R e c o v e r y
Overview
Part I
Background on Recovery
– Is Recovery Possible?
– What is Recovery?
Part II
Part III
Part IV
Part V
Recovery Pathways
A Vision of Transformation;
Creating the Future
Recovery in Practice
Recovery Coaching
R e c o v e r y
Who started the idea of recovery?
• People speak out and write about
recovery experiences
• Research findings support the fact of
recovery
• Vision of recovery described by
rehabilitation educators; Dr. Anthony
– Changes in our historical understanding
– New definitions of diagnosis
– New thinking about chronicity 
R e c o v e r y
Let’s hear from Raymond, whose
story illustrates the points Dr. Anthony
makes about how the system can
contribute to “chronicity.”
Is Recovery Possible?
Study
Size
# Yrs
Outcome
Bleuler (1972). Zurich
208
23
53-68%
Huber (1975). Germany
502
22
57%
Ciompi & Muller (1976).
289
37
53%
Tsuang (1979). Iowa
186
35
62-68%
Harding (1987). Vermont
269
32
62-68%
Ogawa (1987). Japan
140
22.5
57%
DeSisto (1995). Maine
269
35
49%
Harding used “the medical criteria for recovery”: no current signs and symptoms of any
mental illness, no current medications, working, relating well to family and friends,
integrated into the community, and behaving in such a way as to not being able to
detect having ever been hospitalized….” Harding
…but these findings are not new.
The results of Moral Treatment in the 1800s
McLean Hospital
1818- 59% of 732 were discharged as
1830 recovered, much improved, or
improved
Bloomingdale Asylum,
NYC
1821- 60% of 1,841 patients admitted
1844 discharged as “cured or “improved”.
Worcester State Lunatic
Asylum
1833- 80% of those ill less than a year
1840 recovered.
Pennsylvania Hospital
for the Insane
1841- 8,546 admissions. 45% cured and
1882 25% improved on discharge
Worcester study
completed in 1880
1833- 984 discharged patients. 58%
1846 remained well throughout their life.
Robert Whitaker, Mad in America and Gerald Grob, Mad Among Us
Moral Treatment Practitioners….
a value on the person
“I have nowhere met, except in romances, with
fonder husbands, more affectionate parents, more
impassioned lovers, more pure and exalted patriots,
than in the lunatic asylum… A man of sensibility
may go there every day of his life, and witness
scenes of indescribable tenderness to a most
estimable virtue.” 1801. Philippe Pinel. Paris France
R e c o v e r y
Moral Treatment Practitioners….
a value on the person
“If there is any secret in the management of the
insane, it is this: respect them and they will
respect themselves; treat them as reasonable
beings, and they will take every possible pain
to show you that they are such; give them your
confidence, and they will rightly appreciate it,
and rarely abuse it.”
1833. Samuel Woodward, M.D., Worchester Asylum
R e c o v e r y
Moral Treatment Practitioners….
HOPE
“I think it is not too much to assume that
insanity is more curable than any other
disease of equal severity; more likely to
be cured than intermittent fever,
pneumonia, or rheumatism.”
1843. Samuel Woodward, M.D., Worchester Asylum
R e c o v e r y
Moral Treatment Practitioners….
a value on environment
“It should never be forgotten that every object of
interest that is placed in or about a hospital for the
insane, that even every tree that buds, or every
flower that blooms, may contribute in its small
measure to excite a new train of thought, and
perhaps be the first step towards bringing back to
reason, the morbid wanders of the disordered
mind..”
Thomas Kirkbride, M.D. 1841.
Pennsylvania State Hospital
R e c o v e r y
What does RECOVERY mean?
• A common human experience.
• Developing new meaning and
purpose in life. (W. Anthony, 1993).
• Develop and further rebuild
important connections (L. Spaniol)
R e c o v e r y
Our Definition of Recovery
Remembering who you are
and using your strengths to
become all you were meant to be.
R e c o v e r y
Don’t forget
To remember who you are
Where you came from
Where you’ve been thus far
Its so easy for the hard times
To leave scars
When you forget to remember
Who you are
Disappointment
Difficulties
Diagnosis
Disappointment
Difficulties
Disease
Diagnosis
Disappointment
Difficulties
Disabled
Disease
Diagnosis
Disappointment
Difficulties
Disempowered
Disabled
Disease
Diagnosis
Disappointment
Difficulties
Disenfranchised
Disempowered
Disabled
Disease
Diagnosis
Disappointment
Difficulties
Demoralized
Disenfranchised
Disempowered
Disabled
Disease
Diagnosis
Disappointment
Difficulties
Dysfunctional
Demoralized
Disenfranchised
Disempowered
Disabled
Disease
Diagnosis
Disappointment
Difficulties
A person
Assets
A person
Abilities
Assets
A person
Achievements
Abilities
Assets
A person
Authentic
Achievements
Abilities
Assets
A person
Authority
Authentic
Achievements
Abilities
Assets
A person
Autonomous
Authority
Authentic
Achievements
Abilities
Assets
A person
R e c o v e r y
What We Know . . .
• Recovery is an up-and-down process.
• Symptoms may remain, but people still
RECOVER!
• Symptoms are less troublesome and happen less
often.
• Recovery can happen whether or not we still take
medication.
• Recovery does not mean that one did not have a
mental illness.
• Recovery from the consequences of being ill is
often harder than recovering from the illness itself.
What People Recover From.
