‘The Four Stages of Recovery’, from Mark Ragins

IMG_3040Mark Ragins is a leading recovery figure in the mental health field. He was a pioneer in setting up MHA Village, a recovery community based in Los Angeles. His writings are well worth a read. Here is what Mark has to say about the four stages of recovery in an article entitled The Road to Recovery. What Mark says here is just as relevant to people recovering from addiction.

‘Recovery has four stages: (1) hope, (2) empowerment, (3) self-responsibility and (4) a meaningful role in life.

Hope
During times of despair, everyone needs a sense of hope, a sense that things can and will get better. Without hope, there is nothing to look forward to and no real possibility for positive action.

Hope is a great motivator, but for hope to be truly motivating, it has to be more than just an ideal. It has to take form as an actual, reasonable vision of what things could look like if they were to improve. It’s not so much that people with mental illness will attain precisely the vision they create, but that they need to have a clear image of the possibilities before they can make difficult changes and take positive steps.

Empowerment
To move forward, people need to have a sense of their own capability and their own power. Their hope needs to be focused on things they can do for themselves rather than on new cures or fixes that someone else will discover or give them.

To be empowered, they need access to information and the opportunity to make their own choices. They may need encouragement to start focusing on their strengths instead of their losses. Sometimes they need another person to believe in them before they’re confident enough to believe in themselves.

“Readiness” often occurs only in retrospect after they have done something successfully, so waiting until a person with mental illness is ready to move on can often be stagnating and disempowering. Often people have to experience success before they believe they can be successful.

Self-Responsibility
As people with mental illness move toward recovery, they realize they have to take responsibility for their own lives. This means they have to take risks, try new things and learn from their mistakes and failures. It also means they need to let go of the feelings of blame, anger and disappointment associated with their illness.

This is a particularly difficult stage for people with mental illness and their caregivers. Old patterns of dependency must be broken, and mental health professionals need to encourage clients to take charge instead of settling for the ease and safety of being taken care of.

A Meaningful Role in Life
Ultimately, in order to recover, people with mental illness must achieve some meaningful role in their lives that is separate from their illness. Being a victim is not a recovered role, and frankly, neither is being a survivor.

Newly acquired traits like increased hopefulness, confidence and self-responsibility need to be applied to “normal” roles such as employee, son, mother and neighbor. It is important for people to join the larger community and interact with people who are unrelated to their mental illness. Meaningful roles end isolation and help people with mental illness recover and “get a life.”

This series of stages can provide a roadmap, albeit a fluid one, of the process of recovery that can be applied, specifically, to helping people recover from having a serious mental illness. For me, it has been a much better roadmap than the medical model’s version.

Although the medical model relies on objective, measurable signs and symptoms and scientifically defined illnesses, psychiatric histories rarely feel “real.” On the other hand, subjective, experiential stories of recovery almost always do. I have heard many moving accounts by people with serious mental illness who have described to me what it is like to travel on a  road to recovery.’

So let’s just summarise here some of the key factors that facilitate a person’s recovery from addiction:

Hope, that takes the form of an actual, reasonable vision of what things could look like if they were to improve. This hope needs to be focused on things the person can do for themselves rather than on new cures or fixes that someone else will discover or give them.

Empowerment, the person having a sense of their own capability and their own power. To be empowered, the person needs:

  • access to information and the opportunity to make their own choices
  • encouragement to start focusing on their strengths instead of their losses
  • another person to believe in them before they’re confident enough to believe in themselves.

Self-responsibility for their own lives, which means taking risks, trying new things and learning from mistakes and failures. The person must also let go of the feelings of blame, anger and disappointment associated with their illness.

A meaningful role in life that is separate from the person’s substance use problems.  Being a victim is not a recovered role. The person must attain “normal” roles, such as employee, son, mother and neighbour, rather than be an “addict” or “alcoholic”. They must join the larger community and interact with people who do not have a substance use problem. Meaningful roles end isolation and help people to recover and “get a life.”

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