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WORK TITLE: Recovery’s Edge
WORK NOTES:
PSEUDONYM(S):
BIRTHDATE:
WEBSITE:
CITY:
STATE:
COUNTRY:
NATIONALITY:
http://www.smu.edu/Dedman/Academics/Departments/Anthropology/People/Faculty/Myers * https://www.smu.edu/News/Experts/Neely-Myers * http://www.vanderbilt.edu/university-press/book/9780826520807 * https://ctc.georgetown.edu/myers
RESEARCHER NOTES:
PERSONAL
Female.
EDUCATION:University of Chicago, Ph.D., 2009.
ADDRESS
CAREER
Southern Methodist University, Dallas, TX, assistant professor. Previously taught at University of Chicago and the George Washington University.
MEMBER:American Anthropological Association, Society for Medical Anthropology, and Society for Psychological Anthropology.
AWARDS:National Institute of Mental Health research award and Hogg Foundation for Mental Health Research award.
WRITINGS
Contributor of chapters to books and articles to journals, including Medical Anthropology Quarterly, Psychiatric Services, the Annals of Anthropological Practice, Transcultural Psychiatry, and Culture, Medicine and Psychiatry.
SIDELIGHTS
Neely Laurenzo Myers is an assistant professor of anthropology at Southern Methodist University in Dallas, Texas. Myers is a sociocultural anthropologist focused on medical, psychological, and psychiatric anthropology. A biographer on the Southern Methodist University Web site wrote: “She has worked in the U.S. and Tanzania with women, veterans, and youth diagnosed with posttraumatic stress disorder, major depression, bipolar disorder and schizophrenia and substance abuse disorders. Currently, she studies the experience of early psychosis in Dallas, including among refugees/migrants, African Americans, and Latinos.”
In 2003 then-president George W. Bush created the New Freedom Commission, tasked with convincing mental health service providers to promote “recovery” instead of producing long-term, “chronic” mental health service users. In response to that, Myers spent three years researching a mental health facility called Horizons in urban America in an effort to relate to others exactly what goes on in these programs. Horizons serves over six thousand clients throughout a large city or area. It tells the stories of people who are struggling to live independently, find satisfying work, and develop relationships. Myers documents that the bar has been set so high, it makes it difficult for these patients to be considered “recovered.” The result of this three-year study is the book Recovery’s Edge: An Ethnography of Mental Health Care and Moral Agency.
Myers tries to show the obstacles that patients encounter in their quest to deal with their mental illnesses. If they still have to deal with poverty, crime, and other issues, achieving “recovery” is a difficult road. Choice reviewer A.Y. Lee was impressed by Recovery’s Edge and commented: “This study also indicates a necessity to reevaluate the recovery movement and explore other approaches in mental health care reform. A good work for readers of medical anthropology and health studies.”
On the Somatosphere Web site, Ellen Rubenstein wrote: “Myers’s writing is notable for its literary quality, and she does an admirable job of interweaving research literature and ethnographic artistry. Rather than presenting a chronologically linear narrative arc, the stories (often mere snippets rather than complete tales) ricochet in time and space, a rhetorical maneuver that seems to mimic the fragmented and chaotic existence of Horizons members.” Rubenstein concluded: “While specialist readers may yearn for more theoretical thickness, nonspecialists will appreciate its vivid descriptions and vibrant characters, which showcase the value of long-term, in-depth ethnographic research. With compelling writing that appeals to a general audience, this book is essential reading for anyone with an interest in social justice and the American mental health care system.”
BIOCRIT
PERIODICALS
Choice, June, 2016, A.Y. Lee, review of Recovery’s Edge: An Ethnography of Mental Health Care and Moral Agency, p. 1510.
ONLINE
Georgetown University Web site, http://ctc.georgetown.edu/ (May 8, 2017), author faculty profile.
Somatosphere, http://somatosphere.net/ (March 4, 2016), Ellen Rubenstein, review of Recovery’s Edge.
Southern Methodist University Web site, https://www.smu.edu/ (May 8, 2017), author faculty profile.*
Anthropology
Neely Myers
Assistant Professor
Ph.D. 2009 University of Chicago
Heroy Hall 455
214-768-3545
Medical Anthropology
Psychological Anthropology
Psychiatric Anthropology
Public Anthropology
Anthropology of Care
Health Services Research
Madness, Trauma and Recovery
Mixed Methods
Social Inequality
North America
Tanzania
Recent Happenings
Dr. Myers is the recent recipient of National Institute of Mental Health research award and Hogg Foundation for Mental Health Research award to investigate ethnographically decision-making for young people after an initial episode of psychosis in Texas. She is also engaged in ongoing fieldwork on mental health in Northern Tanzania supported by the SMU University Research Council.
