Recovery 101 has 3 parts. Part A contains the 10 Fundamental Components of Recovery:(Hope, Self direction, Individualized and Person Centered, Empowerment, Holistic, Non-Linear, Strengths Based,Peer Support, Respect,Responsibility); Part B describes the six stages of grief, which often hinders recovery, while Part C outlines the L.E.A.P. program, which has considerable success in helping people achieve Recovery.
Grief experienced by consumers of mental health services, whether due to the stigmas associated with mental illness, or with loss in their lives can trigger relapse.
Family members can also experience grief at the time of diagnosis, and re-grieve when their family member experiences a relapse or fails to develop age related skills.
(SOURCE: The Journal Vol. 5 No. 3 1994. Recovery, Parental Grief The Journal Vol. 5 No. 3 1994. Recovery, Parental Grief Regrieving by Diane Welch Vines, R.N. Ph.D. )
The journey from shock to acceptance is, perhaps, the greatest obstacle on the road to recovery.
Shock
Total disbelief. Your world is thrown upside down. You feel out of control. Rarely is anyone prepared. At best you go through the motions. Memory lapses are common. Shock is a defense mechanism which helps you through the first few days of a devastating event so you don’t feel the full impact of the changed circumstances.
Denial
A buffer to the reality of the situation. Denial prevents us from dealing with the feelings the new circumstances brings with it. The longer we are in denial, the longer we avoid facing our grief. Many who stay in denial begin to find other ways of numbing their pain, often with drugs or alcohol.
We pretend if we don’t think about think about something, it will go away and normalcy will return. However, we must feel the pain in order to begin to heal. . When we refuse to feel the pain, we also prevent ourselves from feeling love, joy and other positive emotions.
Bargaining
I will give up smoking. I'll go to church every Sunday. I’ll check the locks three three times before going out. If only....
But time cannot be turned back. While bargaining provides temporary comfort, if carried on too long, it can prevent healing and the ability to get on with life.
Anger
The sense of being powerless The sense of being powerless… and out of control. Anger at those you feel responsible for placing you in the situation. Blaming God, temper tantrums, outbursts, or turning anger inward; depression. The longer we keep inward; the longer it stays in our bodies.
It will show up in our relationships with others. It will show up as disease, disability or symptoms. It can abolish the ability to work efficiently. The more a person bottles up their feelings of anger, the more likely that person will explode. Unless anger is properly addressed, it can turn to rage.
Guilt
Guilt is a genuine phase of grieving. People will feel as if they have failed or done something wrong. Guilt is more profound when a person is part of a tragedy; survivor guilt. . Blaming ourselves for a dreadful situation is common. We curse our shortcomings and repeat our should haves.
Guilt will hamper progress in healing. Ask yourself , What lesson am I learning from this? How will this change my life ? Will I become a more compassionate and loving person because of it ? Is there some way that the new knowledge I have gained can help someone else ?
Acceptance
As we acknowledge the situation for what it is, our wounds begin healing and we can move on with our lives. This may not mean that the new circumstances are agreeable, or or that grieving is completed. At times we may fall back into guilt or depression. With acceptance we can reinvent ourselves and create a new future.
We may carve out a new sense of values. We can find new opportunities borne out of our loss. While we cannot return to the way it was, we can still discover meaningful things for us to do. A new set of realities has been thrust upon the person diagnosed with a mental illness. Realities which the individual may not be fully aware of. These new circumstances need to be dealt with.
The journey from shock to acceptance is, perhaps, the greatest obstacle on the road to recovery.
(Sources on Grief • Healing Grief by James Van Praagh • The Journal Vol. 5 No. 3 Recovery 1994, , Parental Grief and Parental Grief and Regreiving , by Diane Welch Vines. R.N. Ph.D.)
L.E.A.P.
Listen Empathize Agree Partnership
Communication skills that can work to aid an individual in recovery develop a treatment plan… and and get him or her back on it should they on it should they relapse.
Guidelines for listening
Set aside the time
Agree on an agenda
Listen for beliefs about mental illness
Don’t react
Let chaos be
Echo what you’ve heard
Write it down
Listen
to attitudes about medication •
to concepts about what he can or cannot do
for cognitive deficits caused by the illness
Don’t try to correct the person’s beliefs, scowl, express disappointment, be judgemental, or get angry. The purpose of listening is to understand. The realities of those with a mental illness can be markedly different than for someone without it. Each person with a mental illness is unique, as we all are.
You need to be willing to understand his or her reality in order to build or rebuild trust; and to arrive at consensus on how things should be handled. Ask questions, but leave out the sarcastic comments and trap questions. Ask only questions which are designed to elicit information.
Let chaos be
At times the mentally ill person may not make any sense at all to you.
Empathize
When empathy is conveyed, the person will very likely feel understood and respected. Frustrations about pressures to take the medications. Goals that have not been met. Fears, about medications, about being stigmatized, failing. Discomforts due to medications, weight gain, feeling groggy, slowed down, stiff, being less creative. Desires: to get married, to get out of the hospital, to work, to live on their own, to have children, to go to school. Any feeling that is revealed.
Agree
This does not mean Agreeing that aliens from another planet are controlling every thought.
Whenever you see a window of opportunity to convey your observations and opinions, , always begin with something your client/ loved one already acknowledges and believes. The more common ground you can find, the better.
Agree
Being in the hospital makes it impossible to find work.
It’s hard to do the things you’d like to when you don’t have much money.
It’s hard to do the things you’d like when the medication makes you so tired.
Agree • Normalize the experience (Normalize the experience (I would feel the same in your shoes.) Discuss perceived problems (I can’t sleep at night because I’m on guard that they are going to hurt me.) Review perceived advantages and disadvantages (Whether rational or not.) Correct misconceptions - Check that your beliefs are correct. Information, once thought to be accurate has, at times been shown to be incorrect.
Agree Reflect back and highlight perceived benefits (When you are on medications you sleep better and fight less with your family).
Agree to disagree (The time sequence of events may be remembered differently, problems started before medication was stopped, or after it was stopped.)
Acknowledge that reasonable people can Acknowledge that reasonable people can disagree.
Partnership
Try to agree on goals that are reachable whenever possible. Preferably goals should be agreed upon prior to any crisis situation. At times crisis can be avoided by reviewing a prior agreement, which should be in writing.
Ideally, meetings to discuss the ill person’s feelings and beliefs should be ongoing in a non confrontational, non- threatening, supportive manner. Ask permission to write down anything you think might be important. Keep it in a file/ notebook, along with the date.
(Sources on L.E.A.P. - I Am Not Sick, I Don’t Need Help, by Xavier Amador; Peer Counseling, a course by John Hayes of the Disability Resourses Center, Long Beach, CA)
