Our Sponsors are an important foundation of our online community. Please visit their websites.
Our Associate Sponsors provide valuable support to our community and help build 'The Wall'.
Our partners help move the Wired In agenda forward.
Join our community, create your own profile page, and communicate about what matters to you.
I am reading another excellent book at the moment, A Practical Guide to Recovery-Oriented Practice by Larry Davidson and colleagues. Davidson has been a leading researcher at the forefront of the metal health recovery movement almost since it began.
In their book, Davidson and colleagues describe nine components of being in recovery from mental illness. I outlined the first three components in my last blog:
I now describe the next three components keeping close to Davidson’s description, but referring explicitly to addiction and serious substance use problems when necessary:
4. Redefining self or changing one’s identity
The redefining of oneself, or changing one’s identity, is maybe one of the most essential and overarching aspects of recovery.
Through the development of a serious substance use problem, becoming part of a culture of addiction and experiencing social consequences of their addiction (including prejudice), a person assumes the role and identity of an addict or a person with a serious substance use problem. Their original identity becomes ‘spoiled’.
The process of recovery involves the person recognising this spoiled identity, and developing either the old identity or a new identity, or definition of ‘self’. This identity may contain a constricted role of ‘addict’ (as a part of the new identity), or contain no remnants at all of this aspect of self.
5. Incorporating illness
Incorporating illness into one’s identity and into one’s everyday life refers to the person’s active role in understanding his experiences as a person with a serious substance use problem and finding adaptive ways to assimilate this understanding into his or her everyday life.
The person recognises that they need to develop ways of preventing relapse and resuming substance use, which might involve cognitive and behavioural changes, and learning to deal with their own emotions.
To promote the process of incorporating illness, a recovery-oriented system will work toward creating a more welcoming and healing environment in which people can acknowledge their difficulties and be educated about their substance use problems without losing their status, value or identity.
This education can be provided by people who have recovered from serious substance use problems, or by professionals.
Recovery-oriented systems will invest in educating the general public about addiction and recovery, dealing with the need for timely effective care and support. The person’s loved ones will then have a better understanding of the problem and the choices that they have in helping the person overcome their problem.
A person need not accept a particular framework or conceptual model of addiction (e.g. a biological disease) in order to be in recovery.
The most critical thing is that the person finds a way of understanding what has happened to them. It must make sense to the person and offer the possibility of actively moving forward and rebuilding their life.
6. Managing symptoms
In this model of recovery from mental illness, it is explicitly acknowledged both that compete remission is unnecessary to be in recovery and that most people also find it necessary to gain some degree of control of their symptoms.
In relation to the addiction field, this definition implies that a person may not need to abstinent from all substances to be in recovery [this statement has a variety of implications which I will not go into here]. This definition allow for medically-assisted recovery, such as the use of prescription methadone to recover from heroin addiction.
The way that people overcome their symptoms – which is not just the ingesting, but also the desiring, of substances – does not seem to be as important as the fact they do. The way they overcome their symptoms may involve peer support, psychotherapy, medication, education, and/or alternative methods of healing and self-help.
With all these options, being in recovery involves actively using treatment and support services, or other resources, rather than being a passive recipient of care provided by others.
A recovery-oriented system of care will recognise that there are a multitude of ways that people can recover from a serious substance use problem – each person’s recovery is unique. The system will offer education about and access to a variety of methods of help, from which people can chose those that will work best for them.
People in recovery and their loved ones have the most intimate knowledge of what is effective in helping them manage their problems. Therefore, a recovery-oriented system will provide ample opportunities for, and actively seek input from, people in recovery and their family members.
(To be continued)
O Dave, stop it, your teasing me! ha ha, sorry others who are reading this just to let you know I have orded book to read, the more I read of Davids blog the more I can’t wait to receive my book.
A week today they say it will arrive, Yuppe! can’t help this little humour everyone, I am a addict and want the book NOW, a quick fix, patiences is a virtue. I will just have to wait. Thanks for blog for all to read Dave.
Best Wishes to you and all.
I find the identity component of this really interesting as I was involved in a discussion with this with friends last weekend.
Although alcohol had a negative impact on my life in so many ways, the simple fact that it is not illegal allowed me to participate much more as a member of mainstream society than those with a drug habit.
In turn this seems to have made it easier for me to rebuild my identity and to ‘fit back in’. I am not saying this is true for everyone of course but it is food for thought.
A close friend has found it much harder to work out who she is with all the baggage that being part of a drug subculture in the past involves. It seems as though the whole illegality thing – and all that goes with it – represents an added barrier to working out who you are as a clean person.
I have no answers here, I suppose it just reiterates for me that recovery can never be one size fits all and that diversity of approach is what it is all about.
The new identity concept is interesting to me for various reasons. Even a small thing like changing my vocabulary in early recovery from being a victim of … to a survivor of,…. I am sure had a huge impact on how i felt about my self.
Letting go of ideas about how i felt about myself when i used, was made easier because of simple thing like words and gaining a new perspective on what they meant.
Also letting go of of old ideas about what my life was or was meant to be… and re-framing it along the lines of anything .. ANYTHING was possible instilled a sense of hope.
On reflection I believe i was given the opportunity to find the hero within, through this new understanding of words…. and to an extent creating my own “hero”(for want of a better word) narrative. It is the ongoing shifts in this narrative of my own life and those of others in recovery that never ceases to amaze me and could not in my wildest dreams have envisioned even half of it.
good stuff David and look forward to more. x
Great Dave, the concepy of Self and finding a new identity is of extreme importance……..when I came into recovery I realised I had to let go of the image I had of ‘self’ in many ways… infact it is entirely this point which made me realise something had changed, I could not live with me anymore.
Don’t we play many parts in our addiction, I did, all of these parts protect us, from many things we believe, weakness, keep us from harm and protect us from others and going mad altogether. Before alcohol\drugs and the image I had on the street …I was scared frightened, nervous, anxious and a host more, I saw me as weak so I built an identity of self to cope with that.
Isn’t this what keeps us out there, we could not live in this fear but we couldn’t carry on living in addiction and at some point the latter became more territying than the former.
Our concept of self then has to change a ‘psychic change’ if you want. I cannot speak for others but I can speak for me, at this point I knew if I behaved like the drug and alcohol using me and even though I did not want to use alcohol and drugs, I would. It would set me of an automatic pattern of behaviour that would result in me using. The self that I identified with was setting me up for failure a sit had done many times before.
This meant I had to sit with the frightened little me, I still didn’t like the frightened little me but what choice did I have……….. I didn’t want to use, I wanted too change.
Yes, I recognised a frightened young boy but I had no idea who he was anymore. Whilst that was even more fear! in a way it was still a relief. I could also see that I was more than the horride person I thought I was, I did care and that was a relief.
My dual personalities and I had a few….not in a mental health sense but in the roles I played to survive, or stay ontop of things had to go.
This meant I was to a great degree left with a blank canvass but I had to now become responsible for the things I done whilst creating this new canvass.
I find if I take care of the details on the canvass I am happy generally happy with the picture itself.
Thanks Dave
