We Are

I write this having been inspired by attending the History of Mental Health conference at Leeds Trinity University earlier this week.  This was a joint venture between the British Psychological Society’s History/Philosophy of Psychology Section and the Critical Psychiatry Network.  If you know me or have followed my views in this blog, you’ll be aware that this is right up my street!  The observant among you will notice it’s been a wee while since I’ve posted here - aside from being busy with uni work, I’ve also been writing a few bits for OMQ Fitness & Wellness magazine - so this was the perfect prompt for me to add some fresh material.  I hope you find it a good read.

A key theme over the two day conference was that of the epistemology of mental health: What constitutes knowledge?  Where and whom does it come from?  How is it developed?  Who decides which knowledge is good or best or right?  Given the theme of the event, a large proportion of the delegates would argue that too much credence is given to the knowledge of ‘experts by training’ (psychiatrists and so forth) and not enough to ‘experts by experience’ (those who have experienced mental health difficulties and their relatives & friends).  A very balanced view was given by keynote speaker Gail Hornstein, who suggested no type of knowledge or expertise is superior, but that the two need to become more integrated and be used together, not separately, to best support people’s mental wellbeing.

This notion of separation and fragmentation was another theme that cropped up a lot in my mind over the course of the two days.  Fragmentation between those ‘with’ and ‘without’ mental health problems; between ‘experts’ and ‘patients’; between the ethos of recovery and the obsession with quantitative evidence that underpins funding for services and research; between people’s actual experience of distress and psychiatry’s explanation for it.  I strongly believe that if we can build a more unified, inclusive approach, we can in turn build a stronger mental health system and ultimately a heathier, happier, more productive society.  

To illustrate my thoughts, I first cast my mind back a fair few years, to when I read The Psychopath Test by Jon Ronson.  In hindsight, this was probably my very first taste of critical psychiatry.  I was struck by Ronson’s statement that he had been able to diagnose himself with about 6 ‘mental disorders’ by reading the DSM.  As far as I can remember, I didn’t do a great deal of thinking about this fact at the time, but some years on I’ve become a lot more familiar with this field, and my professional interests have become somewhat consumed with addressing the over-pathologisation (yep, I think I made a new word up) of human experience and mental distress.

One of my favourite things about the conference was a section that encompassed accounts of mental distress from a range of sources.  A key message was that psychiatry’s depictions of and explanations for mental ‘illnesses’ are often very different from those that the individual can make sense of themselves.  Related to this, another key point was that making sense of distress is a process that can take many years, and sticking alabel on it therefore simply doesn’t work (at least not for the labelled individual, or indeed their loved ones).  A third key theme was the need to consider mental distress on a case by case basis, because each occurrence of it is as unique as each person who experiences it.  Putting someone in a category based on your perceptions of their experience isn’t conducive to helping them recover, whereas supporting them to understand their unique experience is. 

To further illustrate my thoughts, I turn to the words of Caitlin Jenkins, who at the event presented her research on service users’ experiences of psychiatric diagnosis, along with snippets of her own experience (she herself has received more than her share of psychiatric diagnoses and treatments over the years).  She noted there is a danger of seeing a person as a series of notes, rather than as a person.  One of her participants spoke of how a diagnosis gives rise to a particular treatment; if that treatment doesn’t work, another diagnosis is given, and so on.  This resonates with my own concerns that psychiatry arbitrarily tries to fit people into boxes in a way that doesn’t facilitate true insight into their experience or therefore how to help them.  This got me thinking about something that’s crossed my mind on occasions before: what would a psychiatrist have to say about me if they had the chance to observe my life or conduct an assessment on me?  I have a few ideas as to how this might go, and present them here with alternative explanations from my own viewpoint.

Lauren’s mood has been variable over the last two weeks; she moves between being bright in mood and full of energy to being low and withdrawn, sometimes within a single day.  These mood swings do not appear to be related to any particular events but happen spontaneously.  At time of writing, Lauren is experiencing a depressive episode; she is staying at home more regularly than usual and neglecting to partake in all of her usual activities.  Previous to this she was showing signs of mild mania; her lifestyle was somewhat chaotic and she presented as being obsessed with completing as many different activities as possible within each day.

