Author: Greg Liotta, MSW/Friday, November 14, 2014/Categories: Recovery, Advocacy, Social
"Do I have to have an open mind on this one?”
He’s one of the brightest, emotionally intelligent men I know. A force in the addictions field, a respected leading clinician, a long-time member of the recovery community with over 20 years clean & sober, and my friend. But when the conversation turned to the new messaging about recovery that’s sweeping the country, the gates of his mind slammed shut.
“Do I have to have an open mind on this?”
Well, that depends, I told him.
How broad is the population you want to serve?
This is not an intellectual exercise. The loyalty people in recovery feel for the 12 steps is an emotional glue tied to gratitude for a second chance at life. For millions, drug and alcohol addiction has taken them to the brink of death, only to be saved by "The Program" of Recovery. Almost everybody has lost a loved one or family member to the disease. When a person’s life is saved by a particular treatment, the bond becomes cemented. And cement is not designed to flex. For many 12-steppers, there is no "gray" area for discussion here. No room for compromise. Within the (12 step) rooms, the thinking about recovery is colored by a powerful emotion-laden lens. When entering this discussion, an individual is wise to exercise more than sensitivity. It calls for reverence.
Still, the trending topic in this country is a broader, more inclusive conversation about what addiction is, how to treat it, and what "recovery" actually means. Let’s face it: as we expand to make room for more cultural diversity in recovery, as well as more complex disorders (dual diagnosis and process disorders including food disorders, sex and love addiction, codependency, debting, internet disorders, etc.) it’s proven to be far more multifarious than anything Bill W. could have imagined. When A.A. was incepted in 1939, the term “process disorder” hadn’t even been invented yet, and black people had not yet gained acceptance to those rooms. The language that gave birth to the program we now know today still reflects the limited consciousness of those times. But the times, “they are a changing.”
Collegiate Recovery is the leading edge on the landscape now, spreading like a brush fire. Like all meaningful revolutions, the conversation is being lead largely by impressive young people like Greg Williams, producer of Anonymous People, Robert Ashford, President of EPR at UNT, and Devin Reaves, MSW from YPR (Young People for Recovery). It’s a phenomenon being powered by people like Stacie Mathewson (founder of The Stacie Mathewson Foundation), and Kristen Kelly Harper, Executive Director of the Association of Recovery Schools (ARS). Michael Botticelli, Director of the White House Office of National Drug Control Policy, has recognized this movement publicly. All of them are buoyed by researchers like John Kelly, Ph.D. and Alexandre Laudet, Ph.D., Director of the Center for the Study of Addictions and Recovery at the National Development and Research Institutes, Inc. They’re modern day alchemists distilling gold from lead, studying what helps people recover from addictions – essentially trying to get their hands around the slippery eel of who benefits from a program that's founded upon "anonymity." This movement is real, imprinting a new presence on the landscape of Higher Education.
Collegiate Recovery provides a safe space for young people in recovery, or in hopes of recovery, to support each other while navigating the rigors of college in recovery-hostile environments. Transforming Youth in Recovery has supported the expansion of collegiate recovery centers across the nation within the past couple of years. Since 2012, the number of colleges that have implemented centers on their campuses has blossomed from about 40 to 120, and it’s just beginning to hit its stride. Young people finally have a safe place to practice sobriety on college campuses all across the country.
Race & Recovery
According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Survey on Drug Use and Health, 23.5 million persons aged 12 or older needed treatment for an illicit drug or alcohol abuse problem in 2009. That is a staggering 9.3 percent of persons aged 12 or older. Of these, only 2.6 million – 11.2 percent of those who needed treatment – received it at a specialty facility. About 60 percent of admissions were White, 21 percent were African-American, and 14 percent were Hispanic or Latino. Another 2.3 percent were American Indian or Alaska Native, and 1 percent were Asian/Pacific Islander.
I’ve attended a number of Collegiate Recovery Conferences over the past few months, each time walking away inspired by the progressive energy. Young people are not afraid to address hard issues. One particular theme keeps rearing its head at these events: “where are all the people of color, and how do we do a better job of drawing them into Recovery?”
