liggins

ental illness and healing are rarely spoken of together – at least in the medical speciality of psychiatry. While healing is occasionally referred to as a desired outcome, particularly in the nursing literature, it is usually not defined or explicated; this is perhaps not surprising given the dominant discourse of recovery. When I first wrote, anonymously, about my personal experience of a lengthy admission to hospital (an experience that was transformative, in contrast to earlier admissions that were (kindly) less successful or indeed detrimental), I described that hospital as ‘a place of healing’ (Anonymous, 1992, p. 5). At that time, I had no professional training in psychiatry; recovery was not a word that had entered my vocabulary. Two decades later, working as a psychiatrist and with all that I now knew professionally about recovery, healing was still the word I chose to represent my personal experience.

This article explores the notion of healing, in relation to mental illness, by offering a conceptualisation of healing – one outcome of a broader research project that set out to explore, through a service user lens, those aspects of place that facilitate healing in mental health care and recovery. I will then argue for a revisioning of recovery with healing at its heart.

Recovery tensions

Recovery has its origins in the growth of consumer/survivor organisations in the era of deinstitutionalisation, amid growing dissatisfaction with mental health services (e.g. Anthony, 1993; Davidson & Roe, 2007). One of the earliest to write of recovery in its modern form was Deegan (1988), providing a first-person account of her illness and recovery experience. Distinguishing recovery from the more passive process of ‘get[ting] rehabilitated’, she described recovery as ‘the lived experience of people as they accept and overcome the challenge of the disability’ (p. 11). Anthony (1993) is credited with the original articulation of a recovery orientation for mental health services, suggesting that recovery would be their guiding vision. This claim, at least in the Anglophone countries, seems to have been born out; but with this mainstreaming of a once emancipatory movement came risk.

Recovery is a concept that is not without debate in the psychiatric literature; the term being used inconsistently with varied implications for policy and practice (Davidson, O’Connell, Tondora, Lawless, & Evans, 2005). A recurring debate is that of ‘recovery from’ versus ‘recovery in’; these are usually taken to mean: the definition (and aim) of recovery is to live well despite symptoms (recovery in), or to live well by achieving remission of symptoms, by returning to ‘normal’ (recovery from) (Davidson & Roe, 2007). These differing perspectives have also been characterised as personal versus clinical recovery, being typified as a tension between the service user perspective (recovery in) and health professionals (recovery from) (Slade et al., 2012).

Some commentators argue that the original vision for recovery has been ‘hijacked’ or appropriated by health professionals (e.g. Slade et al., 2014). Bonney and Stickley (2008) suggest that the uniquely personal aspects of recovery risk being diluted as they are converted to the rhetoric of policy, losing the subjectivity that lies at the heart of lived experience. In 1998, 2 years after I began my psychiatry speciality training, New Zealand adopted a ‘recovery approach’ to guide its mental health service delivery (Mental Health Commission, 1998). My clinical practice is informed by the principles of recovery: a tick-box of competencies that tell me the skills and knowledge that I need (O’Hagan, 2001). However, when I recently began to autoethnographically research my personal experiences of illness, I resisted: the recovery I had come to know as psychiatrist failed to capture the heartfelt quality of my experience as service user. Setting recovery aside, I turned to healing.

Healing as a concept

Medicine, of which psychiatry considers itself part, was traditionally considered a healing profession tracing its roots back to the Hippocratic medicine of Ancient Greece that melded a healing art with scientific discipline (Egnew, 1994). The Enlightenment of the 18th century saw a marked shift towards scientific evidence informing the understanding of illness and hence the role of a physician (Laugharne & Laugharne, 2002). More recently, in the face of increasing technological sophistication and disease focus, many authors argue that modern medicine has lost the art of healing, becoming more disconnected from the patients it treats (Cassell, 1976; Egnew, 2005; Kearney, 2009). A growing interest in healing has arisen in the contention that modern medicine is more interested in ‘curing’ than ‘healing’ (Cassell, 2013; Hutchinson, Hutchinson, & Arnaert, 2009). As with recovery, there remains some debate about whether healing necessitates cure. Much of the recent research directed at an understanding of healing has occurred in palliative and end-of-life care where there may be no expectation of cure.