Courses Taught
ANTH 2301 - Introductory Cultural Anthropology
ANTH 3303 - Self, Culture and Mind: Introduction to Psychological Anthropology
ANTH 3306 - Introduction to Medical Anthropology
ANTH 6317 - Special Topics: The Good Life? Crisis, Care and Recovery from an Anthropological Perspective
ANTH 6317 - Special Topics: Global Mental Health
ANTH 7333 - Data Analysis
Bio
Neely Myers (Ph.D. 2009, University of Chicago) is an Assistant Professor of Anthropology at Southern Methodist University. She is a sociocultural anthropologist focused on medical, psychological and psychiatric anthropology. Before coming to SMU, Dr. Myers taught courses at the University of Chicago and the George Washington University.
Dr. Myers' new book, Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency is available from Vanderbilt University Press. She has also published 20 peer-reviewed book chapters and articles, including pieces in Medical Anthropology Quarterly, Psychiatric Services, Culture, Medicine and Psychiatry, Transcultural Psychiatry, and the Annals of Anthropological Practice. Myers has also served as an elected member (2013-2016) of the American Anthropological Association's Committee on Ethics and is part of the editorial board at Somatosphere (www.somatosphere.net).
Book
2015 Myers, N. Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency.* Nashville, TN: Vanderbilt University Press. * Reviews available from Medical Anthropology Quarterly and Somatosphere.
Selected Journal Articles
2016 Myers, N., Alolayan, Y., Smith, K., Broussard, B. & Compton, M.T. "'Meaningful Day' as a Recovery Construct: A Mixed Methods Study." Community Mental Health Journal. 52:747-756. DOI: 10.1007/s10597-015-9971-4.
2016 Myers, N. & Tali Ziv. "'No one ever even asked me that before': Autobiographical Power, Social Defeat and Recovery among African American Men with Lived Experience of Psychosis." Medical Anthropology Quarterly 30(3): 395-413. DOI: 10.1111/maq.12288.
2016 Myers, N. "Reflections on the Anthropology of Public Psychiatry: The Potential and Limitations of Transdisciplinary Work." In Special Issue: Practical Anthropology for a Global Public Psychiatry (editors: Neely Myers, Kim Hopper and Rebecca Lester). Transcultural Psychiatry 53(4):419-426.
2016 "Recovery Stories: An Anthropological Exploration of Moral Agency in Stories of Mental Health Recovery." In Special Issue: Practical Anthropology for a Global Public Psychiatry (editors: Neely Myers, Kim Hopper and Rebecca Lester). Transcultural Psychiatry 53(4):427-444.
2016 Griffith, J., Myers, N., and Compton, M.T. "How Can Community Religious Groups Aid Recovery for Individuals with Psychotic Illnesses Globally?" Community Mental Health Journal. 52: 775-780. DOI: 10.1007/S10597-015-9974-1.
2015 Myers, N., Lewis, S.E., and Dutton, M.A. "Open Minds, Open Hearts: An Anthropological Study of the Therapeutics of Meditation for Trauma." Culture, Medicine and Psychiatry 39:487-504.
2015 Myers, N., Alolayan, Y., Smith, K., Moore, A., Broussard, B., Haynes, N., Compton, M.T. "A Potential Role for Family Members in Mental Health Service Delivery: the Family Community Navigation Specialist." Psychiatric Services 66(6): 653-655.
2014 Myers, N., Bhatty, S., Broussard, B. & Compton, M.T. "Clinical Correlates of Treatment Disengagement in First-Episode Psychosis." Clinical Schizophrenia and Related Psychoses, 2014, Nov 3:1-21, epub ahead of print.
2013 Bermudez, D., Benjamin, M.T., Porter, S.E., Saunders, P.A., Myers, N., Dutton, M.A. "Mindfulness Based Stress Reduction for Women with PTSD and a History of Intimate Partner Violence: the Clinical Implications of Narrative Changes during the Intervention." Alternative Therapies in Clinical Practice, 9(2): 104-108.
2013 Broussard, B., Kelley, M.E., Wan, C.R., Cristofaro, S.L., Crisafio, A., Haggard, P.J., Myers, N., Reed, T., Compton, M.T. Demographic, socio-environmental, and substance-related predictors of duration of untreated psychosis (DUP). Schizophrenia Research 148(1-3): 93-8.