The question invariably draws applause from well-meaning (mostly white) young folks, who enjoy invigorating conversations about how to resolve “the problem.” The conversation, which always invites a rich expression of ideals and concepts, feels good. Good people having sincere conversations about meaningful things. But they don’t get to the core issue: What is it about US that keeps "others” separate and apart? We invariably walk away without solid answers because, well, maybe we're asking the wrong question. It is a question, which posits a non-problem as a "problem”: that people of color are under-represented in Recovery.
Are they really?
Questions like this put the question square in the lap of the questioner. When asked “why don’t we see more black people coming into the rooms (of A.A.)?”, Peer Recovery Specialist from YPR Devin Reaves once said, “If you want to see black people in the rooms, why don’t you go to the rooms in the black community?” Alas, a light-bulb moment.
What do we mean when we say we want “more diversity” in recovery? If we’re just talking about race, then we’re only skimming the surface of what “diversity” really means. Acceptance of differences is a reflection of an expanded consciousness. The mind that is open to diverse cultural and racial presence in the rooms is a mind that has expanded to allow for diverse beliefs and ideas. The mind that is closed to broader notions of “recovery” is a mind that will never embrace true “diversity.” Color-blindness – the preferred hiding place of many – does not begin to address the issues. “We’re all addicts, race doesn’t matter” makes for a convenient comfort-zone, but is a gross minimization of a person’s unique story and cultural heritage. It cripples a fully authentic engagement by agreeing not to look at real things like our shared history, or the language we use with each other.
Perhaps we ought to be asking different questions, such as: what can we do to be more inclusive of people’s approach to recovery? How can we open our minds to embrace cultural, ethnic, and ideological expressions of recovery that differ from our own?
Is it possible that some populations are on a legitimate path of recovery yet calling it by a different name? How do we count them?
This is the beginning of true “diversity.” The questions force us to explore the slippery definitions “recovery”:
Here’s where it gets tricky. According to SAMHSA, there are approximately 24 million people in the USA that are in “recovery.” Approximately another 25 million are estimated to need some form of recovery, but are not yet there. Of the 24 million that are in recovery, approximately 4 million of them are in 12-Step recovery. There are an estimated 1.25 million Alcoholics Anonymous members in the U.S., which begs the question: Where are the other 20 million practicing their recovery? How are they in “recovery” if they are not in AA or NA?
This presents a problem for our researchers, who typically gather data in places where people use the common jargon for “recovery”: 12-step treatment centers and after-care facilities. They do not include settings where people are practicing an alternative form of recovery (such as church). In such places, people tend not to refer to their path explicitly as “recovery”.
There's evidence that a significant percentage of people identify fitness (marathon running, triathlons, etc) as their “program of recovery.” For others, immersion in a Buddhist or yoga sangha seems to be the ticket. These numbers are near impossible to confirm because in such settings there is a different language used to express “recovery." While a 12-stepper might refer to their “recovery” as their “program” (meetings, working the steps, doing service, and abstaining) a runner might simply say “I don’t drink. I run.” End of story. Just as different faiths have different names to describe “Higher Power,” people use different terms to describe “recovery.” It comes as a surprise to most people that the majority of those in “recovery” don’t actually use the term “recovery.” The question is: are these paths equally deserving of being regarded from a place of “reverence”?
In December 2011, SAMSHA issued an updated official definition of “recovery.” It says:
"A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential."
The definition indicates any path that leads a person to wellness involving four primary dimensions of their lives: Health, Home, Purpose, and Community. Or, in 12-step language, any path that becomes a “bridge back to life.”
Despite this progressive language, here we see the glaring problem: essentially there are two incongruent concepts about recovery. One is the "official definition" (above), which itself inspires spirited debate. The other is the cultural narrative of recovery which has embedded itself in the American psyche, if not globally. When a person says they are “in recovery” from an addiction, it’s reasonable to assume they are referring to AA or NA. From the perspective of many 12-steppers, an alternative model is “not recovery” or, at best, is in a "diluted" form of recovery. Some call it "taking the softer, easier way." Although SAMSHA has opened the door to a broader notion, which the youth recovery movement has run with, there’s no mistaking that the 12-step community is driving the train that is spreading this movement. To the vast majority of the world we live in, it’s simple: “recovery" = A.A., N.A., or other 12-Step programs.
