much to explore: an inquiry into research on recovery

When talking about recovery, there’s much to explore. In the earth, in each other, signs of the hard road of recovery are all around. There is a cultural myth that recovery implies the return to a previous state of health or balance, however, current understandings of it in medicine, psychology and ecology increasingly describe recovery as a ongoing journey where the final goal is unknown and may not closely resemble the original state. We often think of recovery as rest, taking time away, letting recovery happen – but is this accurate? Or, does recovery also require determination and constant vigilance? Whether it’s about healing a hip injury or an ailing ecosystem, a broken heart or an addiction, research provides ideas for the best recovery strategies. In this column we’ll ask, “What is recovery?”,

“What do we know about it from research?” and “How can we apply what we know?” But get ready for a wide-ranging exploration this topic is vast.

What is “recovery”?

The traditional medical psychiatric model considers “recovery” the endpoint of a journey out of illness. It is a process where the end goal is to be “recovered,” where recovery is freedom from a host of symptoms and comes after illness and treatment. Yet even within this model, there has been a shift in views since the early 1980s; recovery is now increasingly define as an on-going journey, one that is unique to each individual and does not have a fixed endpoint. This is called the Recovery Approach and is applied especially to substance addiction and mental illness. In this approach, elements of recovery are personal and there is no universal checklist of symptoms.

Like the Recovery Approach to human health, restoration ecology views the recovery of an ecosystem as a perpetual process. The Society for Ecological Restoration (SER), for example, defines restoration as the process of assisting the recovery of an ecosystem that has been degraded, damaged, or destroyed. Traditionally, an ecosystem was deemed “restored” if it adequately resembled a hypothetical historical condition. Ideas of these “untouched” forests are useful in the restoration process, but they hold more sway in popular imagination than in the study of ecology. Current research shows that ecosystems do not necessarily reach an equilibrium and then sustain it. Ecosystems are chaotic masses of life that compete and coexist, and it is not accurate to think of them as capable of a balanced (in the sense of unchanging) state of “health.”

It seems like no matter how one looks at it, recovery is an on-going journey with a distant and unknown endpoint. So, while acknowledging this open-endedness, what concrete qualities about recovery do we know?

What do we know from research about recovery? Sports medicine does a lot of research on recovery, especially questioning why some patients adhere to their treatment regime better than others. Studies suggest that patients stick to treatments only if they perceive the threat to be dangerous and believe the treatment strategy to be good (i.e. they believe that if they don’t properly treat their knee injury they’ll never play tennis again, but that regularly attending physiotherapy will mitigate this). Shocking? Probably not, but these conclusions are a clear reminder of certain key factors for successful recovery. Are you struggling to stick to a recovery strategy? Perhaps you are not convinced about the severity of the issue or your susceptibility to it. Perhaps you don’t believe you can do anything to improve the situation, or don’t have confidence in the treatment suggested.

Elements of the Recovery Approach are widely known and used, however, some critique it for encouraging false expectations. It risks sending the message that anyone can fully recover through the sheer force of positive thinking.

Balancing optimism with concrete action is perhaps a better strategy. Another concern is that it distracts from the social and political injustices that contribute to people’s instability. For example, for someone who uses a wheelchair, a few political changes to improve access could make a huge difference. Others are concerned that this open model (which avoids prescribed endpoints) can be used to push people out of care before they are ready to do so.

Although they are currently under revision by restoration ecologists and have been critiqued for their North American focus, opposite, are nine attributes of a functioning ecosystem.

How can I support recovery?

There are many ways to support recovery in ourselves, our friends and our world. Hopefully, the research introduced in this article provides some ideas. But go exploring with this, there are few fixed proscriptions beyond patience and kind ness with oneself and others. The SER have an online database of restoration projects called The Global Restoration Network that offers ways to support ecological recovery. Here in Bali, The Pemuteran Coral Reef Restoration Project is SER’s biggest coral reef nursery and restoration project worldwide. Funded through donations from the local community and business- the fish populations are noticeably improving.

It is interesting to consider that this checklist designed for ecosystems, might just apply to us as well.

The key factors in recovery (basic needs, hope, a supportive community) are also some of the most important factors for a healthy, balanced life at any moment. If this is true, then having clearer notions about the process of recovery and what is entails can only be beneficial.

The recovery approached identifies some common factors that can apply to various successful recovery journeys:

– Hope: having hope for oneself and for the future.

– Secure Base: having adequate housing, income, health, and freedom from violence.

– Self-recovery: re-discovering a sense of self. This may require “positive withdrawal” where one retreats from many social interactions and only engages in ways that feel positive and meaningful.

– Supportive Relationships: an important aspect of recovery is having people around who believe in one’s potential to recover.

– Empowerment: having self-control and self-determination.

– Coping Strategies: from medication to regular exercise, the discovery of personal coping strategies is important.

– Meaning: developing a social or work role that is meaningful.

1. The restored system contains the right number and amount of species compare to the reference ecosystem.

2. It consists of lots of indigenous species.

3. All the factors required for the system to continue on its own are present.

4. The physical environment is capable of sustaining the populations.

5. It seems to function normally for its stage of development.

6. It is suitably integrated into the larger surroundings.

7. Potential threats to the ecosystem have been reduced as much as possible.

8. it is sufficiently resilient to endure normal periodic disturbances and stress.

9. It is self-sustaining to the same degree at the reference system and has the potential to endure indefinitely.

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