The Quest for Meaning and Value: Everyone needs a purpose in life, and striving to achieve meaning and value is central to the recovery process. - 'I need to do something that makes me feel that Im not just filling up space. I know for me I need to do something where I feel like Im doing something important'. (cited in Young & Ensing 1999)
What we do is central to the way in which we see ourselves and our relationships with others. In almost any social situation, one is first asked, 'What is your name?' followed by, `What do you do?' Being valuable is important in counteracting despair. A sense of meaning and purpose fosters hope and the development of a positive sense of self.
For many, satisfying work is central. However, meaning and purpose vary from person to person. Work is important, but it is not the only socially valued role. For some people other things are more valued: - motherhood, politics, friendship & sports, environmental activism. church-membership, drama, arts, voluntary w ork, education, and so on. - However, most of these sources of value and purpose are a million miles away from the daytime activities' that are often recommended by mental health workers
The activities and roles which most people with mental health problems derive meaning and purpose span the same range as for those who do not have such difficulties. - How many non-disabled people find meaning and value in, for example, 'traditional occupational therapy' and the activities in 'day centres' ?
That which is valuable and meaningful to an individual cannot be separated from that which is deemed meaningful and valuable in the communities and societies which they inhabit. Although there are many different ways in which people can contribute to the society in which they live, meaning and value are socially determined. If people with mental health problems are to be included in their communities they must have access to the valued opportunities within them.
- Recovery is not an end-point but a continuing journey: people are not `recovered; they are 'recovering'.
- Recovery is not the same as 'getting better': people are not recovering from illnesses, but recovering meaningful and valuable lives whether or not their problems can be eliminated.
Coleman (1999) has argued that professionals may view recovery as little more than maintaining a person in a stable condition. This is certainly not the model described here, which is about development rather than maintenance. However, it is important to remember that clinicians have been rather more pessimistic about people 'getting better' than the long-term outcome literature would indicate. In a review of seven long-term follow-up studies, Harding and Zahniser (1994) concluded that half to two-thirds of people significantly improved to the point at which they required no medications, were working, were integrated into the community, and were 'behaving in such a way as not to be able to detect ever having been hospitalised for any kind of psychiatric problem'.
Turner-Crowson and Wallcraft (2002) asked the question, 'Is there a danger that an over-emphasis on recovery could be an additional burden for people who do not feel they are in "recovery", whereas language such as surviving, coping, or developing strategies for living is more neutral and accepting?' However, they do go on to argue that, 'On the other hand, some find the concept of recovery inspiring and liberating, offering the prospect of going beyond simply "coping with distress":
We accept that the term `recovery' may be open to misinterpretation, but the same may be true of any term. The recovery paradigm described here is founded in the accounts of those have themselves experienced serious mental health problems, and has already gained momentum within mental health policy and practice in the UK, North America, Australia and New Zealand. It has generally proved itself to be dymanic, inspiring and creative approach that can substitute hope for despair. It circumvents sterile arguments between competing intervention models (medication vs. therapy vs. employment vs. self-help vs. complementary therapy, etc.). All or none of these may contribute to the central, overarching, goal of growth and development. The highly individual nature of the recovery process means that different people will find different approaches helpful in the journey of rebuilding valued, meaningful and satisfying lives.
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