Event Description

Event Description

We are pleased to announce the release of our newest Tips & Tools for Recovery that Works! video Overcoming Holiday Triggers.

The holidays can be challenging for those in recovery. The latest video offers ways to help overcome triggers during the holidays.

Click to watch this on our YouTube channel.

Subscribe to the SMART Recovery YouTube Channel

Video storytelling is a powerful tool in recovery, and we are proud to share our SMART Recovery content free-of-charge, available anywhere, on any device. Our videos hope to inform, entertain, and inspire anyone in the recovery community.

Subscribe to our YouTube channel and be notified every time we release a new video.

This clip of Hunter Biden has garnered a lot of attention in recovery advocacy circles.

I have mixed feelings.

Her characterization of him being “in and out of treatment 7, 8 times” frames his relapses as a personal failure in a way she wouldn’t frame relapses in other chronic illnesses, even where behavioral strategies are considered important for recovery.

The first part of his response, “say it nicer to me”, made me uncomfortable. It’s possible I’d feel differently if the interviewer was a man, but it felt a little too close to telling her to smile.

Personally, I’m more inclined to tell people the impact of their messages and set a boundary than to tell them what to say and how to say it. (Though I also might get a little prickly during a lengthy interview that was nearly entirely focused on the bad things people say about my personal and professional life.)

What I liked a lot more was his reframing it for her, “sought treatment, for an issue, like most people.” He also told her it came across as insensitive.

One of the things that interesting here is that Robach’s characterization didn’t violate any language do’s and don’ts. Rather, she conveyed a lack of respect and seemed to frame his relapses as failures of character.

Language is important AND people can use all the right words while still conveying and perpetuating disrespect, judgement, and contempt. Further, people can use the wrong words while speaking from a place of respect, compassion, and equality.

Certain words can insert negative valences and embed assumptions into sentences and thoughts. Those words add bias. Discouraging use of these words makes a lot of sense to me.

Other words may not have an innate negative valence or embed assumptions, but can evoke bias held by listeners. Here, I’m not so sure that prescribing language makes sense–the bias is in the person rather than the language. Changing the language here might avoid evoking their bias, but the bias is still there. The bias emanates from the person, not the words.

(That said, avoiding these words might make sense in some contexts. For example, for public educators and people sharing their stories for the purpose of bias and stigma reduction. They would want to avoid evoking bias when trying to convey bias-reducing messages and information.)

We all want to reduce the bias, but how best to do that?

I don’t pretend to be an expert on bias reduction and I don’t presume there is one correct approach.

Undoubtedly, personal contact with people affected by addiction is a critical strategy. (However, even that is fraught. What may help reduce bias for one population, may increase bias for another. For example, while it’s sometimes disputed, education about addiction as an illness and the possibility of recovery may reduce bias toward people with addiction, that same strategy could inadvertently reinforce bias against people continue to use ATOD.)

In the case of language that adds bias, we can educate people about the bias it adds, the consequences of that bias, discourage its use, and provide alternative language.

Where the issue is bias in the person, rather than in their language, this seems more challenging. I wonder what treatment critics can teach us here.

Harm reductionists and treatment critics often criticize treatment as too directive and too confrontive. Motivational Interviewing is frequently pointed to as a better way.

In 2007, Bill White and Bill Miller published an article about confrontation that distinguished between confrontation as a goal vs. confrontation as a style:

In its etymology, the word “confront” literally means “to come face to face.” In this sense, confronting is a therapeutic goal rather than a counseling style: to help clients come face to face with their present situation; reflect on it; and decide what to do about it. Once confronting is understood as a goal, then the question becomes how best to achieve it. Getting in a person’s face is rarely the best way to help them open up to new perspectives. There is, as Hazelden observed in its 1985 recanting of aggressive confrontation, “a better way.” People are most able and likely to re-evaluate reality within safe, empathic, supportive and nonjudgmental interpersonal relationships that do not necessitate defensiveness.

MI asserts that resistance (or discord, or defensiveness) is a product of the relationship. If our goal is for them to come face to face with the the ways their attitudes and behaviors harm others and doesn’t align with their values or self-perception, MI believes that’s best accomplished in the context of a safe and nonjudgmental relationship. It’s in that context that we might be able to find, explore, and develop discrepancy. A confrontive style will interfere with achievement of our goal.

