Can Principles of Mountaineering Help in Recovery from Mental Illness?

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The picture shows me standing on top of the summit of Cotopaxi (19,347 ft.) in Ecuador (Allow me just a little bit of self indulgence here). I spent less than 2 minutes on the top and had to make arrangements to safely descend. All I had was a brief ‘dopamine squirt’ providing me with a mild dose of euphoria. Was this the most valuable part of the journey? 
At first glance the title may seem like a strange question, but let’s have a look to see if some of the principles of mountaineering apply to individuals in overcoming depression or for that matter any psychiatric disorder or life’s obstacles in general. Over the last few years I have used this analogy with many of my patients with mental illness, with some success in encouraging them with recovery. After the acute phase of illness has been treated, a particular challenge is helping the person get back to recovery. In my experience, a large part of it is a mental shift, equipping individuals with the right mental model.

The Analogy

Coming back to my analogy, let’s look at the key steps in mountaineering. When looking to “conquer a mountain” (I don’t like this word as it denotes a certain arrogance over what should be a serene journey) one chooses to climb a mountain without really having any idea about what that journey will be or what the final destination will look like. In order to reach the top, it becomes essential to focus on the process – taking one step at a time quite literally, one leg after the other, doing it a thousand times, battling altitude sickness, keeping your eyes peeled downwards, ensuring that if you slip you don’t slip too far, ensuring you are roped to your climbing partner looking after both yourself and your partner which then becomes a shared experience – in order to reach the desired outcome. Now the interesting aspect is that that final outcome i.e. the summit, is actually not the real goal, as one needs to safely descend. The descent in mountaineering is considered to be the most dangerous part, as one can get complacent when exhausted. What remains after one reaches base camp, is the experience and a sense of satisfaction but not necessarily euphoria.

Sanil Rege on Cotopaxi summit
Euphoria, which is the dopamine release experienced right at the top is a short-lived experience, but the real joy is in the satisfaction achieved through the entire process.
An ongoing euphoria when coming down the mountain can potentially be dangerous as it can affect concentration and increase the risk of accidents. The feeling of achievement and satisfaction having gone through a process that was gruelling and at times unpleasant is invaluable. Have you already begun to see some similarities with recovery from mental illness?

Beauty and Solitude at 6000m

Beauty and Solitude at 6000m

Let’s look at recovery from mental illness. I do not profess to be able to describe the experience of every mental illness and this analogy does not apply to every person on the path to recovery, but for many that I have shared this analogy with, they’ve appreciated it. I tend to say “Focus on the process, the outcome is a by-product of a good process. One step at a time, focus on the steps, the outcome will evolve and shape itself.”
Your therapist is your climbing partner, slips may happen, manage major slips, and keep supports in place to avoid a major one. Keep your eyes peeled on the process of recovery. It’s the sense of achievement and satisfaction that matter. In other words,euphoria is not equal to happiness. Many may recognise that the dictum may apply to general life as well. It’s an attitude that can enhance resilience.
Most importantly, just like in mountaineering, the summit may not be reached on the first attempt or in fact on many attempts. It is simply up to oneself to evaluate their own strengths and weaknesses and have realistic expectations. Similarly, in recovery from mental illness, not all outcomes should be the same for all individuals. Each goal should be tailored to the individual’s strengths and weaknesses. Goals are fluid and changeable and hence it is important to keep expectations realistic. Not everyone can climb Mount Everest.

The 7 Commandments

So here are my 7 commandments derived from my experiences in mountaineering:
1. Focus on the process and not the outcome
2. Your outcome will be shaped by your process
3. Take the process one step at a time
4. Enjoy the process
5. It may take more than one attempt to reach the summit
6. Not everyone can climb Mount Everest. Choose your own mountain to climb and be realistic
7. Know your strengths and limitations before you make the climb

Most importantly, I couldn’t have done it without my climbing partner (below). So find your’s and get climbing!

Sanil Rege's Climibing partner in Ecuador

Thanks Buddy!

This article is written by Dr Sanil Rege. Sanil is a Consultant Psychiatrist at Vita Healthcare in Mount Eliza and co-founder of psychscene.com. You can follow him on Google+


2 Responses to "Can Principles of Mountaineering Help in Recovery from Mental Illness?"

  1. Marion says:

    Hello,

    I enjoyed thinking about the analogy outlined in the article and appreciate the reflection and hope given through providing such a framework of experience. Re the 7 Commandments – #7 is somewhat problematic as, in my experience, I didn’t and in fact couldn’t, comprehend the context in which my ‘strengths and limitations’ would need to be ‘known’ until I had actually started ‘climbing the mountain’. It was only then that I discovered that previous (i.e. when ‘well’) strengths could be a hindrance and some limitations a help when faced with an unknown, never-ending enormity. My previous ability to ‘fix’ things was useless. A previous limitation of over-thinking became a god-send as I researched and researched what was happening to me.

    Having reached the top of the mountain, my descent (falling off!) produced a shocked realisation that I would be descending to a different landscape than that from which I departed. Further, if your ‘buddy’ as mentioned above had e.g. died on the journey (as happens to one’s Self as was previously understood), the grief and anger around that is another mountain to climb! It is not a matter of slipping, but climbing another mountain!

    I am no longer purely seeking ‘recovery’. Living with a mental injury changes one’s landscape entirely. Different strengths and limitations need to be found and/or learnt and sometimes whilst capability may be there, capacity is not. For me, as I look back at the mountain range(s) I have climbed, and needed to climb, but often alone, without oxygen (!), I now think more in terms of wellness, rather than recovery. Discovering and exploring wellness’ as a wholistic Life-enhancing process, is, fortunately, (for me) far more gentle a process than mountain climbing! – gentle hills instead!

    Thank you for your thought-provoking article.

  2. Psychscene says:

    Thank you for your comments. You have made some valid points and it is useful post in itself. I think one can say that there are many trails that one can use to achieve the same aim, or in some cases, traverse gentler hills. I wish you all the best in your journey , but your insight is refreshing and will certainly hold you in good stead whilst you progress.

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