The Recovery Protocol- Part 1

Introduction
Citizen Psychiatry was formed to represent the unheard survivor voices of adults over my 40-year career in community mental health, who are tired of limping along in life due to poor medication response. This comes after countless drug trials from a psychiatric provider. For those living with long-standing anxiety disorders and chronic depression, ineffective medication response can halt a person’s capacity to believe it is possible to make a personal recovery. Therefore, little effort is made in this regard, sadly leaving people to suspend their lives and dreams.

However, by applying this protocol, people can empower themselves to revoke the suspension of their lives to pursue recovery, which enriches one’s life compared to where it is currently, as in the chapter on The Fable. When recovery is in motion, a “person-led life” can be realized instead of living with the grief of an “illness-led life” (see Break Cycle Chart page). This recovery program allows consumers to partner with their service providers, who would lead this practice during regular “meeting room” appointments. The journey to recovery commences in this relational space, where owning one’s life again can be realized.

The aim of this recovery protocol is not just to build a person’s capacity to weaken the chains of the mental illness hold on one’s life allowing for the individual to transition out of this way of living to an orbit where Person-Centered (led) Living dominates instead of the current, Illness-Centered (led) Living (see What is a Recovery page). Hence, The Illness, whether depression or anxiety disorders, is no longer experienced as the center of one’s life. This protocol accomplishes this by reestablishing oneself at the center of one’s life, which leads to,

a) diminishing the influence of mental illness           
b) weakening the strength of the mental illness
c) loosening the grip of mental illness   

In Citizen Psychiatry, consumers hurting because of inadequate medication returns have long voiced the following question,

“What happens next when medications fail, other than more drug trials?” 

In listening to this consumer constituency, a stream of sentiments has been expressed over decades about living under the reign of poor medication response. Here is a summary of these sentiments,

1. a) I am at my wits’ end. I feel more hopeless than ever before.
2. b) I would rather suffer the symptoms than take these drugs that numb and make my body feel weird.
3. c) I feel like I am languishing with no way out.
4. d) I have gained weight, lost my sexual appetite, and barely had energy due to toxic drug effects
   e) I feel so undervalued by physician providers or psychiatrists when the appointments are primarily about the diagnosis-symptoms-medication-illness management, as if I am the diagnosis that needs fixing. There is more to me than this. I count too.

Such sentiments voiced over time tend to erode an individual’s recovery psychology (recovery mindset) of “Agency” with “Hopefulness”, the core belief set driving a “personal recovery”. Here, the term “recovery psychology” has been defined as,

… representing a belief set forming an attitude that determines the degree to which persons can conceive of having the capacity to make recovery possible by utilizing their personal resources exercised for this purpose.

With poor medication returns, the longer a person cycles in this form of treatment suspension, the greater the erosion of one’s recovery mindset. This impact can piggyback on the internalized stigma of accepting a psychiatric label, making the recovery mindset of the person worse, thus lessening the capacity to feel empowered to pursue a recovery.

Consider this statement from “The Psychiatrist” regarding empowerment in the article: Does the Scientific Evidence Support the Recovery Model? Volume 34, Issue 1, January 2010, pp. 3 – 5,

…People who accept that they have a mental illness may feel driven to conform to an image of incapacity and worthlessness, becoming more socially withdrawn and adopting a disabled role. As a result, their symptoms may persist, and they may become dependent on treatment providers and others…This view is supported by an early study of people with serious mental illness, which found that those who accept that they have a mental illness *(not the label) and have a sense of mastery over their lives *(an internal locus of control) have the best outcomes. However, those who accept the label of mental illness, i.e., *identify with it, tend to have lower self-esteem and an external locus of control, and those who find the mental illness label to be most stigmatizing have the weakest sense of mastery. Thus, internalised stigma undermines the possibility that insight *(accepting the label) will lead to good outcomes. (* This mark denotes inserted text for clarification purposes.)

What “The Recovery Protocol Breakthrough” injects for the first time is a regenerative practice that counters the erosion of an individual’s recovery psychology (recovery mindset) tied to medication failure, especially for those experiencing the label of mental illness as stigmatizing. However, by leveraging the resource capacity of a person, empowerment is cultivated and exercised by,

1) focusing on what is going right in a person’s life
2) bring personal inner and external strengths to the theater of one’s life
3) addressing the hurdles to recovery by diminishing their stress weight and visibility
4) softening and loosening the attachment to the label of the mental illness faced

The program’s regenerative approach contradicts the traditional problem-driven deficit approach of mainstream helping disciplines that asks, “What is wrong that needs fixing?” with asking, “What is going right that empowers?”. With this protocol’s strength-based approach, elevating “Agency” with “Hopefulness” is integral to building a strong recovery mindset, allowing people to move forward in their lives on purpose. When the program is applied, consumers feel visible in the service provider’s meeting room. They can start acknowledging that they, too, are the holders of power to change their illness-led status in their lives to a person-led status rather than defaulting to medications as the only locus of power, psychiatrically, to improve their lives.

