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| Responsibility in the Growth Stage: In Control of Life and Wellbeing |
Responsibility in the Growth Stage: In Control of Life and Wellbeing
Consumers who considered themselves recovered described being in control of the illness and of their lives generally. This control is the result of a long struggle to understand and cope with the illness, and to develop personal resources: ‘Taking responsibility for my life and developing coping mechanisms has been crucial to my recovery’ (Leete, 1989, p. 197). An anonymous consumer, while acknowledging that medications helped to relieve the symptoms, expressed strongly the level of hard personal work involved in taking responsibility for his recovery:
Statements like ‘your illness is getting better,’ ‘your therapist has done wonders,’ or ‘your medication has cured your illness’ infuriate me. Statements like this take the credit away from the mental health consumer and instead bestow the thanks on outside sources. Illnesses don’t get better in most cases; instead clients sweat blood and tears and fight heroically to cope with the symptoms and re-enter mainstream society to the greatest extent humanly possible. (Anonymous, 1994b, p. 25)
Achieving control requires sustained commitment in the face of set-backs, as noted byMary (1994): ‘I feel correct medication is important for people with schizophrenia.
Unfortunately this involves trial-and-error. What’s kept me going is that I am determined to live a normal life’ (p. 18). Although they may continue to use medications or mental health services, people in the Growth stage feel empowered regarding which treatments or services they use, and in choosing when to use them, as described by Deegan (1997) in Chapter 2, and here expressed by Lynn (1994):
Now, I amfinally living where I want, on my own, and I ammy own caretaker. I decide when I need hospitalization. No one pushes me in involuntarily. I still have this voice problem which sometimes interferes with my life, but, fortunately, over the years, I’ve developed a network of good friends who all constitute a great part of my support system. (p. 51)
As Lynn demonstrates, in taking responsibility for their own lives and living autonomously, people are not seeking to live independently of others in the sense that they refuse help and advice. Williams (2000) explained the difference between the meanings of autonomy and independence as the terms are used in Self Determination Theory: autonomy refers to feeling volitional in choosing and pursuing goals (Ryan and Deci, 2000a), and this may require the support of others, whereas independence implies acting without reference to, or support from others (Williams, 2000). Mead and Copeland (2000) highlight that, while consumers can take responsibility for their lives, they need the cooperation and support of those who would help them to succeed in this endeavour:
The person who experiences psychiatric symptoms should determine the course of his or her own life. No one else, even the most highly skilled health care professional, can do the work for us. We need to do it for ourselves, with your guidance, assistance, and support. (p. 328)
And the importance of the positive and empowering attitude of the clinician in this process is illustrated by Greenblat (2000):
Later in my treatment, Dr. Alaoglu gave me more rein in my recovery, listening to my input about the level of medication I was on and taking me seriously when I asked for a decrease or even an increase in my medications. I felt empowered in my recovery. (p. 244)
These lessons in the need for control have been noted by researchers and authors in the other areas of loss. For example, Dunn (1996) investigated well-being following amputation, and found that optimism and a sense of control over the disability was associated with lower depression scores and higher self-esteem.
Similarly, Taylor (1983) found, in work with chronic illness patients and victims of other life-threatening events, that regaining mastery over the event and over one’s life generally was an important element in the readjustment process. This could take the form of either cognitive or behavioural control (Taylor, 1983). Jaffe (1985) also observed that survivors of trauma, including natural disasters and internment in concentration camps, took direct action to overcome the traumatic experience. The rejection of the role of victim reflected the ‘will to live’, and represented the retention of personal power over the current situation and future events (Jaffe, 1985). Jaffe asserted that the rediscovery of psychological control over one’s life was central to self-renewal, and to physical and psychological well-being.
In a qualitative study, Williams and Collins (1999) found that the struggle for control was an important aspect of coping with schizophrenia. They reported that active coping with the illness and life generally was necessary for a person to consider him or herself recovered in the face of possible relapse. They noted that people who had had more experience of relapse learned from each episode and built on their competence in one or more of the areas of symptom management, self-image, social competence, and others’ expectations (Williams and Collins, 1999). Development of these skills then dampened the destabilizing effects of relapse. Taking responsibility for wellness and taking control of one’s life, then, develops the resilience and sense of competence characteristic of the Growth stage. Recovered consumers invariably say that the outcome was worth the struggle:
If we do acknowledge and seriously study our illnesses; if we build on our assets; if we work to minimize our vulnerabilities by developing coping skills; if we confront our
illnesses with courage and struggle with our symptoms persistently – we will successfully manage our lives and bestow our talents on society, the society that has traditionally abandoned us. (Leete, 1989, p. 200)
I do not believe in magical cures for illnesses like mine. It takes very hard work to recover from a series of acute episodes. The problem is compounded by the fact that my will-power was damaged by the illness and my reaction to it. Now that my life is better it is so clear that it was worth it. I hope a lot of people get the help that they need and that their lives become more satisfying and enjoyable. (Anonymous, 1994b, p. 25)
Consumers who considered themselves recovered described being in control of the illness and of their lives generally. This control is the result of a long struggle to understand and cope with the illness, and to develop personal resources: ‘Taking responsibility for my life and developing coping mechanisms has been crucial to my recovery’ (Leete, 1989, p. 197). An anonymous consumer, while acknowledging that medications helped to relieve the symptoms, expressed strongly the level of hard personal work involved in taking responsibility for his recovery:
Statements like ‘your illness is getting better,’ ‘your therapist has done wonders,’ or ‘your medication has cured your illness’ infuriate me. Statements like this take the credit away from the mental health consumer and instead bestow the thanks on outside sources. Illnesses don’t get better in most cases; instead clients sweat blood and tears and fight heroically to cope with the symptoms and re-enter mainstream society to the greatest extent humanly possible. (Anonymous, 1994b, p. 25)
Achieving control requires sustained commitment in the face of set-backs, as noted byMary (1994): ‘I feel correct medication is important for people with schizophrenia.
