An Outsider’s View of Recovery

When I first heard of the “Recovery Model” for mental illness during a hospital stay, I reacted quite angrily. I had been living with Bipolar Disorder I (the more extreme version) for about 26 years. After I was first diagnosed at 19, I went to an honors college while working full time in an Information Technology career. I took two to three classes at a time, sometimes year-round, while living off-campus and paying my way through. I graduated Magna Cum Laude in Computer Science in the Honors College after almost 7 years of study. It was a very long journey while working full time, encompassing the majority of my 20s. With my degree, I advanced in my profession to become a very knowledgeable Senior Database Administrator and Database Architect. With a demanding full-time career after college, I attended seminary part-time in the evenings (an hour drive east at night after work) for three years in pursuit of a Masters of Divinity. Once I decided that degree was not an avenue for me to pursue professionally, I ceased the formal education and started a blog and wrote books, hungrily reading spiritual books all the while. I went to a village eight hours into the interior of Ghana to build two mud brick houses with Habitat for Humanity in 2007. I served as a Stephen Minister (a peer support ministry) and a lay chaplain trained by a mentor chaplain in my church. I went with a group of friends to help a nun in a poor area of Guatemala build cinderblock houses and teach English to the school children. Not long afterwards, I married my sweetheart from that first semester of college when I was diagnosed. We have been married for 8 years and have a four-year-old. 

 

And recently, it all fell apart. It sounds like a lot. You have no idea.

 

I pushed myself so incredibly hard, often far past my limits. While working and paying my way through college, I would nap on the couches in the Student Building between classes and before or after work. I did my homework until late at night. I took the toughest classes: physics, advanced mathematics classes, a rigorous computer science major, a psychology minor, many honors classes in literature (which is a love of mine), especially Native American literature, and other classes on literature from tribal cultures. I read literature from the Maori of New Zeeland, the ancient Nordic and Viking cultures, African cultures, and lots of Native American Literature. Njal’s Saga, The Saga of the Volsungs, Things Fall Apart, The Lone Ranger and Tonto Fistfight in Heaven, Tracks, and all those crazy books from completely different cultures than my own. What moved me forward was just a joy of learning, and the challenge of trying to understand things that were completely outside my experience. At the same time, I was constantly working with my psychiatrist on my medications. A little more antidepressant here, or a little less. Some more mood stabilizer, or switch to another, and on and on, and on. I developed very long-term partnerships with the three successive psychiatrists I have had all these years and we are always working with the meds. Often, I was very tired or strung out from medication changes, especially during those initial periods of two-weeks-to-a-month on a new drug. My moods tended to follow the seasons: depressed—some years hospitalized—in late fall, a tinge hypo-manic in the spring. If we didn’t act fast enough, some years I would need hospitalization by summer. During Winter eleven years ago, I attempted suicide and was hospitalized in an almost catatonic depressive state and underwent bilateral ECT.

 

When the nurse in the hospital suggested the recovery model without explaining it, I reacted. At the time, the entire life I had built was in the process of falling to pieces. She said simply that “recovery from mental illness is possible and many people do it.” She didn’t say what that looked like. I asked her to stay to talk after the class and told her quite sternly, “there is no ‘recovery’ from this: I have been dealing with the regular ups and downs of my illness since I was in my late teens, constantly altering the meds to stay level enough to function well.” I told her that “the neurotransmitter fluctuations are no less demanding than they were at the beginning, and frankly, I have had experiences inside of some of these non-hospital ‘mental health facilities’ that were no less than traumatic.” I could not see how “recovery” from mental illness was realistic. The following is a simplified definition of the recovery model I read on the popular mental health website, verywellmind.com:

[The Recovery Model] is based on two simple premises:

1. 1. It is possible to recover from a mental health condition.
   2. The most effective recovery is patient-directed. [1]

 

