There is no health without mental health.” – Jim Lucey (Irish Times interview, 2017)
Dr Jim Lucey is an Irish psychiatrist who has spent over three decades working in his chosen field of healthcare. In his 2014 book, In My Room: the Recovery Journey as Encountered by a Psychiatrist, Lucey outlines some of what he has learned during this time. He calls the book, which is framed as a collection of anonymised case studies, “an authentic description of the journey from distress to recovery as I have witnessed it”.
The room of the title is both the actual room of the clinic and the metaphorical ‘room’ of the mind. We all visit the former from time to time, but we must be able to live permanently in, or with, the latter. Lucey is compassionately interested in the various ways his patients learn to manage that challenge. He has much to share about the nature of recovery and of keeping well.
Lucey credits the largest part of what he understands about recovery to what he has learned from his patients. ‘Patients’, note, not ‘clients’. He writes that:
Over the past thirty years,my patients have taught me more than can be said and I am very grateful to them. And so the term ‘patient’ is used as a humane acknowledgement and a universal term signifying one who is suffering. To be a patient describes an experience that deserves respect. We will all be patients at some stage and this is part of what it is to be alive.”
Lucey’s respect for his patients is fully evident in In My Room. He laments the shame, stigma and loss of status that too often accompanies a diagnosis of mental illness, and that causes so much extra suffering. (Incidentally, Lucey is refreshing in his insistence that our culture’s institutionalised distinction between mental and physical health is a false distinction: illness always affects body, mind and spirit.) The stories he tells in this book are testaments to his patients’ fortitude and resilience, and to their hard-won personal insights into what it means to be well. They are also testaments to the importance of story itself in the recovery process:
Each person seeking help has a story, and each story has an objective significance as well as a subjective meaning. There may be collateral contributions from relatives, or professional assessments from nursing, psychology or other team members, but the summation of all this narrative is what clinicians call ‘the history’ … The history is the beginning of all objective clinical understanding.”
The word ‘history’ implies a story that belongs to the past but Lucey reminds us that stories also contain the seeds of future developments. Or, as the late, great Ursula Le Guin put it: “Story is change.” We map our lives with story, and to feel one’s story fall to bits, as is often the case with illness, is to experience a terrifying loss of the things that anchor us: location, connection, identity, role – in other words, meaning. This simple fact is frequently underrated. If we have no story, we can have no hope.
How the next chapter of a life hit by trauma or sickness plays out depends so much on what the person struck with trouble thinks their story means. This in turn may depend on whether or not they can retrieve – recover, we might say – any sense of agency over the experience. In illness, especially chronic illness, this often entails an enormous shift in a patient’s fundamental beliefs about what it it is to be active and to have control. The details of any person’s recovery are always unique to that person, but the themes are the same. Recovery is discovery really, discovering the meaning of ability, especially in the face of imposed limits. Recovery might be a visible process involving measurable physical milestones. More often than not, though, the bulk of the journey is an inward one: private, individuated, complex, and invisible to others.
Lucey’s specialist diagnostic skills and pharmaceutical knowledge are obviously vital parts of his patients’ recovery journeys. But what profoundly deepens and enriches his approach is his willingness to keep on listening to his patients’ chaotic, repetitious or paralysed utterances, to listen and listen for the nearly inaudible moment when the thread of a narrative appears, and then to encourage the storyteller to pick up that faint thread and take a small step forward. That’s the kind of support that makes a meaningful recovery possible.
Sue Wootton is co-editor of Corpus. A writer and former physiotherapist, she is interested in the multiple ways that stories (whether fictional or autobiographical) provide resources for wellbeing and routes to recovery.
- Lucey, Jim. In My Room: The Recovery Journey as Encountered by a Psychiatrist. Dublin: Gill & Macmillan, 2014.
- Le Guin, Ursula. Steering the Craft: A 21st-Century Guide to Sailing the Sea of Story. Boston: Houghton Mifflin Harcourt, 2015.