Skip to main content

Advertisement

Log in

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

  • Original Article
  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

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

    Google Scholar 

  • 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.

  • 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 

  • 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 

  • 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.

  • 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.

  • 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 

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

    Google Scholar 

  • 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 

  • 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 

  • 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 

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

    Google Scholar 

  • 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 

  • 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 

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

    Google Scholar 

  • 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 

  • 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 

  • 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.

  • 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 

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

    Google Scholar 

  • 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 

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

  • 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 

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

    Google Scholar 

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

    Google Scholar 

  • 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 

  • 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 

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

    Google Scholar 

  • 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 

  • 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 

  • 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 

  • 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 

  • 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.

    Chapter  Google Scholar 

  • 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.

    Chapter  Google Scholar 

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

    Book  Google Scholar 

  • 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 

  • 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.

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

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  • 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 

  • 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 

  • 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 

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

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

    Book  Google Scholar 

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

  • 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 

  • 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 

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

    Google Scholar 

  • 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 

  • 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 

  • 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 

  • 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 

  • 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 

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

    Book  Google Scholar 

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

    Google Scholar 

  • 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 

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

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pavel Nepustil.

Ethics declarations

Conflict of Interest

Author X, Author Y, and Author Z declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11469-018-0010-x

Keywords

Navigation