The oversimplified definition above is the entirety of the definition I had assumed when I heard the term “recovery” in the hospital. To me, this woman was selling snake oil. And with all I had been through, her comments just plain pissed me off. On the surface, the definition is totally contrary to my own experience and the experience of so many people in my life who live with a serious mental illness. For us, life is a constant ongoing battle just to function and, at times, just to live one more day. Sometimes I have to make it through a tough night to see the sun rise just one more time because I have a wife and four-year-old depending on me to make it through. That amount of desperation—just eking out one more day of life at a time—has been a far too familiar occurrence over the years during the downturns. But my reaction was not because the recovery model was flawed. My reaction was a result of hearing the word “recovery” without any context and no explanation. Recently, I searched the Journal of World Psychiatry and NAMI websites looking for a fuller definition. I discovered one fundamental pillar of the model that speaks to me. In the Journal of World Psychiatry, recovery is seen as a “process aimed to attain a fulfilled and valued life by building on the functions spared by the illness, in spite of the fact that other functions have been impaired.” [2]

 

I know that my moods will likely always have a tendency to wax and wane over the seasons. And my memory can be “mood-congruent,” especially when I am unstable: things I strongly believe when I am in a similar place psychologically come to the forefront. And I have a tendency towards black-and-white thinking. (Humans, by design, have this tendency in order for the brain to sift and categorize the massive amounts of input we receive.) And I have the tendency to make assumptions about others by projecting my own world view, filters, history, and thoughts onto them. (This is also something all humans do to a greater or lesser extent.) In the 1930s, two psychoanalysts developed the Thematic Apperception Test. It showed that people, including “healthy” individuals, project internal things onto pictures of other people 100 percent of the time. I, myself, often see people doing it to others. And I have to catch myself when I do it too. But all of these things are much more acute and affect my daily functioning when I cannot get lots of time for my outlets and coping skills. I need time to reflect, to write, to get enough sleep, to listen to my music (very important), to get some sort of exercise (usually by doing yard work, housework, or work on my car), and, most importantly, to have periods of ever-so-precious “wasted time” to rest and allow my mind to wander. It is intentional solitude with the aim of letting my brain rejuvenate. During this “wasted time,” I think executively about decisions, the direction for my life, and my priorities (short and long-term). And, though I tend to only have only a few close friendships at a time, I need to have some sort of meaningful relationships. When these things are in place, I generally live much more in peace. Without them, my life can be like living in a constant hurricane of fear and intense emotions, especially if the meds aren’t quite right at the time.

 

But I have always had an anxious-avoidant attachment style. How could I compensate for my resulting social anxiety? Specifically, in the absence of any overt acceptance or compliments, how could I keep myself from jumping right to a line of thinking that leads to a belief that, “this person, or worse, this group of people, thought [this negative thought about my character]?”

 

I am learning a lot by watching the School of Life videos on YouTube. My counselor has a PhD in psychoanalysis and a master’s of divinity and also seems to have a wide breadth of knowledge about history, literature, and philosophy. He got me interested in these videos. Specifically, I have learned that all humans, by design, are a hopeless mess, whether they are “mentally healthy” or not. And what others think of me, especially those who do not know me well, is much more a reflection on them than me. Because to be more or less “a mess” is the human condition. That realization itself has made my life much, much less stressful. And, converse to what I would expect, it seems to have made me more approachable and relaxed around others. Knowing that we humans are all “insane” in our own ways takes a great deal of the pressure off of me.

 

The NAMI Metro-Oakland, Wayne, & Macomb Counties (NAMI Metro) website also lays out a more holistic, and what seems to me, a much more realistic definition of recovery than the one I had assumed back in the hospital. I lifted a couple things from it that spoke to me. The first thing that stood out is:

 

Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery. [3]

 

This was a new thought to me. I have never considered the possibility that I could compensate, or get any more stable. I have never thought that things—that life—could get better. I felt I was at the will of the neurotransmitters as they responded to the seasons. I thought that the lack of people my age in the hospital was proof of my own disheartening belief that many of us just don’t live all that long. Up until this point in my life, most of my writing about my illness has been more about how those who suffer with it usually have developed some special qualities, perspectives, and abilities that we might lack if we hadn’t had to endure our illnesses. And I know we do. We have to. But what if there’s more than that? What if there is hope for a life that just isn’t so damn hard?

