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Mental Health Recovery
Newsletter

Volume 3.3, September 2002

Contents

News from Mary Ellen and Ed
including Upcoming Presentations

Recovery Topics:
Relaxation and Stress Reduction
Crisis and Disaster Planning by Anne Frank
How We Do WRAP by Lori Ashcraft

Resources
Two New Videos
SAMHSA Booklets
New Book
Curriculum Upgrade

Welcome to Mental Health Recovery Newsletter, begun in March 2000 and published quarterly from the office of Mary Ellen Copeland. This newsletter is for anyone who wants to learn more about recovering from uncomfortable, often disabling psychiatric symptoms. If you do not have a subscription to this newsletter and would like one, please contact the office of Mary Ellen Copeland by e-mail or click here. Subscription is free by email. Multiple print copies are available: 50 copies for $25 plus mailing; 100 copies for $45 plus mailing. Please contact us and let us know whether we can send you the email version to save a tree.

NEWS from Mary Ellen and Ed

It was a hot, dry summer in Vermont. I (Mary Ellen) spent much of the time catching up from a busy spring and revising the Mental Health Recovery and WRAP Facilitator's Curriculum. I took another relaxation course, spent lots of time with family and friends. Ed planted and nourished a big vegetable garden and added some new fruit trees to his growing orchard. We both did lots of hiking.

Through the spring and summer, we have noticed a lot of e-mails regarding attempts to "debunk" the recovery movement. People in positions of authority claiming that those of us who have these difficult symptoms can never get well and that we need to be kept in our place-even forced to do what others have determined is "the right thing" for us to do, without consideration for our own wants, needs and goals. We find this to be very disturbing.

First, I want to applaud those people who have spoken out so strongly against this counter movement.

And then we remind ourselves, and we want to remind you, that once a movement reaches a certain number of people, there is no turning back. And that is true of the recovery movement. There is no turning back. The movement is too big. We have learned too much about ourselves. We know that many of the myths we were taught were not true. We know the difference between good and bad treatment. And we know lots and lots and lots of things we can do to help ourselves feel better when we are not feeling well. We have taken back control of our lives.

And we have done this with the assistance and support of many, many wonderful, supportive health care providers, family members and friends who have walked this hard journey with us. There is no turning back.

Recovery Topics

Relaxation and Stress Reduction

Using relaxation and stress reduction exercises to help myself feel better is one of my most important wellness tools. I first learned about these exercises years ago, when episodes of mania, depression and severe anxiety dominated my life. I began using them on a day-to-day basis, and noticed that it made me feel somewhat better. Then I started using them at night to put myself to sleep, and to get back to sleep when I awakened early. Sometimes they put me to sleep and sometimes they didn't. But at least I felt a lot more relaxed and seemed to feel better the next day whether I had a good night's sleep or not.

The real test was with "mania". I hated mania. I would get going really fast, my mind and body would be racing. I couldn't slow down. I was irritable, alienating family members, friends and even care providers. I bought a lot of things I didn't need and did things I wish I had never done. It was horrible. Some people say they like it. Not me.

I came up with a strategy that I thought might work, and it has. First, I began noticing early warning signs of mania. Thoughts beginning to race. Not wanting to take a break. Feeling irritated with others who were moving at a slower pace then I was. As soon as I noticed these signs I would lay down on my sofa, put on my headphones and listen to a relaxation tape. Sometimes I would play the same tape over and over. Sometimes I would use different tapes. I have one tape with four different relaxation and visualization exercises on it that I like best of all.. When I finished I noticed that I felt much better. Calm and relaxed. When the signs started to return, I would do another relaxation exercise. On a difficult day I would do them three, four, even five times.

That was 12 years ago. I have had signs of mania since then, but never again a full blown mania. I am so grateful. And it is so easy. I think the real trick is to notice it right away and start "cooling" yourself down.

