Psychiatric Bulletin (2001) 25: 75. doi: 10.1192/pb.25.2.75
© 2001 The Royal College of Psychiatrists
Psychiatric Bulletin (2001) 25: 75
© 2001 The Royal College of Psychiatrists
Recovery as a medical myth
David Whitwell
Southmead Hospital, Bristol BS10 5NB
Sir: I would like to comment on the responses to my paper (Psychiatric
Bulletin, October 1999, 23, 621-622). Prior (Psychiatric
Bulletin, January 2000, 24, 30) states that I was using a medical
concept of recovery; I agree. However, I did not define recovery, and it was
the patients who thought that they had not recovered. I think that this
concept of recovery is part of a medical model in which people suffer from
clearly defined episodes of illness, from which they can hope to make an
equally clearly defined recovery, provided they get the right treatment.
Psychiatry has tended to operate with these oversimplified concepts. My
conclusion is that recovery from mental illness is part of a medical view of
things, and as such is largely a myth. It is an unexamined idea that people
believe, but which does not reflect reality. It also seems that this unhelpful
myth is shared by our patients. One reason for the hold that this myth has is
that it fits quite well with the situations that we face in acute psychiatry.
It justifies interventions that may be urgent and difficult. It is in the
longer term that the model fails.
Hope and optimism are essential in mental health services, as Sayce and
Perkins comment (Psychiatric Bulletin, February 2000, 23, 74).
That is why the medical concept of recovery by which so many are
likely to be disappointed is an unhelpful myth. They mention a
different process of recovery which is slow, and very personal: a
rebuilding of a life, which may take a life time.
We are only now beginning to understand this process and how to help people
with it. It is an exciting and growing field. What is clear is that medical
treatments by themselves do not achieve this. Too often in the past the
traditional medical focus on diagnosis, medication and coercion have been seen
by service users as standing in the way of personal recovery. There is a
problem concerning words here. Recovery is a very positive and uplifting word.
It has been linked into a limited medical model where it does not fit.
Personal recovery may be a better term as it stresses the
individual, and gets away from the idea that this is something that we can do
to people.