The Relational Essence of Natural Recovery: Natural Recovery as Relational Practice

International Journal of Mental Health and Addiction volume 17, pages191–205(2019)Cite this article

Abstract

This article offers a relational practice view to conceptualize natural recovery from addiction concerns. Through the lens of a social practice framework, the processes of natural recovery are seen as specific relational trajectories or transformative pathways involving relationships between humans, non-humans, communities, and philosophies, rather than as a process of symptom elimination. We argue that this kind of conceptualization of recovery acknowledges the many people who manage to recover without treatment or professional help, known as natural recovery. In addiction practices, we can see the dominance of pathologizing interpersonal patterns (PIPs) that maintain the addictive process. Over the course of recovery, we can see the dominance of healing interpersonal patterns (HIPs) that support the recovery process. To utilize this understanding as practitioners, we need to help nourish the platforms where the healing interactional patterns in daily life might be supported and maintained. While this reduces power from the position of “expert” in the biomedical model, it also provides more optimism, as members of the social network we can directly contribute to those healing interpersonal patterns—by the way we relate to, support, and engage with other people.

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References

  1. Biernacki, P. (1986). Pathways from heroin addiction: recovery without treatment. Philadelphia, PA: Temple University Press.

    Google Scholar 

  2. Borg, M. (2007). The nature of recovery as lived in everyday life: perspectives of individuals recovering from severe mental health problems. PhD dissertation, Institute for Social Work and Health Sciences, Faculty of Social Sciences and Technology Management, NTNU, Trondheim.

  3. Borg, M., & Davidson, L. (2008). Recovery as lived in everyday experience. Journal of Mental Health, 17(2), 129–141. https://doi.org/10.1080/09638230701498382.

    Article  Google Scholar 

  4. Burman, S. (1997). The challenge of sobriety: natural recovery without treatment and self-help groups. Journal of Substance Abuse, 9, 41–61. https://doi.org/10.1016/S0899-3289(97)90005-5.

    Article  CAS  PubMed  Google Scholar 

  5. Carballo, J. L., Fernández-Hermida, J. R., Secades-Villa, R., Sobell, L. C., Dum, M., & García-Rodríguez, O. (2007). Natural recovery from alcohol and drug problems: a methodological review of the literature from 1999 through 2005. In H. Klingemann & L. C. Sobell (Eds.), Promoting self-change from addictive behaviors: practical implications for policy, prevention, and treatment (pp. 87–101). New York: Springer.

  6. Cloud, W., & Granfield, R. (2001). Natural recovery from substance dependency: lessons for treatment providers. Journal of Social Work Practices in the Addictions, 1, 83–104. https://doi.org/10.1300/J160v01n0107.

  7. Davidson, L. (2001). Us and them. Psychiatric Services, 52(12), 1579–1580. https://doi.org/10.1176/appi.ps.52.12.1579.

    Article  CAS  PubMed  Google Scholar 

  8. Davidson, L. (2003). Living outside mental illness: Qualitative studies of recovery in schizophrenia. New York: New York University Press.

    Google Scholar 

  9. Davidson, L., Borg, M., Marin, I., Topor, A., Mezzina, R., & Sells, D. (2005). Processes of recovery in serious mental illness: findings from a multinational study. American Journal of Psychiatric Rehabilitation, 8(3), 177–201. https://doi.org/10.1080/15487760500339360.

    Article  Google Scholar 

  10. Dawson, D. A., Grant, B. F., Stinson, F. S., Chou, P. S., Huang, B., & Ruan, W. J. (2005). Recovery from DSM-IV alcohol dependence: United States, 2001-2002. Addiction, 100(3), 281–292. https://doi.org/10.1111/j.1360-0443.2004.00964.x.

    Article  PubMed  Google Scholar 

  11. Dreier, O. (1999). Personal trajectories of participation across contexts of social practice. Outlines: Critical The Social Studies, 1(1), 5–32 Retrieved from http://ojs.statsbiblioteket.dk/index.php/outlines/article/view/3841/3335.

