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July 2014 |
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Cover story |
Recovery
deficit setting of ‘doing to’.
The psychiatrist Adolf Meyer (1900) went on to make a number of significant
observations which at the time – and perhaps still today, in some quarters – were
regarded as radical. People can and do recover; even those in the midst of
illness possess valuable strengths and it’s our interactions in the social world, in
the everyday, that are key to recovery.
The founding of AA in 1935, with its emphasis on mutual aid and self-help,
has major significance in this recovery history, as does the civil rights movement
of the 1960s and the consumer/survivors/ex-patient movement of the late
1980s and early 1990s. Phil Hanlon, professor of public health at the University
of Glasgow, outlines another kind of history in his book
The Future Public Health
(2012), which I believe also has deep significance for the British recovery
movement. He suggests that there have been four waves of public health, which
have brought significant improvement to health over the last 184 years.
Each new wave begins while the previous wave is at its peak. The first wave of
public health (1830-1900) saw the rise of ‘classical public health interventions’ –
a recognition, before the science caught up, of the importance of clean water and
sanitation. In this period we see the growth of municipal power and influence,
and the beginnings of the rise of the ‘expert’. The second wave (1890-1950)
sees the continued ascendency of the expert, the flowering of ‘scientific
rationalism’, expansion of hospitals, health visitors and the germ theory of
disease. The third wave (1940-1980), born of a deep demand for change and a
post-war consensus, sees new forms of social solidarity and collective
responsibility leading to the creation of the NHS, the welfare state and social
housing. While the fourth wave (1960-2000), which also sees the rise of neo-
liberalism (perhaps a partial response to the third wave?), focuses on individual
risk factors and lifestyle issues.
These four waves have had a significant impact on health and continue to do
so. However Hanlon is very clear, as are many others in the fields of public
health, economics, environmentalism and politics (to name a few), that we are
now, all of us, in an age of crisis, staring into the abyss and facing the
‘challenges of modernity’. Across the developed world and increasingly in the
‘majority world’, people are getting sicker in increasing numbers. As communities
continue to fragment and social ties fray (something Bruce Alexander describes
eloquently in his book
The Globalization of Addiction: A study in poverty of the
spirit,
2008), levels of unhealthy dependency – drugs being just one among many
– and mental distress are rising dramatically.
Needs are rising and resources are dwindling. Hanlon contends that current
interventions are failing to address societal issues because they are grounded in
an acceptance of cultural norms that are fundamentally part of the problem:
‘economism (the belief that money will sort things out), individualism,
consumerism and materialism’ – all of these driven and sustained by the deficit
world we live in. Modern society is unequal, inequitable and unsustainable, says
Phil Hanlon in
The Future Public Health
.
It’s not all doom and gloom and this, I believe, is why the British recovery
movement, if it learns from its history and puts social justice at its heart, has a
major role to play in the response to this crisis of modernity. Hanlon suggests
there is a need for a ‘fifth wave of public health’ which will challenge the rampant
individualistic consumerism that underpins a dominant economic model based on
endless growth – a model that is taking us, as I commented in Birmingham, ‘to
hell in a hand basket’. While we have been encouraged to focus on the ‘canaries
in the mine’, those who are the first visible casualties of a sick society, fixing
them and returning them to productive life, we have been discouraged,
interestingly, from looking at the mine itself. So while we rebrand and tinker at
the margins, all of us ‘users’ within a dysfunctional system, we remain silent as
to the really destructive addictions.
As George Monbiot put it in the
Guardian
on 27 May, this issue is ‘the great
taboo of our age – and the inability to discuss the pursuit of perpetual growth
will prove humanity’s undoing... The inescapable failure of a society built upon
growth and its destruction of the Earth’s living systems are the overwhelming
facts of our existence. As a result, they are mentioned almost nowhere. They are
the 21st century’s great taboo, the subjects guaranteed to alienate your friends
and neighbours.’
Hanlon believes that our current system, with its acceptance of modernity’s
‘norms’ and overriding emphasis on the objective (evidence and science) at the
expense of the subjective (the many meanings found within the ‘I’ and the ‘we’)
is failing. He calls for new ‘integrative’ approaches that will bring the subjective
and objective together on equal terms, valuing the stories and wisdom found
within families, neighbourhoods and communities. He suggests that we need new
approaches that are ‘creative, ecological, ethical and beautiful’, which will
reintegrate ‘the good, the true and the beautiful’ – grand language that needs to
be turned into reality within communities, which is where I believe the British
recovery movement comes in.
In positioning ‘recovery’ as the ‘remaking of meaning’, and a shift from a deficit-
based world to new strength-based ways of being, it is possible to see the
movement as central to the search for the ‘good, the true and the beautiful’. Where
else would you start if not with those who still struggle in this deficit world, with the
people who are trying to recover, with the ‘canaries’ and with the people who have
managed to ‘remake’ themselves? Where else will we find the wisdom and the
learning that will enable us all to deal with our damaging dependencies?
Which is why the UKRF is promoting a recovery month in September that
supports movement toward a strength-based world founded on community
resilience and potential; a month that will write new hopeful stories. And it’s why
we’re gathering in Leicester on 26 September at an event entitled ‘Creating
Narratives for the recovery movement: the good, the true and the beautiful’. We
believe we will make the path by walking it. So we’ll do a little walking together. I
hope some of you can join us.
Alistair Sinclair is UKRF director. The UKRF’s event, ‘Creating narratives
for the recovery movement: the good the true and the beautiful’ is on
26 September in Leicester. Details at www.ukrf.org.uk
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