Dialogical Recovery Approach: Using Severe Emotional States (AKA Schizophrenia) for Self-Integration

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Length: 1 hour

Honoree Address:  Daniel Fisher, MD, PhD

I was diagnosed with schizophrenia at age 26 while carrying out research at NIMH on the neurotransmitters supposedly responsible for mental health conditions. Through four episodes of extreme emotional states for which I was hospitalized, I was able to integrate at a deep level.  I became a psychiatrist in order to humanize the mental health system, but found that larger systemic change was needed. Through founding the National Empowerment Center and being a member of the White House Commission on Mental Health, I assisted many others with lived experience of recovery to construct an inspiring recovery paradigm as the basis for policies to replace the deadening maintenance model.  I have also learned that recovery is enhanced by a positive re-framing of distress as potentially growth promoting.  Part of such a re-framing is to move away from diagnoses to more narrative-based descriptions.  If instead of an individually-based, illness model, the person experiencing distress and those close to them understand their so called symptoms are attempts at deep integration as described by John Weir Perry, then personal growth is possible. I propose a synthesis of recovery and dialogue, called a Dialogical Recovery Approach, consisting of a combination of Open Dialogue, Recovery Dialogues, and emotionalCPR.  We advocates find the Finnish Open Dialogue description of distress as residing in the space between the members of a person's social network as more conducive to growth of all involved. I describe the 2-year training program in Open Dialogue, which I completed at the Institute for Dialogical Practice, and the application of this approach in private practice. I also discuss the application of dialogical principles in systems change through recovery dialogues in a community mental health center. Lastly I discuss the use of emotionalCPR as a vehicle for public education in personal growth through application of dialogical principles by the general population.

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