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Cultural contexts and constructions of recovery 

Cultural contexts and constructions of recovery
Chapter:
Cultural contexts and constructions of recovery
Author(s):

Ademola Adeponle

, Rob Whitley

, and Laurence J. Kirmayer

DOI:
10.1093/med/9780199691319.003.0008
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date: 05 December 2019

This chapter examines the social and cultural roots and implications of current concepts of recovery. Consistent with biomedical notions of illness and disease, psychiatry has tended to frame “recovery” largely in terms of outcomes, as “recovery from illness”. However, during the last decade the term “recovery” has come to refer to a social movement promoting a reorientation in psychiatric care, toward ensuring that individuals can live a full life in their communities. Along with this reorientation, recovery is increasingly conceived of as a process, rather than an outcome, with individuals described as “being in recovery” rather than as “recovering from” an affliction. The new recovery “movement”, with its roots in civil rights and independent living movements, arose in part as a reaction to perceived attitudes of pessimism and paternalism inherent in conventional psychiatric care. It envisions for individuals with mental illness a reassertion of their rights to a dignified and meaningful life in the community and a renewed sense of agency, with an active say in the direction of their own healthcare. Although sometimes framed in the universalistic language of human rights, recovery is rooted in specific cultural concepts of self and personhood. The consumer-oriented recovery model, which is popular in the USA, builds on a Euro-American individualistic and egocentric concept of the person. However, in other cultures, sociocentric, ecocentric, or cosmocentric conceptions of personhood may have more salience. These differing cultural concepts of the person influence the trajectories of illness, modes of adaptation, response to interventions, and definitions of positive outcome. In particular, cultural notions of the person's connection to family, community, and spirituality play a key role in local notions of recovery. This will be illustrated with examples from qualitative research with African-Americans in the USA, indigenous peoples in Canada, and patients in Nigeria. Understanding the cultural and historical roots of recovery provides a framework for considering the relevance of recovery for diverse cultural groups, both within North American and European societies and in other parts of the world.

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