What is Mental Health Recovery?
Worldview and differing perspectives
It is likely that in any discussion about mental health recovery there will be some differences of opinion about the characteristics of recovery. This should come as no surprise both because recovery is a unique and individual experience and also because we all have a slightly different worldviews. Our worldview relates to how we see and understand the world around us. It is influenced by our past experiences, our personal values and our culture.
Being aware that we all have slightly different worldviews, and being open to this, is an important skill for peer support workers.
Our worldview also influences our understanding of mental health and recovery. Some people may have an understanding of mental health which is biologically based. From this perspective it is our biology which determines our behaviour. This means that it is our genes and instincts which drive us.
This perspective believes that we are biologically determined by what we are born with and we therefore have little control over how we develop: we are predisposed to behave and respond in particular ways and this is determined by our genes. From this perspective, mental health problems develop from physical/biological causes like defects in the functioning of the brain or genetic factors. The methods of dealing with these defects are usually through drug treatment, such as the prescribing of anti- depressants to alter the chemical activity in the brain.
A psychological perspective suggests the way in which we behave is a result of psychological (emotional) problems acquired through learning experiences in our lives. There are two key approaches to understanding the origins of these experiences.
Psychodynamic perspectives seek to understand by focusing on the individual’s feelings and emotions and the relationship with these and early childhood experiences.
Behaviourist perspectives argue that behaviour is learnt by observing and modelling other individuals who have an influence on our lives — for example, family members — and these behaviours are maintained by a process of rewards and punishments in the environment. They also believe that behaviour can be unlearnt.
From perspectives the preferred treatment for mental health issues is based on talking therapies. The social perspective focuses on our social environment and how this impacts our development. It suggests that mental health issues are determined by the social context in which we live and the things which have happened to us in that environment. The social environment includes the family, wider community such as relationships formed at school, within the workplace as well as wider social factors like socioeconomic status, gender, sexual and ethnic identity. In reality there is a complex interplay between these different perspectives. Because our understanding of the human mind is far from complete the models we apply are far from complete, and debate can rage between supporters of different models.
One strength of taking a recovery approach is that it can rise above these debates, as it is more concerned with the process and outcome of recovery than the underlying causes of mental health problems. Recovery is fundamentally concerned with the belief that people can and do recover from even the most serious and long-term mental health issues.
It’s impossible to develop a complete list of recovery characteristics but some of the more commonly identified themes are listed here. Remember recovery is unique and individual so you may not agree with all of these points and that is fine. We all have different worldviews.
Recovery is often described as an active process. This can mean both that people need to feel ready and able to play a part in their recovery. Other people certainly support and encourage that process but people often describe playing an active role in leading their own recovery. Making tools available for people in the process can be very helpful.
Recovery is also commonly described as a journey which can have ups and downs. For some people recovery is less about a destination and more about the process or journey. For this reason some people prefer to describe themselves as being in recovery rather than recovered.
Periods of illness might traditionally have been described as ‘relapse’ or considered as evidence that recovery was ended. Our new understanding of recovery suggests that periods of illness can lead to growth and the development of strengths that contribute to the longer-term aim of a satisfying and fulfilling life in the presence or absence of symptoms.
For some people recovery can be a process of discovery. This means it might be as much about overcoming the losses experienced as a result of becoming unwell and discovering a new and different life. This is different from getting back to the way things were before illness struck which is not always possible.
Many people describe themselves as being in recovery despite continuing to experience symptoms. For some the important thing is about having a different relationship with those symptoms and a greater degree of control.
It is important to clarify at this stage that recovery is not necessarily easy or straightforward. Recovery can be a long-term process which takes strength and commitment. We do though know that recovery is possible and peer workers are uniquely placed to share that hopeful message.
Any definition of recovery runs the risk of not connecting with people’s own unique experience.
It is at best a distillation of many different people’s varied experience. This description was developed by the Scottish Recovery Network and was based on the experiences of a wide group of people who contributed to a narrative research project.
Recovery is being able to live a meaningful and satisfying life, as defined by each person, in the presence or absence of symptoms. It is about having control over and input into your own life. Each individual’s recovery… is a unique and deeply personal process.