Patricia Deegan’s insightful quote differentiates between healing, recovery, and being ‘cured.’ It’s crucial to understand that recovery is a proactive stance, not a cure for illness. Misinterpreting this can lead to damaging consequences. This distinction is particularly important in the mental health field, where support often comes only in moments of acute crisis or at the onset of a significant incident. Yet, it’s those navigating the grey areas of clinical-case management, often overlooked by the system, who are in dire need of our help. These situations should be seen as the real crisis in mental health care.
In discussing mental health, I’ve often used ‘mental health’, ‘mental illness’, and ‘disorder’ interchangeably, aiming to connect with a broad spectrum of beliefs about these conditions. However, precision in language is key, as it shapes our understanding and approach to mental health issues. This hit home for me when I finally read ‘I am Not Sick I Don’t Need Help’ by Xavier Amador, a book my brother gave to my parents during my first psychiatric admission in high school. Avoiding it for years, I feared it would bring back painful memories of that admission. Yet, when I did read it, I found it enlightening, especially in its discussion of how individuals with severe insight loss often cling to an image of themselves before their illness.
Everyone has their limitations, often described as deficits or ‘weaknesses.’ While some may view these terms negatively, they’re an integral part of the human experience. These challenges, though difficult, can illuminate brighter areas of our lives. Amador addresses this ‘brokenness’, especially in those with severe mental health disorders. He acknowledges the struggles that are visible to others and those that are more covert, hidden away from public view.
As a therapist, I often contemplate the balance between aiding clients and avoiding fostering dependency or learned helplessness. It’s a delicate balance, focusing on the broken aspects of their lives that might never fully heal, while also fostering independence and resilience. This involves acknowledging that some goals might be unreachable due to functional impairments, and treatment should focus on enhancing quality of life rather than just symptom management.
There’s a spectrum of functional impairments, ranging from those who can achieve goals with minimal assistance to those whose health is so unstable that they pose a danger to themselves or others. Understanding this spectrum is crucial in providing appropriate care and support.
Treatment should not just focus on managing symptoms, but on strengthening the actual, broken points in a person’s functioning. Why? Because treating the symptom alone is like putting out a house fire without rebuilding the home. Our goal should be to create pathways for individuals to maintain their desired quality of living.
Some people never experience relief from their symptoms, due to chronicity or untreatable impairments. Not every symptom is rooted in a diagnosis; sometimes, flaws in our personalities govern the expression of our limitations. Refocusing treatment to target these weak points in functioning, regardless of the symptom, is crucial. I have seen clinicians and peers dwelling on unresolved and chronic symptoms as if strengthening a person’s weaknesses in functioning wouldn’t help them move forward in their healing.
Let’s be honest about healing. While we can address our impairments, sometimes the wounds or scars don’t close. They need daily ongoing care. Like an emphysema patient on oxygen, sometimes daily maintenance and care is the only way to keep moving forward in healing and recovery. Being honest with yourself about your mental and physical status will go a lot further than waiting for a miracle cure or, even worse, ignoring the problem because it’s unmanageable.
If good health means healing, then feeling better will require us to have better self-management skills moving forward. It isn’t the problem that is the crucial thing to always focus on resolving. It’s the solution. Accepting the solution for what it’s worth will require you to sharpen your self-management skills to live the quality of life you want and choose for yourself.
In conclusion, the journey of healing and recovery in mental health is a complex and multifaceted one. It requires a nuanced understanding of the individual’s needs, challenges, and strengths. As practitioners, our role is to guide and support our clients on this journey, helping them to navigate the broken parts of their existence and to find a path towards a fulfilling and manageable life. This approach not only fosters resilience but also empowers individuals to take an active role in their own recovery process.
Author Info:
Max E. Guttman
Max E. Guttman is the owner of Mindful Living LCSW, PLLC, a private mental health practice in Yonkers, New York.