Unfortunately this involves trial-and-error. What’s kept me going is that I am determined to live a normal life’ (p. 18). Although they may continue to use medications or mental health services, people in the Growth stage feel empowered regarding which treatments or services they use, and in choosing when to use them, as described by Deegan (1997) in Chapter 2, and here expressed by Lynn (1994):
Now, I amfinally living where I want, on my own, and I ammy own caretaker. I decide when I need hospitalization. No one pushes me in involuntarily. I still have this voice problem which sometimes interferes with my life, but, fortunately, over the years, I’ve developed a network of good friends who all constitute a great part of my support system. (p. 51)
As Lynn demonstrates, in taking responsibility for their own lives and living autonomously, people are not seeking to live independently of others in the sense that they refuse help and advice. Williams (2000) explained the difference between the meanings of autonomy and independence as the terms are used in Self Determination Theory: autonomy refers to feeling volitional in choosing and pursuing goals (Ryan and Deci, 2000a), and this may require the support of others, whereas independence implies acting without reference to, or support from others (Williams, 2000). Mead and Copeland (2000) highlight that, while consumers can take responsibility for their lives, they need the cooperation and support of those who would help them to succeed in this endeavour:
The person who experiences psychiatric symptoms should determine the course of his or her own life. No one else, even the most highly skilled health care professional, can do the work for us. We need to do it for ourselves, with your guidance, assistance, and support. (p. 328)
And the importance of the positive and empowering attitude of the clinician in this process is illustrated by Greenblat (2000):
Later in my treatment, Dr. Alaoglu gave me more rein in my recovery, listening to my input about the level of medication I was on and taking me seriously when I asked for a decrease or even an increase in my medications. I felt empowered in my recovery. (p. 244)
These lessons in the need for control have been noted by researchers and authors in the other areas of loss. For example, Dunn (1996) investigated well-being following amputation, and found that optimism and a sense of control over the disability was associated with lower depression scores and higher self-esteem.
Similarly, Taylor (1983) found, in work with chronic illness patients and victims of other life-threatening events, that regaining mastery over the event and over one’s life generally was an important element in the readjustment process. This could take the form of either cognitive or behavioural control (Taylor, 1983). Jaffe (1985) also observed that survivors of trauma, including natural disasters and internment in concentration camps, took direct action to overcome the traumatic experience. The rejection of the role of victim reflected the ‘will to live’, and represented the retention of personal power over the current situation and future events (Jaffe, 1985). Jaffe asserted that the rediscovery of psychological control over one’s life was central to self-renewal, and to physical and psychological well-being.
In a qualitative study, Williams and Collins (1999) found that the struggle for control was an important aspect of coping with schizophrenia. They reported that active coping with the illness and life generally was necessary for a person to consider him or herself recovered in the face of possible relapse. They noted that people who had had more experience of relapse learned from each episode and built on their competence in one or more of the areas of symptom management, self-image, social competence, and others’ expectations (Williams and Collins, 1999). Development of these skills then dampened the destabilizing effects of relapse. Taking responsibility for wellness and taking control of one’s life, then, develops the resilience and sense of competence characteristic of the Growth stage. Recovered consumers invariably say that the outcome was worth the struggle:
If we do acknowledge and seriously study our illnesses; if we build on our assets; if we work to minimize our vulnerabilities by developing coping skills; if we confront our
illnesses with courage and struggle with our symptoms persistently – we will successfully manage our lives and bestow our talents on society, the society that has traditionally abandoned us. (Leete, 1989, p. 200)
I do not believe in magical cures for illnesses like mine. It takes very hard work to recover from a series of acute episodes. The problem is compounded by the fact that my will-power was damaged by the illness and my reaction to it. Now that my life is better it is so clear that it was worth it. I hope a lot of people get the help that they need and that their lives become more satisfying and enjoyable. (Anonymous, 1994b, p. 25)
