Perception and Recovery
Reprinted from "Self-Management" issue of Visions Journal, 2003, 1 (18), pp. 11-12
Life is not easy and it can demand our complete attention, but the ability navigate life’s daily difficulties relies on perceptions; perceptions dictate action. Humans have the distinct ability to endure hardships for the sake of future reward in a way other members of the animal kingdom do not. This allows us to design bridges, plan surprise parties, and tie our shoelaces. Perceptions are powerful, and the power of human perception is unprecedented. Our perceptions have allowed us to reshape the world through science, literature, and art, allowing us to successfully execute what we imagine. Imagining how a building will look is not enough; we must also be able to perceive how best to construct it.
Perception also has a means of acting on our health in a way that is not completely understood by science, but we can gain some insights by describing two phenomena: the placebo effect, and the relationship between perception and
The placebo effect enables an illness treatment that would otherwise have no medical value whatsoever to affect recovery or alleviation of symptoms. If a patient is given a treatment with no medical value and believes that it will work, it sometimes will. This belief can be supplied by cultural beliefs, personal beliefs, religion, or even through trust in the person who administers this treatment. It is so remarkable a phenomenon that research studies evaluating the efficacy of different treatments must go through elaborate controls to ensure that positive results are not in fact the same improvements that could have been noted had subjects been given an inert placebo treatment rather than an active treatment.
Perception also enables people to endure discomfort to a greater extent if they are led to believe that this discomfort is temporary. Breznitz1 investigated this phenomenon by asking subjects to keep their hands in ice-cold water, a painful prospect. The experimenter told one group that the test would last four minutes, but did not give the information about a time limit to the other group, even though the test was to last four minutes for both. It turned out that participants in the second group were 50% less likely to keep their hands in the water for the full four minutes than the group that had been told the test would last four minutes. The group who had been told about the timeframe were better able to withstand the discomfort, since they saw a limit to it.
This effect was first noted during the Second World War, when flight crews on missions over Germany were noted to be suffering from stress-related illnesses. Almost daily they would fly into danger and suffer terrible casualties; their morale was understandably low. A team of psychologists was then consulted, and the problem of stress-related illnesses was reduced through their advice. It was their opinion that crew members could perceive no end to their ordeal and this was feeding their stress; so the psychologists suggested changing this perception by specifying a definite limit to the number of missions each crew member had to fly. Each crew member was then informed that their tour of duty would end after forty missions. The incidence of illness declined.
In both cases, illness-related phenomena (pain, stress-related illness) were shown to be influenced by psychological processes, and in both of these cases, the primary active agent could be loosely defined as hope.
The success of illness management strategies for mental illness can be said to hinge on perception, in the sense that their success requires the belief that one will in fact succeed. Success also hinges on a vision of the self having an active role in recovery. Exercising perceptual power in this fashion can put mind over matter. The only problem is, of course, perception itself.
With the onset of mental illness, the world no longer seems the same as it did before illness. This can undermine mental health consumers’ ability to interact with the world and achieve goals, large or small. If, for example, someone who is depressed perceives a grumpy cashier’s manner as personal dislike, this can further fuel symptoms of depression; by contrast, someone without depression is better able to excuse and/or ignore the cashier’s manner.
Hope for recovery is hard when faced with long-term illness. Upon diagnosis, consumers are often told that their illnesses are likely to be lifelong, and therefore they must struggle with a sense of very-real-yet-invisible boundaries. This concept of internal barriers is such an abstract and implacable concept that often consumers can feel defeated by it. Therefore, people with mental illness cannot perceive any eventual improvement, or generate the motivational energy necessary to embark on a strategy for managing the illness.
It is in human nature to hope. One can be persuaded to hope by any number of means, either by oneself or through friends, family, observation or caregivers. One psychologist, Nicholas Humphrey, claims that this hope can come from three different means of persuasion: personal experience (observing something yourself), rational argument (relying on logical argument), and external authority (the influence of a respected authority figure).2
Any one or combination of these factors can enhance (not guarantee) the success of an illness management strategy. Perhaps observing the recovery of someone with a similar diagnosis on a documentary can aid someone in envisioning recovery. Perhaps a therapist or psychiatrist can fuel this hope by describing the likelihood of success of a treatment regimen. Believing in the logic of a well-researched illness management strategy can also work.
Building belief takes work and maintaining that belief in spite of inevitable setbacks can be crucial to learning to live with illness. Successfully changing perceptions — changing the way you look at yourself and the world — can be pivotal to the success of illness management and recovery.
About the authorCoralie is Employment Database Administrator and Insurance Project Research Assistant at CMHA BC Division
- Breznitz, S. (1999). “The effect of hope on pain tolerance.” Social Research, 66, 629-652.
- Humphrey, N. (2000). How to solve the mind-body problem. Charlottesville: Imprint Academic.