Earlier this week, SAMHSA released what is supposedly a unified definition of recovery. While I feel that attention to this topic is not futile, I also feel that recovery from mental illness or substance abuse is an inherently personal status. I liken this definition to how we feel about “freedom” or “love”, each person has their own unique perception.
The posting of this report sparked a lively discussion on a forum that I belong to. Below are some of the compelling comments posted by one of the members. With his permission, I have copied it here.
The phenomenon of our field struggling to define "recovery" is astonishing. The SAMHSA effort seems to be motivated around how to decide what resources to make available to efforts around addiction. That's a noble effort.
Some earlier work to define "recovery" got bogged down in other ways, like deciding if total abstinence was or was not an element of recovery and whether those treated with buprenorphine or other medications are in bona fide "recovery."
Deciding what resources are needed to address a problem is important and practical. Defining "recovery" for other people, however, is absurd.
Do we ever hear of endocrinologists convening a conference to define "recovery" from adult-onset diabetes? Or even psychiatrists arguing about how to define "recovery" in regards to bulimia or anorexia nervosa? Or even FEMA and Red Cross professionals arguing about how to define "recovery" from an earthquake?
"Recovery" from a disease, disorder, natural disaster, or personal crisis can only be defined by the individual who suffers. We only create confusion when we try to create an idiosyncratic vocabulary for the addiction field by enshrining the clinician's vision as the only way to justify a human being's goals.
Clinical professionals stick to a professional vocabulary when communicating with each other. That is, clinical professionals use words like:
Remission Relapse
Symptoms Exacerbation
Co-morbidities Impairment
Function Dysfunction
The word "recovery" however, simply means (roughly) "the subjective experience of the individual struggling with a given problem."
For a group of professionals to try to define "recovery" for their clients is inherently paternalistic and condescending. It's a symptom of inappropriate boundaries by the professionals.
Best wishes,
Steve Coulter, MD
What do you think? Should professionals define recovery for the people they serve?
The posting of this report sparked a lively discussion on a forum that I belong to. Below are some of the compelling comments posted by one of the members. With his permission, I have copied it here.
The phenomenon of our field struggling to define "recovery" is astonishing. The SAMHSA effort seems to be motivated around how to decide what resources to make available to efforts around addiction. That's a noble effort.
Some earlier work to define "recovery" got bogged down in other ways, like deciding if total abstinence was or was not an element of recovery and whether those treated with buprenorphine or other medications are in bona fide "recovery."
Deciding what resources are needed to address a problem is important and practical. Defining "recovery" for other people, however, is absurd.
Do we ever hear of endocrinologists convening a conference to define "recovery" from adult-onset diabetes? Or even psychiatrists arguing about how to define "recovery" in regards to bulimia or anorexia nervosa? Or even FEMA and Red Cross professionals arguing about how to define "recovery" from an earthquake?
"Recovery" from a disease, disorder, natural disaster, or personal crisis can only be defined by the individual who suffers. We only create confusion when we try to create an idiosyncratic vocabulary for the addiction field by enshrining the clinician's vision as the only way to justify a human being's goals.
Clinical professionals stick to a professional vocabulary when communicating with each other. That is, clinical professionals use words like:
Remission Relapse
Symptoms Exacerbation
Co-morbidities Impairment
Function Dysfunction
The word "recovery" however, simply means (roughly) "the subjective experience of the individual struggling with a given problem."
For a group of professionals to try to define "recovery" for their clients is inherently paternalistic and condescending. It's a symptom of inappropriate boundaries by the professionals.
Best wishes,
Steve Coulter, MD
What do you think? Should professionals define recovery for the people they serve?
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