What is Recovery?
In short: The term “Personal Recovery” or “Recovery” can be defined as a transformative personal shift in mindset where the individual transitions from “Illness Centered Living,” an unrecovered position, towards “Person-Centered Living,” where the individual, and not the illness, is at the “Helm” of one’s life. (See Terms and Definitions, fuller definition)

With this definition in mind, recovery frees up personal space in a person’s life, resulting from The Illness (mental health conditions) by taking up another orbital position within the person other than at the center of the individual’s life. This transformative transition frees up personal space, whereby the person can regain their center position in their life (see page on What is a Recovery charts). As such, the objective of this recovery protocol is to strengthen an individual’s capacity to take back the central position within themselves, thereby allowing the mental illness (s) to retreat into a low-intensity orbit where its grip, influence, and strength diminishes. This is no different than living with a physical condition like asthma. Either the asthma dominates the center of a person’s life, or the person dominates with asthma in tow, in a strong recovery position. For many people, making a recovery is stress-relieving and liberating, whether medications are involved or not.

For individuals feeling pinned under the weight of their mental illness (depression, anxiety disorders), applying the recovery protocol breathes life into treatment and drives recovery, transforming “psychiatric surviving” to “personal thriving” compared to their present constrictive-labored way of living.

-The quality of one’s recovery mindset or psychology can either hinder or enhance recovery outcomes.

Unlike the “Pill” used in making a psychiatric recovery, a “personal recovery” requires leveraging personal resources, such as skills, abilities, hopes, purposes, talents, interests, passions, roles, and values connected to elevating “Agency” and “Hopefulness” and building back a healthier recovery mindset. This focus produces a regenerative impact on their well-being that enhances an individual’s mental health status.

–Pill taking alone cannot cultivate a recovery when poor medication returns exists.

To date, the chemical route (medications), as the first line of treatment, is leaving people with protracted (without relief) depression and anxiety disorders in a state of “treatment suspension” until a new “Pill” or combination thereof comes on board that is effective. Without building a stronger recovery psychology, the opportunity to shift from living an illness-centered position towards a person-led position, for many, becomes an elusive dream. However, by applying the program, a window in a person’s life can open where recovery can begin to take flight.

– The “Pill” addresses the chemistry of the psychiatric illness and not the psychology of recovery-

Citizen Psychiatry advocates for including a “recovery-first-policy” in the Meeting Room of a provider, acting as a complementary co-partner to treatment. This protocol also applies to psychotherapy treatment, which psychiatric providers turn to as adjunctive therapy to enhance medication responsiveness and for their patients to learn how to cope better with such conditions, as well as from the fallout in their lives. For other non-clinical service providers in mental health, the program can complement and add significant value to enhancing the person’s service goals.  The equation for this formulation can be summed up like this,

For consumers, poor medication response is psychiatrically called “medication resistance.” Unfortunately, people languishing with “medication resistance” tend to find their recovery psychology degrading, over time, the longer the illness condition is in existence. For many consumers, the adverse impact of “medication resistance” tends to produce a sense of powerlessness, worthlessness, hopelessness, and helplessness to effect change in their lives, the opposite of empowering a strong sense of “Agency” with “Hopefulness”.

In the end, many consumers find fault with themselves when experiencing “medication failure” by engaging in self-blame. Even people with a religious core can feel punished by God for feeling unfit and unworthy of a life worth living. The guilt experienced can, in and of itself, suffocate a recovery. What service providers fail to understand is that such feelings can lead individuals in treatment to conceive that they are too complex and broken to treat or recover. Also, feelings of dejection and disappointment connected to the lack of treatment progress with “Pill” swallowing can leave individuals believing that the system is failing them or does not possess the ability to treat them. This is an empowerment destroyer.

The mission of Citizen Psychiatry is to champion the consumer to introduce and implement the recovery program as a practice within The Meeting Room of the provider to complement not just psychiatric or psychotherapy treatment but with other service professionals in mental health in order to put the consumer back in the driver’s seat as a co-partner towards enhancing and living out their best lives.

Continue to The Recovery Protocol Part 2 – Click Here