In the years since I first became aware of the effectiveness of relaxation and stress reduction techniques, I have read many books about different relaxation styles and techniques. The libraries usually have a good supply. I have taken several courses and attended several workshops on relaxation and stress reduction. I have invested in many tapes and now CD"s (they are inexpensive compared to the costs for medications, or for the damage I might do if I experienced mania.) I have learned yoga and various styles of meditation. My abilities to relax deeply continue to improve. Just this past summer, I took a course in self hypnosis that brought me to a new level of deep relaxation and a general feeling of well-being.

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There are many different kinds of relaxation and stress reduction techniques. Most of them involve some deep breathing. They may include focusing on parts of your body and feeling them relax or tensing and relaxing the various muscle groups in your body. There may be some movement. You may be instructed to visualize yourself in a beautiful place like walking along the beach or in a meadow of wildflowers. They you repeat positive affirmations. Some of them may be really helpful to you. Others may not feel helpful or right to you at all.

I can do some relaxation exercises without using a tape or CD. I just take a few deep breaths, progressively relax my body working from my toes up-although sometimes I work from the top of my head down. Or I lean back and visualize a beautiful scene or focus on a wonderful time in my life. This is really handy when I am in a public place, like on a train or bus, or when I want to relax quickly. However, most of the time I listen to one of my relaxation tapes or CD's. My focus tends to be better. I find that it is especially important for me to use a tape or CD if I have early warning signs of impending difficulties. You can buy these tapes and CD's in health food stores and bookstores. There are many websites where they can be purchased as well.

If cost is an issue for you, you could purchase some inexpensive tapes, and record your own relaxation tape. You could do it yourself or ask a friend or counselor to do it for you. Read the instructions slowly, from one of the many books, including mine, that describe these exercises.

I include relaxation and stress reduction in my WRAP. In my Daily Maintenance Plan I have "do at least one relaxation exercise". If I am triggered I take a few deep breaths before I do anything else. Then I may choose to take a time out and do one or several exercises or a yoga stretch or two.

If I have early warning signs, I do at least there of these exercises a day. If things are breaking down, I do at least five a day. It takes a lot of time, but if it prevents a crisis, it is well worth it.

Crisis and Disaster Planning
by Anne Frank

One of the things we do where I work at certain phases of our projects is conduct a "lessons learned" meeting, to go over what we did wrong and what we did right. If the project is entering another phase of development, we revise our planning documentation to incorporate what we've learned, to emphasize doing the things we did that worked and to clearly point out the traps we fell into. This type of planned or ongoing revision of a WRAP plan should factor into a section on Recovering from a Crisis or Post Crisis Planning.

For me, the time right after a crisis is when I am most likely to be able to clearly see what I might have done to prevent the crisis, and thus the best time for me to revisit my written plan (which needs a lot of work at the moment!) It is also a time when I know quite clearly what I wish people would have done for me if I could have mustered the courage to ask. I may be able to write down things that would help for next time, even if I still am not up to asking for help yet. My last serious crisis wasn't all that long ago, and I found that the people in my life were truly wonderful. I gained some confidence in it being ok to ask for help which will make it easier in the future. I'm leaning heavily on a few people right now to help me through a few rough weeks at work, drawing on what I learned when I landed in the hospital and hopefully preventing a recurrence.

As far as disaster planning goes, I think a certain amount of preparedness is prudent, but living "on alert" cannot become a way of life. I live in a hurricane zone, and for about 4 months every year there is a reasonable probability of a sizable storm reaching us. In the almost 19 years I've lived here, there have been 2 hurricanes. So, the danger is real, but I'm clearly not going to spend my life hiding in the basement.

There are things that are necessary to plan for, though. The last hurricane we had was bad, but not severe, and it left us without power for 4 days. Natural gas was not disrupted, but with no electricity, there was no electric ignition to turn burners on. Water was OK for us because we have city water, but for people with pumps, they had no water. Having a couple of weeks supply of drinking water, a weather radio, AM/FM radio, supply of fresh batteries, food for our cats, food for us that doesn't require cooking, a couple week's supply of medication on hand all the time... I try to do this all the time.

