Classic Blog – ‘What is Recovery?’: Julie Repper & Rachel Perkins

2007_0116walpole0097-220x164In my blogs, I will be exploring the nature of recovery and will sometimes focus on the ideas of someone else (or a group of people). I’ve previously looked at how David Best has talked about “What is Recovery?” David described key principles underlying addiction recovery.

In this blog, I am going to look at what Julie Repper and Rachel Perkins have to say about “What is Recovery?”, as described in their excellent book Social Inclusion and Recovery: A Model for Mental Health Practice. They include a number of quotes about recovery, some of which I will use here.

As Julie and Rachel point out the concept of mental health recovery did not come from professionals and academics. It emerged from the writings of people who themselves face the challenges of life with mental health problems. On the basis of such accounts Anthony (1993) described recovery as:

‘… a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness. Recovery involves the development of mew meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.’

Julie and Rachel emphasise that recovery is not about symptom reduction. It is about gaining a meaningful and valued life. Here are the key features of recovery they describe (although not in the same order):

1. Everyone’s recovery is different and deeply personal. There are no rules of recovery, or formula for ‘success’
‘Everyone’s journey of recovery is unique. Each of us must find our own way and no-one can do it for us.’  Pat Deegan

2. Recovery does not refer to an end-product or a result. It is not an outcome but a continuing journey
‘Recovery is a process, not an end-point or a destination. Recovery is an attitude, a way of approaching the day and the challenges I face… I know I have certain limitations and things I can’t do. But rather than letting these limitations be occasions for despair and give up, I have learnt that in knowing what I can’t do, I also open up the possibilities of all I can do.’ Pat Deegan

3. Recovery is not the same as cure
“It does not mean that all suffering has disappeared, that all symptoms have been removed, or that functioning has been completely restored. Rather, remaining symptoms and problems interfere less with life.”

‘One of the biggest lessons that I learnt to accept is that recovery is not the same thing as being cured. After 21 years of living with this thing it still hasn’t gone away.’ Pat Deegan

4. Recovery is not a linear process
‘The recovery process is… a series of small beginnings and very small steps. At times our course is erratic and we falter, slide back, re-group and start again…’ Pat Deegan

5. Recovery is not specific to people with mental health problems
“Everyone experiences the challenge of recovery at some point in life, e.g. when someone we love dies, or when we experience losses, traumas, illness or injuries.”

‘Recovery is a process of healing physically and emotionally, of adjusting one’s attitudes, feelings, perceptions, beliefs, roles and goals in life. It is a painful process, yet often one of self-discovery, self-renewal and transformation. Recovery is a deeply emotional response. Recovery involves creating a new personal vision of one’s self.’ Spaniol et al.

6. Recovery is about taking back control over one’s life
“Mental health problems are often presented and perceived as uncontrollable, or their control is seen as the province of experts. Recovery involves a person taking back control.”

‘Over the years I have learnt different ways of helping myself. Sometimes I use medications, therapy, self-help and mutual support groups, friends, my relationship with God, work, exercise, spending time in nature – all of these measures help me remain whole and healthy, even though I have a disability.’ Pat Deegan

7. Recovery is about growth
It is all too easy for a person to become nothing other than their ‘illness’: a schizophrenic’: a ‘manic depressant’. Their identity may become defined by their illness.

Recovery involves redefining identity in a way that may include, but moves beyond, that ‘illness’, or completely redefining identity with no reference to the original illness. “It includes overcoming not only the challenge of mental health difficulties, but also the effects of the discrimination and exclusion which accompany them.”

‘My recovery was about how to gain other people’s confidence in my attitudes and potential… in my own experience the toughest part was changing other people’s expectations of what I could do. Combating a disempowering sense of being undervalued…’ May

8. Relapse is not failure, but part of a recovery process
‘I have found that although my symptoms may seem… worse, relapsing… is not the same thing as ‘having a breakdown’… rather I am breaking out or breaking through… out of some fear-filled place where I have been trapped… through to new ways of trusting people and myself… it means I am growing, breaking out of old fears and into new worlds – learning to make fiends and keep them, to trust people, and to love people.’ Pat Deegan

9.  A recovery vision is not limited to a particular theory about the nature and causes of mental health problems
“… a recovery vision does not commit one to a social, a psychological, a a spiritual, or an organic understanding of distress and disability, nor to the use or non-use of medical interventions. Whatever understanding of their situation a person comes to, recovery is an equally important process.”

10. Recovery can, and does, occur without professional interventions
“A person’s own resources and those available to him/her outside the mental health system are central to the process. There are many paths to recovery, including choosing not to be involved with the mental health system. Recovery is not a professional intervention, like medication or therapy, and mental health workers do not hold the key. Many people have described the enormous support they have received from others who have faced a similar challenge.”