In essence, the so-called ‘recovery approach’ to treating mental illnesses is concerned with the assumption that, instead of trying to lessen the severity of the symptoms of mental abnormality in patients, psychologists/psychiatrists should strive to empower the former, as thoroughly sovereign individuals. According to the advocates of the recovery paradigm, this creates the objective precondition for such patients to function as the society’s productive members. As Turton et al. (2011) pointed out, “Key attributes of a recovery-oriented approach include treatment approaches that promote autonomy, self-management, and the reclaiming of identity (including physical, sexual, spiritual, group, and cultural identity)” (p. 127). The recovery paradigm’s main conceptual premise is that “Recovery can occur without professional intervention. Professionals do not hold the key to recovery—the individual does. The task of professionals is to facilitate recovery; the task of people with a disability is to recover” (Levin, Hennessy, & Petrila, 2010, p. 467). The origins of the recovery movement date back to the publication of the book Perceval’s Narrative by John Perceval in 1830, in which the author challenged the appropriateness of the conventional (biomedical) psychiatric interventions. Nevertheless, it was specifically during the course of the 20th century’s last three decades that the recovery movement in psychology/psychiatry came into prominence. This particular development was predetermined by the fact that, throughout the 20th century second half, there has been collected plenty of evidence that undermines the soundness of the assumption that mental illnesses are necessarily chronic (Carpenter, 2002). In its turn, this presupposed the qualitative shift in some psychologists’ understanding of what accounts for the actual goal of their professional activities. That is, this goal began to be perceived ultimately related to the notion of holistic ‘recovery’ – something that cannot be quite described in any rigidly definitive terms. As Thornton and Lucas (2011) suggested, “Whether someone has recovered or not depends not on the plainly descriptive matter of whether they have returned to a statistically normal state but rather on reaching a normatively or evaluative characterized state that constitutes well-being” (p. 26). However, it would be wrong to assume that the increasing popularity of the recovery movement has been solely predetermined by the growing amount of evidence that the biomedical outlook on the epidemiology of mental illnesses is not quite valid. In fact, it is specifically the rise of neo-Liberalism (and of its ideological ‘child’ – political-correctness), which contributed towards the legitimization of the recovery movement more than anything else did.
The reason for this is that, due to being concerned with promoting the idea that one’s individual rights and freedoms cannot be restricted (even if this results in undermining the society’s overall integrity), neo-Liberalism naturally calls for the deinstitutionalization of the public sphere (Rustin, 2014). The fact that this is indeed being the case can be illustrated, in regards to the ongoing privatization of America’s military, law enforcement, penal, banking, and health care sectors – all in the name of greater ‘efficiency’. This is exactly the reason why, instead of referring to the mentally ill people as potential patients, the affiliates of the recovery paradigm prefer to refer to such people as ‘health consumers’, “A critical aspect of the recovery concept is to eschew the label ‘patient’ for the politically correct label of ‘consumer’” (Braslow, 2013, p. 782). The proponents of neo-Liberalism also favor the continual ‘atomization’ of society, when people are being encouraged to pursue highly individualistic lifestyles while considering the very existence of the institutionally imposed laws and regulations detrimental to their personal agendas in life. As the above-quoted author pointed out, “The term recovery… is an amalgam of cultural beliefs, treatment practices… that began with the deinstitutionalization trend of the late 1960s and 1970s” (Braslow, 2013, p. 783). Therefore, it is quite explainable why the advocates of the recovery movement criticize the conventional conceptualization of a mental illness, as something that can be rationalized and assessed, in regards to the measure of its severity. Apparently, due to their close association with neo-Liberal values, these people are emotionally discomforted by the idea that mental illness is the socially defined and therefore thoroughly objective category, “The concept of illness, whether bodily or mental, implies deviation from some clearly defined (social) norm” (Szasz, 1972, p. 15). This simply could not be otherwise – the mentioned values are strongly anti-social. Therefore, there is nothing too surprising about the fact that, according to the practitioners of the recovery paradigm, it is a priori impossible to define the precise meaning of the notion of ‘mental abnormality, on one hand, and of the notion of ‘mental adequacy’, on the other. Consequently, there can be no criteria for distinguishing between these mental states. In the eyes of