How Can Health Care Professionals Address Learned Helplessness?

Clinicians often ask us, "What about people who aren't interested in recovery, and who have no interest in peer support and other recovery concepts?" What we often forget is that MOST people find it undesirable to change. It's hard work! People have gotten used to their identities and roles as ill, victims, fragile, dependent and even as unhappy. Long ago we learned to "accept" our illnesses, give over control to others and tolerate the way of life. Think how many people live like this in one way or another that don't have diagnosed illnesses. It's easier to live in the safety of what we know, even if it hurts, than it is to do the hard work of change or develop hope that conceivably could be crushed.

Our clinical mistake, up to this point, has been thinking that if we ask people what they need and want, they will instinctively have the answer AND want to change their way of being. People who have been in the mental health system for many years have developed a way of being in the world, and particularly being in relationship with professionals, where their self-definition as patient has become their most important role.

Our only hope for accessing internal resources that have been buried by layers of imposed limitations is to be supported in making leaps of faith, redefining who we'd like to become and taking risks that aren't calculated by someone else. We need to be asked if our idea of who we'd like to become is based on what we know about our "illnesses". We need to be asked what supports we would need to take new risks and change our assumptions about our fragility and our limitations. When we see our closest friends and supporters willing to change, we begin to try out our own incremental changes. Even if this means buying ingredients for supper instead of a TV dinner, we need to be fully supported in taking the steps to recreating our own sense of self and be challenged to continue to grow.

Recovery is a personal choice. It is often very difficult for health care providers who are trying to promote a person's recovery when they find resistance and apathy. Severity of symptoms, motivation, personality type, accessibility of information, perceived benefits of maintaining the status quo rather than creating life change (sometimes to maintain disability benefits), along with the quantity and quality of personal and professional support, can all effect a person's ability to work toward recovery. Some people choose to work at it very intensively, especially when they first become aware of these new options and perspectives. Others approach it much more slowly. It is not up to the provider to determine when a person is making progress - it is up to the person.

What Are Some Of The Most Commonly Used Recovery Skills And Strategies?

Through an extensive ongoing research process, Mary Ellen Copeland has learned that people who experience psychiatric symptoms commonly use the following skills and strategies to relieve and eliminate symptoms:

• reaching out for support: connecting with a non-judgmental, non-critical person who is willing to avoid giving advice, who will listen while the person figures out for themselves what to do.

• being in a supportive environment surrounded by people who are positive and affirming, but at the same time are direct and challenging; avoiding people who are critical, judgmental or abusive.

• peer counseling: sharing with another person who has experienced similar symptoms.

• stress reduction and relaxation techniques: deep breathing, progressive relaxation and visualization exercises.

• exercise: anything from walking and climbing stairs to running, biking, swimming.

• creative and fun activities: doing things that are personally enjoyable like reading, creative arts, crafts, listening to or making music, gardening, and woodworking.

• journaling: writing in a journal anything you want, for as long as you want.

• dietary changes: limiting or avoiding the use of foods like caffeine, sugar, sodium and fat that worsen symptoms.

• exposure to light: getting outdoor light for at least 1/2 hour per day, enhancing that with a light box when necessary.

• learning and using systems for changing negative thoughts to positive ones: working on a structured system for making changes in thought processes.

• increasing or decreasing environmental stimulation: responding to symptoms as they occur by either becoming more or less active.

• daily planning: developing a generic plan for a day, to use when symptoms are more difficult to manage and decision making is difficult.

• developing and using a symptom identification and response system which includes:

  1. a list of things to do every day to maintain wellness,

  2. identifying triggers that might cause or increase symptoms and a preventive action plan,

  3. identifying early warning signs of an increase in symptoms and a preventive action plan,

  4. identifying symptoms that indicate the situation has worsened and formulating an action plan to reverse this trend,

  5. crisis planning to maintain control even when the situation is out of control.