    Google Scholar 

  12. Gergen, K. J. (2009). Relational being. New York: Oxford University Press.

    Google Scholar 

  13. Graham, M., Young, R. A., Valach, L., & Wood, A. (2008). Addiction as a complex social process: an action theoretical perspective. Addiction Research & Theory, 16(2), 121–133. https://doi.org/10.1080/16066350701794543.

    Article  Google Scholar 

  14. Granfield, R., & Cloud, W. (2001). Social context and “natural recovery”: the role of social capital in the resolution of drug-associated problems. Substance Use & Misuse, 36(11), 1543–1570. https://doi.org/10.1081/JA-100106963.

    Article  CAS  Google Scholar 

  15. Hari, J. (2015). Chasing the scream. The first and last days of the war on drugs. London: Bloomsbury Circus.

    Google Scholar 

  16. Hodgins, D. C., & el-Guebaly, N. (2000). Natural and treatment-assisted recovery from gambling problems: a comparison of resolved and active gamblers. Addiction, 95, 777–789. https://doi.org/10.1046/j.1360-0443.2000.95577713.x.

    Article  CAS  PubMed  Google Scholar 

  17. Johnson, T. A., & Wilhelmsen, K. H. (2014). Evalueringsrapport recoveryverksteder [research report on recovery communities]. Senter for psykisk helse og Rus, Høgskolen Buskerud og Vestfold [center for mental health and substance abuse, Buskerud and Vestfold University College]. Norway: Drammen.

    Google Scholar 

  18. Klingemann, H., Sobell, L. C., Barker, J., Blomqvist, J., Cloud, W., Ellinstad, T.,... & Junker, C. (2012). Promoting self-change from problem substance use: Practical implications for policy, prevention and treatment. Springer Science & Business Media.

  19. Krupa, T. (2004). Employment, recovery and schizophrenia: integrating health and disorder at work. Psychiatric Rehabilitation Journal, 28(1), 8–15. https://doi.org/10.2975/28.2004.8.15.

    Article  PubMed  Google Scholar 

  20. Lewis, M. (2015). The biology of desire. Why addiction is not a disease. New York: Public Affairs.

    Google Scholar 

  21. McNamee, S. (2015). Radical presence: alternatives to the therapeutic state. The European Journal of Psychotherapy and Counselling, 17(4), 373–383. https://doi.org/10.1080/13642537.2015.1094504.

    Article  Google Scholar 

  22. Mudry, T. E. (2016). Behaviour is in the practice: examining excessive behaviours using a practice framework (Doctoral dissertation). University of Calgary, AB.

  23. Mudry, T., Strong, T., & Chang, J. (2014). A life history of a PIP: Snapshots in time. In K. Tomm, S. St, D. W. George, & T. Strong (Eds.), Patterns in interpersonal interactions: Inviting relational understandings for therapeutic change (pp. 82–102). New York: Routledge.

    Google Scholar 

  24. Nepustil, P. (2016). Recovered without treatment: the process of abandoning crystal meth use without professional help. Chagrin Falls, OH: Taos Institute Publications.

    Google Scholar 

  25. Nepustil, P., & Camargo-Borges, C. (2014). Renouncing methamphetamine: a relational perspective. International Journal of Collaborative-Dialogic Practices, 5(1), 69–82.

    Google Scholar 

  26. Ness, O. (2016). De småting: Om relasjonell etikk og samarbeid i psykisk helse- og rusarbeid [the small things: Relational ethics and collaboration in mental health care]. In B. Karlsson (Ed.), Det går for sakte [It’s moving too slowly] (pp. 58–71). Oslo: Gyldendal.

    Google Scholar 

  27. Ness, O., Borg, M., & Davidson, L. (2014). Facilitators and barriers in dual recovery: a literature review of first-person perspectives. Advances in Dual Diagnosis, 7(3), 107–117. https://doi.org/10.1108/ADD-02-2014-0007.

