Resilience or recovery or both

I recently read this interesting, and misleading, Psychology Today article entitled How to Survive (Practically) Anything. It is actually an interview with Psychiatrists Steven Wolin and his wife Sylvia. The interview is introduced as follows.

Early November past, Steven Wolin, a soft-spoken psychiatrist, walked onto a stage in Dallas and delivered a critical karate chop to the 4,000 members of the American Association for Marriage and Family Therapy sitting in stunned silence before him. He told them that America is being turned into “a nation of emotional cripples” under their eyes.

Uh huh. You’ve got the selling of “mental illness”, and the selling of the pharmaceutical products that go along with “it”, right, front, and center. In the Not Only Department, you’ve got an ever expanding Nanny State to take care of this ever growing population of slackers, wastrels, artificial invalids, and other responsibility evaders.

Over the past 10 years, he said, traditional psychiatric thinking “has slipped out of professional hands, where it had shortcomings enough, into the popular culture, where it has gone wild. I am referring to the Recovery Movement, which I believe has become dangerous. It completely bypasses our capacity for resilience. It glorifies frailty, lumps trivial disappointments with serious forms of mental illness, and portrays the human condition as a disease.”

I have to take issue with this bashing of the Recovery Model of treatment. I don’t, for one thing, know why recovery would be considered at odds with resiliency, ostensibly the subject of this interview. I have my own issues with the Recovery That Is Not Recovery Model of treatment, all too common these days, but that is altogether another matter entirely.

Steven: The Damage Model is a belief about the intergenerational transmission of disease. It basically says that if your family is having trouble, the chances that you are going to get it are very high. It derives from traditional psychiatric thinking, conventional wisdom, and popular psychology, which stress how children growing up in adverse circumstances suffer lasting emotional disturbances. I call this prediction, with its bias toward pathology, the Damage Model. It is prophecy of doom.

I’ve seen this Damage Model put forward more often by conventional professional psychiatrists than I have by persons, amateur, paraprofessional, or professional, emphasizing the Recovery Model of treatment. It is my feeling that Dr. Wolin is being very defensive about his own profession while seeing only what he wants to see in what he calls the Recovery Movement. I believe that this movement, as he puts it, is probably more complex, varied, and diverse than he imagines it to be.

Steven Wolin and his wife oppose to this Damage Model of treatment a Challenge Model of treatment.

Steven: Both models start with the observation that the troubled family can inflict considerable harm on its children. In the Damage Model, children are seen as passive and without choices to help themselves. In the Challenge Model, the family is not only a destructive force but an opportunity. Survivors are challenged by the family’s troubles to experiment and to respond actively and creatively. Their preemptive responses to adversity, repeated over time, become incorporated into the self as lasting resiliencies.

Some of the statistical information presented in this interview is very encouraging. We learn, for instance, 85% of the children of alcoholics don’t become alcoholics; 70% of the children of child abusers don’t become child abusers; and, 90% of the children of schizophrenics don’t become schizophrenic. What worries me is that we may also be contributing to a discrimination problem by focusing solely on those who don’t develop a condition. There is another challenge, and this is the challenge for the alcoholic who triumphs over his or her alcoholism, the child abuser who ceases to abuse children, and the schizophrenic who recovers his or her reason. Resiliency, for me, is not just a matter of resisting the transmission of negative behavioral traits.

I recognize that the cult of victimization may have its devotees, but I think that such is the kind of thing a person can easily walk away from relatively unscathed. On the other hand, self-help advocacy does represent a survival/thrival technique for the person who may have experienced some set backs in life, and who may desperately require just such a dividend tool. However hard it might be to abandon the disabilities profession for the abilities profession, I don’t think it is any less hard for a psychiatrist to throw his or her own well intentioned doing for others business overboard. One way or another, people will get where they need to go. To tell the truth, I could use less of what is euphemistically referred to as self-help literature, and less psychiatry in the world, to boot.

The interview ends with a warning against developing the rigidity of a tin man. A danger the resilient type is credited with developing. I’m thinking, yep, if we’re talking resilience here, rubber might be thought of as the preferred element.