Lack of opportunities
for Growth
Numerous Losses
Experience of dehumanization and
degradation and spirit breaking
Lack of commitment
from service systems
and politicians
By permission of Dr. Kaly
Low expectation
& lack of hope
from professionals
R e c o v e r y
Recovery Pathways
from our experience
•
•
•
•
•
Hope
Choice
Empowerment
Recovery Culture
Spirituality; meaning and purpose
R e c o v e r y
Recovery Pathway 1: Hope
In the movie “The Beautiful Mind” John
Nash hears what Pat Deegan refers to as “the
prophecy of doom”. Notice how Professor
Nash struggles to hold on to hope, “I can do
this,” in spite of Dr. Rosen’s words,
“schizophrenia is degenerative, over time
you’re getting worse.”
R e c o v e r y
Hope
• Hope is the beginning.
• It’s a thought that things can get better and a
feeling of courage with a spark of new energy.
• Creates a “turning point”.
• Hope means “I can have dreams”.
• A vision of a better future; there are “no limits.”
• Someone else can hold the hope. “And there was
this person”.
HOPE
R e c o v e r y
A person comes to our crisis
service. They are crying,
frightened and filled with despair.
How can you communicate hope?
R e c o v e r y
Recovery Pathway 2: Choice
In the movie “The Beautiful Mind”
this dramatic scene illustrates the
consequences and the fear associated
with not having the choice.
Recovery Pathway 2: Choice
The Old Story
overprotection
abandonment
No choice
•Coercion and force
•No recovery
•Person disappears
•No support
•Hospitalization, jail,
homelessness
•No recovery
•Person disappears
Recovery Pathway 2: Choice
The Recovery Story; Its about Relationship
Relationship
overprotection
abandonment
•Mutual responsibility
•Engagement
•Support/love
•The person reappears
Recovery Pathway 2: Choice
The Recovery Story; Its about Relationship
=
Recovery
abandonment
•Mutual responsibility
•Engagement
•Support/love
•The person reappears
R e c o v e r y
Recovery Pathway 2: Choice
"It is our choices that show what we truly are,
far more than our abilities."
J.K. Rowling (1965 - )
Harry Potter and The Sorcerer's Stone
• “The more I choose, the more I
recover.” (Kristina)
• Because, making choices is how we
remember/discover who we are.
• Recovery value: each person is the
expert in what works for them.
R e c o v e r y
Recovery Pathway 2: Choice
The freedom to choose
and the right to make mistakes
Question:
What about risk?
• Risk sharing not risk management
• Risk prevention plans
• WRAP crisis plan
• Advance Directives
R e c o v e r y
Recovery Pathway 3:
Empowerment
• Resistance is the beginning of getting
power back; finding my voice.
• Resistance fosters Resilience. The person
begins to come back and remember who
they are.
• Recovery is the person’s job; they have to
have the power.
Recovery Pathway 3:
Empowerment
Entitlement
old
belief was
Empowerment
Disability;
being a victim
looking for
someone
to take
The ability
to
care/fix
me.
perform;
to produce the
results I want.
Enlightenment
Ability; discovering my
gifts and strengths
Empowerment corresponds to the level of
personal responsibility and accountability.
Victim
Disempowered
Personal
Responsibility
Responsible
Accountable
0%
Personal
Responsibility
Responsible
Accountable 
0%
100%
30%
Victim
Disempowered
70%
100%
Personal responsibility is a willingness to be the source of the results in your life.
Personal accountability is a willingness to own the results in your life.
R e c o v e r y
Recovery Pathway 4:
Recovery Culture
The belief that “recovery is a fact”
invites us to transform our service
environments and culture.
R e c o v e r y
Recovery Culture
• Create relationship. Provide support.
• Create community. People find a valued
social role.
• Celebrate diversity.
• Maintain a positive level of consciousness.
Map of Consciousness David Hawkins, M.D.,Ph.D.
God-View
Life-View
Power
Force
Self
Is
All-Being
One
Loving
Wise
Merciful
Inspiring
Enabling
Permitting
Indifferent
Vengeful
Denying
Punitive
Disdainful
Perfect
Complete
Benign
Meaningful
Harmonious
Hopeful
Satisfactory
Feasible
Demanding
Antagonistic
Condemning
Vindictive
Despising
Level
Enlightenment
Peace
Joy
Love
Reason
Acceptance
Willingness
Neutrality
Courage
Pride
Anger
Disappointing Desire
Frightening
Fear
Tragic
Grief
Hopeless
Apathy
Evil
Guilt
Miserable
Shame
Death
Log
Emotion
700 + Ineffable
600
540
500
400
350
310
250
200
175
150
125
100
75
50
30
20
0
Process
Pure
Consciousness
Bliss
Serenity
Reverence
Illumination
Understanding
Abstraction
Forgiveness
Optimism
Trust
Affirmation
Scorn
Hate
Craving
Anxiety
Regret
Despair
Blame
Humiliation
Transcendence
Transfiguration
Revelation
+
Intention
Release
Empowerment
Inflation
Aggression
Enslavement
Withdrawal
Despondency
Abdication
Destruction
Elimination
_
R e c o v e r y
In the movie “What About
Bob?” Dr. Marvin’s negative
level of consciousness (anger)
creates disaster. Bob, on the
other hand, experiences joy and
has good fortune.
R e c o v e r y
In the movie “A Beautiful Mind” Professor
Nash gradually recovers from very serious
psychiatric experiences using the level of
“reason”. But what John Nash discovers is
that it wasn’t until he found the power of
love that he had the energy to overcome and
fully recover.
Recovery Pathway 5: Spirituality
• Spiritual expression is not a symptom
of a mental illness
• Connecting within and beyond the self.
• Finding meaning and purpose
• Develop spiritual competence
– Meditation, contemplation, prayer
• Spiritual practices
– Service to others.
– Treating each other with kindness and
respect
R e c o v e r y
Now let’s listen to Pat Deegan
describe the beginning of her
recovery process.
R e c o v e r y
…the best is yet to come!