In the past week, there have been a couple of NYT stories that provoked a reaction from recovery advocates. One, about Diego Maradona, celebrated his legacy but click bait teasers said that his addiction “marred” his legacy. The other, about digital 12 step meetings and treatment, used the term “substance abuse” in the headline. I was also involved in a similar issue with a professional association publication where a piece had “substance abuse” in the title.

I detected no disrespect or contempt in the latter two articles, just use of discouraged words. The Maradona coverage seems more loaded with judgement and potentially stigmatizing language (even though it’s not clear to me that it didn’t align with his own framing of his SUD).

If I had to choose between prioritizing changing people’s words or changing their hearts in relation to ATOD problems, I’m much more interested in changing hearts. If we were to change their hearts, their words wouldn’t matter all that much. And, I guess all of this makes me wonder if all the attention on managing what comes out of their mouths, pens, and keyboards distracts us from changing hearts.

I’d also add that there are a lot of groups who are passionate about their particular cause and are trying to change language around their cause. For example, last night I listened to an interview with the founder of PETA who discourages the use of the words “pet” and “owner.” My point here is that members of the media and the public have a lot language direction coming at them, it’s enough that it’s difficult to keep up and enough to evoke some resistance that may have have much more to do with this context than SUDs in particular.

The text below is a post from a while back. It is about the Surgeon General’s attempt to tweet a destigmatizing message that addiction is a disease rather than a moral failing and it happens in good families, including his own. However, he used the word addict, which set off criticism of him for using stigmatizing language. I scrolled through the responses and, fortunately, the nastier responses appear to have been deleted.

Something is amiss in recovery advocacy.

Earlier this week, the Surgeon General’s office tweeted the following paraphrase of a speech given by the Surgeon General. (Later clarified to be incorrectly transcribed.)

Addiction is not a moral failing and that it affects “good” families. Nice message, right? We need more influencers to say the same kind of thing, right? Not so fast.

Recovery advocates corrected him for using the word “addict” (some corrections were pretty generous, others were more scolding) and he responded with the following:

People with addiction have called themselves addicts for decades and I’m not aware of any in-group vs out-group differences in use.

John Kelly (2010) was the first person I recall focusing on the associations people have with various words related to people with addiction. That work has been extended by White, Wakeman, Ashford, and Brown.

This work started with words that have innate negative valences, like “abuse” and “dirty.” It’s since extended into all sorts of other words, like addict, relapse, and involves calls for “person-first language” (which emerged in the late 1980s for other populations).

My memory of the emergence of all of this attention to language was at the level of advocacy with storytelling. As a strategic matter, recovery advocates were encouraged to tell their stories with certain language that was found to be less likely to arouse bias and stigma.

On the one hand, this made pragmatic sense to me for advocacy efforts. On the other hand, this also felt backwards. Abandoning objectively neutral words because some people (usually people who hold a negative bias toward people with addiction) have attached negative associations to them seems like a recipe for tail-chasing. What happens when the new words acquire a negative association? Do we just keep changing terms as people with biases learn them and contaminate the new words with their bias? (Also, who does this put in control of our language?)

We’ve already seen this happen. Opioid Replacement Therapy and Opioid Substitution Therapy were replaced by Medication Assisted Treatment, which is now on the do-not-use list. This creates significant descriptive problems for the sake of stigma reduction–an early recovery advocacy goal was to distinguish treatment from recovery. The new preferred term, Medication Assisted Recovery, conflates treatment and recovery, undercutting a key message of methadone patient advocacy efforts.

From Walter Ginter, medication-assisted recovery advocate:

The problem with the methadone community is we have too many people who think methadone is a magic bullet for that disease—that recovery involves nothing more than taking methadone.

This view is reinforced by people who, with the best of intentions, proclaim, “Methadone is recovery.” Methadone is not recovery. Recovery is recovery. Methadone is a pathway, a road, a tool. Recovery is a life and a particular way of living your life. Saying that methadone is recovery let’s people think that, “Hey, you go up to the counter there, and you drink a cup of medication, and that’s it. You’re in recovery.” And of course, that’s nonsense. Too many people in the methadone field learn that opiate dependence is a brain disorder, and they think that that’s all there is to it. But just like any other chronic medical condition, it has a behavioral component that involves how you live your life and the daily decisions you make.

White, W. (2009). Advocacy for medication-assisted recovery: An interview with Walter Ginter.