2013 Bermudez, D., Benjamin, M.T., Porter, S.E., Saunders, P.A., Myers, N.A., Dutton, M.A. "A Qualitative Analysis of Beginning Mindfulness Experiences for Women with Post-Traumatic Stress Disorder and a History of Intimate Partner Violence." Complementary Therapies in Clinical Practice, 19(2): 104-108.
2012 Myers., N. "Towards an Applied Neuoanthropology of Psychosis: The Interplay of Culture, Brains, and Experience." Annals of Anthropological Practice, Special Issue: Neuroanthropology and its Applications, 36(1): 113-130.
Book Chapters
2016 Myers, N. "Psychosis in the United States." For Our Most Troubling Madness, Tanya Marie Luhrmann and Jocelyn Morrow, eds. Berkeley: University of California Press.
2015 Myers, N. "Chapter 17: Shared Humanity" among Nonspecialist Peer Care Providers for Persons Living with Psychosis: Implications for Global Mental Health." In Global Mental Health: Anthropological Perspectives. Kohrt, Brandon, and Emily Mendenhall, Eds. Left Coast Press.
2015 Myers, N. "Diagnosing Psychosis-Scientific Uncertainty, Locally and Globally." For Diagnostic Controversy: Cultural Perspectives on Competing Knowledge in Healthcare." Smith-Morris, Carolyn, Ed. Routledge: New York.
2015 Myers, N. "The Ties that Bind." For Community Health Narratives. Mendenhall, Emily, and Kathy Wollner, Eds. University of New Mexico Press: Albuquerque.
Memberships and Affiliations
American Anthropological Association
Society for Medical Anthropology
Society for Psychological Anthropology
Neely Myers
Neely Anne Laurenzo Myers
Neely Myers
To interview this expert:
Call 214-768-7650 or
e-mail smunews@smu.edu
Assistant Professor of Anthropology
The work of Neely Myers, an assistant professor of anthropology, focuses on mental health and mental health care, especially for people experiencing psychiatric disabilities.
She has worked in the U.S. and Tanzania with women, veterans, and youth diagnosed with post-traumatic stress disorder, major depression, bipolar disorder and schizophrenia and substance abuse disorders. Currently, she studies the experience of early psychosis in Dallas, including among refugees/migrants, African Americans and Latinos, with funding from the National Institute of Mental Health and the Hogg Foundation for Mental Health. She hopes to advocate for mental health reform in Texas, the U.S. and globally.
Myers is the author of the recently published Recovery's Edge: An Ethnography of Mental Health Care and Moral Agency (2015, Vanderbilt University Press), about the inner workings of a mental health clinic run, in part, by people who are themselves "in recovery" from mental illness. It critically examines people in recovery through intimate stories of their struggle to find meaningful work, satisfying relationships, and independent living. She has also published journal articles and blogposts in multiple venues.
Center for Trauma and the Community
NEELY MYERS
Neely Anne Laurenzo Myers
Postdoctoral Fellow
Georgetown University
Department of Psychiatry
Research Division
2115 Wisconsin Ave. NW, Suite 120
Washington, DC 20007
Phone: 202-687-7365
Fax: 202-687-0694
Email: nlm42@georgetown.edu
RESEARCH INTERESTS
Culture and mental health; psychotic disorders; community-based participatory research; ethnographic methods; contemplative practices
REPRESENTATIVE PUBLICATIONS
Dutton, M.A., Bermudez, D., Matás, A., Majid, H., & Myers, N.L. (in press). Mindfulness-Based Stress Reduction for low-income minority women with a history of intimate partner violence. Cognitive and Behavioral Practice. doi: 10.1016/j.cbpra.2011.08.003
Myers, N.L. (2011). Update: Schizophrenia across cultures. Current Psychiatry Reports. 13, pp. 305-311.
Myers, N.L. (2010). Culture, stress and recovery from schizophrenia: Lessons from the field for global mental health.” Culture, Medicine and Psychiatry, 34, pp. 500-528.
Myers, Neely Laurenzo: Recovery's edge: an ethnography of mental health care and moral agency
A.Y. Lee
CHOICE: Current Reviews for Academic Libraries. 53.10 (June 2016): p1510.