The word ‘heal’, derived from the Old English haelen (‘the condition or state of being hal, safe or sound’; Egnew, 1994, p. 1), is defined as ‘to make sound or whole’ (Stevenson & Waite, 2011). While authors continue to aver that healing remains enigmatic, certain attributes are consistent in the literature. Healing is described as an intensely personal process or journey (Hsu, Phillips, Sherman, Hawkes, & Cherkin, 2008), with each person’s experience being subjective and unique (Glaister, 2001). This may be perceived as a journey back towards a previous state (Hsu et al., 2008), or more commonly forward movement and transformation (Egnew, 1994; Glaister, 2001). Some authors suggest healing is an active, energy-requiring process (Glaister, 2001; Wendler, 1996); others that it may be serendipitous in the context of relationship (Egnew, 1994).

Healing is multidimensional: physical, emotional, intellectual, social and spiritual, with varying individual emphases (Egnew, 1994). Healing may be accompanied by a sense of wholeness and involves the relief or transcendence of suffering. Mount, Boston, and Cohen (2007) conceptualised healing as being movement along a continuum from ‘suffering and anguish at one extreme to an experience of integrity and wholeness at the other’ (p. 373). Similarly, in an attempt to operationally define healing, Egnew (2005) suggested that it is ‘the personal experience of the transcendence of suffering’ (p. 255). He described suffering as ‘an intrinsically disagreeable experience that is angst of an order different than pain, though it may involve pain … [that] subsumes nonphysical dimensions – social, psychological, cultural, spiritual – associated with being a person’ (p. 171). This existential view of suffering was captured in Cassell’s (1982) widely quoted explanation that ‘suffering occurs when an impending destruction of the person is perceived; it continues until the threat of disintegration has passed or until the integrity of the person can be restored in some other manner’ (p. 640).

Connection, wholeness and finding meaning are recurring themes in the healing literature. Connection is often expressed as a function of the healer–patient relationship (Hsu et al., 2008; Scott et al., 2008; Wendler, 1996), but others broaden connectedness beyond the interpersonal. Mount et al. (2007), in a phenomenological study of people with a life-threatening illness, identified four types of healing connections: with oneself, others, the phenomenal world as experienced through the five senses, and with ultimate meaning. While most authors emphasise a sense of wholeness, definitions are elusive (Boyd, 2000). Egnew (1994) suggested that wholeness can be different for each person. Some authors refer to restoring or achieving balance across the physical, emotional, intellectual, social and spiritual domains (Glaister, 2001; Hsu et al., 2008). Cassell (1982) argued that ‘transcendence is probably the most powerful way in which one is restored to wholeness’ (p. 644). Although defined in the Oxford Dictionary (Stevenson & Waite, 2011) as the action of surmounting or rising above, Cassell (1982) suggested that transcendence is a deeply spiritual experience that ‘locates the person in a far larger landscape’ (p. 644), this description having resonance with a project that set out to explore place and healing.

Healing is necessary when there has been a disruption of integrity or wholeness, experienced as suffering. Frankl (1962), reflecting on his experiences in concentration camps, suggested that ‘suffering ceases to be suffering in some way at the moment it finds a meaning’ (p.115), arguing that a fundamental human quest is the search for meaning. Finding meaning is a fundamental process in healing; telling stories is at the heart of these efforts to find and make meaning in our experiences and lives, and the lives of others (Charon, 2006). Harter and Bochner (2009) asserted that there is an ‘inextricable connection between narrative and healing … unexpected life experiences call forth stories, and … narrative provides the hindsight to make meaning of the past and move toward a more hopeful future’ (p.114). It is these ideas of stories of a journey from suffering, to connection, wholeness and meaning that were taken forward into this study.

The study aim/question

The landscape of mental health services has changed almost unrecognisably over the last 50 years, with large often geographically remote asylums being replaced by small acute mental health units usually co-located with general hospitals (Liggins, Kearns, & Adams, 2013). The research evidence for and evaluation of the quality of inpatient care is limited with ‘a relatively weak evidence base’ (Thornicroft & Tansella, 2004, p. 286). Some authors suggest that this neglect is due to a focus on community services, with the community portrayed as good and hospitals as bad (Bowers et al., 2006; Glasby & Lester, 2005). There is, however, considerable commentary on the state of acute inpatient psychiatry, predominantly expressing concerns (e.g. Fitch, Daw, Balmer, Gray, & Skipper, 2008; Sainsbury Centre for Mental Health, 2006).