I often experience ups and downs in mood, sometimes to a greater extent than others, but see that as a normal part of human experience and manage it accordingly.  Sometimes I do feel like my changes in mood are happening for no particular reason, but I can usually identify the causes in hindsight if not at the time. I’m quite self-aware as I practice mindfulness, so can usually recognise my mood changes quite quickly and look after myself well to keep on top of this.  Over the last couple of years I’ve had ups and downs with my physical health, which I seem to be getting better at managing.  I thrive on being really busy and active and have realised that I tend to feel healthier physically as well as mentally when I keep this up, so when I feel good I make the most of it by doing as much as possible.  I’m really ambitious so not one to waste time!  However, it’s really important to recognise when I need to take things down a notch.  I recently had a spell of feeling poorly for a few days and responded to my body telling me to take it east by having a rest week.  This meant I did gentle exercise rather than my usual intense, structured training, and spent the rest of my free time relaxing at home.  After a few days of this I felt much better and more myself.

Lauren has been persistently non-concordant with her medication.  She expresses paranoia and delusions that it will be harmful to her and do no good, and that the whole mental health system is one big conspiracy.  Lauren becomes highly argumentative when staff attempt to explain the benefits of her treatment and why she needs it.

I have no desire to take brain-altering drugs that will cause a multitude of unpleasant and potentially harmful effects.  Ultimately, we don’t really understand exactly how these drugs work and what their effects are on the body long-term.  There is no real difference between these drugs and illicit ones, except that psychiatric meds have been packaged and marketed in a way that implies they will fix some sort of problem or deficit, rather than as psychoactive substances (which they are).  Because I feel so strongly about this, any discussion about psychiatric meds is likely to end up quite heated; not least if someone is trying to get me to take them! 

Lauren has been very low in mood and withdrawn today.  She has refused to spend time with others and spent a lot of time isolating herself in her room, doing nothing.

I meditated a lot today, which made me feel very peaceful and at one with myself and the world.

From my experience working in a psychiatric hospital, I genuinely believe that my fictional patient notes above are quite a realistic representation of what might be written about me if I were unfortunate enough to be subjected to this.  The problem is that once you’re in a mental health service, the system seems to be hell-bent on giving you a diagnosis, and this is really difficult to shake.  In Caitlin’s research I mentioned above, one participant noted how a diagnosis is given, which gives rise to a particular type of medical treatment, and when it doesn’t work, another diagnosis is applied, along with a change in medication, and so on.  This resonates with me from my experience working in mental health, where new diagnoses and medication combinations appear to be flung around in a sometimes arbitrary, trial-and-error type of manner.  In my fictional situation above, I can see how my diagnosis might have changed to try and fit my presentation at each time, perhaps from bipolar disorder to paranoid schizophrenia to major depression, and no doubt over a number of years of ‘failed’ attempts at treatment and defiance of the system probably ultimately some sort of ‘personality disorder’.

I’ve talked before about how I feel that my determination to take good care of myself has really helped me to stay mentally well.  When I feel things are not going so well, I take the time to understand why this is and work out a way of remedying this.  I am very fortunate that I have always been able to do this with just myself and my friends & family for support, but I am all too aware of the many people who need extra support from mental health services to get well.  Unfortunately, the approach to mental health that has developed over the years jumps straight to medical solutions, with room to explore and work through distress being reserved for the lucky few that are able to access such services, or a kind of bolt-on to medical treatment.  At the conference that prompted me to write this post, I was inspired by the story of a mum who had seen her son go through acute psychosis, which she and he were helped through by support from SoteriaBradford.  He had been prescribed a variety of antipsychotics, none of which had relieved his distress, and the thing that really started to help him was a therapeutic approach called Open Dialogue, which he and his mum engaged with as a family.  This is a long process that requires concerted effort from therapist, patient and their families, but by engaging with this process they were able to identify factors that had contributed to his declining mental health, which ultimately supported him to come through the psychosis.  As a family they recognise that this may return at some stage but are confident that by accepting it and working with it rather than trying to force it to be silenced pharmaceutically, they can cope when this occurs.  Interestingly, there was no major trauma leading to his illness, but a culmination of elements of life and how he perceived them that took their toll. 

The point I’m really trying to make here, and the reason for the title of this post, is that, simply, we are all human, and could do well to remember that more often.  In her talk at the History of Mental Health conference, Gail Hornstein talked of how we’re always placing ourselves and others into categories – patient or professional, expert by experience or expert by training, those needing support or those offering it.  In reality we all have various roles and identities we fulfil and usually sit on a spectrum or fit within multiple categories simultaneously – if we can embrace this, perhaps we can achieve more than we would’ve done otherwise – for instance, Peer Support has become quite buzzword in the mental health arena, yet it is a term reserved for a relationship between patients and other patients.  Why not apply peer support to the staff too?  Surely they need support as much as those they seek to help, both in terms of professional development and looking after their own wellbeing?  And, indeed, to return to my original point about epistemology (where does knowledge come from?), professionals could do well to accept that patients may be able to help them too, and offer knowledge about their condition that no diagnostic label could ever hope to shed light on.

