Academic journal article Advances in Mental Health

Relational Recovery: Beyond Individualism in the Recovery Approach

Academic journal article Advances in Mental Health

Relational Recovery: Beyond Individualism in the Recovery Approach

Article excerpt

Introduction

Recovery is said to be 'personal'; it is 'deeply individual'. Why would anyone object to that? Because we are not isolated individuals, to put it bluntly. (Rose, 2014, p. 217)

In recent years, the recovery approach has increasingly influenced mental health policy and practice throughout the English-speaking world (Slade et al., 2014). As Hunt and Resnick (2015) observed, recovery is 'the rallying cry of 21st century mental health care reform' (p. 1235). With its genesis in the liberatory psychiatric survivor movement of the 1960s and 1970s, recovery has since 'gone mainstream', and is enthusiastically embraced by mental health professionals, academics and policymakers alike (Braslow, 2013; Rose, 2014). Like the biopsychosocial approach in psychiatry, which provided the grounds for the adoption of holistic and integrated approaches in mainstream mental health services (Falloon & Fadden, 1993), the recovery movement offered a powerful language with which to critique and move beyond the narrowness of the biomedical approach to mental health. While the biomedical approach emphasises clinical recovery, as indicated by the remission of mental health symptoms, the recovery approach centres on personal recovery, which aims not necessarily at symptom-free normality, but rather 'living a satisfying, hopeful, and contributing life, even when there are on-going limitations caused by mental health problems' (Mental Health Commission of Canada, 2012, p. 12). In this way, as Duff (2016) noted recovery 'connotes neither the full restoration of health nor the symptomologies of chronicity, introducing the need for new ways of conceiving of health in illness' (p. 2, emphasis added). Recovery is seen as an ongoing journey rather than a final destination, with consumers1 described as 'being in' recovery rather than 'recovering from' mental ill-health (Davidson, O'Connel, Tondora, Styron, & Kangas, 2006).

The recovery approach is an important alternative to coercive, deficit-based mental health practices, and as such currently enjoys enormous support. Yet recovery is not without its critics. Some commentators have noted its conceptual fuzziness, highlighting the bewildering array of ways in which the notion of recovery is put to work, 'variously used to mean an approach, a model, a philosophy, a paradigm, a movement, a vision and, sceptically, a myth' (Roberts & Wolfson, 2004, p. 38). Others have argued that the radical intent of the original concept has been subverted by governments and mental health professionals, who have deemphasised notions of social justice and promoted a 'normalising' view of recovery that ultimately aligns with biomedical discourse (Harper & Speed, 2013; Hunt & Resnick, 2015; Rose, 2014). Perhaps the most persistent criticisms, however, have focused on the individualistic worldview underpinning most conceptualisations of recovery. As Adeponle, Whitley, and Kirmayer (2012) observed, the 'consumeroriented recovery approach builds on Anglo-American individualism and on an egocentric concept of the person as a self-sufficient, self-determining, independent entity' (p. 116).

In this article, we outline and expand upon the existing critiques of the individualistic nature of the recovery approach. We argue that while interpersonal relationships are currently recognised as a component of the recovery process, they can more accurately be seen as suffusing all aspects of recovery, including experiences like hope, identity and empowerment, which are often seen as purely intra-psychic processes or achievements. Drawing together recent bodies of research that view recovery as an inherently social process, we explore the notion of relational recovery, which is a way of conceiving recovery based on the idea that human beings are interdependent creatures; that people's lives and experiences cannot be separated from the social contexts in which they are embedded. This paper is largely focused on the theories underpinning different conceptualisations of recovery, and is not intended as a guide to practice. …

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