell them to stay home and let others run their lives approach.”
Helping people manage their symptoms too often turns into professionals trying to manage people.
Black and white thinking does not work well in a colorful world.
We, as in professionals, used to think there were two kinds of people, the mentally ill and the “normal” people. Recently we have realized that most of those things we call mental illnesses and substance use disorders are chronic conditions, not acute ones. You may become more depressed or less depressed depending on other factors in your life. Substance abuse gets better if you stop drinking and using but being dry or putting down the drugs is not the same thing as being really sober or recovered.
Recovery means different things to different people.
Recovery from a chronic disease or disorder is not about a cure. It is about managing your life to have the best life possible regardless of whatever challenges someone is facing. The psychiatrist idea of recovery might be not hearing the voices and taking their meds as prescribed. Your idea of recovery might be having a relationship, a place of your own and being able to engage in productive activates regardless of whether you hear the voices or not.
We need a new focus in the treatment of mental and emotional issues.
Rather than so much focus on the disease model and what disease does that person have? What is sorely needed is a focus on wellness, resiliency, and recovery. How can someone having had an episode of this thing we are calling mental illness learn to increase their wellness and live the manner of life they chose to live.
For far too long we have focused on what the mentally ill can’t do and the result has been convincing ourselves, the mentally ill, and society that they will never get better. As we shift the focus from expecting a full, complete “cure” to learning how to reduce or manage the symptoms of a chronic condition it becomes increasingly clear that recovery and a full life are possible.
Stay tuned and in future blog posts, we will talk again about wellness tools and how to make recovery possible.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books