Thursday, April 28, 2011

Recovering from mental illness

Bipolar Disorder mental illness recovery?
Recovery as a concept is about the process of building a meaningful life as defined by the person with a mental health problem themselves.

There are four key processes suggested:
  1. Finding and maintaining hope
  2. The re-establishment of a positive identity
  3. Finding meaning in life
  4. Taking responsibility for one’s life

Concepts of Recovery:
From Wikipedia. There is some variation in how recovery is conceptualized within models. Professionalized clinical approaches tend to focus on improvement, in particular symptoms and functions, and on the role of treatments; consumer/survivor models tend to put more emphasis on peer support, empowerment and real-world personal experience.

Recovery can be seen in terms of a social model of disability rather than a medical model of disability, and there may be differences in the degree of acceptance of diagnostic "labels" and treatments. In psychiatric rehabilitation, the concept of recovery may be used to refer primarily to managing symptoms, reducing psychosocial disability, and improving role performance.

A review of the psychiatric literature suggested authors are rarely explicit about which concept they are employing; the reviewers called "rehabilitation" perspectives those which focused on life and meaning within the context of supposedly enduring disability, and "clinical" those which focused on observable remission of symptoms and restoration of functioning.

From the perspective of psychiatric rehabilitation services, a number of qualities of recovery have been suggested: recovery can occur without professional intervention; recovery requires people who believe in and stand by the person in recovery; a recovery vision is not a function of theories about the cause of psychiatric conditions; recovery can occur even if symptoms reoccur; recovery changes the frequency and duration of symptoms; recovery from the consequences of a psychiatric condition are often far more difficult than from the symptoms; recovery is not linear; recovery takes place as a series of small steps; recovery does not mean the person was never really psychiatrically disabled; recovery focuses on wellness not illness; recovery should focus on consumer choice.

For many, "recovery" has a political as well as personal implication where to recover is to find meaning, to challenge prejudice (including diagnostic "labels" in some cases), perhaps to be a "bad" non-compliant patient and refuse to accept the indoctrination of the system, to reclaim a chosen life and place within society, and to validate the self. Recovery can thus be viewed as one manifestation of empowerment.

An empowerment model of recovery may emphasize that conditions are not necessarily permanent, that other people have recovered who can be role models and share experiences, and "symptoms" can be understood as expressions of distress related to emotions and other people. Recovery may be seen as more of a philosophy or attitude than a specific model, requiring that "we regain personal power and a valued place in our communities. Sometimes we need services to support us to get there".

My Own Recovery
1. Finding and maintaining hope:
For me recovering from mental illness means freedom from energy and mood swings, like sleep disturbance and the kind of depressive withdrawal that has kept me in bed for up to 20 hours a day, during my worst periods of hopelessness. Freedom from what health care professionals call symptoms, means feeling at home in my body, I feel recovered because I'm finally comfortable in my own skin, free of the fearful neuroception that excludes any maintaining of hope. For as long as I was motivated by unconscious fear, each new finding of hope and maintenance of it followed the classic bi-phasic cycle of the autonomic nervous system that maintains the bipolar condition.

Like the finding of hope that the initial bipolar diagnosis brought, when the relief was quite wonderful, yet like so many others that burst of hope for a stable future could not be maintained through the trail and error experience of a cocktail list of hit and miss medications. Over a thirty year period only the cycle of dashed hope was maintained while my autonomic nervous system remained hidden from any conscious awareness, until insights won through education revealed the power of my trauma conditioned nervous system.

Insight has been the key to my bipolar recovery, and finding new hope for a future that is greeted with an anxiety free anticipation like never before. Armed with new insights from almost a decade of earnest reading and self growth experience I now inhabit my body in a way not known since birth. Having explored many of the observational theories and concepts about the human condition which inform most talk therapies.

I settled my recovery strategy on somatic psychotherapies which are informed by recent discoveries in brain/body neurobiology. In particular Peter Levine's somatic-experiencing and his techniques for discharging the survival energies bound up in a truncated trauma response. An unconscious and habituated natural FREEZE response is at the center of my bipolar experience, with a cyclothymic-anxious-sensitive disposition a genetic susceptibility rather than any single gene cause.