Patient-centredness is supposed to be at the heart of mental healthcare these days, yet still so many people within services don’t feel listened to or supported effectively.  As an example, those wanting to prioritise losing weight or giving up smoking are often told “let’s get your mental health sorted first”, rather than trusting that this person intuitively knows what they need and may see improvements in their mental health as a result of working on their own personal goals.  Using this innate personal knowledge in conjunction with, rather than in opposition to, the knowledge of healthcare professionals, could be a powerful tool in helping people to recover and master their own wellness in a holistic way.  An anecdote from my own work comes to mind here: I work as a Wellness Coach, supporting people to make lifestyle changes around weight management, physical activity, smoking and alcohol.  We recently had a client who the staff member that initially spoke to believed needed intensive mental health support, as he reported having used such services extensively in the past.  On speaking with this person myself and exploring in more depth what their priorities were, it turned out they felt getting more active was exactly what they needed in order to improve both their physical health and mental state.  This sits perfectly within my remit as a coach, whereas others might have pointed him in the direction of a mental health service, not fully understanding what it was that he wanted to achieve.  After a few weeks of working with him on some basic goal setting and action planning, he was feeling much more positive, in control and ready to move on with this healthier new lifestyle without ongoing support.

I could talk about this forever, but I’m aware that I’ve already gone on a bit and may be pushing my luck in terms of keeping or losing your attention!  If you’ve read this far then thanks for persevering.  I just want to end by emphasising my message that being human is a powerful thing, and I believe that by nurturing this fact – by always bearing in mind that ourselves and others are, simply, human, and relating to ourselves and each other as such (rather than as categories, diagnoses and so on), then we can cultivate recovery, wellness, happiness and achievement of our potential.  This can be far more powerful than what can be achieved by constantly striving for the perfect labels to separate ourselves off into various boxes.  We are human, we can grow and develop by understanding ourselves and being understood by others, we do have the capacity to recover and heal from trauma, and we will build a happier and healthier society by nurturing these qualities of humanity.

Angel With A Shotgun

I want to start by acknowledging the emotive and controversial nature of some of my recent postings, both here and via Facebook/Twitter.  I have attracted some criticism and resistance, which I fully expect as it goes hand in hand with having strong and somewhat less-than-conventional views & opinions.  It is true that I sometimes speak in extremes, present things as more black & white than they really are, and make bold statements.  This is because I so strongly feel there are things that need to change radically, and this won’t happen if the status quo isn’t challenged fervently and compellingly.  This is why I write in an emotive and zealous style: my aim is to inspire positive change and innovation, or at least persuade people to think a little differently about certain things. 

The result recently has been what might best be described as an attack on psychiatry in my writing, elements of which may come across as vindictive (or indeed false) to some readers.  I accept this fully, but have no real qualms in light of what I’ve just explained.  I will listen to anyone who has something to say on the matters I write about, which is why I’m always so keen to invite comments on my posts!  I know there are many different perspectives on the things I discuss, and that it would be possible to present more balanced accounts than the ones I offer.  This is not least because the very issues I am passionate about are particularly complex and sensitive ones. 

Most poignantly, I have recently experienced criticism for making the bold claim that, essentially, there is no such thing as mental illness.  I realise now it was unwise to make such a statement in isolation as there is a hell of a lot behind it and it sounds incredibly insensitive (This said, all it takes is a look at a text such as The Myth of Mental Illness by Thomas Szasz or Cracked: Why Psychiatry is Doing More Harm Than Good by James Davies to see where this point comes from).  The post in question was a Tweet reading: “So... If #mentalillness was actually a thing, it wouldn't be called 'mental illness'.  It would just be called 'illness'... #foodforthought”.  The abruptness of this claim was mainly because of Twitter’s less-than-generous character limit for Tweets, but also partially because I indeed intended to make a bit of an unconventional statement to get people thinking. 

What I have to stress, first and foremost, is that this does not mean I don’t see mental health as important, or believe that people in mental distress are in desperate need of help, or that their difficulties aren’t genuine; in fact, these things could not be more opposite from the truth.  I simply see mental health in a different light to the conventional medical one, which unfortunately results in a bit of alienation from my field of work, since the accepted approach is largely medical.  I advocate non-medical approaches, which are seen as dangerous and unsupported by evidence by some of my colleagues.

