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observe the recovery process firsthand. I came to understand that even individuals with serious mental illness can recover, given supportive circumstances and appropriate tools—not the least of which is self-acceptance.

      Much of the research on recovery from mental illness corroborates my experience. The next part of this introduction provides a brief overview of the history of our understanding of how mental illness and the stigma associated with mental illness undermines identity and recovery and how rebuilding one’s sense of self aids recovery. Following is a sample of the distinguished theorists and psychotherapists who believed the experience of self is central to treatment of and recovery for people diagnosed with mental illness.

      Paul Eugen Bleuler coined the term “schizophrenia,” which literally means, “split mind.”⁵ Bleuler intended to convey that one of the paramount symptoms of schizophrenia is the fragmentation of the thought process, including the sense of identity. Building upon Bleuler’s work, Sue Estroff, a contemporary researcher in the field of the subjective experience of people diagnosed with serious mental illness, called schizophrenia an “I am” illness, conveying that having a mental illness strongly and negatively impacts sense of identity.⁶

      Alfred Adler, noted psychoanalyst and associate of Sigmund Freud, the father of psychoanalysis, was one of the earliest mental health leaders to recognize the association of mental illness and low self-esteem, which he called “the inferiority feeling.”⁷ Adler was also one of the first to employ psychotherapy to assist people with serious mental illness, and he regarded helping patients pursue useful roles to promote their self-esteem as a goal of treatment.

      Harry S. Sullivan, also a psychoanalyst, was well known for his work in enhancing the understanding and psychotherapeutic treatment of psychotic disorders. Sullivan theorized that problems existed in what he termed the “self-system” in individuals who developed conditions such as schizophrenia.⁸ Sullivan and his followers relied, in part, on improving patients’ self-systems to assist them in their recovery.

      Carl Rogers, renowned psychologist and originator of “client-centered therapy,” worked with individuals suffering from a variety of psychological problems, including serious mental illness. He maintained that low self-esteem is a major component of all mental health problems.⁹ His methods of “active listening” and “unconditional positive regard” were shown to be associated with improvement in the self-esteem of his clients and the amelioration of their symptoms.

      The psychiatrist R. D. Laing devoted his career to assisting individuals diagnosed with serious mental illness. In his book, The Divided Self, Laing described how suffering individuals lose their connection not only to the social world but also to parts of their identities.¹⁰

      Over the past thirty years, researchers in the field of recovery from mental illness have demonstrated several key points you might find useful in your own journey of recovery:¹¹

       • Mental illness contributes to confusion or impoverishment about one’s sense of identity or “who I am.”

       • Stigma associated with mental illness also plays a huge role in eroding self-worth and identity. Stigma can exist internally, stemming from one’s own negative attitudes about mental illness before illness onset, while the attitudes of other people, including family, coworkers, and neighbors, can perpetuate it.

       • Recovery seems to proceed best when the diagnosed individual accepts the fact of having an illness but does not self-berate or self-stigmatize.

       • Awareness of and building upon personal strengths and interests support the recovering individual. Therapeutic techniques aimed at increasing awareness about one’s identity also facilitate recovery.

       • Psychotherapy techniques such as cognitive behavioral therapy (CBT) can foster a more realistic and holistic sense of self, helping to improve self-acceptance and facilitate recovery.

       • Peer and family relationships can be vital to promoting recovery.

      The remainder of this introduction features the story of Vanessa Hastings and her experience with mental illness. Vanessa describes classic symptoms of anxiety and depression, including obsessive thinking, social withdrawal, sleep disturbances, weight gain, crying spells, fatigue, and suicidal thoughts. Depression, anxiety, and other mental illnesses are often associated with experiences of loss. In Vanessa’s case, childhood losses included a separation from her parents at an early age, domestic conflict that left her with unmet needs, and a traumatizing altercation with her father during her teens.

      Later, various medical problems and her father’s chronic illness and early death added to her anxiety and sense of loss. Yet, she has managed to actively support her recovery from mental illness by not only relying on psychotherapy and medication but also by engaging in frank yet gentle self-reflection, moving beyond blame, allowing herself the space and time to grieve her losses, and remaining determined to rise again after each setback. I hope Vanessa’s story inspires you to work toward self-acceptance and come to believe that you too can recover.

My Recovery from Anxiety and Depression

      By Vanessa Hastings

      As I recall my nearly lifelong battle with mental illness, I envision the phoenix, that fiery mythical creature so often depicted in slow, laborious ascent, the embers and ashes of its apparent destruction sliding from its golden wings. This imagery serves as one small component of my recovery.

      The first signs of my depression surfaced in junior high, when I started to become a little edgy and cynical. Many adolescents temporarily exhibit these characteristics, but they became ingrained in my personality, protective and even fun on simmer but harmful at a boil, and my teenage angst became a long-term love/hate affair with obsessive thinking.

      In high school my first serious romance thrived on and fed my dysfunction. To be fair, my boyfriend and I brought out the worst in each other, engaging in intermittent periods of verbal and physical abuse that eventually became the norm until I found the strength to break it off. My parents, divorced now for the second time, were missing in action, and I fended for myself on a number of levels. When my generally loving and doting father tried to reassert his authority during my senior year, I stood my ground; he physically attacked me, and then I moved out. These situations put me in a state of hypervigilance, a place I’ve visited more than a few times since then.

      The transition from high school to college kicked off my first serious bout of depression. I managed to excel academically, but otherwise, I made few friends, slept often, gained weight, and cried almost constantly. My first sessions with a therapist shed some light on the roots of my distress, but I continued on a path of dysfunction, not only in my relationships with men but also in my friendships with females and in the way I conducted myself in the workplace.

      Despite considerable stigma against help-seeking here in rural Wyoming, where people tend to revere stoicism, I read numerous self-help books and saw therapists through the rest of my twenties and into my early thirties, relying on one in particular to gain significant personal insight and to survive my maternal grandmother’s suicide and my mother’s suicide attempts. I continued to experience debilitating depressive episodes, but I sensed the key to my recovery hovering just beyond my grasp.

      My epiphany came after a particularly short but destructive romantic relationship and an online study of abandonment issues. I called my dad’s sister, who had taken me in during times of domestic violence between my parents throughout my childhood. “When did I first come to stay with you?” I asked.

      She hesitated. “Well, you were about two and a half, and things were pretty bad between your mom and dad,” she said. “I asked them if I could take you, and they agreed. We even arranged to have custody of you, so we could make decisions in case of any emergencies. In fact, I think we still have custody of you.”

      Despite feeling slightly stunned, I laughed a little at that. “How long did I stay with you?” I asked.

      “About six months,” she said, adding that I saw

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