So . . . I get the pragmatic and strategic reasons to encourage advocates to adopt certain language but question the wisdom of it. However, this has evolved from a strategy to be used by recovery advocates to a requirement of anyone making public statements on the topic, with call-outs for shaming and being an agent of stigma.

I also don’t understand whose wishes this represents. How many people with addiction object to or feel harmed by the term addict? Hasn’t our message been that we’re resilient and resourceful people who only want the same opportunities as everyone else–the elimination of discriminatory barriers to treatment, employment, school, etc?

I’ve also previously expressed anxiety before about treatment and recovery being drawn into culture war battles. (And, culture wars have only heated up over the last several years.) Of course, this isn’t a culture war hotzone, but the enforcement and call-outs give it a similar feel–that there are sides, and one side is righteous and fighting for justice, while the other side are agents of stigma, injustice, and discrimination.

• At what point do some of these efforts to reduce stigma alienate potential allies? IDK.
• How well do recovery advocates represent to the beliefs, preferences, and priorities of people with addiction? IDK. However, it’s difficult for me to believe that these reactions to this tweet are representative of the views of significant numbers of people with addiction outside of advocacy circles.

Kristin Roha, MS, MPH, Public Health Advisor for HIV, and Dr. Neeraj Gandotra, M.D., Chief Medical Officer

Established in 1988, World AIDS Day allows the people of the world to show support for people living with and affected by HIV, and to commemorate people who have lost their lives to AIDS. In 2020, the COVID-19 pandemic has provided an urgent reminder that pandemics can devastate communities, lives, and livelihoods. The theme for World AIDS Day 2020 is “Ending the HIV/AIDS Epidemic: Resilience and Impact.” We at SAMHSA have seen how the COVID-19 crisis has exacerbated the challenges faced by people living with HIV, substance use disorder, and mental disorder. SAMHSA is proud to stand with our federal partners, our grantees, and the people of the world in observing World AIDS Day 2020.

SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities. People with mental or substance use disorders are at an increased risk of HIV in the form of high-risk drug use behaviors, particularly injection drug use, and high-risk sexual practices that frequently occur during intoxication and in the situation of untreated mental illness. Increasing capacity and service delivery to those with substance use disorder will result in increased screening, detection, and then linkage to those with HIV/AIDS in this high-risk population; treating substance use disorder and mental disorder is a form of HIV prevention. Substance use treatment centers, like SAMHSA’s grantees and partner organizations and community mental health centers, serve on the front lines of the HIV epidemic as important pathways to HIV testing, treatment for people who test positive, and prevention services to ensure people who are HIV-negative stay negative.

As one of several collaborating HHS agencies participating in the federal initiative Ending the Epidemic: A Plan for America, SAMHSA’s principal goals are to: reduce new HIV infections, improve HIV-related health outcomes, and reduce HIV-related health disparities for racial and ethnic minority communities. The pathway to meeting these goals is through:

1. Increasing testing frequency,
2. Increasing referrals to treatment for HIV positive individuals and pre-exposure prophylaxis (PrEP) for HIV-negative individuals, and
3. Supporting linkage to HIV treatment for enrollees who test HIV-positive.

In 2020, our mission was complicated by COVID-19, as SAMHSA’s grantees have navigated the intersection between the COVID-19, opioid, and HIV/AIDS pandemics. But SAMHSA’s grantees and partner organizations have risen to the challenge, and developed innovative ways to deliver substance use disorder, mental disorder, and HIV testing and referrals in a largely virtual space. Thanks to updated guidelines from the CDC, SAMHSA grantees have been able to leverage alternative testing strategies, such as HIV self-testing, which allows individuals to perform their HIV tests in their own homes.

2020 also saw the launch of the ‘I am ready’ campaign, part of the Ready, Set, PrEP program, which removes cost barriers to increase access to PrEP medications nationwide. In FY2020, SAMHSA grantees screened nearly 19,000 individuals for HIV, including 577 newly identified HIV-positive people, and linked 564 of those people to lifelong treatment. Our eventual goal is to ensure that every beneficiary of SAMHSA programming receives an HIV test, post-test counseling, and linkage to treatment or prevention services.