My husband would add a lot of stuff to this list, and I have more stuff on my list too... there is a fire extinguisher, blankets, first aid kit, windshield washer fluid in my car. I have fire extinguishers in most rooms in my house. Kleenex boxes everywhere. We stock up on basic supplies at one of those warehouse type stores where they are cheap and we only have to go every few months. Living in a state of "preparedness" has more or less been a lifelong habit of mine, and it prevents self-induced crises. If being prepared becomes a habit, you don't need to panic when something unexpected happens. Make a plan in advance for how you will contact loved ones in the event of a bizarre disaster, and a backup plan. Then get on with living your life.

How We Do WRAP
By Lori Ashcraft, Ph.D., Executive Director,
META Services Recovery Education Center

Editor's comment: The following article describes one of many, many wonderful programs around the country that incorporate WRAP and Peer Support into their work. I am beginning to collect this information for a paper I plan to complete in the next several years. As I collect this information, I will be putting descriptions of these programs on the website. So if you are wondering how to incorporate recovery into your system, these articles may give you some ideas.

Today we tried to remember the moment when we first heard about WRAP. It's become such an integral part of our programs that it's hard to remember it not being there. Gene remembers me sitting at my computer and finding Mary Ellen's website about two-and-a-half years ago. Little did we know at the time that that would be the beginning of a wonderful journey that would provide us with ways of helping people manage their symptoms and gain a sense of empowerment in their lives.

To "fast forward", we attended the next workshop held in Brattleboro, and came home with a vision, conceived on the plane during our return flight, of how we could begin to bring WRAP to our community. We didn't have any funding in the beginning, so we started by adding WRAP to our existing services. The first groups only had one or two people but we stayed with it. We discovered that it worked best not to invite people to a group (they've been "grouped" too many times) or a class (schools have not been pleasant places for many people), but to invite them to a luncheon meeting to do WRAP. We got a great deal from a sandwich place across the street.

The WRAP curriculum we now use has eight classes two hours each. Classes are offered four days a week on a two week cycle. This works well because people can complete their WRAP at their own pace. A few have completed their WRAP in two weeks, others choose to attend one class a week and complete in two months, and so forth. Many attend for two or more class cycles. The classes are open ended so people can join at any point. Each day begins with an overview and a review of what has already been covered.

After about twenty people had completed their WRAP, we had a graduation celebration, complete with balloons, cake and ice cream, and certificates of completion. We encouraged graduates to invite their families and friends as well as all our employees. At our first graduation, a woman came in that none of us recognized. She talked about how the WRAP had changed her life. Turns out, she was in the first class of one or two people held in one of our crisis centers months earlier. Usually all the graduates speak, but at the end, one young man had not yet spoken. We asked him if he would like to say anything, and he slowly stood up and started to talk. He said the WRAP had helped him a lot and that he now had a way to handle his symptoms better. At this point, a man that we had never seen stepped to the middle of the room. " I don't know who you people are, or what you do, or how you do it. But this I do know: I have never heard my son speak a sentence before. My hat is off to you. Thank you." This was the beginning of many graduations, and many touching personal stories of people learning to use WRAP to recover.

Last winter, after seeing our results, our funding source (Value Options) asked us to expand our efforts. We started WRAP classes in 15 case management/clinic locations across the Phoenix metropolitan area and now offer 60 WRAP classes a week with classes ranging in size from five to fifteen. All of our instructors are peers trained in WRAP facilitation and peer support. Usually classes have two instructors. When we trained the instructors, we also trained key people at each case management location to support them in recruiting and logistics. Each team has a laptop and a projector with a Power Point presentation with each day's curriculum and movies of real stories of experiences with WRAP and recovery. Sometimes the peers work individually with people after class to help them through "stuck" places but most of the work is done in the class. This year we will have around 1,500 people complete WRAP classes.

