I’ve recently been corresponding with a woman, let’s call her Alice, who is concerned about the part of the Eleanor Longden story where Eleanor states that “Hearing voices is like left-handedness; it’s a human variation, not open to cure, just coping.” Alice pointed out that since some people do find a way to a place where they no longer hear voices, it is misleading to state that there is “no cure.” She went further to say that she considers complete recovery, from psychosis or trauma, to have happened only when a person no longer experiences any kind of disadvantage due to the psychosis or trauma. Since hearing voices has some disadvantages, this means she believes it isn’t appropriate to call it complete recovery if the person still hears voices.
My reply to her was as follows:
I share your problem with the “not open to cure” language, as I think it does convey an impression of having to resign to being stuck with a problem, and like you say, since we know some people are helped to transition to not having voices, why not hold out hope to everyone that this is at least a possibility for them?
However, I still am very much opposed to your definition of recovery, and I will try to explain why.
I’m not sure that there is any kind of experience that doesn’t have some kind of ill effect. For example, if one’s parents are too nice and one’s childhood too idyllic, one may later have the ill effect of feeling too overprotected and of being too unprepared for the world’s harshness.
Every way of living, and every way of organizing oneself, has some set of advantages and disadvantages. This can be seen for example in choice of geographic location. If you live in New York, there’s lots of culture and stimulation, but it’s hard to get nature and solitude, or any kind of small town feel. If you live in a small town or out in the country, you miss other things.
People whose lives are affected by trauma, and/or by psychosis, often end up places they would never otherwise be as a result of the trauma and/or psychosis. But later, upon recovery, they may choose to stay in some of those places, because they accept the set of advantages and disadvantages that come with them, or it just isn’t worth the bother of moving and getting set up somewhere else. Metaphorically speaking, it’s as though one were kidnapped and taken to a foreign country. The kidnapping was traumatic, but later perhaps one adjusted to the foreign country and found a way of living there that was successful, that made a move back to one’s original location seem not desirable.
Now imagine someone comes along and says “you have obviously failed to recover from the kidnapping, because you are still experiencing some disadvantages due to the kidnapping, namely all the disadvantages that come from living in this particular location.” What’s wrong with that logic? The problem with the logic is that it neglects acknowledging that the person would also have some disadvantages if they moved back to the town from which one was kidnapped, or to some other location. There will always be disadvantages, to whatever way of living. It seems to me that a person who felt a need to move, even to a less desirable location, just to show that his/her living location was not directly or indirectly a result of the trauma, would really be a person who was still acting like a victim of trauma, while the one who lived happily in the location where he/she had originally been taken due to the traumatic event/kidnapping might be the one who was recovered. Of course, some in their recovery might move back to their home town, but the key thing to acknowledge is that there are diverse ways of recovering, and that it is up to the person to define what recovery is for them.
“Trying too hard to be normal” incidentally is often a common problem in people who have been diagnosed with psychosis and similar problems. A more functional belief can be that “it’s normal to be different” and to accept differences that don’t cause unacceptable problems. We are all different as a result of our pasts, whether we are trauma survivors or not. All these differences come with a set of advantages and disadvantages. There is no reason that those of us who are trauma survivors should feel compelled to get rid of all the differences we have that might be a result of the trauma: such a compulsion in itself can screw up our lives.
My contention is that as long as the person has found a meaningful life, with a set of advantages and disadvantages that seem acceptable, without disability or need for treatment, that is recovery. That doesn’t mean the person has nothing further to strive for – life is full of things to strive for – but it means that “recovery from trauma” or “recovery from psychosis” is no longer the focus.
Incidentally, the woman, Eleanor Longden, in the news story I linked to in starting this discussion, in her chapter in the “Living with Voices” book, said “I am proud to be a voice hearer. It is an incredibly special and unique experience. I am so glad that I have been given the opportunity to see it that way because recovery is a fundamental human right and I shouldn’t be the exception. I should be the rule. That is why I want to be a part of this movement to change the way that we relate to human experience and diversity.”