From within these ranks there is currently a powerful, high-profile push to remove the stigma of addiction for people in recovery. Beyond the stigma of addiction, however, we’ve yet to seriously address “Recovery Stigma.” How do we dismantle the idea that only one path of recovery is valid, and as such, paths that don’t conform to the 12 steps are invalid?
Perhaps a better question is: do we really WANT to?
Language & Recovery "Privilege"
Recently I met with one of the leading champions of recovery in the USA. A respected leader in the field of addiction & recovery. I asked him, before addressing a group, if he could expand his narrative to go beyond only talking about drug and alcohol addiction. What about recovery from sex addiction, internet addiction, gambling addiction, food addiction, and all the things most people in the group were suffering from? I mean, we're talking about “reducing stigma", aren't we? He twisted up his face, and said, "Well, that's tricky stuff. We (addicts and alcoholics) have had a hard enough time breaking the stigma for ourselves. I’m not really comfortable talking about that. It’s complicated." Hmmm. Okay. Yes, it’s complicated.
In the world of recovery, we need to be mindful not to evoke the sense of “privilege” that’s often illuminated in our language. Words reflects underlying belief systems. When discussing “white privilege,” we refer to a sense of entitlement to be first, to assert a superior position, to be recognized before anybody else, and to insist that “our way” is the “right way.” If not acknowledged, this same consciousness will express itself in other domains, including recovery. In society today, we’ve come to a point where a recovering alcoholic can reach a lofty position in the White House. A recovering sex addict? A recovering gambler? Not so much. Such entitlement is difficult to be aware of because it seems natural to the one with the privilege. As such, it can be difficult for someone to acknowledge when they are making the “other” feel “less than.”
When 12-step advocates say, to those who are recovering through another avenue, (or not practicing “abstinence”) that they are “not ready yet,” they have not “surrendered yet,” or that they are looking for an “easier, softer way,” they are projecting a belief system, rather than a fact. It’s a failure to recognize that what is true for one may not be true for another. ”Half measures will not avail us," says Bill W. Chapter Five in the Big Books makes it clear: "Rarely have we seen anyone fail who has not thoroughly followed our path. Those who do not recover are people who will not or cannot completely give themselves to this simple program, usually men or women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault. They seem to have been born that way. They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty. Their chances are less than average.” Language like this is inherently alienating for one who may be struggling in this paradigm, or (the vast majority) who have chosen a different recovery path. It makes broad assumptions about the superiority of "our path", and sweeping (unfounded) generalizations about other people's mental / emotional status.
As an addictions counselor I can attest that it is far from "rare" to see someone "fail" (relapse). More people “fail” than not, and there are many more reasons why people fail to achieve sobriety. One of those reasons may very well be the insistence that resisting this approach is nothing but a symptom of pathology, and that when they stop resisting, things will fall into place.
Some argue that that a full on abstinence-only approach, which allows for zero tolerance of any deviation, is the “easier” path. For some, it's much harder to wrestle with the immense complexities of life, including the vast variations of the human experience. And for others, the slippery snake of denial and deception gains dangerous traction if given any quarter. The deeper one looks, the more glaringly obvious it becomes that there is no “one solution” to addressing this problem. There are those for whom there is simply no better path than the 12 steps of A.A. For others, all that’s required is surrender to Jesus, and for others, all that’s needed is a job. The challenge is, how do we determine which path of recovery is best for each individual? And how do we support them without exercising a sense of privilege?
Race & Recovery
According to SAMSHA, "Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations, including values, traditions, and beliefs are keys in determining a person’s journey and unique pathway to recovery. Services should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs."
By many accounts, the percent of Black, Latino, and Native American people standing up to be counted as people in Recovery is significantly less than whites. There is no way to know if they don’t show up in these statistics because they have a different cultural ethic about being counted for such things, if they just don’t come into recovery with the same vigor as white people, or perhaps other possibilities worth considering. It may be that these populations more frequently lean toward a different expression of “recovery.” It appears that for many people of color, “recovery” is found in a deeper involvement with church and family. And while Bill W. and Dr. Bob were careful enough to put a chapter in the Big Book for Agnostics, they forgot about the Christians who have no interest in any book bigger than the Bible. Perhaps to a larger degree than whites, many people of color are finding their “recovery” through Jesus, the local parish minister, the fellow congregation, and family. A person can find redemption quite well in that setting, if given enough support. Cultural sensitivity in the Recovery community calls for greater mindfulness about the language we use, being cautious not to alienate those that are “other” with an eye toward broader definitions of the term “recovery”.
