Thoughts on Recovery
A friend of my recently turned my attention back toward thinking about “Recovery”. Over my 36 years in the Social Services, I have come to realize several things. First of all, it does not much matter WHAT we are recovering from. The term is common in Substance Use Disorder (SUD) treatment, and also used in Mental Health settings. These areas are so entwined that the field is adopting the overarching term of Behavioral Health.
Over the past several years, I have begun to realize that “Recovery” also applies to other situations which we experience. Physical Health for example, also requires a time of “Recovery”. Just as in SUD experiences, a knee replacement requires many, if not all of the same steps, along a similar path,with the same end goal-a return of function.
If I need a knee replacement, that process starts with some sort of pain, issue, or injury which I ignore, tolerate and avoid for years or decades. My knee eventually collapses, and I writhe on the floor in pain. EMS is called, and the Doc at the Emergency Department feels the Rice Krispies, and refers me to an Orthopedic Specialist. Lower power interventions are attempted, The Ortho Doc prescribes Ibuprofen and Tylenol for the pain. Physical Therapy ensues for weeks or months, an Occupational Therapist gives me a brace. Eventually, these interventions often do not succeed, and I then wind up alerting TSA Agents at metal detectors.
The parallel process often happens with SUD/MH/Trauma situations. Things happen gradually, over time, build up and a crisis ensues. That same process above repeats,except we change physical therapy to mental health therapy, and the Occupational Therapist becomes a Psychologist or Case Manager.
The analogy between physical health and mental health breaks down a bit when we reach the point where we cut out the defective body part and replace it. That works well for knees, I admit. Not so much for brains :)
The cycle is Pain/Problem->Years->Tolerate/Adapt->Therapy/Treatment>Resolution, (hopefully). The central point is that first of all, people follow a recovery process, regardless of the cause.
Underlying that is that there is no “Butterfly” moment, where we’re treated over a weekend, a cocoon bursts open, and we are magically fixed. Recovery is a long, step by step process.
As a society, we seem to be more accepting of that process when it relates to a physical cause, such as a hip replacement. We’re good with understanding that if someone takes a saw, cuts out old bone, and replaces that with a titanium part, there will be some needed follow through. Though we have made progress, the expectation for recovery is still different for behavioral health issues.
I believe that the difference may lie in the way that the conditions are seen. A hip replacement is more acute than Addiction, Bipolar Disorder or Schizophrenia. These are more chronic conditions,and they will require longer term or lifetime care.
For what it’s worth, my dream is that we, as a society see and treat Behavioral Health issues the same way that we now treat Diabetes. Not to be too personal, but my Grandmother and my father were both diabetic. They were both fine in the long run, and lived long, full lives. That said,they DID have to take medication daily, check their glucose levels, eat healthy and such.
Nobody ever shamed them because of their “defective” pancreas. People continue to be shamed (and wrongfully shame themselves) because of their “character defects” if the issue is addiction or mental illness.
That is why the recovery process seems to still be different from physical health to behavioral health.
Good Luck and Best Wishes.