    Article  Google Scholar 

  28. Nicolini, D. (2012). Practice theory, work, & organization: an introduction. Oxford, England: Oxford University Pres.

    Google Scholar 

  29. Price-Robertson, R., Obradovic, A., & Morgan, B. (2016). Relational recovery: beyond individualism in the recovery approach. Advances in Mental Health, 15, 108–120. https://doi.org/10.1080/18387357.2016.1243014.

    Article  Google Scholar 

  30. Reinarman, C. (2005). Addiction as accomplishment: the discursive construction of disease. Addiction Research and Theory, 13(4), 307–320. https://doi.org/10.1080/16066350500077728.

    Article  Google Scholar 

  31. Robins, L. N., Helzer, J. E., & Davis, D. H. (1975). Narcotic use in Southeast Asia and afterward. An interview study of 898 Vietnam returnees. Archives of General Psychiatry, 32(8), 955–961.

    Article  CAS  PubMed  Google Scholar 

  32. Rumpf, H. J., Bischof, G., Hapke, U., Meyer, C., & John, U. (2009). Remission from alcohol dependence without formal help: current status of the research. Sucht (Search), 55, 75–85. https://doi.org/10.1024/2009.02.03.

    Article  Google Scholar 

  33. Schatzki, T. R. (2012). A primer on practices: theory and research. In J. Higgs, R. Barnett, S. Billett, M. Hutchings, & F. Trede (Eds.), Practice-based education: perspectives and strategies (pp. 13–26). Rotterdam: Sense Publishers.

    Google Scholar 

  34. Shove, E., Pantzar, M., & Watson, M. (2012). The Dynamics of Social Practice. In The dynamics of social practice: everyday life and how it changes. London, UK: Sage.

    Google Scholar 

  35. Slade, M. (2009). Personal recovery and mental illness: a guide for mental health professionals. Cambridge: Cambridge University Press.

    Google Scholar 

  36. Sobell, L. C., Cunningham, J. A., & Sobell, M. B. (1996). Recovery from alcohol problems with and without treatment: prevalence in two population surveys. American Journal of Public Health, 86(7), 966–972.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Sobell, L. C., Ellingstad, T. P., & Sobell, M. B. (2000). Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions. Addiction, 95(5), 749–769. https://doi.org/10.1046/j.1360-0443.2000.95574911.x.

  38. Speck, R. V., & Attneave, C. (1973). Family networks. New York: Pantheon Books.

    Google Scholar 

  39. Strauss, J. S. (1996). Subjectivity. Journal of Nervous and Mental Disease, 184(4), 205–212.

    Article  CAS  PubMed  Google Scholar 

  40. Tew, J. (2008). Social perspectives on mental distress. In T. Stickley & T. Basset (Eds.), Learning about mental health practice (pp. 235–250). West Sussex, England: John Wiley & Sons.

    Google Scholar 

  41. Tew, J., Ramon, S., Slade, M., Bird, V., Melton, J., & Le Boutillier, C. (2012). Social factors and recovery from mental health difficulties: a review of the evidence. British Journal of Social Work, 42(3), 443–460. https://doi.org/10.1093/bjsw/bcr076.

    Article  Google Scholar 

  42. Thege, B. K., Woodin, E. M., Hodgins, D. C., & Williams, R. J. (2015). Natural course of behavioral addictions: a 5-year longitudinal study. BMC Psychiatry, 15(4), 4. https://doi.org/10.1186/s12888-015-0383-3.

    Article  Google Scholar 

  43. Tomm, K. (1991). Beginnings of a “HIPs and PIPs” approach to psychiatric assessment. The Calgary Participator, 21–24.

  44. Tomm, K., St. George, S., Wulff, D., & Strong, T. (2014). Patterns in interpersonal interactions: inviting relational understandings for therapeutic change. New York: Routledge.

    Google Scholar 

  45. Topor, A. (2001). Managing the contradictions. Recovery from severe mental disorders, Department of Social Work, SSSW No. 18, Stockholm University, Stockholm.

