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| Identity in the Preparation Stage: Taking an Internal Inventory |
Identity in the Preparation Stage: Taking an Internal Inventory
‘Taking stock’ of the self during preparation for recovery is mentioned frequently by consumers and by researchers (e.g. Davidson and Strauss, 1992; Williams and Collins, 1999; Mead and Copeland, 2000; Sells, Stayner and Davidson, 2004). In the Awareness stage the person recognizes that there exists a part of him or her that is not affected by the illness (Davidson and Strauss, 1992). During the Preparation stage, the person takes stock of his or her skills and strengths in order to build on them to rediscover a positive sense of identity.
Ultimately we must conquer stigma from within. As a first step – and a crucial one – it is imperative for us as clients to look within ourselves for our strengths. These strengths are the tools for rebuilding our self-image and thus our self-esteem. (Leete, 1989, p. 199)
The idea of taking stock of the personal resources necessary for a task was illustrated by Betty (Davidson and Strauss, 1992) in the passage on Hope, above. Mead and Copeland (2000) described the need to rebuild a positive sense of self by testing out one’s internal resources. This involves taking risks in trying out new activities to re-establish a sense of self that is not limited by beliefs about the illness. The person not only rediscovers lost aspects of the self, but may also discover new aspects, which are then incorporated into a new sense of self (Davidson and Strauss, 1992; Young and Ensing, 1999).
However, it is not only strengths and limitations that are assessed during the Preparation stage – the person also needs to develop a durable sense of self – that is, a sense of being the same person one was before the illness (Sells, Stayner and Davidson, 2004). As one of Young and Ensing’s (1999) participants expressed:
It feels like I haven’t lost touch with me altogether. That I amstill wandering around in there and that I just have a little more work to do to find me, but you know maybe if I get up and go and search I’m there somewhere. And little by little I will find me again. (p. 226)
The person needs to separate thoughts and emotions that were caused by the psychosis from their core beliefs (Williams and Collins, 1999). This appears to be the process described here by Wentworth (1994):
The internal definitions of reality (my assumptions, beliefs, attitudes, thinking) that I held when I first got manic had to be changed for me to heal though I didn’t realize it consciously at the time. I had to grow in understanding. That took a lot of work and a lot of time. I took a long time turning understanding into behavioral change. (p. 83)
The rediscovery of his or her positive qualities and deeply held values forms the basis for setting goals which uphold these values. For example, Schmook (1994) vividly describes her process of taking an internal inventory: I began to believe in myself. I accepted myself just as I was. I wrote things down on paper about myself; things that I needed to change and things I couldn’t change. I started to think about the things I wanted to do with my life when I got better. (p. 2) This inner search may involve reassessing one’s values and finding them wanting. New values may then be adopted and new goals identified. A reordering of values is well recognized as a form of coping and adjustment to life circumstances (e.g. Taylor, 1983; King, 1998; Emmons, 1999c; Coursey et al., 2000; Elliott and Kurylo, 2000; Calhoun and Tedeschi, 2001), and this phenomenon is well documented in the popular press. John (1994) found that he had to re-examine the values he grew up with: ‘Where I grew up, the ideal was to be tough, sporty and sexually successful .. . . I am regarded as the disabled one. But I have gone beyond these standards and found other qualities in life’ (p. 8).
Learning from others’ experience is another source of inspiration, and the need to connect with others is a frequent theme in the recovery literature. Peer support groups can provide a safe arena for challenging oneself in a non-stigmatizing environment (e.g. Schmook, 1996; Spaniol and Gagne, 1997; Young and Ensing, 1999; D. Marsh, 2000; Mead and Copeland, 2000; Tenney, 2000). As in the Awareness stage, the possibility of a positive identity can be inspired by prominent successful people:
The walls of the psych ward crumbled further in my mind as I came to see that others with my illness had contributed to society. I found out that my two favourite writers, Hemmingway and T. S. Eliot, each had a neuro-chemical disorder . . .. the significance of this fact can hardly be overestimated . . . these great writers not only lived in society but they had a hand in shaping the society in which they lived.
(Fekete, 2004, p. 192)
The dual tasks of taking an internal inventory of one’s core values, and taking stock of one’s strengths and weaknesses, mirrors Waterman’s (1984) two metaphors for identity formation: discovery and creation. The former applies to the process of discovering the ‘true self’; the second implies there is no pre-existing self, so the person needs to create an identity. Both of these processes can be seen as occurring in the Preparation stage. The person needs to examine his or her values, changing them if deemed necessary, and then seek ways in which to live up to these values by setting appropriate goals. When the individual rediscovers what makes him or herself truly valuable, he or she gains a sense of the possibilities of a positive identity (Pettie and Triolo, 1999). Fekete (2004) explains:
‘Taking stock’ of the self during preparation for recovery is mentioned frequently by consumers and by researchers (e.g. Davidson and Strauss, 1992; Williams and Collins, 1999; Mead and Copeland, 2000; Sells, Stayner and Davidson, 2004). In the Awareness stage the person recognizes that there exists a part of him or her that is not affected by the illness (Davidson and Strauss, 1992). During the Preparation stage, the person takes stock of his or her skills and strengths in order to build on them to rediscover a positive sense of identity.