The research question, ‘what makes a place a place of healing’ in mental health care and recovery, had its origins in the concern that we still do not have it right with respect to the places in which we provide mental health care. Aspects of place that facilitate healing in mental health care and recovery were explored through a service user lens. The focus of this article is on the resulting conceptualisation of healing as a journey of exploration.

Method

Autoethnography, literally the study of the culture of the self, is a research methodology in which the researcher has an active presence, usually as a participant (Chang, 2008; Ellis, Adams, & Bochner, 2011). With its origins in post-modernism, autoethnography turns on its head the usual scientific notion of the neutral, objective researcher (Liggins et al., 2013). It argues that as a participant in my own research, I am as close as I can get to the social process, with the potential for greater depth and understanding (Beresford, 2005). In autoethnography, bias is acknowledged and anticipated: my positionality is as overt as I can make it:

The research process foregrounded my personal experience of admissions to hospital, in dialogue with other service users who self-identified as being somewhere, when unwell, that they considered healing for them. In approaching this research, the intention was to talk with people who in the usual course of events would be admitted to a mental health unit when unwell. There were few inclusion and exclusion criteria except age 18–65 years, at least one admission to a mental health unit for more than a few days and having been somewhere when unwell that the participant considered healing. Not wanting to make assumptions about what might be healing for others, the definitions of place and healing were deliberately left open, and this is reflected in the range of places we identified.

Ethics approval was gained in 2012 and 10 people, in addition to myself, were recruited through service user networks by word of mouth and snowballing: eight women and two men (all names changed to protect confidentiality), most being interviewed on two occasions. The resulting data comprised historical writings (mine) and in-depth individual interviews, which were transcribed and analysed thematically, with further development of emerging ideas through an autoethnographically informed and iterative process: a reflexive, back and forth movement between my story and their stories, making connections and developing meaning (Liggins, 2016).

Participants were not asked what diagnoses they had been given though some told me they had been depressed, and at times suicidal; others described experiences that they called psychosis, or that I recognised as psychosis. While several people talked about being labelled with one or more illnesses, none overtly claimed the labels for themselves.

Results

We identified a range of places that were healing for us; these included both historical and current mental health facilities, and community places such as respite, friends’ homes and an art studio. Our length of stay, or association, with these places varied: from days and weeks to several years. The length of association was particularly important in how places facilitated healing – healing is a journey that is hard work and takes time. Some people chose to talk about more than one environment that had been healing for them; a few also spoke of places, experienced either in their personal or working lives, that had healing characteristics.

Our experience and understanding of our healing places was contextual: in telling our stories, we offered rich pictures of what it had been like to be unwell and then how that changed. Although not originally a focus of the research, it was these descriptions that supported a conceptualisation of healing and provided a context for understanding the means by which place can facilitate healing and recovery.

What it was like to be unwell

Our stories of illness were redolent with threat, fear and intense emotions described in terms such as maelstrom, battered, fierce fire and rock bottom. We waited in fear for the often unknown and inexplicable to happen, taking us away from the selves that we knew; we were suffering:

These were experiences that we struggled to make sense of. We identified feeling lost; confused and uncertain, with respect to our thoughts, emotions and perceptions. Most stories identified a loss of hope; we experienced our illnesses as relentless, with nothing changing, and beyond our control:

Disconnection was a recurring theme in our stories and was experienced multidimensionally: we described disconnection from aspects of ourselves, from others and the physical realm. We also experienced spiritual and cultural disconnection. I described, when depressed, going away to a place ‘where I cannot hear myself, and no-one can hear me; a place where I cannot be soothed and I cannot soothe myself’:

Using metaphor, we powerfully described experiences that conveyed a sense of fragmentation or even disintegration. I said of my illness that ‘my world would fall apart; I would fall apart’; others described being: scattered, shattered, smashed and broken:

These words provoke a visceral reaction in response to a threat to our integrity or wholeness, powerfully capturing the subjective threat that was at the core of our suffering.