 

When I read it, something else stood out in the NAMI Metro definition of recovery. It corroborated the World Psychiatry article. It says,

 

Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). The process of recovery moves forward through interaction with others in supportive, trust-based relationships.

 

At this particular point in my life, I have had to reconsider unhealthy relationships as well as the direction of my career. Those things are yet to be determined. And both are very scary and all wrapped up with my identity. My four-year-old daughter loves David Bowie (especially his songs Heroes and Space Oddity), so we read a child’s biography book on him. The major theme throughout his life was one of constantly re-inventing himself. It sounds so good on paper. But I will tell you from my experience that it is a frightening, ungluing, and disorienting process to go through before there is a good outcome. People often refer to it as having a “breakdown,” and that is an apt word for it. Tolstoy and Dostoyevsky have been there for sure, and I have heard or read it from several sources, including their biographers, modern philosophers, spiritual writers, and from such writers as Virginia Wolfe, some variation on the belief that the two of them wrote novels whose complex characters contained more wisdom on the human condition than just about all the psychology and self-help books out there. These “reinventing” periods in my life consist of putting one foot in front of the other, observing the results, (sometimes having an argument with God), recovering, listening, and then taking another step in the same direction, or turning and altering my trajectory.

 

The last paragraph of the NAMI Metro recovery model webpage mentions “hope,” which I have never really fostered consciously for myself. But it seems that I had some sort of blind hope that I could do anything I set my mind to. I think I demonstrated this in my life by repeatedly getting back up after a ninth-round knockout: over and over again, year after year. I think the “hope” I unwittingly fostered is probably a great deal do to my unorthodox, Abrahamic-rooted spirituality. The last paragraph in the NAMI Metro article says,

 

Recovery provides the essential and motivating message of a better future – that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process. Mental health recovery not only benefits individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in our society, but also enriches the texture of American community life. America reaps the benefits of the contributions individuals with mental disabilities can make, ultimately becoming a stronger and healthier Nation.

 

In my case, my hope was, “with a little help and some support from my family and friends, a loyal mutt, and the right meds, I can do [whatever it was I wanted to accomplish].” But I will tell you that, for me, hope comes and goes. Yet the last paragraph in the NAMI Metro definition presents something much, much deeper that I have believed ever since I seriously studied literature in college and scripture in seminary. Throughout the long history of humankind, all over the world, people with mental illness (though we only call it that in modernity) have shaped history. I think that if one were to strike out all the writers who had “breakdowns” or mental health issues, humanity would scarcely have any written history. It is very striking when one delves into the lives of those who have left behind an indelible footprint on history. So many of the ancient writers, poets, prophets, musicians, artists, philosophers, mathematicians, scientists, saints, medicine men, tribal leaders, world leaders, and so many of the “helpers” who have come and gone in peoples’ lives (sometimes almost mysteriously) have made huge contributions to societies all over the world for all of recorded human history. In addition, I think that sometimes these “helpers” do so almost unnoticed, just by helping and influencing one other person in a chain. Because, in a lot of cases, what we have endured and learned in our own experiences gives us a gift of understanding and empathy that can be used to help others. I believe that learning from our trials can bestow a particular wisdom over time that can redeem what we’ve gone through when it helps those around us. Redemption of our faults, failures, and, especially, our trials, happens when something good comes out of them. And, for me, this feature of learning from my experiences to help others is a large part of the reason I am still here. I can look back on my life and see a purpose, a reason for my existence, and an unseen loving hand guiding me at crucial points.