Without self-determination people with severe mental illness
who are in recovery can feel like they are just spinning their wheels. Self-determination
in recovery is the process of taking back one’s life, of regaining control over
one’s destiny. It’s about making decisions and advocating for the human right
to make choices for oneself. Self-determination is the catalyst that moves true
recovery from mental illness forward.
Self-determine touches every area of recovery from daily
living to medical care. So for me self-determination manifests as a series of
lists that I can check off and feel a sense of accomplishment. For example, I
have list of day to day activities that have to be taken care of in order for
me to get through my day. I start with the cleaning of my home and my personal
hygiene. These things have to be in place before I can even think about
accomplishing anything else. For people with mental illness this is a challenge
because sometimes the symptoms of mental illness interfere with one’s ability
to clean the cat box, wash the dishes, take a shower, etc. Sometimes, we have
to fight for the sheer will to do these things.
This is where self-determination comes in to play. In these
moments we have to use every tool we have to fight for the life we envision for
ourselves. We have to use positive self-talk, affirmations, and we sometimes
have to negotiate with ourselves. Like, I will get the laundry done and
afterwards I will have cup of my favorite herbal tea and zone out in front of
the television for 30 minutes.
Self-determination informs our decisions about housing,
employment, finances, worship and relationships. We have a right to live in
safe and affordable housing. We have a right to participate in meaningful work,
have enough money for leisure activities, worship in whatever way we feel
comfortable, and have mutually satisfying relationships.
In regards to our medical care, we have a right to person
centered treatment. In this arena we get to make critical decisions about which
doctors treat us, what treatments we receive, what medications we take, and
what is done for us when we are in crisis. So, it’s critically important for us
to use our tools like the wellness recovery action plan and advanced directives.
These documents outline our wishes for treatment and care from family members, friends
and healthcare professionals. They are living documents that that need to be
modified as our lives change and transform. They need to transform with the ebb
and flow of our daily living.
Many of us remember a time when decisions were made for us. We
were told where we could live, what to eat and when, and if we could even leave
the hospital after a crisis. Some of us were warehoused in mental institutions
for years, subjected to cruelty and mistreatment in nursing homes, and babysat
in day programs. Thank God times have changed. We have choices now and we need
to take full advantage of those opportunities.
Sounds ideal right? So what could hold us back from living our
lives in self-directed way? Well, there is fear. Some of us have lived lives
where we were totally dependent on others and/or the government. We have been
told by well-intentioned people that we are limited in our opportunities. Some
of us have been told by doctors that we will never work again, that it would be
irresponsible to have children or to expect companionship. We haves been told
by loving family members that life is too stressful for us and we should just
sit back and collect a check that will barely cover our living expenses.
And then there is ignorance. Many of us don’t know what’s out
there and we are afraid to find out. We all don’t have a ton of experience
navigating through this life and we aren’t sure how to do it. This is where
peer support really shines. When we see recovery modeled for us by people who
struggle in the same way we do we become inspired and hopeful. After all hope
is the cornerstone of recovery. With hope, the possibilities are endless.
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