Gordon's definition of recovery
What a great definition of recovery from Gordon McManus. From his online contribution to the Maudsley website and from his written work, this epithet emerges: Recovery is to have effective therapies, to have a meaningful life, and to get a new identity. Brilliant. I have come across many definitions of recovery, but for me this is the most useful. Well done Gordon.
How do I link in with this, how is this applicable to my life? Of course the key factor in my revolving door time was medication. Bad medication by injection and with horrendous side effects was no good, it led to multiple admissions and readmissions, with non-compliance on discharge. The NHS could be sure each time that this was going to happen. Good medication by tablet has enabled me to live without recurrence of extreme symptoms, and the associated self neglect and disasterous lifestyle. A meaningful life. Clearly there was no meaning for me with living in a ten-bed male dormitory with a curtain for privacy, with days in Industrial Therapy packing soap into boxes to the compulsory sound of Steve Wright In The Afternoon on Radio 2 via the unit loudspeakers, and having no intellectual or stimulating activities. Oh yes there was one activity:- smoking, you always had a fag, that was your stimulation. Since community care was introduced I have accumulated a number of aspects of my life that are meaningful. Getting two degrees was meaningful. Being creative at art, digital art, gardening, writing and music has been meaningful. Starting and runing a social enterprise has been meaningful. Engaging in sessional paid work has been meaningful. As for the new identity, that has taken on new meaning. When I was in employment during breaks in my asylum time, I would generally do OK, but of course the conversation with colleagues would never touch on hospitalisation, mental illness, or getting a criminal record. It would never touch on the injections in the backside that would usually then be part of my life. My identity as a worker in offices excluded mention of that. Today I am happy with myself and gain self esteem by being able to think again and to stretch myself. That is a new identity, maybe not so much for the outward impression I give, but for me personally to be comfortable with.
A couple of comments on Recovery: There are real aspirations from service users to work (according to surveys such as NMHDU) but in many places there are no jobs, and there remains a degree of ignorance and discrimination about mental health. With the public profile of mental health being so unhelpful, many employers are reluctant to give a chance to people with a background of mental illness. Another more insidious aspect of Recovery is that by being defined as 'recovered', services can be withdrawn, as there is said to be no more need for support. This change in eligibility means service users can be vulnerable to being assessed for non-existant jobs and having support withdrawn.
For me, Gordon McManus's book 'From Communism to Schizophrenia and Beyond' is a great read and a major key into consideration and deep thought. Gordon places Recovery in a four-stage continuum. This goes from starting with a normal life, to getting ill and probably being hospitalised, to the recovery stage, and then on to a new normality. That last stage is what eludes many people I know. We are fed ideas of what normaility should be, how normal people think. With all the prejudices imparted by the media and politicians in more populist moods. So many people would really like to be accepted as normal. It's very difficult to accumulate what makes up a normal life. But many people with mental illness, who may be in the recovery stage that Gordon includes in his model, would really love to leave behind the world of day care, mental health workers, psychiatrists, State support, workless days. They can recall those glimpses of normality that they experienced in childhood, or at interludes in their life as a sufferer. Reality is in many ways a social construct. Life in civilisation does not depend on raw Mother Nature either for food or for shelter. Food and shelter are provided, there is no link with their origin in social situations. So what a comforting social situation may school days be. A natural progression through the next higher class for many, seniority gained, and needs provided for. Then for some, today for half of all young people, on to university. This is all a social construct that feeds and nourishes. Compare that to the social construct that faces many mental health service users:- stigma and discrimination, dependency, poor outcomes under many headings, and no way out. For many, they would love to get to the fourth of Gordon's stages, a new normailty, but that remains for many thousands elusive. Nevertheless you can see how beguiling is that prospect of no longer being in a mental health environment, but being independent, self-sufficient, with a lifestyle agreed to be normal.