Metaphors of healing

Early in this research process, I was asked what healing meant to me: I said that healing was being able to get on with my life. Even then, I knew these words did not do justice to my experience. As I spoke the words, and still when I consider healing, my hand goes to my heart. Other research participants similarly endeavoured to describe what healing meant for them; but there were limitations in this articulation: I still have a sense that aspects of our experiences were beyond words. One way of dealing with this ineffability was the use of metaphor:

I described healing as ‘getting to the heart of me’, ‘piecing myself back together’ and ‘growing into my skin’. Other participants described aspects of healing as ‘a nice warm bandage’; ‘blooming’; ‘taking off a tight hat’; ‘learning to do the rides’; ‘stripping right back, to build yourself up again’; ‘the blocks that were laid out, scattered everywhere, started to come together’; and ‘those moments of contentment’ when we knew ‘this too must pass’.

These phrases brought to life an experience, describing experiences of movement and change, transformation and sometimes transcendence:

In these experiences of building ourselves up again and growing into our skins, the blocks that were scattered began to come together – a journey towards wholeness. Sometimes this was a return to before, but sometimes these experiences took us beyond where we were – we bloomed.

A journey that takes time and is hard work

Healing was both journey and destination. The journey was not an easy one; it was hard and often painful, some of us referring to this as work. I remember my university supervisors’ surprise when I commented that despite my many years of training and then work as a psychiatrist, and my subsequent years as doctoral student, my journey to recovery was the hardest work I had ever done.

In my early experiences at the Hall, I was ‘struggling with emotions that had no form, no recognition, no meaning. A maelstrom of confusion. So much running from what I didn’t understand and trying so hard not to run’. On this journey to healing I needed to not ‘run away’; rather than disconnect, I needed to stay with the confusion, with the sense of being battered by emotions that I didn’t understand. Alice described the hard work and pain associated with her process, but powerfully identified her belief that this was necessary:

Similarly, Barb anticipated the pain she expected to go through in the process of facing her demons:

Colin words evocatively captured the work and effort involved:

And in this process, he ‘bloomed’:

We described the journey of healing as taking time, and this was one of the differentiating features of the places that we identified as healing. For some participants, their healing place was a haven, providing a time out of sorts for a few days or weeks; others had a lengthy association with our place of healing, measured in months or years, embarking on a journey of exploration:

Exploration, connection and integration

As a counterpoint to our sense of being lost, disconnected and fragmented, our descriptions of the healing journey suggested experiences of connection, integration and transformation. Exploration was a necessary part of these journeys:

We talked of ‘facing’, or ‘facing into’, and ‘finding our essence’:

Exploration opened us up to possibilities, facilitating the discovery and testing of the connections that underpinned our healing. Our experiences of connection were multi-dimensional: cognitive, connecting thoughts, developing understanding; emotional, beginning to recognise and link emotions and experiences; intra- and interpersonal, connecting and developing relationships with ourselves and with others; and phenomenal, connecting to our senses and our physical environments:

As we explored, looking more deeply into ourselves, we began to make sense of, to understand our experiences, making connections: we developed wisdom, finding ourselves and re-engaged with our worlds:

Healing is necessary when there has been a disruption of integrity or wholeness. While often considered in relation to physical integrity such as a laceration or broken limb, we experienced an existential disruption. Defined by our illnesses, both in label and experience; disconnected, fragmented and lost: we suffered. Our life’s meaning had collapsed, with little hope for change. Just as Cassell (1982) suggested that ‘[suffering] continues until the threat of disintegration has passed’ (p. 640), and as the antithesis to our sense of fragmentation, Barb alluded to healing involving a process of integration: ‘strand by strand, tying it together so it’s firm and then putting it back where it belongs’. Integration is one of those processes that is perhaps beyond explication, but we knew it took time and practice. Through integration, I filled the nooks and crannies of the shell that was my skin, becoming whole; just as Barb reconnected with her thoughts; and Alice took the time and faced her illness, her skills going down to another level. Utilising Margaret’s words, through integration the experiences became ‘part of the fabric of who we are as people’, and in the process we became whole again; the gaps were filled, the cracks were mended. Although I wonder if anyone can be truly whole, perhaps we all are a work in progress.

Wisdom, ‘some combination of education, practice, apprenticeship, personal experience, and deliberate reflection about life matters’ (Baltes & Smith, 2008, p. 57), implies a deeper form of knowing. Being grounded in experience, the evolution of wisdom required both time and effort. Exploration had elements of both doing and being, and I wonder if it is in those moments of stillness, of being with ourselves, that integration occurred. Perhaps wisdom is the expression – in words, actions and emotions – of integration and integrity, and the stories that we told were an expression of that wisdom.