I have to say that I absolutely, whole-heartedly support the notion of evidence based practice.  Who wouldn’t?  To base care on knowledge of what does and does not work is the obvious way forward.  However, inasmuch as one might criticise ignorance of elements of the evidence base, it is equally negligent to take such evidence at face value.  We should be especially concerned with the presence of ‘publication bias’, which is more prominent in some fields than others, psychiatry and pharmacology included.  Publication bias occurs when those who review a research paper for publication may be keen for a positive result to make the journal more readable, or prefer papers that match their own views & findings, and so on.  It also occurs when researches manipulate their data or change their original research protocol retrospectively to make their hypothesis supported, when their original tests did not achieve this.  

 

There is considerable evidence for the existence of publication bias and this has been shown, for instance, to inflate the efficacy of psychiatric drugs and diminish  their harmful effects.  It has also led to evidence of completely non-medical and very successful approaches to psychosis being hidden.  In case you’re interested, I am taking my facts here from peer-reviewed sources!

If we couple this with the incredibly unscientific basis upon which the diagnostic criteria for mental illness are put together, we have two of the key reasons I largely reject the biomedical model of mental illness.  This post isn’t the place to go into detail about diagnosis (see my post Freedom, and more to come in the future), but I’ll say this small piece for context:  Whereas physical illnesses are discovered by the presence of some sort of physical marker, for the vast, vast majority of mental illnesses, such physical markers are absent and the diagnostic criteria declared by psychiatrists, albeit based on well-founded patterns observed in behaviour, etc. 

The above is why I suggest ‘mental illness is not really a thing’.  As soon as a clear-cut biological cause is discovered for a mental illness, it becomes a physical illness.  In other cases, the ‘illness’ gest removed from the repertoire of psychiatry (homosexuality as a prime example).  Hence, there is no need for the distinction.  Mental distress is a different thing to illness.  It is caused by a combination of many things, such as trauma, environment, socio-economic factors, and perhaps elements of biology.  But the lack of distinct biological markers makes mental illness clearly separate from physical illness. 

For these reasons, I feel psychiatry has gone too far in its medicalisation of mental distress, which is why I am fighting hard for a move towards less medical approaches.  I do not see it as any less important to support and help people with mental health difficulties than any of my colleagues do.  In fact, it couldn’t be more important to me.  Allow me to use some lyrics to illustrate:

They say before you start a war

You’d better know what you’re fighting for

…

I’m an angel with a shotgun

Fighting till the war’s won

I don’t care if Heaven won’t take me back

…

Sometimes to win

You’ve got to sin

Don’t mean I’m not a believer

My motives and intentions are good and pure; I know what I’m fighting for and I know it’s right.  Why would I open myself to criticism, even the possibility of resentment, from people I admire, like and respect if this weren’t the case?  It’s tough, even heart-breaking, to experience this, but I cannot be acquiescent; I absolutely have to do all I can to make things better.  This means perhaps sinning against my own profession, but I do this in the knowledge that what I’m doing is good… a bit like an angel with a shotgun! (Except I’m not big-headed enough to describe myself as an angel!)

It is difficult to explain all this in a way that’s concise and means people will get where I’m coming from, but I hope I’ve gone some way to making my position and the motives behind my actions clear.  I would love to hear from you whether you agree with my outlook or not, and look forward to lots of productive work, debates and discussions with colleagues, friends and new acquaintances in the coming months and years.

What is Recovery?

Recovery in the context of mental health is one of my biggest passions.  I noted in a previous post (link below) how pleased I was that the NHS Trust I work for is increasingly implementing recovery-focussed approaches into practice.  Whilst this is a step in the right direction, it is my contention, particularly in light of recent reading, that it is not enough.  The crux of what leads me to believe this lies with a simple question: what is recovery?  The extent to which services, interventions, etc. are deemed to be conducive to recovery will inevitably vary depending on how you answer this question, and I posit that the generally accepted definition of recovery is somewhat different to the one I subscribe to.  As a result, in some cases, ‘recovery’ interventions may be damaging in certain ways, if helpful in others.  I’ll explain why…

I have been fortunate in recent months to come into contact with a lovely lady by the name Marion Aslan, founder and director of charity Elemental Wellbeing, who has become a great source of influence and inspiration for me.  In The Art of Thriving: Beyond Recovery, Marion addresses the issues of defining and implementing recovery in great depth.  Here, I will synthesise some important points made in the book with my own judgements and observations, in order to illustrate my concerns over the credibility and efficacy of recovery approaches within mental health services.

