Kathleen M. Pike, PhD

Recovery is a Verb

When will it end? How many more days until it is over? All of us are asking these questions every day about COVID-19. It’s natural that we do so. This is the way we typically frame our questions about ill health. Most of us think of recovery as an endpoint, and endpoints are important. We want as few people as possible to get sick – and even fewer to die – in this pandemic.

COVID-19 is impacting virtually every dimension of daily life for all of us. And we don’t know when it will be over. For people with serious mental illness like depression, anxiety, eating disorders, bipolar disorder and psychosis, the experience is familiar. These individuals have a deep wisdom to share with all of us. Recognizing that too much of life will be lost waiting for recovery as an outcome, people with lived experience of serious mental illness define recovery as a process by which we maximize quality of life every day in spite of imperfect and challenging circumstances.

In this Five on Friday, I share with you results from a study led by Sara Wetzler that our team published this week in the International Journal of Eating Disorders. We summarized and synthesized the perspectives of individuals with lived experience of an eating disorder. Collectively, these individuals identified six factors that they count as essential to their recovery journey. For them, recovery is a verb, not a noun. Recovery is a mindset, not the absence of symptoms on a checklist. Their wisdom can help all of us as we navigate our global recovery journey with COVID-19.

1. Supportive Relationships. This dimension captures the essential role that support and encouragement from others play along the journey of recovery. The experience of feeling connected to others and having a community where we feel we belong and feel understood is essential to the experience of recovery. Family, professionals, friends, colleagues, and healthcare providers can all play a role here. Peers with similar experiences of mental illness have a unique opportunity to connect and reduce the experience of isolation that is too often associated with mental illness. I am inspired by the outpouring of support that has been my experience and observation as we navigate the current pandemic. I feel better after just a few minutes of a family chat on FaceTime. How do I remember this when all goes back to normal? 

2. Hope. The essential truth here is that when we struggle with ill health, believing that we can get better is critical to activating and facilitating the recovery process. Feeling hopeful is key to motiving us to seek help and persevere through difficult times. Hope is buoyed by a belief in oneself and in others’ capacity to help us chart a future that is not burdened by the illness. Without hope, the world is dark. Hopelessness is correlated with increased risk of suicide. Believing in ourselves and others is key to feeling hopeful about recovery – whether it is as individuals living with mental illness or as societies living with this pandemic. A vital message for health providers always and for public figures and organizational leaders today.

3. Identity. Enduring mental illness can take over one’s life. People – health providers, family, and friends alike – can begin to only see the person as their illness. Essential to living in recovery is developing a sense of self separate from the mental illness. People with depression can still love to cook. People with eating disorders may love renaissance art. Remembering that we are more than our illness and continuing to engage in personal growth separate from the ill health are key. Recognizing that this needs to happen all along the journey is at the heart of the Recovery Movement. It cannot and should not wait until the clinical symptoms resolve. This is true for individuals with serious mental illness embracing recovery all along the journey. It is true for all of us in our current compromised circumstances due to COVID-19.

4. Meaning and Purpose. Finding meaning and coming to understand one’s purpose sits at the heart of the journey of life for us all. For those living with an eating disorder or other serious mental illness, the illness can take over and squeeze out all else. People run the risk of becoming nothing other than their illness. In the midst of the pandemic, we run the risk of letting it take over our lives. When we embrace recovery as a mindset and a verb, we are propelled not to succumb to the illness (or the pandemic). Preserving time and energy to pursue work and other activities not driven by the illness or the pandemic supports our search for meaning and purpose. This is part of the rationale for promoting work programs for people with serious mental illness. It is also part of the reason why the dramatic loss of work for so many people during the pandemic is so serious. 

5. Empowerment. Confidence, agency, and resilience are rooted in empowerment. When we take responsibility in our lives, we discover what we can control, what we need to accept, and what power we have to find health and meaning in the mix. The individuals represented in our study describe the invigorating experience of focusing on their strengths and learning to recognize their value in ways that enable them to contribute to the greater good of society as well. For each of us today, the question might be, what qualities and strengths can I bring to help ease the burden of COVID-19 at home and globally?.

6. Self-compassion. It really is worth adding one more to my standard five points when the bonus focuses on self care. Living a life of recovery means practicing self-kindness and self-acceptance. When we acknowledge and learn to be aware of our own emotions and needs, we have the potential to be kind to ourselves and strengthen our capacity to take care of ourselves. A seed for developing empathy for others, too. This is relevant for anyone living with mental illness and relevant for all of us living with the daily burden of this global pandemic. 

The great gift that the Recovery Movement has given us all is redefining recovery as a moving picture rather than a still photo. With this new framework, recovery is a way of being in the world where we are realizing our potential and living a life characterized by supportive relationships, hope, identity, meaning, empowerment and self-care, despite the messiness, chaos, confusion and paradox of the world around us.

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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