In Chapter 3 of my new book Transforming Pain Into Power: The Story of North Wales Recovery Communities (NWRC), I write about a mental health research project that describes various factors that facilitate recovery. These same factors play an important role in recovery from addiction, and are key factors underlying the successes seen with members of NWRC. Here is that section of my book (pp. 51-53).
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In his fascinating book Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia, Larry Davidson describes qualitative research involving open-ended narrative interviews with 100 people diagnosed with schizophrenia. [1] I briefly summarise here some of the main findings from this important study, since it also provides key insights into the process of recovery from addiction. It should be noted that the recovery movement in the mental health field began in the 1970s, primarily as a civil rights movement.[2]
Davidson describes the most important finding in relation to clinical practice is ‘one that underlies all others’:
‘… recovery requires the active role of the person with the disorder. Recovery, in other words, is something that the person with schizophrenia does, not something that can be done to him or her by others. Love, positive regard, and the support of others are essential to providing a foundation for the person’s efforts at recovery.’ [1, p. 207]
In relation to the latter sentence, people with schizophrenia may feel at times that there is no place for them in the community in which they live. The most effective antidote to these feelings of ‘isolation and estrangement is the care, acceptance, or love of another person.’ Having some place where the person feels that they belong, and they are accepted as a peer, is key to recovery. In fact, Davidson emphasises that the first essential components for a person to recover are gaining a sense of belonging and hope. This means that trust and a strong therapeutic relationship need to be established in a clinical environment, which is often difficult given the hierarchical nature of traditional clinical relationships.
This research showed that knowing that someone else believes in you, particularly when you don’t believe in yourself, is particularly important. Connecting with peers also affords the opportunity for you to care about and help other people, leading to a sense of accomplishment and pleasure. Being in a true reciprocal relationship helps one gain the feeling of being a worthwhile human being. Such opportunities are often not present in hierarchical kinds of relationships.
The research conducted by Davidson and colleagues also revealed the importance of participants being engaged in meaningful, productive, and enjoyable activities which helped them gain a sense of agency. Involvement in such activities, and finding one’s niche in the community, helps one develop a new self (identity) and sense of purpose. In summary, the researchers state:
‘…that most of the work of recovery happens in the person’s life outside of treatment relationships and settings. In addition to belonging and hope, the successes and pleasures the person needs to experience in order to gain a sense of agency are more likely to occur—and to be personally relevant and gratifying when they do occur—as part of intrinsically meaningful activities that take place in natural, community settings.’ [1, p. 203]
References:
[1] Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia, New York University Press, 2003.
[2] Larry Davidson, Jaak Rakfeldt and John Strauss, The Roots of the Recovery Movement in Psychiatry: Lessons Learned, John Wiley & Sons, Ltd, 2010.