  46. Topor, A., Borg, M., Mezzina, R., Sells, D., Marin, I., & Davidson, L. (2006). Others: the role of family, friends, and professionals in the recovery process. American Journal of Psychiatric Rehabilitation, 9(1), 17–37. https://doi.org/10.1080/15487760500339410.

    Article  Google Scholar 

  47. Topor, A., Borg, M., Di Girolamo, S., & Davidson, L. (2011). Not just an individual journey: social aspects of recovery. International Journal of Social Psychiatry, 57(1), 90–99.

    Article  CAS  PubMed  Google Scholar 

  48. Vaillant, G. E. (Ed.). (1980). The doctor’s dilemma. London: Crooma Helm.

    Google Scholar 

  49. Vandereycken, W. (2012). Self-change in eating disorders: is “spontaneous recovery” possible? Eating Disorders, 20(2), 87–98. https://doi.org/10.1080/10640266.2012.653942.

    Article  PubMed  Google Scholar 

  50. Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374, 363–371. https://doi.org/10.1056/NEJMra1511480.

    Article  CAS  Google Scholar 

  51. Vriends, N., Bolt, O. C., & Kunz, S. M. (2014). Social anxiety disorder, a lifelong disorder? A review of the spontaneous remission and its predictors. Acta Psychiatrica Scandinavica, 130(2), 109–122. https://doi.org/10.1111/acps.12249.

    Article  CAS  PubMed  Google Scholar 

  52. Waldorf, D. (1983). Natural recovery from addiction: some social-psychological processes of untreated recovery. Journal of Drug Issues, 13(2), 237–247. https://doi.org/10.1177/002204268301300205.

    Article  Google Scholar 

  53. Waldorf, D., & Biernacki, P. (1979). Natural recovery from heroin addiction: a review of the incidence literature. Journal of Drug Issues, 9(2), 281–289. https://doi.org/10.1177/002204267900900212.

    Article  Google Scholar 

  54. Wampold, B., & Imel, Z. E. (2015). The great psychotherapy debate: the evidence for what makes psychotherapy work. New York: Routledge.

    Google Scholar 

  55. Whitaker, R. (2002). Mad in America: bad science, bad medicine, and the enduring mistreatment of the mentally ill. New York: Perseus Books.

    Google Scholar 

  56. Whiteford, H. A., Harris, M. G., McKeon, G., Baxter, A., Pennell, C., Barendregt, J. J., & Wang, J. (2013). Estimating remission from untreated major depression: a systematic review and meta-analysis. Psychological Medicine, 43(8), 1569–1585. https://doi.org/10.1017/S0033291712001717.

    Article  CAS  PubMed  Google Scholar 

  57. Woods, S. (2004). Untreated recovery from eating disorders. Adolescence, 39(154), 361–371.

    PubMed  Google Scholar 

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Author information

Affiliations

  1. Our Lady of the Lake University, 411 SW 24th Street, San Antonio, TX, 78207, USA

    Tanya Mudry

  2. Spolek Narativ, V Aleji 114/31, 620 00, Brno, Czech Republic

    Pavel Nepustil

  3. Department for Education and Lifelong Learning, Norwegian University of Science and Technology, 7491, Trondheim, Norway

    Ottar Ness

  4. Department for Health, Social and Welfare Studies, University College of Southeast Norway, P.O.Box 7053, 3007, Drammen, Norway

    Ottar Ness

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  1. Tanya Mudry
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  2. Pavel Nepustil
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  3. Ottar Ness
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Correspondence to Pavel Nepustil.

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Mudry, T., Nepustil, P. & Ness, O. The Relational Essence of Natural Recovery: Natural Recovery as Relational Practice. Int J Ment Health Addiction 17, 191–205 (2019). https://doi.org/10.1007/s11469-018-0010-x

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Keywords

  • Recovery
  • Natural recovery
  • Relational recovery social practice theory
  • Addiction