Recovery as Expansiveness
Addiction is about bondage. It’s characterized by a narrowing of consciousness, a shrinking away from the expanding nature of life. It is the contraction of infinite possibilities and joy in the world.
Recovery is about liberation, expansion, and becoming a part of the world in a way not possible when tethered to a destructive way of life.
But that is only true for me. For you, it might be something else.
There are many - perhaps millions - for whom recovery is simply a means to stop drinking, drugging, or engaging in reckless behaviors.
My path led me into recovery in 1990 after struggling to manage depression & anxiety with a process disorder. My recovery has taken many twists and turns, relapses and re-discoveries, and forays into various disciplines. After 17 years, my deepest expression of recovery was found in a spiritual community where I’d gone to live for one full year. During this time I meditated 3 hours a day, prayed incessantly, and practiced every step without actually calling them “steps.” I wasn’t “working it.” I was participating joyfully in the dance of life. When life was harsh, I didn’t “work harder,” I released more. It was a lifestyle steeped in the 8 limbs of yoga, which in itself is an abstinence-based model of living. I was supported by a loving community. The biggest difference was that we didn’t call it “recovery,” and I didn’t identify myself as “an addict.” I didn’t feel the need to be reminded of my fundamental “brokenness”; I’d already been hypnotized by that belief. Affirming my basic goodness was nourishing to me, and my life flourished in that environment. My practices grounded me in a profound peace. I became free of identification with anything that harmed my body, mind, and soul. My anxieties and depression lifted completely, and my compulsions subsided. And though I was happier, more joyous and free than at another other time in my life, I’ve often been told that I was not working a “true program of recovery.”
Following that experience, I went to work as a Primary Counselor at a 29-day treatment facility providing 12-step based treatment for chemical dependency. A humbling experience. What I learned there, after too many disappointments, was there is no way to prescribe a one-size-fits-all treatment for any individual. Every person who came before me was remarkably unique, and those I was effective with were the ones I was able to truly “see” for who they were. They all had commonalities. They all suffered from addictions, and over 90 percent of them also presented with underlying emotional & mental disorders. But the truth is, not one of them suffered in exactly the same way. Addiction may be addiction but there are no two people who are touched exactly the same by it. As such, there are no two people, regardless of their diagnosis, that respond to the same exact treatment. Some needed motivation, some needed acceptance. Some needed abstinence forever, some needed abstinence for a while, and some just needed a damn job. But all of them needed to learn a new way to relate to their pain, and a new story from which to shape their identity. Every person who came before me was seeking peace and happiness. Rarely were they looking for any sort of program. They were looking for themselves. In fact, it took me quite some time before realizing that not everybody is seeking the same expression of recovery. Many just want to stop killing themselves so they can get back to the business of their lives. A significant percentage of my clients initiated treatment with a solid resistance to 12 Step recovery out of an aversion to “joining” something. They weren’t signing up for becoming a “member” of a group that requires an adherence to a dogma or system. I came to see the arrogance in my prescribing this pathway to people who were abundantly clear they were not having it. Great harm was done by conveying to some of them that, unless they “surrendered to the program,” or followed the mandate of Step One, that they had little chance of success. Had I been more present to each individual before me, I might have been a better counselor. Instead of insisting they “work the steps,” hand in their assignments (step work) on time, or fulfilled my expectations, I might have been more effective in helping them to find a path that would bring them peace.
This is the beginning of “diversity” in Recovery. If we are sincere about wanting to broaden our rooms to embrace all race, creeds and cultures, we have to look at these issues. When we can begin to make space for the differences in the way people pursue health, wellness, peace, and joy in their lives, we can begin to make space for different cultures. When we begin to make room for all people to experience the path which is most likely to make them happy, joyous and free, we are truly carrying the message. When we can see others beyond the veil of our own biases, we become free.
May we all become free.
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