Recovery is not a model
Recovery is not a model - you can’t set the goal posts on what a person should do in order to recover. No, ask the person what they want to do. If recovery is going to the cornershop once a week, that’s fine. Its their recovery. Its not about what society thinks recovery is.
If you think about it and relate it to the fact that 73% of people in psychiatric services have been abused, then in order for someone to begin a recovery journey you need to address power. When someone is being sexually abused there is a massive power imbalance. The person who is being abused feels like they have no control. If you then get a mental health professional telling you what to do and how to recover, you are straight away recreating a power imbalance. So the person won’t react well to it, but they then get the blame for being disengaged. Professionals don’t take responsibility for why people disengage from services, perhaps its in their approach. Carl Rogers summed it up well years ago when he said the relationship is more important than the therapy. Never been a truer word.
I know many people who have been through a process of recovery and are now living meaningful and purposeful lives and there is a key common element in their story – a worker took an interest in them and they shared abit of themselves. For me it was Sally. She shared a bit of herself with me and broke down the barriers which was fantastic. My daughter is a psychiatric nurse on a secure unit and I instill this in her. So she will say yes I have got children and these are their names, my dad hears voices. She won’t give them her address. I understand in some circumstances – maximum security they are not allowed to give away too much on a personal level because of all the talk about manipulation. But they could say, yes I went away for Easter, its about normalizing and relating. Think about it, if a mental health professional wants to ask questions about someone, why should the person tell them anything if they don’t know anything about the mental health professional. Where is the basis for relationship?
I’ve got no problem with people learning. If we don’t learn we don’t progress but in psychiatric services, the number of times I’ve had psychiatrists say to me – I’ve got a student with me, can they sit in today? Now if I’d been very honest about the abuse, setting myself on fire, the voices- that person that I don’t know is privileged to my life. What if the next day they decide they don’t want t be a psychiatrist and they walk away from their training and then they see me in a pub, will they discuss what was meant at the time to be confidential? Well if I have to trust them to that extent, so they should trust me with a bit of themselves.
What is recovery? This is a big question – recovery cannot be defined – it's a very individual thing. People have recovered since we walked the planet but we are very resilient and we find a way to survive. Services are telling you how to recover – but you can’t define recovery by measured outcomes – what does recovery meant to the individual? How can they be supported to reach their own definition?
You have got to ask the person what they want. There are lots of people in mental health that through peer pressure have been pushed into jobs and education that they didn't want to do and as a consequence they have a break down. Now one fantastic thing about having an acute admission is that it is an opportunity to reinvent yourself - you go in one person you don't like, while you are in there you can work on re-inventing yourself! Give them something purposeful – a raise in self confidence, self esteem they are the foundations of what they need. Not a plan with measurable outcomes.