the movement’s endorsers, insanity is just as normal and socially appropriate as it happened to be the case with sanity, “In their speeches and writings, recovery activists portrayed madness not as an illness but as an alternative state of being… they celebrated ‘mad pride,’ suggesting that the route to wholeness lay in accepting their uniqueness” (Tomes, 2006, p. 722). This, of course, implies that the recovery movement is ideology-driven to a large degree and that it is being only formally concerned with its advocates’ officially proclaimed agenda of trying to help mentally inadequate people to become fully integrated into society. Moreover, this also suggests that the movement in question cannot be considered scientifically legitimate, as well. The reason for this is apparent – by insisting that recovery is a process (rather than the measurable set of outcomes), the movement’s advocates do nothing short of undermining the methodological soundness of psychology and psychiatry, as the theory-based scientific disciplines. It is understood, of course, that such terms as ‘empowerment’, ‘wellness’, and ‘self-actualization’, commonly utilized by the affiliates of the recovery paradigm, do sound sophisticated and discursively progressive. However, since there cannot be any universally accepted definition, as to their denotational significance, they are essentially meaningless – at least, within the methodological framework of psychology/psychiatry. What happens, as a result, is that the very government’s practice of financing mental institutions, where mentally ill patients undergo rehabilitation, while prevented from causing any harm to society, begin to appear rather unjustified. If there can be no ‘patients’ but only ‘health consumers’, then why bother with investing funds into maintaining the mental health segment of the national health care system fully functional? It would be so much more cost-effective to just allow mentally ill individuals to roam free while hoping that they will eventually be able to attain ‘self-actualization’. This course of action would correlate perfectly well with the main ideological premise of neo-Liberalism – the government’s involvement in just every domain of public life must be severely limited.
Thus, we can speculate that the true objectives of the recovery movement in the mental health sector are concerned with: a) Reducing the number of governmental expenditures on health care – something that should help the government of just about every Western country (particularly the U.S.) to address the problem of the rapidly growing budget deficit. b) Saving on governmental investments in health care education. While operating within the conceptual framework of the recovery paradigm, just about anyone can claim to be an utterly effective psychologist/psychiatrist, for as long as he or she is able to prove its involvement in the process of a particular ‘health consumer’ becoming gradually ‘empowered’ – regardless of whether this process exhibits any positive dynamics or not. c) Benefiting the country’s pharmacological industry. This conclusion naturally derives out of the well-known fact that the most effective way of reducing the acuteness of mental anxieties in a particular person (which supposedly leads towards ‘empowerment’), is prescribing him or her anti-depressant drugs. The transformation of ‘patients’ into ‘health consumers’ naturally presupposes this eventual scenario.
In light of what has been mentioned earlier, it will be thoroughly logical to conclude that, if allowed to continue gaining momentum, the recovery movement will inevitably result in the deterioration of the quality of psychological/psychiatric education in the U.S. Moreover, it will also contribute to the exponential growth of the population of mentally ill people (the causes of mental illnesses are mainly genetic). Both developments are taking place, as we speak. Thus, there is indeed a good reason to doubt the overall beneficence of the recovery movement – quite despite the fact that it is being driven by the seemingly noble set of considerations, on the part of its endorsers.
Braslow, J. (2013). The manufacture of recovery. Annual Review of Clinical Psychology, 9, 781-809.
Carpenter, J. (2002). Mental health recovery paradigm: Implications for social work. Health & Social Work, 27 (2), 86-94.
Levin, B., Hennessy, Kevin, D., & Petrila, J. (2010). Mental health services: A Public health perspective. Oxford: Oxford University Press.
Rustin, M. (2014). Belonging to oneself alone: The spirit of neoliberalism. Psychoanalysis, Culture & Society, 19 (2), 145-160.
Szasz, T. (1972). The myth of mental illness. London: Paladin, 1972.
Thornton, T., & Lucas, P. (2011). On the very idea of a recovery model for mental health. Journal of Medical Ethics, 37(1), 24-28.
Tomes, N. (2006). The patient as a policy factor: A historical case study of the Consumer/Survivor movement in mental health. Health Affairs, 25 (3), 720-729.
Turton, P., Demetriou, A., Boland, W., Gillard, S., Kavuma, M., Mezey, G., & Wright, C. (2011). One size fits all: Or horses for courses? Recovery-based care in specialist mental health services. Social Psychiatry and Psychiatric Epidemiology, 46 (2), 127-136.