Conceptualised as journey and destination (or perhaps resting place), healing was an intensely personal process of exploration in which we found ourselves. Facilitating connections, we developed understanding; with time and practice, we integrated our hard-earned wisdom; developing meaning, and becoming whole, our suffering was transformed. We arrived in these places distressed, struggling with illnesses that we did not understand; disconnected and fragmented, we had lost ourselves. In response to these experiences, a place that was healing was one that offered safe haven, (metaphorically) holding us enough in a collaborative environment of care, hope and trust; while providing or creating space and opportunities for the hard work of exploration that underpinned our healing (Liggins, 2016).

Discussion: healing the heart of recovery

The capacity to heal is a universal, albeit unique, human experience; discussion in the healthcare literature is largely independent of medical speciality or diagnosis. Recovery, as applied in mental health, is context-specific. In mental health literature, there is little mention of the concept of healing but are we in fact talking of the same thing? As a researcher I decided to set aside the dominant mental health discourse of recovery, but, as I read more widely, exploring the literature, the distinction became blurred. I ‘discovered’ Deegan (1996) describing recovery as a journey of the heart – or perhaps I should say re-discovered. I remember reading Deegan as a junior trainee and being inspired but put her experience-based writing aside as I continued my training: ‘becoming a psychiatrist’.

Conceptualisations of personal recovery as an active journey involving change, have resonance with healing (Lapsley, Nikora, & Black, 2002; Leamy, Bird, Le Boutillier, Williams, & Slade, 2011; Onken, Craig, Ridgway, Ralph, & Cook, 2007). Neither recovery nor healing requires absence of disease or cure, and both involve at their core unique and deeply personal processes that emphasise connectedness, meaning and transitions in identity (Egnew, 1994; Hutchinson et al., 2009; Onken et al., 2007). There is, however, a hint of difference in some literature, perhaps reflecting the ‘recovery from’ and ‘recovery in’ debate (Davidson & Roe, 2007). Deegan (1996) described recovery as a journey of the heart, but also that ‘recovery is an attitude, a stance, and a way of approaching the day’s challenges’ (p. 96). Similarly, Anthony (1993) wrote of recovery as a ‘way of living a satisfying life … even with limitations caused by illness’ (p. 527). In contrast to the wholehearted endeavour of healing, recovery for me still carries a suspicion of personal deficit to be struggled against.

Both Anthony and Deegan worked in rehabilitation psychiatry and their early work is written within a frame of disability, with Anthony explicitly referring to adjustment to disability being part of recovery. My journey was one of personal recovery, developing a life that is satisfying and hopeful; I am able again to contribute to society. But as I skied down that slope in the fields behind the Hall, and when I walked out their door for the last time, I also experienced a sense of peace and joy, and of wholeness. There is a qualitative difference to my experience, Colin’s blooming, Margaret’s being in the sanctities of creation, and Barb’s moments of contentment, that is often missing from formulations of recovery. These qualities are perhaps better captured by the concept of healing.

Deegan (2002) has described recovery as a process of healing and transformation, suggesting that the concept was not necessarily the problem, rather it was the recovery I had come to know as a clinician. Recovery’s translation from the richness of experience, often expressed as metaphor, into the professional language of principles and policy resulted in loss of the heartfelt, subjective qualities of personal recovery. I began this project disconnected from recovery but have come to re-embrace the concept with healing at its heart: I suggest that it is through healing that I achieved recovery. Healing reminds us of the fundamental personal processes at the heart of our journeys. As a universal human experience, healing removes the sense of othering that is at the heart of mental illness stigma. Recovery offers a widened vision incorporating community and societal issues and responsibilities such as stigma, social integration and rights for and of citizenship (e.g. Hamer, 2012).

Conclusion

Healing is conceptualised here as the intensely personal experience at the heart of recovery. As a process and a destination, healing is necessary when there has been a disruption of integrity and wholeness, experienced as suffering. We described healing as a journey of exploration that takes time and hard work, facilitating connection and integration, understanding and wisdom. It is in the exploration that healing can occur, implying that we are not passive (or even active) recipients of care; rather we are active participants creating or making use of the opportunities available to us, developing a story that is uniquely ours. A recovery that I recognise and that recognises me is one that embraces, and put at its heart, the lived experience of mental illness and healing.