Many readers are likely to disagree with and even be offended by some of the things I say here, and many will probably see some of my views as quite cynical.  I will start on a positive note, which is that I believe everyone has the propensity to recover from what society calls mental illness.  I use that phrase because I personally prefer the term distress and have recently learnt a lot about what my friend Marion terms “the politics of madness and the psychiatric deception”.  I have touched on this in previous posts and will do more of the same later, but in a nutshell - and I know this is a very bold statement - knowing the facts leads me to view mental illness essentially as something that is defined, constructed, created and perpetuated by psychiatry.  With this in mind, here is a quote from Marion’s book:

“[Psychiatry] contains madness by seeing symptoms of illness rather than consequences of distress and ‘treating’ these so-called symptoms in a superficial way.  Instead of working with distress and allowing the individual to flourish, they are often maintained.  If this were not true why do so many people remain in the system for years, the same problems that brought them to psychiatry continuing to hinder their growth and independence?  Workers…talk about ‘revolving door clients’ as if it were the fault of the individual…rather than any inherent failing within the system.”

In other words, rather than helping people to become better, services are often perpetuating problems by taking a closed-minded, reductionist medical approach.  As such, the introduction of recovery approaches – in my experience, largely in the form of peer support workers and recovery education – is refreshing and encouraging.  The question is, are these approaches really facilitating recovery?  To continue addressing this question, let me go back to the topic of defining recovery.

The NHS confederation notes three key principles in recovery, as highlighted by mental health service users.  These are:

• the continuing presence of hope that it is possible to pursue one’s personal goals and ambitions
• the need to maintain a sense of control over one’s life and one’s symptoms
• the importance of having the opportunity to build a life beyond illness

This all sounds good to me, but unfortunately, in practice, it’s not really happening like that.  Somewhat paradoxically, the very same web page the above was taken from also defines recovery as “ the process through which people find ways of living meaningful lives with or without ongoing symptoms of their condition”.  The problem, to me, lies in the concept of living with symptoms of an ongoing condition, although I am encouraged by the addition of the term ‘or without’.   


It seems to me, from experience, that the assumption by most is that recovery is about managing a condition, maintaining a certain level of functioning, avoiding crisis, but continuing to suffer symptoms of some chronic condition.  Since such ‘symptoms’ are simply elements of human experience (that cause varying degrees of distress) that have been medicalised and categorised into illnesses by psychiatry, this is quite frustrating. 



Onto a positive note: people can and do recover from mental ‘illness’.  By this I do not just mean people function in society without crisis and manage their symptoms effectively; I

mean they become completely free from the illness, the diagnosis, the mental health system.  They thrive.  How do they do this?  According to Marion, recovery comes when “support challenges the long-term ways of working found in traditional services.  Warmth of welcome, sharing of knowledge and common ground…offers a fertile place for people to put their distress into context, find acceptance of their coping strategies and behaviours which some in psychiatry deem maladaptive…organisations [that provide this type of support, give] the individual a sense of purpose, responsibility and self-worth.  This is the thriving which my colleagues and I firmly believe in.”



As I write this, I am reminded of a talk given by Rachel Perkins at a recovery conference I attended last year.  Rachel notes the importance of recognising the difference between clinical and non-clinical recovery.  Clinical recovery is about reduction in symptoms, maintenance of a decent level of functioning, usually by taking medication long-term.  Non-clinical recovery is about building a meaningful life and reaching a state of wellbeing and functioning that is quite possibly beyond where the person was before becoming distressed or ‘unwell’.  



This way of working challenges the status quo and the lucrative medical model embraced by psychiatry and mental health services; therefore, it can be incredibly difficult to secure funding and support for such endeavours.  Meanwhile, available resources are generally allocated to those ‘recovery’ approaches that may be serving to perpetuate the illness-medication model, thus contributing to the problem of ‘revolving door patients’ referred to previously.  This is actually the opposite of recovery, so it is somewhat a paradox!  “If the medication works as well as it is purported to, why are people still in the system – often with their original problems unresolved?”.  More on this in a later post.  



As much as each person is different, so is each person’s experience of mental distress and their recovery journey.  Medicalisation detracts from this, not only causing harm in many cases but culturally reducing our ability to deal with distress autonomously.  I was inspired by the aforementioned talk by Rachel Perkins, who spoke of the notion that each one of us should be experts in our own recovery and wellbeing and that of those around us.  As such the very notion of a recovery ‘model’ is almost futile.   


