... or Taking the route less travelled.
Jef explains the fundamental approach within mental health rehabilitation to helping patients to see, and feel the difference between appropriate and inappropriate thinking. Recovery starts with the decision to do things differently.
Going against Impulse 
I’ve had the honour and privilege of working with, and sharing the experience of, thousands of people in early recovery, whether in residential, day care or mutual aid environments and I have noticed that those who recover, from any form of behavioural health problem, such as addictions, depression and anxiety, are those who consistently go against their impulses, pushing through, trying new things; in essence, those who swim upstream.
This starts with the moment you go against your impulse to give in, to let go, to believe all the people who tell you how much you have disappointed them, how you will never amount to anything, and you stand up and ask for help. Asking for help is not a thing that is easily done when you are suffering, silently and guiltily. It requires the belief, or at least, as Patrick Casement describes it in “On Learning from the Patient”, the unconscious hope that things can get better, that you can pull through.
The moment somebody asks for help and engages in the journey of Recovery, they are already taking a road they have never travelled.
Known Bad or Unknown Good
It’s basic human nature to fear change. But I would go further: we genuinely believe (often on an unconscious level) that when we’ve been feeling, thinking or behaving in a particular way for a long time, it must be a good way to do things. We tend to prefer something that is a known bad to something that is an unknown good. Life may be painful, but it represents something that we have survived so far. Our drugs and alcohol, for instance, seen by everybody else as the problem, feels very much like the solution. People can learn to endure considerable emotional pain rather than risk existential change; change concerning our very sense of self.
Wanting something better
There is a turning point, a choice point, at which the sufferer, whose natural human tendency may be to allow the currents of their illness to carry them downstream, stands up and decides that they want something better, that they are willing to swim against the tide and get well.
Therefore, Recovery starts with a decision to do things differently. So, considering Recovery is a sign in itself that you are able to swim upstream the key to moving forwards is to not stop there, but, as I stated at the beginning of this article, Recovery requires that we continue to make the least obvious decision again and again. As they say in the 12 step fellowships: ‘Noting changes if nothing changes’.
The person who swims upstream goes to a meeting on the day they really don’t want to, they speak up when they most feel like staying silent, the stay silent and listen when they want to drown everybody out, they say no instead of always saying yes and say yes to new ideas and opportunities.
And this is not limited only to actions.
Wrong Habits - or Bad Habits?
Most of us are quite comfortable in accepting that our behaviours may be unhealthy habits. We may well have been told, time and time again, that our behaviours are inappropriate and wrong. We sort of get that. Smoking is an obvious example. We are willing to recognise, perhaps reluctantly, that these are habits that we would be happier and healthier without. However, far fewer people are able to also accept that their thoughts may also simply be habits, learned at a time long gone that may now be self-sabotaging or even plain wrong. But they can be. If I used to commit a lot of petty crime, I may have learned to think that I am in trouble every time I see a policeman. Twenty years on, of a relatively crime free lifestyle, if I still think that I am in trouble when I see a policeman, is that not a habit that is wrong?
What if, following the example, I felt guilty or afraid every time I saw a policeman? Is that feeling inappropriate too? Is it false in the sense that it does not truly reflect my current life? Traditionally, the one thing we believe to be unquestionable, almost sacred, are our feelings. We are taught to believe that feelings are never wrong and they can never be questioned. My behaviour might be unhealthy, my thinking might be erroneous, but we believe that they are justifiable to anyone who feels the way I do right now.
Are 'Feelings' Truth?
Feelings are very important and they are true in the sense that if you are feeling afraid, then you are afraid, whether you have reason to be or not, and that feeling needs to be respected and taken seriously at that moment. However, might there also be room within our recovery, and our new-found decision to do things differently, to create a healthy space within ourselves and in our interactions with others to accept that our behaviour, thoughts and feelings, may often simply be habits, that are open to healthy reflection and, therefore, to change?
Feelings, most of the time, are just habits too. A habit is an action, thought or feeling that is repeated so often that it becomes typical of somebody, although they may not be conscious of it. Feelings, just like actions, can be learned behaviours. We learn, through repetition, how to automatically feel in any given situation. Those feelings dictate how we think, and therefore, how we behave. Due to my previous life as a petty criminal, I automatically feel afraid when I see a policemen, I then think about what I may have done wrong and what is going to happen to me, and I hide my face and cross the road. But if I haven’t done anything wrong, then surely the feeling of guilt is just a habit, the thoughts that follow and the behaviour they compel me to do, belong to a time in my past.
Feelings are often habits that we have learned through repetition. It is an automatic response to a familiar situation or event.
Many of those who successfully change, are those who can begin to accept that their thoughts, actions and feelings, too, can be something that they give themselves permission to question, and to change.
The first step of your Recovery, when you decided to embrace change, and every single step after that which moves us forward, is taken by pushing a little against our habits; those things that seem the easiest and most obvious thing to do.
A Hundred Tiny Risks 
A key responsibility for those of us who work with people in Recovery, who design the therapeutic spaces that comprise our offices and clinics, is to create an environment where our patients are safe and are encouraged to take a hundred tiny risks, new decisions, new thoughts and even feelings, every day. Change is scary, but they should never have to do it on their own. Change requires change and that should be applauded and enabled.
Our patients, who have entrusted something incredibly important to us: their lives and the quality of those lives, deserve all our efforts to create such spaces, as they, figuratively, plunge forward and cycle free of their illness, taking risks and returning to that magical moment of childhood when they let go of the handlebars and cried: “Look dad! No hands!!” Remember that? The sky became the limits.
Jef Mullins is Head of Training and Development for various rehab units.