I found hope by allowing myself the full experience of a six week manic episode which has helped me make sense of my three decade long bipolar experience, when viewed through new insight's and a felt acceptance of my trauma conditioned nervous system. I now use Levine's "titration" method on a daily basis to help maintain the hope I found in insightful education and its experiential integration, the process continues in this journey of a life.

"The good life is a process, not a state of being. It is a direction not a destination." _Carl Rogers

2.The re-establishment of a positive identity:
A positive identity in whose eyes? This question seems to go to the heart of our public and private experience of life, or as above "a political as well as personal implication." During my most troubled private years, my public identity was held in reasonably high esteem thanks to success in a family business built largely on manic energy. Publicly I was seen in a positive light because I played the socio-economic game, while suffering the nightmare of a private identity which was held hostage by an unseen, unconscious identity within.

The concept and philosophy of personal identity is as fractious as the notion that mental illness is no different to physical illness, or that mental health is grounded in knowing exactly what the mind is. Is our conscious sense of self driven by the instinctual need to identify objects in the external world? Are the objective conceptions of our left brain driven more by instinct than we care to knowledge?

My identity has taken on new meaning these days and is contained in holistic feelings of what I am, not who I am and being identified by the label of my social name. This sense of what I am feels more valid than who I am, when understood as the self esteem of feeling comfortable, secure and confident inside my own skin. Using Levine's titration technique to discharge the survival energies of trauma conditioning, I now feel whole and instinctively complete, equipped to face each passing moment with free flowing spontaneity, a real manifestation of empowerment.

Traumatized people are too “suppressed,” too stuck in “primal defenses” more appropriate to our amphibian or reptilian evolutionary predecessors. In what ethologist’s call “tonic immobility,” helplessness, we are “scared stiff.” In human beings, unlike animals, the “state” of temporary freezing becomes a long term “trait.” A paralysis of will, shame, depression and self loathing following in the wake of such imposed helplessness. Peter A. Levine Ph.D.

"Recovery can be seen in terms of a social model of disability rather than a medical model of disability,... of diagnostic "labels" and treatments," with that bracketed word forming the cornerstone of so much resentment towards objectifying our experience as labeled symptoms. I'm hoping that you can see the link here to my previous descriptions of an (animal) autonomic nervous system, and sense how objective logic is a product of instinctive survival needs. Surely the visual identification of objects in the external world underpins our immediate experience of a minds eye and is the bedrock of human reason? Is our objective logic an emotive expansion of the reflex orienting response?

Accepting the reality of my evolved nature with an unconscious and habitual freeze response as the core of my bipolar condition, my recovery is now centered on a holistic feelings of wellness, not an absence of labeled symptoms. My identity is now grounded in a felt awareness of the sensations of being, rather than an objectified mentality based on the separation of objects. Unlike an elaborate clock my 100 million cell brain has no hard edged definable parts for easy identification, especially when viewed through the feedback loops of brain/body nervous system activity operating at millisecond speeds.

Why does the body remain tense and restless, even while a person sleeps? The answer might be that 
the body is still responding to stressful experiences from the past that were internalized by a 
natural protective response called - the FREEZE RESPONSE.

3. Finding meaning in life:
Its been three days since I typed the words "finding meaning in life," an action that triggered much contemplation and an exploration of the sensations that have fueled my intellectual disposition in life. Over the last three days I have felt the survival energies trapped within my nervous system like never before, experiencing a deep warmth in my feet that borders on a burning sensation. These past few days I have really felt the power of Peter Levine's titration method in discharging the instinctual energies unconsciously conditioned by traumatic experience.

It feels like a further integration of my self growth experience over the last few years and the integration of a technique I had intellectually agreed with, without a real felt sense of what it means. Bipolar disorder has had such an impact on my life that finding its meaning has energized my purpose and direction for more than a decade now. In January 2010 I packed my life into 32 Kilo's of luggage and a carry on bag containing some of my precious books, and I flew from Australia to Thailand.

