WRAP (Wellness Recovery Action Plan)With apologies to Mary Ellen Copeland
When I was first diagnosed, I had never heard of WRAP. I formulated something that I call “Manual Override”. I came to the conclusion that I was an educated, intelligent guy and I would use my intellect to over come my illness.
Essentially, manual override is about recognizing your symptomatic thoughts and behaviors and differentiating them from who you are and who you want to be. Symptomatic behaviors are fairly obvious: Eating too much or too little, sleeping too much or too little, poor personal hygiene, compulsive gambling, drinking, and substance abuse, etc. The thoughts should be obvious also. Some people call them voices. Others call them tapes (Time to upgrade to CDs or memory chips!). Common ones are sexually perverted stuff, thoughts of violence and destruction, and of course, everyone’s favorite, the winner and still champion, “I am worthless, there is no reason to go on living, I should kill myself!” (And you thought you were the only one!) For those of us who suffer from a mental illness, it is easy to have these thoughts and behaviors. It should be simple to recognize them for yourself as the thoughts and behaviors of a mentally ill person and stop doing them. Simple yes. Easy no! It takes practice, and practice you must. You aren’t going to just pick up a golf club and play on the pro tour! You aren’t going to master manual override on the first try either. But if you want to do it, you have to keep trying.
Manual override is something that I do in my mind. WRAP is different. It is a written plan for you, the people around you, and your healthcare professionals. The parts of WRAP are: The things to maintain your wellness on a daily basis, The primary indicators that you are about to have a problem, The things that you and others need to do when you become episodic, What to do when things really go bad, and What you think are the indicators that you are improving, able to handle the situation on your own, and what other people can do to help. In the best scenario, it is way to get better and maintain yourself. In the worst case, it gives you a voice when you cannot speak for yourself.
Some of you may have an issue with the word recovery. Recovery is not recovered! Recovery is an ongoing process. I don’t think it ever ends. Maybe management is a better word, but it doesn’t make as nice an acronym!
FYI! I am not a trained WRAP instructor. I can only give you a brief overview of the course and plan. There is a website;http://www.mentalhealthrecovery.com that I’m sure has a more detailed description of the course and plan. Much like a support group, I believe it is much more beneficial to actually attend the class in person, than it is to view it on a computer screen. The course that I took was a four day/three hour class. I’ve heard of it being offered as one, two, and three day courses of varying lengths. WRAP is open book! You can use whatever resources you want to formulate it. You can ask for help, and use other peoples ideas. You can change it later if you want. No penalty! No extra Charge! It might be best not to try to do this all in one sitting. Do a little each day. Go back and review what you have written before forging onward. Let’s begin. I. Write down a story or make a list of things that you already do to take personal responsibility for your own wellness. Then write down some things that you would like to do to claim more responsibility for your own wellness.
II. Make a list of the people you count on for support. Make another list of the people that you support what qualities do you like most in your supporters and what do you have to offer others.
III. Who are your professional healthcare supporters? What do you like and dislike about them? Is there anything new you would like to try, and what do you think you need to do to accomplish that goal?
IV. Write down your own medical history. Include you family members and any current conditions and treatments. Don’t be afraid to make a list of the questions you would like to ask your professionals.
Important parts of the course are some exercises to help you to fill out the plan. Make a list of some positive things about yourself. Also, make a list of some of the negative thoughts. Examine them critically, look for evidence, to see if they are true. If in fact they are true, write down some things that you think you can do to change them.
V. Make a list of things that commonly (or uncommonly) trigger you. Do you ever have preliminary symptoms that indicate the onset of an episode? Write those down as well.
VI. Maybe your symptoms have become very severe, or they have gone on for longer than usual. How severe? What kind of behaviors will you be doing?
How long is critical? How well have you done before. Do I want to see a doctor? Go to the ER? Write all that down.
VII. Either you think that everything is Ok, the sky is falling, or you don’t think anything at all. What are some indicators, particularly to other people, that it is time for them to take over? What things need to be done? who do you want to do what? Who do I want to see and talk to/ don’t want to see or speak to? Is there a particular doctor or hospital you like/ Don’t like? I there a particular drug or therapy that you think would be effective/ not effective/ dislike intensely? It is important to plan out these last two stages when you are thinking clearly. Do not wait until you are having a problem! Remember, you can always change it!
VIII. Lastly, what are some good indicators that you are doing better and ready to care of some/all of your responsibilities? Are you going to need some help? From who? And with what?
Once you have completed writing out your plan, it is recommended that you review it regularly. Weekly is what is recommended, but I’m sure that monthly is equally good. It is after all a recovery/maintenance tool. You may change you mind, think of something new, or the mental health journaler’s lament, “I wrote that! I must have been crazy!” You are supposed to make copies and give them to friends, family members, and you physician. Some of this stuff may be very personal and you may not want it widely distributed. You ought to give a copy to at least one other person. Failing that, leave a copy somewhere that someone else can find it if needed.
Learning, writing, and using this plan can work. it doesn’t matter whether you use WRAP or manual override. The key elements are motivation to get better, a belief that you can get better, actually implementing the program, and persistantlyusing it, even at times when it doesn’t work so well (remember, you can change your plan!).
This my stop. See you next month.
Baco