What is it about WRAP? Why has a relatively simple process made such a powerful impact? Well, it starts with HOPE: Hope that recovery is possible. The second equally powerful aspect is "And YOU can do it yourself!" This combines hope with personal responsibility instilling the confidence that each person can recover under their own power when in a recovery-oriented environment. This is often the first time people have heard that THEY have something valuable to contribute to their healing process. The third part of the process is "OK, here's a roadmap"-- the WRAP plan itself, ready for use at the moment the internal shift takes place. Hopeful, self-generating, profound, practical: It's as simple as that!!

Resources

Two New Creating Wellness Videos Available: Wellness Tools and WRAP

You may be familiar with the video "Creating Wellness-Key Concepts" produced by the Mental Illness Education Project. In this video, I discuss with a group in a workshop setting the key concepts of mental health recovery-hope, personal responsibility, education, self advocacy and support, as well as getting good health care and medication management. I am delighted to announce that two new videos are now available-Wellness Toolbox and Wellness Recovery Action Planning. Again, using an interactive workshop format, I describe the most common wellness tools and get more ideas from the group, and then work with the group in developing a Wellness Recovery Action Plan including the Crisis Plan or Advanced Directive.

These videos can be used by individuals who are working on their own recovery, and can supplement or be used as the discussion focus for groups. More Information ...

Several years ago, I worked with a focus group of 10 people from around the country to develop a series of six mental health recovery booklets for the Center for Mental Health. These booklets are now available free by calling 1-800-789-2647 or through http://www.mentalhealth.org/highlights/whatsnew/. If you might want other booklets they have available, go to http://www.samhsa.gov/centers/clearinghouse/clearinghouses.html.
The titles and numbers of the booklets are:

• SMA-3715 Recovering Your Mental Health: Building Self-esteem, A Self-help Guide
  
  
• SMA-3716 Recovering Your Mental Health: Making and Keeping Friends, A Self-help
  Guide
  
  
• SMA-3717 Recovering Your Mental Health: Dealing with the Effects of Trauma, A
  Self-help Guide
  
  
• SMA-3718 Recovering Your Mental Health: Developing a Recovery and Wellness
  Lifestyle, A Self-help Guide
  
  
• SMA-3719 Recovering Your Mental Health: Speaking Out for Yourself, A Self-help
  Guide
  
  
• SMA-3720 Recovering Your Mental Health: Action Planning for Prevention and
  Recovery, A Self-help Guide

The booklet, Recovering Your Mental Health: A Self-Help Guide, is still available as well. We developed this booklet with the assistance of a focus group of ten people from around the country--people who are working on their own recovery. The first 18,000 copies have been distributed and the second printing of 35,000 copies is now available. People are really hungry for mental health recovery education. You can get free copies from the Knowledge Exchange Network (KEN) by calling 1-800-789-2647 or through www.mentalhealth.org. Refer to booklet SMA# 3504.

New Book

Finding Care for Depression, Mental Episodes & Brain Disorders by Robert Sealey, BSc, CA is a layman's guide with tips and traps, teaching tales, tools and references for restoring mental health. After deteriorating over 25 years due to minimal, conservative and negligent care Robert set out to explore the mental healthcare maze. He was shocked to learn that many patients receive poor quality care so he resolved to take action. While advocating for himself and clients of his consulting practice, Bob interviewed 150 trusting patients and developed practical tools for finding care, including a mental healthcare compass, TAYO - the healthcare planner and an extensive annotated bibliography of 250 books for restoring mental health. Bob's co-author, Dr. Abram Hoffer, an experienced psychiatrist has cared for thousands of schizophrenic and depressed patients. He contributed a chapter called, How Orthomolecular Medicine Can Help. Available from http://www.searpubl.ca

Bob is working on a forms kit to accompany the guide. Readers who purchase the 90 Day Plan for Finding Quality Care will receive a three month supply of forms to monitor their progress, document their problems and support their efforts to find competent caregivers and cooperate with ethical treatments. Available in print or on CD so mental health organizations can print multiple copies for patients and members of support groups.

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