There are many dictionary definitions of strength. “Being strong in body or in numbers, mental force, potency, cogency of argument, effective action, intensity, endurance, sturdiness, efficacious, and vitality.”1,2 After nearly 140 years of looking for deficits, damage, problems, and pathology, mental health care is beginning to turn upside down and is now learning to focus on strengths to build recovery from serious and persistent psychiatric problems.3.4

Positive Psychologists are also studying ingredients such as courage, hope, wisdom, creativity, perseverance, giving to others, happiness, autonomy, self-regulation, and future-mindedness.5,6  Imagine that! If you look beyond the diagnostic label and odd behaviors, you will undoubtedly unearth many strengths, such as aspirations, competencies, and talents in each struggling person. In addition, it is important to catalogue environmental resources, social supports, and opportunities (if provided) which each individual has to use in bootstrapping his or her self toward recovery. 7,8Much to our great surprise at the state hospital, many people actually have gotten better in spite of little or no ‘insight’, symptoms not going away first, history of substance abuse, traumatic experiences, mixed efficacy of medications, many medical problems, and even, in spite of, some kinds of help we offered. When we shifted from the list of problems to strengths, we found all sorts of useful areas with which to engage people in their own recovery process. One group of people we first looked at had an overwhelming list of problems and pathology (e.g. depression, delusions, assaultive behavior, suicidality, manipulative behavior, poor social skills, demoralization, acting out, anger, unpredictability, poor hygiene, lack of motivation) – the list went on and on. When we took a second or third look for strengths, this is what we found in the same group of individuals: a sense of humor, persistence, musical and other artistic talent, cultural heritage, spirituality, education, affability, feistiness, charm, intelligence and again the list went on and on! 9

Think about it.  Wouldn’t you rather have people appreciate your strengths and help you grow with those attributes rather than focusing on all the deficits that we, as fallible humans, have? The irony is, if you mostly ignore the problem areas and focus on the strengths, goals, and aspirations that a person has, problems are gradually found to be intolerable to the person and lessen over time while dreams begin to come true. Ignoring problems is exactly the opposite of what clinicians have been repeatedly taught and at first it doesn’t make sense to our ears because we learned to “fix broken things.” But living broken things can indeed fix themselves when clinicians, family members, and friends hold up mirrors which reflect the healthy and competent parts of ourselves. And that is the secret of rehabilitation.

Selected References:

  1. Webster’s Unabridged Dictionary (2nd Ed.). New York, Random House. 1998, pg. 1882.
  2. Webster’s College Thesaurus (Revised). New York, Random House, 1998.
  3. Harding, CM: Keynote: Turning the Recovery Model Downside Up and Outside In for the Silver School of Social Work at NYU conference, Oct.27, 2010.
  4. Weick, A; Rapp, CA; Rapp, W; Sullivan, P; & Kisthardt, W: A strengths perspective for social work practice. Social Work, 89, 350-52, 1989.
  5. Seligman, MEP & Csikszentmihalyi, M (Eds.): Positive Psychology [Special Issue] American Psychologist, 55 (1), 2000.
  6. Vaillant, GE: Aging Well. Boston, Little Brown, 2000.
  7. Rapp, CA: The Strengths Model. New York, Oxford University Press, 1998.
  8. Anthony, W., Cohen, M., Farkas, M., Gagne, C.: Psychiatric Rehabilitation (2nd Ed). Boston, MA. Center for Psychiatric Rehabilitation, Sargent College, Boston University, 2002.
  9. Harding, CM: Grand Rounds – Personal Assets for Recovery: Hiding in Plain Sight.” Westborough State Hospital, MA., Sept. 11, 2007.

This essay is a revision which was originally published in RECOVERe-works (No. 67, Jan., 2011 p. 1) for the Center for Rehabilitation and Recovery in the Coalition of Behavioral Health Agencies in New York City.

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