Recovery vs. Disease Management

hopeThe Hopeworks Community blog has an outstanding post contrasting recovery and disease management.

His focus is on mental illness, but the parallels are clear. One can’t help but reflect on the fact that the addiction recovery movement rose in response to the failure of the mental health system to help addicts recover.

There’s a lot there. It’s worth reading the entire post. Here are a few of my favorite points.

  • Recovery believes that individuals matter.  No degree of impairment or difficulty makes them matter less.
  • Disease management believes that the disease or diagnostic label is the most important thing about anybody.

On recovery vs. symptom management:

  • Recovery  believes the primary thing the  individual recovers is  control over his own life through the acquistion of knowledge, the development of tools that enables him with the support and encouragement of others to begin building the type of life that enables him to be the best and most version of himself possible.  It believes that recovery involves success in activities, connection with other people, in the contetxt of a life of meaning and is important to that individual is important: his thoughts, feelings, goals, aspirations, and interests.  No degree of impairment makes those things matter least.
  • Disease management believes  that symptom management is the best things can be.  And for the most part it believes that those symptoms will be chronic, always in danger of reoccuring.  It largely believes that medication will be a life time need.

On hope:

  • Recovery assumes that hope is a real thing.  Life can and should be a movement towards better things.  The steps may be slow and require much in the way of patience, but no matter how slow or small they are they are real and should be valued and treasured.
  •  Disease managment believes that hope is limited to symptom management.  It assumes that people will need continual treatment and that life will always tend to be disrupted by the “course of the disease.”  Life never really gets better, the hope is that it get less worse.

On the humanity of people with mental illness:

  • Recovery assumes that mental illness does not cause you to lose anything essential to being a human being.  Mental illness may block you.  It may disrupt you.  It may damage you.  It may detour you.  It does not diminish what it means for you to be a human being.
  • Disease management believes that the much of what you do, much of what you think, much of  what you feel, and even much of what you believe is either a symptom of your disease or a reaction to a symptom of your disease.

Personal responsibility:

  • Recovery assumes personal responsibility.  It is not something done to you.  It is not something you are given as much as it is something you get.
  •  Disease management identifies responsibility as following directions given to you by medical personal.

On helping that helps the helper:

  • Recovery assumes that you can support and help others, that often, the greatest help you get is in the help you give.
  •  Disease management believes that your capacity to give to others is not as great as people who are not “mentally ill.”  They do not believe you can be near as helpful as a medical person.

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