Copyright: COPYRIGHT 2016 American Library Association CHOICE
http://www.ala.org/acrl/choice/about
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Full Text:
Myers, Neely Laurenzo. Recovery's edge: an ethnography of mental health care and moral agency. Vanderbilt, 2015. 191 p bibl index afp ISBN 9780826520791 cloth, $49.95; ISBN 9780826520807 pbk, $22.95; ISBN 9780826520814 ebook, $9.99
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2015-10083 CIP
Anthropologist Myers' three-year ethnographic study of current mental health care reveals a sharp contrast between a well-meant ideal and a gloomy reality. The recovery movement pursued by many mental health care professionals as well as patients themselves ideally emphasizes total recovery of patients with mental illnesses in order to become rational and autonomous again, and eventually reenter employment and social life as normal, worthy members of society. Myers' three-year fieldwork in a mental health clinic made her believe that the goal of total recovery is too difficult for patients to achieve when their own mental illnesses are not sufficiently treated, and when they still suffer from social stigmatization, poverty, crimes, and other problems. The main purpose of her study, as Myers (Southern Methodist Univ.) emphasizes, is not to show a failure of this "recovery journey," but to reveal the obstacles on the journey that prevent it from succeeding. This study also indicates a necessity to reevaluate the recovery movement and explore other approaches in mental health care reform. A good work for readers of medical anthropology and health studies. Summing Up: ** Recommended. All levels/libraries.--A. Y. Lee, George Mason University
Lee, A.Y.
March 4, 2016
Neely Laurenzo Myers’ Recovery’s Edge: An Ethnography of Mental Health Care and Moral Agency
By Ellen Rubinstein
Recovery's Edge cover imageRecovery’s Edge: An Ethnography of Mental Health Care and Moral Agency
by Neely Laurenzo Myers
Vanderbilt University Press, 2015, 192 pages
“RECOVERY! GET IT, GET OVER IT, OR GET OUT!!!” –Vera
Neely Myers’s beautifully written ethnography is a detailed look at one organization’s attempt to follow the Bush Administration’s 2004 unfunded mandate to make mental health care services more “recovery-oriented.” Broadly speaking, recovery-oriented care means eschewing the traditional focus on symptom reduction and relapse prevention in favor of finding ways to reintegrate individuals with serious mental illnesses as valuable members of their chosen communities. For recovery advocates, such care requires upsetting the traditional clinician-patient power dynamic by enabling and encouraging patients (now “consumers”) to make their own decisions. For policymakers, it means reducing the cost of caring for chronically ill mental patients by preparing individuals to re-enter the workforce as productive, taxpaying citizens “in recovery.”
Myers explores what recovery-oriented care looks like at Horizons, a rehabilitation organization serving over six thousand “members” (mental health care service users) throughout a large city. Horizons’ new CEO upsets the organization’s status quo by hiring “peers,” individuals with lived experience of mental illness, to spearhead Horizons’ recovery-oriented restructuring. Enter Vera, the feisty and passionate “person in recovery” who is tasked with running Horizons’ first peer-led treatment program, the Peer Empowerment Program (PEP). Vera is a constant, guiding presence throughout Myers’s book, alerting Myers to the daily indignities that members suffer and demonstrating what truly empathetic care looks like. She has a knack for connecting with the most downtrodden, frustrated, angry, and seemingly hopeless individuals who come through PEP’s doors. “Treat people like a person,” she tells Myers, “and they will become one” (75).
Vera’s approach, treating people like valuable human beings above all else, is exactly what is missing in the implementation of recovery-oriented care. Instead, Horizons’ recovery model prioritizes workforce reentry over relationships—or, as Myers so incisively puts it, “work in place of wellness” (52). Recovery is conceptualized as a metaphorical journey toward steady employment, laden with American cultural expectations about the transformative potential of journeying. Only once employed do members prove themselves worthy of social recognition and reintegration, or what Myers describes as “moral agency.”
Moral agency is the theoretical crux of Myers’s argument, a term she borrows from bioethicist Erika Blacksher’s (2002) research on poverty’s effects on sense of self. Invoking the work of Blacksher, Arthur Kleinman, and Angela Garcia, Myers defines moral agency as “a person’s freedom to aspire to a ‘good life’ in a way that leads to intimate connections to others” (13). Horizons’ (and other agencies’) vision of recovery is such that moral agency is bestowed only after members have (1) become rational, (2) become autonomous, and (3) become hardworking. For a marginalized, stigmatized, destitute population caught in a mental health care system that dis-incentivizes work (make too much money, and risk losing disability benefits), these are impossibly high standards. And because the focus is on work rather than on building sustainable relationships outside of the mental health care system, members often find themselves going the journey alone. Myers’s contention is that intimate relationships, much like the unconditional acceptance Vera offers (although Vera, too, believes in the socially restorative power of work), must come first for members to have any chance of succeeding in their recovery journey.
