1. Applied Recovery Let’s stop preaching And start practicing
Brian Miller, Ph.D.
NAMI Utah 2011

2. Applied Recovery “The universe is made of stories, not atoms."
--Muriel Rukeyser, poet
-- we should understand the power of the stories we tell (good or bad)
--we must work to tell the difference between the stories and the direct experience of our life

4. Applied Recovery “Optimism is the true moral courage”
-Ernest Shackleton

5. Sir Ernest Shackleton was the commander of the most dramatic adventures in history
Left in August, 1915, to lead the first land crossing of the Antarctica Continent
Arrived at South Georgia island in November and was told by whalers the ice was too bad– had to wait 1 month to set out for the edge of the continent.
Spent 6 weeks battling through 1,000 miles of pack ice but on January 18th the ice “closed around us like we were an almond in toffee”

6. For two days, men tried to break the ice to create a water channel, but the water quickly froze back up and made matters worse.

7. Decided would have to winter aboard the ship and sail in spring
Decided would have to winter aboard the ship and sail in spring. Had plan to ration supplies and developed strategies for keeping morale up such as playing football and hockey on the ice.

8. By October, driven by wind and tide, ice began to squeeze against ship and slowly crush it.
Took supplies off the boat and three lifeboats and set up an ocean camp established on an ice flow 1 ½ miles away

9. On November 21st the ship disappeared

10. Ice underfoot begins to break up
Hauled supplies and lifeboats until they could get to open water

11. Put in water attempting to go west back for help, but drifting ice forced to go east for 30 miles to Elephant Island

12. By now it had been 497 days since they had been on land.
Shakleton realizes no help is forthcoming– decied only chance is to get back to the whaling station 800 miles away across the most stormy stretch of ocean in the world.

13. Sets out in a 21’ boat, the James Caird, believing it would take 1 month.
Contantly wet, huge waves, frozen wet sleeping bags, reindeer hide rotten and frozen. Constantly having to chip ice off sails and boat, rest on rocks serving as ballast, frost bite on fingers.
Only apble to get sighting every 7 days or so. Termed “the greatest navigational feat of all time”
Saw the island after 14 days, half of what was expected.
Next morning, story blew them back and they lost sight of the island.

14. Men on elephant island lived in overturned boats covered with canvas from sails, survived on nothing but penguin meat.

15. Shakelton had landed 22 miles from Stromness, had to cross the backbone of mountains running entire length of island
Two crew member were too weak, shakleton and two crew members set out to cross glaciers, snow fields, and ice slopes.

16. Boats weren’t available to go after his crew on Elephant island
Boats weren’t available to go after his crew on Elephant island. After four failed attempts to get through, got a Chlilean steamer to make way to elpehant island. By now it has been 107 days since he left the Island.

17. All 22 crew members survived in the most dramatic rescue of all time.

18. Applied Recovery “Where there is no vision, there is no hope”
--George Washington Carver
Consider the losses Shakleton experienced:
Locked into ice
Planned to winter aboard
Crushed ship
planned winter camp
Ice melts underfoot
Sailed boats to island
No pending rescue from island
Set course across Drake passage
wrong side of island
Climbs and hikes
no ships
after four unsuccessful trips, finds Chilean vessel

19. “Though much had been lost, much abides…” --Tennyson
As soon as we focus on what was lost– the disruption of the plan– we stop moving forward (and problem solving)
The Buddha: a spoonful of salt in a tea cup will taste very salty, but in a lake will be clean, pure water.”

20. Everything changes when you see the “crisis” as a demand for new skills rather than “I am suffering from a tragedy.”

21. Applied Recovery
Applied Recovery is about moving from the philosophical to everyday utility.
Pope John Paul XXIII:
“Consult not your fears, but your hopes and dreams. Think not about your frustrations, but about your unfulfilled potential. Concern yourself not with what you tried and failed in, but with what is still possible for you to do.”
I am impatient with the world of recovery– we are talking too much and still not getting it.
Has become political (consumer vs. survivors; EBP vs. recovery (not possible!) peer-directed vs. professional
Vaguely and over-defined
Cut the gordian knot: definition from “Dr.” John Paul 23rd

22. Applied Recovery
Successful recovery does not change the fact that the experience has occurred, that the effects are still present, and that one's life has changed forever.
Rather, successful recovery means that the person has changed, and that the meaning of these events to the person has also changed. They are no longer the primary focus of the person's life."
--Bill Anthony, 1993
Recovery doesn’t mean recovery from symptoms, it means recovering the rest of your life
Applied Recovery asks: “how do we live a good Life”?
Story of Houdini

23. Set aside these truths for now:
Medications may be profoundly helpful;
Major mental illnesses have biological origins;
Symptom self-management is effective and empowering.
The symptomatic course for serious mental illness is better than clinicians usually believe.

