New PsychOdyssey OpEd: What Is Recovery?

“Recovery” means many things to many people. It is a concept without a concensus.  Tennessee mental health advocate and consumer Larry Drain, blogging at Hopeworks Community, offers a wonderful reflection on his personal understanding of “recovery”. (Read it here.) But maybe can we go even a little further than Mr. Drain’s moving description?

Isn’t recovery really tripartite concept? Isn’t it a process (or journey), an outcome (or destination), and an ideal (or philosophy)? Accordingly, doesn’t recovery have three components: medical, rehabilitation, and empowerment? The medical component consists of hospitals, doctors, and medications for stabilization, often considered an outcome. The rehabilitation component consists of skills and supports for community integration, often considering a process. The empowerment component consists of wellness, self-awareness, self-help, and hope for perseverance, often considered an ideal. The sciences of the three components are, respectively, psychiatry, psychiatric rehabilitation, and psychology. All three are necessary, perhaps in varying measures at various times, always as determined ultimately by the individual in recovery. No one paradigm (e.g., medical vs. rehabilitation vs. empowerment, etc.) is usually sufficient, nor is the term “recovery” usefully reduced only to one paradigm. Recovery is a big tent. Geneticist Kenneth Kendler (2005) warns against “the paradigm wars”, calling us instead to embrace “explanatory pluralism”.

Thus, isn’t recovery in principle a reformulation? Austrian psychiatrist and Nazi death camp survivor Victor Frankl (1992) gives us all with any challenge a good starting point for considering recovery as reformulation. “What we really needed [to stay alive in the camps],” he wrote, “was a  fundamental change in our attitude toward life. We had to learn ourselves and, furthermore, had to teach the despairing men, that it did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life–daily and hourly. Our answer must consist, not in talk and mediation, but in right action and right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual.”

References:

Frankl, V. E. (1992). Man’s search for meaning. Boston, MA, Beacon Press. p. 85.

Kendler, K. S. (2005). Toward a philosophical structure for psychiatry. American Journal of Psychiatry 162(3): 433-440.

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