To assist our grantees and partner organizations in their efforts to combat the HIV epidemic, SAMHSA has produced resources and funded grants that aim to address the intersection between substance abuse, mental disorder, and HIV/AIDS. In 2018, Dr. Elinore McCance-Katz reached out to colleagues to urge the substance use treatment communities to focus on the synergistic epidemics of substance use disorder HIV, and viral hepatitis. In 2019, Dr. McCance-Katz reached out to colleagues again to endorse greater utilization of oral fluid testing among all programs as an effective tool for HIV screening. Again in 2019, SAMHSA also produced a social media resource, the New HIV Prevention Platform. SAMHSA’s Substance Abuse and HIV Prevention Navigator Program for Racial/Ethnic Minorities provides training and education around the risks of substance misuse, education on HIV/AIDS, and needed linkages to service provision for individuals with HIV. SAMHSA’s Technology Transfer Centers provide technical assistance in real time to grantees navigating the COVID-19, opioid, and HIV epidemics.

Published in November 2020, SAMHSA’s Prevention and Treatment of HIV among People Living with Substance Use and/or Mental Disorders aims to inform health care and administrators, policy makers, and community members about strategies to prevent and treat HIV among individuals who have mental illness and/or substance use disorders.

On World AIDS Day 2020, SAMHSA would like to thank our staff, grantees, federal partners, and the substance use disorder and mental health community as a whole in working toward our shared goal of ending the HIV epidemic. SAMHSA understands the difficulties inherent in delivering care during the COVID-19 epidemic, and we thank you for your diligence and your flexibility during this time of great uncertainty. Thank you for the work you do to save lives and improve the health of the people of America.

I have been thinking lately of the generational shifts in the recovery movement and what it means for our collective future. Young people in recovery face an uncertain future. Less opportunity, less optimism about the future and strained social networks have made things been particularly hard for them. They have been devastated by deaths of despair. They tried to navigate an acute and fragmented SUD care system nearly impossible to use even as their friends and family died from addiction. They have lived through false promises of change that comes with every new funding initiative that never reaches the ground and experienced a myriad of scams associated with patient brokering, urine testing schemes and the business end of the treatment industry. Why would they place trust in us or the SUD care system we have developed over the last five decades? They want change now. Can we blame them for losing faith in us, and the flawed care system we have today? Should they not expect more?

Yet, those of you who are in these generations, I ask you to withhold harsh judgement on us. And I hear back “OK Boomer (although I am a generation Xer), I do appreciate the work done by the generation of recovery advocates that came before me and helped where I could along the way. They gave us what we have today. Consider what they did and not just what they failed to do. Before then we pretty much had nothing. It is important to remember that in 1970, there was no funding for drug and alcohol treatment, just jails, mental institutions, frontal lobotomies and electroshock therapy. Those recovery advocate boomers created our care system.

What they accomplished is certainly less than half a pie, but every sliver took a full court, unified effort with a whole lot of blood sweat and tears. As soon as they achieved that small slice, forces starting whittling away at it. Many of those things stem from the implicit biases that exists against anyone with addiction, persons in recovery and to some degree everyone who is involved in trying to help us. I would point out that in my state (Pennsylvania) reimbursement rates for outpatient treatment were higher in adjusted dollars when I walked into treatment in 1986 than they are now, with roughly a tenth of the administrative burdens. Members of our workforce qualify for welfare, and when people gain experience, far too often they migrate away from this work. Our peer services are moving out of the hands of our recovery community and are being over professionalized. We are repeating pitfalls of the past and failing to heed the lessons of history, yet again. Not much pie left on this fork and every reason to expect change.

I can tell you that there have been a lot of unintended consequences of our “old guard” advocacy efforts. The ones I see without exception are a result of consistently underestimating the degree of stigma and implicit bias against persons with addiction and the recovery community. We advocated for a greater voice in polices and to some degree only accomplished elevating the stigma. We advocated for more resources and when they came, they never reached us and instead went to academic groups and beltway bandits that show up when the grass is green and roll out of town as soon as the resources go away. When they are in town, they dismiss our lived experience, patronize us or shut us out when we raise inconvenient truths. We are patronized by the very systems and services we advocated for.

Yet, the only way through this is always together. History shows us that. You rightly want change now. Experience lends me to be cautious and at times to consider unintended consequences. That may look too cautious to you. A truism is that if you change too quickly or the wrong things in haste, the outcome may not be the one you want.  The gains are typically realized by those who can exert the most influence. It is never us unless we are united.