Some comments on Gordon's account of his involvement with the British Communist movement...I can provide a kind of triangulation with Gordon's memoire of his time as an activist. It goes without saying that Marxist socialiam has nothing to do with democratic routes chosen by the likes of the Labour party. Social democrats are seen as selling out and not representing the working class. Gordon is quite a brave person for identifying himself with revolutionary socialism, for that is what he does. His active days were over many years ago, but especially during the period of the Cold War, that was a very brave thing to do, to speak out for a workers' state. I can link in with many of the issues Gordon raises. For example, many people will be curious as to why exactly it was that the Soviet Union, the USSR (the Union of Soviet Socialist Republics), collapsed and allowed the USA to be the victors in the Cold War. Gordon states his opinion that it was the policy of state monopoly capitalism in the USSR that was the cause. The party alienated workers as much as a capitalist state would, and it was this tension that led to Gorbachev compromising with the West so that free elections could take place in 1992. The version I gleaned from the Open University and their higher level course 'Global Politics', and also from the staff at Brighton University from 1995 to 1998, after all the dust had settled, was that the pressure put on the USSR by the USA and the West was too much for the Soviets to bear, and there followed economic and political collapse. So Regan's threat to implement Star Wars, and to ratchet up miltary costs, together with more openness and cultural exchange with the West, was too much for the antiquated and inefficient Soviet economy to stand. Soviet citizens were demanding Western lifestyles and consumer goods, and the cost of countering a space-based system of nulear weapons, caused the Soviet Union to collapse, unable to keep up with the expenditure of the West. Whatever version you accept: Gordon's, the OU's, or another, it's an interesting subject. There was no invasion, no MAD (Mutually Assured Destruction) exchange of Inter-Continental Ballistic Missiles equipped with nuclear warheads. Just we began to read of elections in Russia, the Berlin wall coming down, and that was the end of the Cold War, not even any surrender or victory parades. Other parts of Gordon's experience with communism I was familiar with too. Where Gordon writes of Scientific Socialism (as opposed to Utopian Socialism) I might talk of the dictatorship of the proletariat and the withering away of the state. I found it important to recognise these facets of Communism while at Reading University. I have to say that I was never one to see value in action to take over the state by revolution in the name of the workers. My sympathies if at all, were to establish self-sufficient communes with urban outlets. This never came about for me. But I recognise Gordon's list of hard-left groups. He lists Communists, Trotskyists, Maoists, and Anarchists. We had no Soviet Communist group at Reading that I knew of. But there were Troskyites (also known as International Socialists), Maoists, and Anarchs. I sympathised with the anarchists as they had a direct route to getting out of the rat race and mass society with all its contradictions, false consciousnesses, and hypocrisies. So I can testify, if that's any good, to where Gordon is coming from in a political sense. I can see his point, and as I said earlier, he was a brave man to agitate for revolutionary communism. For me, the message of Marx is that the dictatorship of the proletariat and the withering away of the state are historically inevitable. Workers and the Party are the human agents through which this will happen, it is a task and will not happen automatically. Personally I find that proposition problematic. But look what Marx wrote in the 1840's with his Manifesto, the one that ends with 'Workers of the world unite, you have nothing to lose but your chains', or words to that effect. Then Marx wrote of continuing crises in capitalism, and that this may arise because of the system's need to expand. We will always have ups and downs in economic cycles. How relevant that is today - was that really published in 1848? How is it that Gordon Brown PhD was once able to announce 'an end to boom and bust'? In that way, communism is scientific, it states the rules by which its enemy, capitalism, works. Marx's work on economic cycles holds good today. Gordon writes of alienated labour, and this has for me links to dialectics. Alienation is the way that the working class is exploited, then rebels, then takes over the means of production, this last being a synthesis of the first two, which are thesis and antithesis. For me, the way that people live with no handle at all on where or how their food and shelter come about:- that is alienation, and I can see the point in 21st century ecotherapies to get people back to Nature. I agree that an alienated society will be expoited by the division of labour. So for me Marxism has some valid timeless points, and I regret that I did not realise that life is no rehearsal, and therefore missed chances to make a difference. For me, mental illness had a crucial part in this.
Recovery for me is one element or ethic among many that I have experienced, especially since 1990 and the advent of community care. That is not to say it has no value, far from it. I think that many of these ways of working have impacted on a certain number of individuals and therefore they are valuable. Among the 30 or so elements to mental health care since the closure of the asylums have been, in no particular order: user involvement in the planning and delivery of care (from the 1990 legislation); the debate on whether to rename patients consumers, customers, users, or service users; partnership working; stakeholding; holistic approaches; person centred service delivery; commissioning and re-commissioning; contracting out; user led services; recovery; and so on. One model from the days when the asylums were first seriously questioned for demolition was the patient committee, indeed I was a member of the patient committee on a ward that was 'self-care' and had no nurses as long ago as 1978. All of these ethics I am sure have made a difference to a number of individuals, and the writs of innovations in openness, participation, democracy and accountability all have a lasting effect even today in 2013. I am sure that recovery will have a lasting place in care delivery, even if it does not retain a pivotal influence, as new innovations proceed. Gordon's definition of recovery and his analysis of its place in mental wellbeing are accurate and an essential component of understanding this way of providing mental health care.