Limitations

This study has offered a formulation of mental illness and healing, but the methodology of autoethnography comes with limitations. Aspects of healing in this context deserve further exploration from a service user perspective. This might include the notion of healing as a journey of exploration and the forms this can take; and opportunities for connection: connection in mental health care is usually considered only in the context of interpersonal relationships, but the wider healing literature, and this small study suggests that connection can be multi-dimensional. The concept of healing connects mental health to the wider healthcare and social science literature, creating opportunities for multidisciplinary research and understandings.

The article explores the often-overlooked concept of 'healing' in psychiatry, contrasting it with the dominant discourse of 'recovery.' The author, a psychiatrist with personal experience of mental illness, found 'healing' better captured her transformative inpatient experience than 'recovery,' despite her professional training. The piece argues for a revisioning of recovery with healing at its core.

Recovery Tensions

Recovery emerged from consumer/survivor movements, advocating for a guiding vision in mental health services. However, its mainstreaming led to debate, particularly concerning 'recovery from' (symptom remission/return to 'normal') versus 'recovery in' (living well despite symptoms). This tension often reflects distinct perspectives between health professionals and service users. The author felt professional conceptualizations of recovery did not fully capture her lived experience, leading her to explore healing.

Healing as a Concept

Historically, medicine was a healing profession, but modern medicine's focus on 'curing' over 'healing' has led to a re-emphasis on the latter, especially in contexts like palliative care where cure may not be possible. Healing is defined as 'to make sound or whole' and is characterized as an intensely personal, subjective, and multidimensional journey (physical, emotional, intellectual, social, spiritual). It involves the transcendence of suffering, moving from anguish towards integrity and wholeness, and finding meaning. Connection (with self, others, the world, ultimate meaning) and wholeness are recurring themes, often achieved through exploration and narrative.

The Study Aim/Question & Method

The research aimed to answer 'what makes a place a place of healing' in mental health care and recovery, using an autoethnographic methodology where the researcher shares personal experiences alongside those of other service users. Ten participants were recruited. Data included historical writings and in-depth interviews, analyzed thematically through an iterative process connecting the author's and participants' stories.

Results

Participants identified various healing places, noting that healing is a difficult journey requiring significant time and effort. Experiences of illness were described with metaphors of threat, fear, loss of hope, disconnection, and fragmentation (e.g., 'maelstrom,' 'shattered'). Healing was similarly expressed through metaphors like 'growing into my skin,' 'piecing myself back together,' and 'blooming,' signifying movement, change, and transformation. The healing journey involved exploration, leading to cognitive and emotional connections, self-discovery, and re-engagement with the world. This process fostered understanding, integration, and wisdom, transforming suffering into wholeness. A healing place provided a safe, collaborative environment that offered space and opportunities for this difficult exploratory work.

Discussion: Healing the Heart of Recovery

While often treated separately, personal recovery concepts significantly resonate with healing, both involving active, unique, and deeply personal processes emphasizing connectedness, meaning, and identity transitions without necessarily requiring symptom absence. The author suggests that clinical translations of recovery have diluted its heartfelt, subjective qualities. By integrating healing into recovery, the concept re-embraces the fundamental personal processes and universal human experience, countering stigma and broadening the vision to include societal issues.

Conclusion

Healing is conceptualized as the intensely personal experience at the core of recovery, necessary when integrity or wholeness are disrupted by suffering. It's an active journey of exploration, fostering connection, integration, understanding, and wisdom, ultimately transforming suffering and enabling wholeness.

10 Key Points:

1. Healing vs. Recovery: The article contends that healing, though rarely defined in psychiatry, offers a more profound understanding of personal transformation in mental illness than the dominant concept of recovery.

2. Author's Perspective: The author's personal experience of mental illness and a transformative hospital admission led her to prioritize 'healing' over 'recovery,' despite her professional training as a psychiatrist.

3. Recovery Debates: The concept of 'recovery' is debated in psychiatry, particularly concerning the difference between 'recovery from' (symptom remission) and 'recovery in' (living well despite symptoms), often mirroring clinical vs. service user perspectives.

