The End Goal is Recovery, Right?

I have stopped using the word ‘recovery’. This means that the sentence ‘I am in recovery’ is no longer going to be coming out of my mouth, which at first seems quite negative. But it is not the same as saying ‘I am not in recovery’ (which I would not say any way, because that would still be using said word).

I first began questioning ‘recovery’ when I found out about ‘Recovery in the Bin‘ on Twitter, although this was some time ago. I agreed mostly with everything they talk about, although maybe not to the same extent that they do.

I’ve done some reading on the recovery narrative, and how it has been taken over by neoliberalism, and places pressure on the patient. It is like you have to be in recovery. You have to be getting better, and it seems a bit… demanding. There are plenty of physical illnesses where patients are not expected to fully recover, and yet the emphasis placed on recovery within mental health seems to demand that you do, that to be fully recovered is the end goal.

We all need end goals… or think we do. That we do X, Y and Z, and then we have achieved the goal and that is done. However, I am beginning to think that there does not need to be an end goal, or at least for me personally; I can only ever speak for myself.

I am not being negative, I am not saying that I will not ever be what many describe as ‘recovered’. I just think maybe I will not, and maybe that is ok. It does not mean I am going to spend my whole life struggling or being a victim, it just means that I have come to an understanding that I might always live with mental illness, and that living with mental illness… well, it is not the end of the world. I can still be happy, still get on with my life and still be me.

The pressure of the recovery narrative is, I think, harmful to me. The pressure some professionals place on recovery is harmful. People can be discharged or excluded from services for not getting better and I do not agree with this. Why can we not support people in managing, even if they stay where they are? And I know the answer to this. If someone is not going to fully recover, they might (MIGHT) always need some degree of support from health services = not exactly cheap or ideal for the NHS. Mental health services are thinking about your discharge as soon as you are in them, their goal is to get you better and get you out.

But what even is ‘better’? I get a bit sick of, and sceptical of, the wonderful recovery stories. I had anorexia, and to some extent you could say I do. I am not fully recovered. It does not control me any more, I am not underweight, I manage my eating to varying extents. I do not need treatment any more. But neither would I make a fantastic magazine story. I am less ‘Woman Had Anorexia, Nearly Dies and Now She Loves Her Body and Eats Whatever She Wants and is Magically Amazing and Living Life to the Full’ and more ‘Woman Had Anorexia, Now Manages it’.

Not such a great headline. Not going to attract much attention aka not what anyone wants to publish, or talk about. It just is not that exciting.

And yet I am happy, fine and content with it.

When you are ‘ill’ people will throw stories at you of people who had Anorexia and now they are better and that becomes your goal (or should, apparently). I just never found any of that very helpful. Hearing from, talking to people who had fully recovered… I just felt like I would have found it more helpful to hear from someone who still struggles, but manages. Someone who is still living with it, but is getting on with their life, and is healthy and happy despite it.

‘Recovery’. ‘Survivor’. ‘Warrior’. These words just do not help me, personally. You hear people describe people who fully recover as being strong. Does that mean those that do not are weak? If you have not made a full recovery, does that make you a failure?

The recovery narrative, while it can be inspiring and motivating, also can be damaging. It can also be taken on by mental health services in a way that is detrimental to patients, puts extreme pressure on them due to the expectations involved, and is heavily linked to the discharge of said patients. Get them in, recovered, and out.

Borderline Personality Disorder was not an NHS priority many years ago. Help did not really have to be provided, because people believed it was a disorder nobody could recover from, and if you cannot get better, why treat it? And then the paper was published… ‘Personality Disorder: No Longer a Diagnosis of Exclusion’ because people realised actually, you can get better. And that was fabulous that it was now a bigger priority and not a death sentence and yet at the exact same time… why does an illness need to be something that can be gotten rid of, why does someone need to be able to fully recover, in order to deserve help? We sure as hell do not treat physical illness like that.

And you know, things can get bettER. Some people do describe themselves as fully recovered, and one day that might happen for me. It just is not my priority any more. Aiming for ‘recovery’ helped me a lot because it felt like if I was not getting better, I was getting worse and I dreamt of being one day, finally ‘recovered’. It gave me hope, or that is what I thought.

But because life has not worked out the way that said dream was supposed to go, and I have not fully recovered… the narrative of recovery, that goal, became unhelpful. We can live with mental illness without that being a negative thing. We do not have to ‘beat it’ to be strong, successful or happy. If we do feel like we reach a place where we are fully better, fabulous. I am not knocking that or saying it is not possible.

But if we end up living our lives with some degree of mental illness, that probably fluctuates over time… becoming sometimes worse, sometimes better… I just think that is OK and the more I think about it, the stronger my distaste of that word, ‘recovery’, becomes.

I am Natalie. I have mental health problems and I am not fully recovered. I might never be fully recovered. It does not mean in ten years time I cannot be in a relationship or having kids, or finally having my dream career. I do not need to be fully recovered and symptom free in order to have, or to deserve those things. I do not need need to sit in front of an employer and be able to say ‘I had mental health problems’ and I do not need to be totally fine to manage a relationship or not scare off potential partners. I do not need to be mental illness free to be a good parent and I do not need to reach some end goal of a full recovery to look back on my life and be proud of it.

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