Unfortunately the notion of individualisation is not really present in many mental health services at the moment; it seems that the notion of recovery has been watered down and moulded to fit the already existing modes of treatment: as Marion notes, the implementation of recovery principles such as service user involvement are “manipulated to fit into the organisational box...[they embrace] what suits and fits into the still predominantly biochemical system”.  I have witnessed this myself in peer support workshops I have co-facilitated in my workplace, where alongside endeavouring to teach people valuable skills to manage their distress, there is still seemingly relentless reference to the notion that one has a severe and enduring illness and must learn to live with this, helped by medication.  And so I find myself greeting these sessions with an odd mixture of admiration and disdain.  

Medication puts a sticking plaster on distress without addressing the issues behind it

As I write I am struck by thoughts of research into depression, which I have been investigating elements of for an upcoming university assignment.  Such research sometimes talks of recovery from depression, often measured by a reduction in symptoms based on a generic measurement tool.  Whilst I can see why such tools are useful, I strongly feel we need to move away from this limited view and to give people enough respect and credit to believe that they can truly recover and thrive, and to embed this into the way we work with people in distress.  Medication may help reduce symptoms, but it does nothing to deal with whatever issues and traumas caused the distress in the first place. 



This reminds me of my previous post about interpretations of suffering.  If we take suffering not as a sign of illness but as a part of human experience, we can then see it as something that can be worked through and learnt from.  To quote Marion again, “we have to take responsibility for our own recovery and not rely on others to do it for us!  Recovery is hard work!”  This is likely another key contributing factor to a lack of real recovery in services: quick fix approaches are (arguably), at the point of delivery, quicker and more efficient; there is enormous pressure on beds in mental health services and medication is seen as the quickest way to get someone out of hospital.  I maintain that in the long run this is less effective and far more likely to end up with further crises and hospital admissions, where true recovery approaches would not have led to this.  


What’s to blame for services not living up to promises to recovery recovery-focussed care?  Pressure on staff time and unnecessary bureaucracy are factors, but the unrelenting medical approach and the culture is creates is probably most to blame.  The Art of Thriving talks of service users becoming disillusioned with services because staff see the patient in terms of illness and not wellness or sanity, interpret coping strategies as ‘symptoms’, focus on medication and fail to recognise the relationship between life events and mental distress.



And so arises the need to go beyond recovery and embrace The Art of Thriving.  This will be different for each individual, but crucially, facilitating recovery and thriving in a meaningful way cannot happen without there being a shift in the culture of mental health services.  Related to this is the question as to whether hospital is even the right environment for the majority of people experiencing mental distress.  I honestly don’t believe it is.  If things are to improve and true recovery is to be achieved by more than just the odd few individuals who break free from the psychiatric system, I feel what is needed is a wholesale review of the way we support people in distress.  I won’t say anything further on this other than that I take a great interest in Loren Mosher’s Soteria House project, which you can learn about in this video:
 

 

In the context of our current cultural perspective of mental illness, my views are controversial, and as I stated earlier I know my view will be challenged by a lot of people.  I realise I have made some bold statements and not all of these are completely backed up in this piece; there is only a certain amount I can say in just one post and will return to some of the key issues later.  But please know my sole aim is to help people overcome distress and live meaningful lives.  It is unfortunate that these values are so heavily contradicted by the current psychiatric system and that I must so radically criticise the work currently being done in the field.  However, I hope you can find some agreement with my approach based on what I’ve said here. 



So, to return to our original question; what is recovery?  I have demonstrated here how my view of it contrasts with psychiatry's, and would be interested to know others' take on this.  It is your choice whether to believe in recovery, whether to believe in thriving, whether to believe in the biomedical approach to mental health, whether to believe in individuals’ ability to master their own wellbeing.  I hope that whatever you choose to believe is based on sound knowledge of the truths behind it.  I believe there are a hell of a lot of people out there who simply want to do the best for others, as I do, and hope that more and more of us will start challenging the current system and channelling our efforts towards true recovery.


NOTE: for copies of The Art of Thriving (£6 + P&P) and other books by Marion Aslan, please contact marionaslan@aol.com



Links:




Previous post mentioned in introduction: http://laurenscloud.blogspot.co.uk/2013/10/all-we-do-is-aim-for-better-things.html


NHS Confederation – Recovery: http://www.nhsconfed.org/Publications/briefings/Pages/Supportingrecoveryinmentalhealth.aspx



Elemental Wellbeing: http://elementalwellbeing.org/