4. Healing's Historical Context: Medicine's traditional role as a healing profession has shifted towards 'curing' in modern times, prompting a renewed interest in fundamental healing, especially in contexts where cure is not the aim.

5. Multidimensional Nature of Healing: Healing is an intensely personal and subjective journey, encompassing physical, emotional, intellectual, social, and spiritual dimensions, and does not necessarily equate to cure.

6. Core Elements of Healing: Key attributes of healing include the transcendence of suffering, the achievement of wholeness (making one 'sound or whole'), finding meaning, and establishing various forms of connection (self, others, phenomenal world, ultimate meaning).

7. Autoethnographic Methodology: The study utilized autoethnography, where the researcher's personal experiences are interwoven with those of other service users to explore what constitutes a 'place of healing.'

8. The Journey of Healing: Healing is depicted as a challenging, time-consuming journey of exploration, requiring hard work and involving movement from states of disconnection and fragmentation to integration and understanding.

9. Transformation of Suffering: Participants' stories illustrated illness as profound suffering, disintegration, and loss. Healing involved a transformation where suffering found meaning, leading to renewed wholeness and wisdom.

10. Re-Visioning Recovery: The article proposes that integrating 'healing' at the heart of 'recovery' can restore the personal, heartfelt, and transformative qualities often lost in policy-driven clinical formulations, thereby enriching the mental health discourse and combating stigma.

Here's an extended explanation of the 10 key points:

1. Healing vs. Recovery: While 'recovery' is widely used in psychiatry, this article suggests 'healing' provides a deeper, more personal understanding of transformation in mental illness. Traditional psychiatry focuses on 'recovery' as managing symptoms and returning to a previous state. 'Healing' encompasses a more holistic process of becoming whole despite the presence of illness, focusing on personal growth and understanding.

2. Author's Perspective: The author, a psychiatrist, draws on her own experience of mental illness. Her transformative hospital stay led her to value 'healing' as a concept surpassing 'recovery,' which she found limiting despite her clinical training. This personal perspective emphasizes the experiential aspects of mental health.

3. Recovery Debates: Within psychiatry, there are ongoing debates about 'recovery.' Key distinctions include 'recovery from' (eliminating symptoms) and 'recovery in' (living well with symptoms). These different perspectives often reflect divergences between clinical goals (symptom management) and the lived experiences of service users (quality of life, personal meaning).

4. Healing's Historical Context: Historically, medicine was seen as a 'healing' profession. Modern medicine's emphasis has shifted towards 'curing,' However, there's a resurgence of interest in 'healing', particularly in situations where a cure isn't possible such as in palliative care. This return emphasizes care, comfort, and wholeness rather than solely focusing on eliminating disease.

5. Multidimensional Nature of Healing: 'Healing' isn't just about the absence of disease. It's a highly personal journey that includes physical, emotional, intellectual, social, and spiritual elements. It acknowledges that a person's well-being is multifaceted and that healing must address these different dimensions to be truly effective.

6. Core Elements of Healing: Central to 'healing' are the transcendence of suffering (finding meaning and purpose despite pain), achieving wholeness (becoming 'sound or whole' as an individual), finding personal meaning, and establishing connections with self, others, the phenomenal world, and a sense of ultimate meaning or purpose.

7. Autoethnographic Methodology: The study employs autoethnography. The researcher integrates her personal experiences with those of other service users to explore 'places of healing.' This approach values subjective experiences as valid data, revealing nuances often missed in traditional research.

8. The Journey of Healing: 'Healing' is portrayed as a challenging, ongoing journey. It requires effort and involves shifting from disconnection and fragmentation to integration and understanding. The journey emphasizes active participation and exploration of one's inner landscape.

9. Transformation of Suffering: The stories from participants highlight how illness can cause suffering, disintegration and profound loss of self. 'Healing' involves turning this suffering into something meaningful. This transformation leads to a renewed sense of wholeness, deeper wisdom, and the ability to integrate difficult experiences into one's identity.

10. Re-Visioning Recovery: The article argues for embedding 'healing' in 'recovery'. This integration restores heartfelt, subjective, and transformative qualities that can be lost. Doing so enriches the discourse around mental health and combats stigma by emphasizing the individual’s journey toward wholeness rather than solely focusing on illness and symptom management.