The chasm between Horizons’ recovery philosophy and the reality of members’ everyday struggles becomes evident as Myers maps out the three steps of the recovery journey ethnographically (Step 1: Take Your Medications. Step 2: Self-Advocate. Step 3: Work for Intimacy). Perhaps the most poignant story is that of Maison, a gregarious Korean War veteran and amateur blues singer who is Horizons’ “show pony of recovery” (58). After years of stability, sobriety, and devout adherence to taking his medication (Step 1), Maison suffers a relapse of his mental illness. In quick succession, he loses his Horizons housing and his role in the community. Myers argues that Maison’s lack of moral agency precipitated his rapid decline: “When he began to have trouble, there was no safety net for him, no intimate web of connections to catch him as he fell. Besides staff, no one outside of Horizons seemed to know he existed, except me” (85). Maison enjoyed an active and valued role at Horizons as long as he remained in recovery, but his relapse reveals the contingent nature of these clinic-based relationships, leaving him socially and emotionally abandoned when he falters.
The takeaway is that although Horizons’ efforts (and those of the American mental health care system writ large) to provide recovery-oriented care are well intentioned, adherence to the current model of recovery, a model that does not foreground moral agency, only sets its members up to fail.
There is hope, however, and in the final chapter Myers briefly describes what successful recovery-oriented care can look like—care that extends beyond the current “edge” of recovery-oriented services offered. Myers makes an impassioned plea for service providers to meet service users at their level, drawing on Annemarie Mol’s concept of “the logic of care” to encourage attention to living with, rather than recovering from, serious mental illness (157-158). Myers suggests that a critical reframing of what recovery means may provide an alternative, and ultimately more successful, approach to offering recovery-oriented care. She proffers her own three-step alternative to the current recovery model: Step 1: Gain moral agency (which requires providing people with resources and opportunities to become valued members of their local communities). Step 2: Form intimate relationships. Step 3: Engage in “work” (any activity that is personally meaningful).
Myers’s writing is notable for its literary quality, and she does an admirable job of interweaving research literature and ethnographic artistry. Rather than presenting a chronologically linear narrative arc, the stories (often mere snippets rather than complete tales) ricochet in time and space, a rhetorical maneuver that seems to mimic the fragmented and chaotic existence of Horizons members. Myers writes of PEP, “And the people kept coming—in and out, out and in, an endless tide” (31)—and so, too, do people flow in and out of focus throughout her book, with Vera at the center as a beacon of recovery-oriented philosophy and care. This approach captures the precarious circumstances, both material and psychological, in which members live; they are in imminent danger of losing their minds, their possessions, and their support systems.
Myers draws heavily on clinical and social psychiatric literature to contextualize the ethnography—her book provides an excellent summary of over a decade’s worth of major perspectives in psychiatry—and engages less with conversations in anthropology. Moral agency, despite its centrality to Myers’s argument, is a concept deployed without much attention to its anthropological or philosophical lineage, and only in the final few pages does Myers expand on the brief definition offered at the outset (and quoted above). Moral agency and intimacy suffer conceptual slippage; oftentimes the two seem interchangeable, and intimacy, a complex phenomenon in its own right, is never unpacked. And while Horizons members are presumably the agents at the center of moral agency, moral agency is more often than not described as a characteristic bestowed upon them by others (primarily, staff), not a quality they seem capable of generating by themselves.
But perhaps that is the point, at least at Horizons, where recovery-oriented care lacks the imagination and resources necessary to assist profoundly disadvantaged and disabled individuals in combating “the demoralization, misrecognition, existential crises, and catastrophic conditions of everyday survival” (156). It is Myers’s heartbreaking descriptions of those conditions as experienced by the members she befriends that make this book so valuable. While specialist readers may yearn for more theoretical thickness, non-specialists will appreciate its vivid descriptions and vibrant characters, which showcase the value of long-term, in-depth ethnographic research. With compelling writing that appeals to a general audience, this book is essential reading for anyone with an interest in social justice and the American mental health care system.
Ellen Rubinstein is an anthropologist and Postdoctoral Fellow in the Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School. Her research explores caregivers’ conceptualizations of mental illness in the U.S. and Japan.