24. Applied Recovery
The three “grand essentials” to happiness in this life are something to do, something to love, and something to hope for.”
--Joseph Addison

25. Applied Recovery: How do we live a good life?
“We’re happier when we are healthy, well-fed, comfortable, safe, prosperous, knowledgeable, respected, non-celibate and in love.“
--Stephen Pinker

26. Components of Applied Recovery
Self:
Self verification
Self Esteem
Self Efficacy
What were we doing when MI hit? Building an identity
You are not your diagnosis anymore than you are your social security number.
Components of self:
Self verification
Self Esteem
Self Efficacy
WHO study

27. “For the most part. However Kimwana was allowed to drift back and forth from illness to relative health without much monitoring or comment from the rest of the family. Periods of troubled behavior were not greeted with the expressions of concern or alarm and neither were times of wellness celebrated. As such, Kimwana felt little pressure to self-identify as someone with a permanent mental illness.”
From “Crazy Like Us” by Ethan Watters

28. Components of Applied Recovery
What can we do?
Acceptance
Mutuality
Belonging
Problem-solving rather than reacting

29. Components of Applied Recovery
2. Secure base
Appropriate housing
Sufficient Income
Freedom from violence
Adequate Healthcare
2. Secure base
Appropriate housing
Sufficient Income
Freedom from violence
Adequate Healthcare
Now I want to take a break and ask—if we are looking away from illness and symptoms– what makes a rich life for any of us—mentally ill or not. What makes people happy?

30. What make people happy (anyone)?
The one thing most studies on happiness agree on is this: family and relationships are the surest way to happiness.
Close behind are meaningful work, positive thinking, and the ability to forgive.
What does not seem to make people happy are money, material possessions, intelligence, education, age, gender or attractiveness

31. What make people happy (anyone)?
“Now and then its good to pause in our pursuit of happiness and just be happy.”
--Guillaume Apolinaire

32. Components of Applied Recovery
3. Family relationships
Mutually enjoyable moments
Meaningful role in the family
Get support
4. Meaningful engagement
Family relationships
Mutually enjoyable moments
Meaningful role in the family
Get support
4. Meaningful engagement
Harvard study– we are happiest when we are physically involved in something, or socializing. We are unhappiest when we are physically inactive and “just thinking”.

33. Components of Applied Recovery
“The best moments usually occur when a person’s body or mind is stretched to its limits in a voluntary effort to accomplish something difficult and worthwhile.”
--Mihaly Csikszentmihalyi

34. Components of Applied Recovery
Help them find what they are excited about
A job that takes them where they want to go
Money to buy things they want to have
Activities that allow them to help others
Activities that allow them to express themselves

35. Components of Applied Recovery
5. Positive Thinking Patterns
Positive, but founded in reality
Writing your story, seeing it as a connected story
Gratitude
Forgiveness
Mindfulness
Positive, but founded in reality (not every day, in every way…) but reality based
Writing your story, seeing it as a connected story– writing a personal narrative as one who has struggled, has good times and bad but is rising to challenge and learning to live well.
Gratitude– gratitude journal
Forgiveness
Mindfulness-- savoring

36. Components of Applied Recovery
6. Giving to others
Helping role in the family
Volunteer work
Daily goal to help someone
Peer Assistance

37. Components of Applied Recovery
7. Meaning
“People who are impoverished, depressed, suicidal, care about more than about their suffering. They care—sometimes desperately– about virtue, about purpose, about integrity, and about meaning.”
--Martin Seligman, the “father” of positive psychology
Imagine genie offers sublime happiness in dream state– or increased happiness but sibling not born– or IQ less by twenty points but happiness twenty points higher– now e now our lives are about more than mere happiness.

38. Components of “Applied Recovery”
Social/Family role
Guiding philosophy, religion, politics or culture
Coherent Narrative

39. 8. Personal freedom
people simply cannot be happy unless they determine their own fate and are left to make their own choices.
“Wealth of Time” is the luxury of choice

40. Difficulties are just things to overcome, after all. Ernest Shackleton