In the recent context of deinstitutionalization and longitudinal studies pointing to a large
number of positive long-term outcommes for people affected by a psychiatric disorder
(schizophrenia, bipolar disorder, eating disorder, severe personality disorder, etc.), the
possibility of overcoming the consequences of a psychiatric pathology emerges as a solid
fact. Therefore, the existence of this possibility calls for the identification of the
determinants underlying of the various outcomes over time of those affected by a severe
psychiatric disorder, in particular those likely to underpin the most positive developments.
While it is well known from a medical point of view that certain dimensions affect the
prognosis of persons affected by a severe psychiatric disorder (such as the persistence of
negative symptoms or cognitive disorders in schizophrenic disorders), prognosis from a purely
medical perspective (and putting aside the role of the person and his environment) seems to
be able to account only for a modest proportion of the prognosis of people affected by a
serious psychiatric disorder.
It is this fact that has gradually led to the emergence of complementary models capable of
enriching the understanding of the determinants of the future of people affected by a severe
psychiatric disorder, in particular models inviting to separate "becoming of the person" from
the " psychiatric disorder "to take into account the" personal role of the person "in his or
her own healing. This perspective is the "recovery" perspective.
Recovery process is defined as a personal trajectory which includes the person's experiences
and the reactions of his / her environment following the installation of a psychiatric
disorder, which can support a mode of release of the status of "psychiatric patient".
Recovery thus implies an "approach underpinned by the understanding of the human response to
pathology" (Noiseux) and, one might add, of its environment.
This definition of "recovery" is also subjective because it is tied to very personal
experiences and related to the person's own norms as to what it means to be "re-established".
The subject engages in a long, progressive process, without return to the previous state. In
a dynamic response to an equilibrium perturbed by the disease, we are interested in restoring
a new equilibrium rather than the factor triggering its loss. Recovery is seen as a
trajectory punctuated by decisive moments on a background of progressive change, this process
oscillates between awareness, ambivalence and forward shift.
However, while these studies point to a number of crucial dimensions involved in the recovery
of a severe psychiatric disorder, one of the important limitations of these studies is the
distance from any psychopathological consideration, thus setting aside the possibility of
specific processes of recovery depending of the pathology. The identification of recurrent
experiential logics specific to the various psychiatric disorders therefore appears to be an
important field of investigation. It would potentially be able to guide the development of
new therapeutic devices based on the recovery model.