A pair of statisticians, Cohen and Cohen [Cohen P, Cohen J. The clinician's illusion. Arch Gen Psychiatry (1984) 41::1178–1182 ] first introduced the notion of the "clinician's illusion" to account for the tendency among practitioners, who treat ambiguous and prolonged illnesses, to assume that the ways in which such illnesses present in clinical care settings represent the ways these illnesses look both over time and among the broader population of persons afflicted with them.
Based on a combination of advanced statistics and common sense knowledge that people who are neither acutely nor severely ill are less likely to access clinical care, the Cohens' theory offered an explanation for how and why mental health professionals might retain their traditionally narrow and negative view of outcome in a condition like schizophrenia despite the accumulation of longitudinal data which suggests otherwise.
Simply stated, when people are managing their condition adequately on their own they are much less likely to seek care.

We know that only about one-third of individuals experiencing a serious mental illness will access care from a specialty mental health setting, meaning that those people having the most difficulty are most likely to be seen. We also know that few of these people will receive interventions that are evidence based or optimally effective4 and few will adhere to the treatments offered to them over time.

We know that only about one-third of individuals experiencing a serious mental illness will access care from a specialty mental health setting,11 meaning that those people having the most difficulty are most likely to be seen. We also know that few of these people will receive interventions that are evidence based or optimally effective4 and few will adhere to the treatments offered to them over time.

At one end of this broad spectrum, some studies have demonstrated that between 20% and 65% of people achieve a "good outcome" over time, ranging from mild impairment to functional recovery.3,6 A small minority of people (under 20%) experience increasing impairments over time, whereas a sizable number experience sustained periods of symptomatic relief and improved functioning disrupted by episodes of recurrence or relapse. It is these periods of symptomatic relief and improved functioning which are now being described as representing periods of remission, and there is increasing recognition that such improvements are common.

In other words, if a person has had a condition which was once severe enough to warrant a diagnosis of schizophrenia and that condition has since improved to the point at which it would no longer qualify for that diagnosis, then that person's condition can be said to have gone into remission. Such a state is labeled "remission" rather than "recovery" because, as the authors explain, the notion of recovery is understood to involve a "more demanding" and "longer term phenomenon" in which the person is "relatively free of disease-related psychopathology" and has the "ability to function in the community."
Like in other chronic illnesses, periods of remission may be time-limited, interspersed with periods of relapse or recurrence, and also do not constitute a full return to premorbid functioning. Remission, therefore, is described as "a necessary but not sufficient step toward recovery.

Remission implies that the person is not yet recovered but remains vulnerable to relapse or recurrence. It represents, at worst, a tenuous hold on a temporary period of diminished illness severity or, at best, a stepping stone on the way to a fuller and longer term period of sustained recovery. Unless the concept of remission likewise is taken to be a transitional step for the field on the way to development of a concept of sustained recovery, then it will fall short of satisfying the demands of patients and their families.

Recovery "from" schizophrenia is consistent with the conceptualization of recovery introduced by the remission working group, in which a person becomes "relatively free of disease-related psychopathology" and is able to "function in the community" over a prolonged period of time

At least for the foreseeable future, not everyone with schizophrenia will achieve this form of recovery. While post-Kraepelinian pessimism is no longer warranted, neither is a Pollyanna-like optimism that everyone will recover from schizophrenia.

This concept does not have as much to do with level of psychopathology as with how a person manages his or her life in the presence of an enduring illness.

All contributors seem to agree that this form of recovery refers to a unique and personal process rather than to a uniform end state or outcome and that it involves a person's self-determined pursuit of a dignified and meaningful life in the communities of his or her choice

The New Freedom Commission defined this form of recovery as "the process in which people are able to live, work, learn, and participate fully in their communities" and acknowledged that "for some individuals, recovery is the ability to live a fulfilling and productive life despite a disability.

The American Psychiatric Association endorses and strongly affirms the application of the concept of recovery to the comprehensive care of chronically and persistently mentally ill adults ... This t emphasizes a person's capacity to have hope and lead a meaningful life ... and includes 'maximization' to each patient's autonomy based on that patient's desires and capabilities, patient's dignity and self respect; patient's acceptance and integration into full community life; resumption of normal development. The concept of recovery focuses on increasing the patient's ability to successfully cope with life's challenges, and to successfully manage their symptoms.

With its focus on "chronically and persistently mentally ill adults" who have an ongoing need to manage symptoms, this position statement cannot liken being in recovery with schizophrenia to recovery from acute medical disorders. In fact, this form of being in recovery pertains to the 35%-80% of an ill population who do not experience full recovery over time. But if this second form of recovery is only applicable to people who do not recover, why is it called "recovery"? Surely this contradiction would lead to considerable confusion in the field, as it most assuredly has.

This notion of recovery was borrowed by the consumer movement from their counterparts in the addiction self-help community, who considered themselves to be "in recovery" as long as they were making active efforts to manage their sobriety and rebuild a meaningful life in the wake of their addiction

They should be able to reclaim their lives and autonomy without first having to recover from mental illness. As we noted in the quotation from Camus above, the important thing in this view is not to be cured but to live a meaningful and full life with "one's ailments."

In psychiatry, this right remains intact except and until a person poses serious imminent risks to self or others, is gravely disabled, or is determined to be incapacitated by a judge.20 In all other circumstances, people with serious mental illnesses retain the right to sovereignty over their person. As a result, to become recovery-oriented practitioners are expected to respect people in recovery as full partners in the treatment and rehabilitative enterprise, entitled to the same degree of collaborative, shared decision making, and informed consent as they and others are entitled to in other branches of medicine

this form of being in recovery primarily involves people with "psychiatric disabilities" taking back their lives in an active and purposeful fashion, pursuing their desires to "live, work, learn, and participate fully in their communities," rather than waiting for an eventual cure