Almost eighteen months on and the process of finding meaning in mania continues, a quest that seems to be defining the meaning of my life. Knowing all to well the stigma of mental illness and loss of family and friendships, recovering my dignity in those eyes will bring a certain meaning to my existence. In particular I need to prove to my four sons that their father is not crazy, while at the same time rejecting the usual socio-economic path to group inclusion that would guarantee their respect.

These days meaning comes from my need to overcome, to discover the nature of my manic depression and boost my self respect through that process. The notion of mental illness has never sat well with me, as I'm sure it does not for so many others. Suggestions that I should forget the experience of mania because its an illness like diabetes, misrepresents my sense of reality with a vengeance. Having had the experience of losing my rational mind the very last thing I could do was forget about that, with my best efforts only managing to suppress and deny it.

Turning the energies of mania towards study and the courage to fully experience it, with hopes of allowing an integration process led me through six weeks of mania and the slow processing of that experience. Purpose and meaning have strengthened into resolve and improved self esteem as depression failed to claim me following my six week sojourn into the delusional energies of so-called mental illness.

Meaning has come from re-framing mental illness towards "neuroception" and my autonomic nervous system, with its miss-understood freeze response an underlying stimulus to most so-called mental illness. Meaning has come from understanding that mania is about energy and the innate roots of emotion, and cannot be understood by the objective logic of our "after the fact" rationalizing mind.

Writing this blog and allowing the evolution of my own natural processes is bringing a deeper meaning to my life than any contemporary economic process that I've tried. Money and success did not make me feel comfortable inside my own skin, nor did any other form of addictive, socialized denial that I rationalized as purpose and meaning. Last Sept/Oct brought all the familiar mystical thoughts and feelings about the meaning of life that hyper-mania typically brings.

Religious and spiritual thoughts always accompany the energies of my psychotic periods, as the great existential questions fill my mind, my sense of being. Sensations of walking in my own footsteps as destiny unfolds brought hints of needing to be what I am, not who I had become. Insights into the nature of my being have brought a felt sense of meaning to my life, beyond any projection of who I should or should not be.

4. Taking responsibility for one's life:
What exactly does taking responsibility mean? Does it mean taking care of myself without need of medical intervention, without any professional supervision? Does it mean letting dependent relationships that are entwined with concepts of mental illness fall by the wayside? In taking responsibility for myself I have been charged with irresponsibility towards others, like family and friends. In order to pursue my recovery it has been necessary to cut-off from those who seek to maintain a belief in the medical model of mental illness, regardless of its damage to my sense of wellbeing.

In taking responsibility for myself I have needed to outgrow my natural dependency needs, my reliance on the hierarchy of conventional wisdom. Taking responsibility for myself has meant educating myself beyond well meaning advice and common awareness. Taking responsibility has meant seeking my own insights into the nature of my conditioned response to life, with its problematic behavior patterns. Taking responsibility has led to embracing the wonder of this information age in which we live, regretting only that the internet came late in my life.

Taking responsibility has meant a concerted effort to educate myself about what goes on inside me at a neurological level. Taking responsibility has meant working hard for my own salvation and giving up all wishful thoughts of someone or something else's intervention. Taking responsibility has meant a firm commitment to wade through the mountains of information available and sort the wheat from chaff, and in doing so find the pure gold that is meaningful insight.

Recovering from mental illness has been a patient process of insight gaining self awareness, that only a good education could bring. Education insights accompanied by felt sensations have been the keys to my recovery, with the academic insights of men like Allan Schore and Stephen Porges, cemented by the somatic experiencing methods of Peter Levine. Recovering from mental illness has become a solid awareness that "mental illness" was never the problem for me, with an unconscious autonomic nervous system at the heart of my bipolar behavior, conditioned from birth by traumatic experience.

Recovering from mental illness has been possible for hundreds of thousands of people around the world, and it is a wonder of this modern age that we are able to share our stories of the journey together and raise the level of common awareness.

Neuroception?-An Unconscious Perception?