Ultimately we must conquer stigma from within. As a first step – and a crucial one – it is imperative for us as clients to look within ourselves for our strengths. These strengths are the tools for rebuilding our self-image and thus our self-esteem. (Leete, 1989, p. 199)
The idea of taking stock of the personal resources necessary for a task was illustrated by Betty (Davidson and Strauss, 1992) in the passage on Hope, above. Mead and Copeland (2000) described the need to rebuild a positive sense of self by testing out one’s internal resources. This involves taking risks in trying out new activities to re-establish a sense of self that is not limited by beliefs about the illness. The person not only rediscovers lost aspects of the self, but may also discover new aspects, which are then incorporated into a new sense of self (Davidson and Strauss, 1992; Young and Ensing, 1999).
However, it is not only strengths and limitations that are assessed during the Preparation stage – the person also needs to develop a durable sense of self – that is, a sense of being the same person one was before the illness (Sells, Stayner and Davidson, 2004). As one of Young and Ensing’s (1999) participants expressed:
It feels like I haven’t lost touch with me altogether. That I amstill wandering around in there and that I just have a little more work to do to find me, but you know maybe if I get up and go and search I’m there somewhere. And little by little I will find me again. (p. 226)
The person needs to separate thoughts and emotions that were caused by the psychosis from their core beliefs (Williams and Collins, 1999). This appears to be the process described here by Wentworth (1994):
The internal definitions of reality (my assumptions, beliefs, attitudes, thinking) that I held when I first got manic had to be changed for me to heal though I didn’t realize it consciously at the time. I had to grow in understanding. That took a lot of work and a lot of time. I took a long time turning understanding into behavioral change. (p. 83)
The rediscovery of his or her positive qualities and deeply held values forms the basis for setting goals which uphold these values. For example, Schmook (1994) vividly describes her process of taking an internal inventory: I began to believe in myself. I accepted myself just as I was. I wrote things down on paper about myself; things that I needed to change and things I couldn’t change. I started to think about the things I wanted to do with my life when I got better. (p. 2) This inner search may involve reassessing one’s values and finding them wanting. New values may then be adopted and new goals identified. A reordering of values is well recognized as a form of coping and adjustment to life circumstances (e.g. Taylor, 1983; King, 1998; Emmons, 1999c; Coursey et al., 2000; Elliott and Kurylo, 2000; Calhoun and Tedeschi, 2001), and this phenomenon is well documented in the popular press. John (1994) found that he had to re-examine the values he grew up with: ‘Where I grew up, the ideal was to be tough, sporty and sexually successful .. . . I am regarded as the disabled one. But I have gone beyond these standards and found other qualities in life’ (p. 8).
Learning from others’ experience is another source of inspiration, and the need to connect with others is a frequent theme in the recovery literature. Peer support groups can provide a safe arena for challenging oneself in a non-stigmatizing environment (e.g. Schmook, 1996; Spaniol and Gagne, 1997; Young and Ensing, 1999; D. Marsh, 2000; Mead and Copeland, 2000; Tenney, 2000). As in the Awareness stage, the possibility of a positive identity can be inspired by prominent successful people:
The walls of the psych ward crumbled further in my mind as I came to see that others with my illness had contributed to society. I found out that my two favourite writers, Hemmingway and T. S. Eliot, each had a neuro-chemical disorder . . .. the significance of this fact can hardly be overestimated . . . these great writers not only lived in society but they had a hand in shaping the society in which they lived.
(Fekete, 2004, p. 192)
The dual tasks of taking an internal inventory of one’s core values, and taking stock of one’s strengths and weaknesses, mirrors Waterman’s (1984) two metaphors for identity formation: discovery and creation. The former applies to the process of discovering the ‘true self’; the second implies there is no pre-existing self, so the person needs to create an identity. Both of these processes can be seen as occurring in the Preparation stage. The person needs to examine his or her values, changing them if deemed necessary, and then seek ways in which to live up to these values by setting appropriate goals. When the individual rediscovers what makes him or herself truly valuable, he or she gains a sense of the possibilities of a positive identity (Pettie and Triolo, 1999). Fekete (2004) explains:
After the soul-shattering experience of a psychotic episode and the personality distortions that come with it, no issue is more compelling than the question of identity, and this question can be divided into two parts. The first question is ‘Who am I?’, or self-concept. The second question is ‘What am I?’ or ‘What have I become?’ This is the issue of symptoms. (p. 190)
In Lysaker and Bell’s (1995) case study of work and volition, a participant illustrated how a sense of self is a prerequisite to building a meaningful life. ‘R’ explained that he was unable to make plans or set goals for himself as he had no self-understanding.
He had no coherent sense of self to provide a ‘foundation for meaning and eventually give his energies a shape’ (p. 397).
In Lysaker and Bell’s (1995) case study of work and volition, a participant illustrated how a sense of self is a prerequisite to building a meaningful life. ‘R’ explained that he was unable to make plans or set goals for himself as he had no self-understanding.
He had no coherent sense of self to provide a ‘foundation for meaning and eventually give his energies a shape’ (p. 397).
