Tuesday, July 28, 2015

How to wrap a successful rebuild

I know a thing or two about reconstruction, and most of the tricks I keep up my sleeve I picked up mid act. The trick I presented to Mr. PNU on Sunday is probably one of the most useful I've encountered.

The concept of wellness is three-fold. 

(1) Identity is based on needs and values.
(2) Needs and values shape actions.
(3) Well actions produce overall physical and mental health.

Ten years ago, six weeks prior to the birth of my youngest son, I experienced a mental break. Spousal abandonment paired with my faulty chemical wiring took its toll. I put in the struggle to stay afloat for three months after I found myself alone, pregnant, already a single mother to three children, and now bankrupted by my second husband. 

My ship sunk and I spent two weeks in a behavioral health unit in the North Country in order to regain a solid footing and start again. But starting over from mental decimation is no simple task. One doesn't simply return to the outside world and resume the activities in which she previously engaged. I was unable to work, and barely capable of maintaining care of myself and my children with the help of a mental health agency and a slew of caseworkers and therapists. The rebuild to independence took a full year. Restoration to my present state, four more.

At first, leaving my house took assistance. I made all shopping trips and appointments with the company of either my caseworker or a psycho-social rehabilitation worker. They made home visits for two to three hours, three times a week to assist me in loading batches of laundry, preparing meals, and endless evaluation of my mental state and the activities necessary to create a health life.

These women helped me build a Wellness Recovery Action Plan, or a WRAP plan, based on my self-image, my values, and the necessities of self-care. The rebuild was incremental. I outlined a personal map of daily activities that I normally participated in when I was at my healthiest: grooming, housework, childcare, dietary, social, and leisure. Around these I created goals; some as simple as brushing my teeth, or taking a 20 minute walk outside each day. During each visit from my mental health workers I filled out a checklist to take stock of my progress. It took months before the word "stability" could be applied to my routine. I was approved for government disability status which opened the financial doors to medical and housing assistance, and after two years on the recovery road, evaluating my gains against this WRAP roadmap, I reached a level of health that allowed me social re-entry as a contributing member of my community. 

I began volunteering at the local high school in the drama department, working with hundreds of young people in annual musical productions. I created a non-profit arts program that facilitated my part-time work outside of the home in a setting that offered dance training to both underprivileged youth and my own children. And although I never fully re-integrated socially in the North Country—an unfortunate result of some of the area's cultural hangups rather than my own limitations—I reformulated my emotional toolbox with enough skills that flow into Happy Towne's academic and artistic communities has proven nearly seamless. 

From ground up, I know reconstruction. The WRAP plan is key.

I explained its ins and outs to my husband this weekend following his fall. He eagerly took to the notion, and Sunday evening we sat on our bed in his room, devising a daily roadmap that he can follow. 

Mr. PNU's identity hinges on his relationships with God, his family, and his friends. He hedges this with his intellectual ability and the value he places on being a good human being. His needs are simple: hygiene, food, sleep, social activities, his therapies, and cognitive work. We outlined his routine, from rising at 7:30 AM and calling his aides to assist him in with toileting and oral hygiene, to a daily check-in with me at 9 PM when we read scriptures together and offer our couple's prayer each night. His goals include being in bed for no longer than 45 minutes at a stretch, making phone calls and attending nursing home activities to initiate social interaction, reading for 1-2 hours each day, doing Lumosity exercises for at least an hour, and spending an hour each day with me enriching our marriage. I've taken these—schedule and goals—typed them up in large font to hang on his wall, where, depending on the time of day, Mr. PNU can self-manage his own recovery.

If Monday's implementation of this approach is any indication of how well the WRAP plan works, my husband is well on his way to cutting through the physical and cognitive barriers that hinder his return home. I can't take credit for this methodology, but I've lived it, and I think Mr. PNU sees me as a kind of testimonial to its efficacy; enough so that he's invested himself completely in the concept. After five years in their care the North Country mental health agency that introduced me to the WRAP plan referred to me as their success story, though I was never comfortable with the title. 

But perhaps now, being this side of recovery and at a point where I can use the skills I've learned to help my husband who is desperate for his own rebuild, I am.

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