Thanks, interestingly put. Dr. Abram Hoffer, has four criteria for recovery, one of which was being free of signs and symptoms. The other three, as you know, are getting along well with friends and family, getting on well in the community, and paying income tax. Dr Hoffer, who died within the last year at age 90, was of an age where the hearing voices movement was only just beginning to evaluate voice hearing in a more positive light. I have tended to rely on Dr. Hoffer’s criteria, but am tailoring my opinion more and more to thinking that meeting three out of four benchmarks ain’t bad. The Bible is big on voice hearers and yet still refers to madmen, so even back then there must have been some recognition that it’s what you make of the voices that counts.
“Alice’s” approach to hearing voices seems to me to be the same as the mh system’s, namely that it is a symptom of an illness, a bad (mad) thing that needs to be fought/overcome, a disadvantage only, with the voice hearer being nothing but the victim of this “illness” (or of the past abuser so often represented by the voices). A lot of people probably see it that way, although I suspect, that most of them don’t do so before they get in touch with the mh system. Hearing voices can be extremely distressing, but at the same time I for one never once doubted that there was meaning and value to the voices. In the meantime, accepting the voices and exploring their meaning confirmed my initial suspicion, that they were valuable messages from my unconscious, the key to a greater understanding of myself. So, why would I have wanted to get rid of them, when I could learn how to look at them, and explore their meaning and value from a place where I did no longer identify as their victim? Actually, this is what recovery means to me, to arrive at a place where one can let go of the drama, of being the victim of one’s past, and move on to grow.
Hearing voices is just a different, extreme, way of thinking thoughts. Thinking thoughts, in an extreme way or not, is just a “symptom” of being human, not of any “illness”. Problematic it only becomes when a person is identified with her thoughts. But then it becomes problematic disregarded whether the way of thinking thoughts is extreme or not.
“Alice’s” approach to me also seems to be the logic consequence of our civilization’s very dualistic way of categorizing things into strictly “good”, healthy, desirable, and strictly “bad”, sick, undesirable. – Apropos of black and white thinking. Another example where, as I see it, the mh system projects one of its own characteristics into its clientele. – Or into suffering and happiness. The dualistic mindset pursues happiness as the ultimate fulfilment, and fights suffering, not realizing that both are two sides of the same thing, that there can’t be happiness without suffering, and vice versa. In order to truly overcome suffering, one would have to overcome happiness too: enlightenment. And no one has yet truly overcome something by turning it into an enemy who needs to be fought.
To my conviction, true recovery presupposes acceptance, presupposes a view of “symptoms” not as the enemy, but indeed as allies. And when I’ve reached a point where I experience “symptoms” as allies rather than as my enemies, there may actually be no longer any need for me to eliminate them. I may even want to hold on to my allies.
Thanks for your comments. I agree with you Marian, especially about the importance of eventually getting to a place where one doesn’t feel a victim of one’s past, but is back in touch with one’s potential as a human being to have a meaningful life despite whatever happened in the past.
As far as black and white thinking – well I think that often is a problem for human beings in general when we are emotionally charged about something! But you are right that the mental health system only wants to see this thinking in its clients, and refuses to notice when it engages in such thinking itself.
Enemies to allies is a much broader topic – can we eventually figure out how to do this with external enemies as well?
Haha! Really good question. I think, we definitely have the potential. The tricky question is whether we, humanity as a whole, can achieve the self-/awareness necessary to see through and let go of our unconscious defence mechanisms such as projection before we’ve managed to pull the rug from under ourselves. Or whether the amount of suffering we’d have to experience in order to become conscious surmounts what we are able to survive as a species. – And, personally, I sometimes think, we’ve already crossed the Rubicon. We just haven’t noticed yet. Another defence mechanism: denial. For instance of the truth that “this too shall pass”.