It is also vitally importance to understanding our own history. People like Bill White who has documented our history are invaluable for understanding the pitfalls and opportunities we face moving forward. The word of caution I would express is to suggest that you not move forward with a mindset that we failed you and the work we did needs to be burned down to the ground, a sentiment I am hearing. If that occurs forces outside our recovery community would use it as an opportunity for further colonization and cooptation. These same lessons are also contained in our own history.

So the question, is as always, what can we build together so that more people can get into and stay in recovery than have in the past?  We are only strong enough to achieve anything when we are all playing the same tune. After spending a whole lot of time listening to our community my sense of that objective is the five-year recovery paradigm.  In this model, we keep people alive through harm reduction efforts, use individualized treatment and a variety of long term, low threshold recovery community support strategies to get people to five years of recovery, the point at which they have an 85% chance of staying in recovery for the rest of their lives

Does this make sense to you my millennial and zoomer brothers and sisters in recovery? If yes or no – lets keep talking and find where consensus lies. Without consensus we will have no pie to carry forward, of that much I am certain.

The conclusion of the two-parter. Part one is here. Professor Selman’s last five essentials:

6. Different therapies appear to produce similar treatment outcomes. Project MATCH, a huge psychotherapy trial showed similar outcomes for the techniques of motivational enhancement therapy, twelve step facilitation and cognitive behavioural therapy. Other trials including British ones have shown the same results. The key thing for me is always around the quality of the therapeutic relationship and what represents best value for money. One more thing; there’s been an important addition to the evidence base since this which changes things. Find it here.

7. “Come back when you are motivated” is no longer an acceptable therapeutic response. The old idea that you need to reach rock bottom before change is possible has been challenged (most clearly by Bill Miller). In a recovery oriented treatment service the workers take on some of the responsibility for helping to generate hope and motivation. In a therapeutic community, the other community members do this very effectively. Motivational interviewing is a useful tool and the importance of the quality of the client/professional alliance is stressed. The old response to blame the client when treatment fails just doesn’t do it any more: we need to hold ourselves to account too.

8. The more individualised and broad based the treatment a person with addiction receives, the better the outcome. The professional and the client developing a care plan together focussing on meeting needs and reaching goals is the ideal. There is plenty of evidence that this makes a difference. If this focusses on building recovery capital across a range of domains, clients are likely to do better. Do enough people in addiction treatment understand the key components of building recovery capital?

9. Epiphanies are hard to manufacture. One way of defining an epiphany is that it is a sudden intuitive realisation of the truth of something. One of the fascinating  things about working in the field of addiction, writes the prof, is coming across people who have had dramatic and sudden life changing recovery experiences. Bill Wilson, the co-founder of AA was one example. Part of the process is overcoming self deception. Hearing others’ stories of recovery experiences is probably important here and, of course, this takes place in mutual aid groups.

10. Change takes time. Who could argue? He gives a rather neuro-scientific description of this, but wins me over in the end when he points out (from the viewpoint of a medic of course) that clinical management gives way to personal management as people move through the stages of treatment; rehabilitation; aftercare and self-management. Of course this is not the route of all to recovery, but it does reflect collective experience to some degree.

And if these are the ten most important things about addiction, then what are the ten most important things known about recovery? I think the language and tone of addiction treatment has changed to focus more on the positives that accrue with recovery than the negatives that are removed or diminished by traditional treatment approaches. This is a good thing, but it’s clear the scientific study of recovery lags well behind the scientific study of addiction. Let’s do some catching up!

Sellman, D. (2010). The 10 most important things known about addiction Addiction, 105 (1), 6-13 DOI: 10.1111/j.1360-0443.2009.02673.x

This is a version of a blog I published a few years ago, but thought it still relevant today.

Doug Sellman is a professor of psychiatry and addiction medicine in New Zealand. In 2010 in the journal Addiction, he attempted the difficult task of distilling the ten things you need to know about addiction from the research of the last thirty years. No mean feat.

Well, what are they?

1. Addiction is fundamentally about compulsive behaviour. In normal behaviours, the control in our brains is top down. In addiction the cortex (the decision making bit of the brain) becomes ‘eroded’ to a ‘dehumanised’ compulsion. Sellman outlines the well-studied brain circuits involved, and points out how this view creates one of the defining marks of addiction: continuing to use despite negative consequences.

2. Compulsive drug seeking starts outside conscious thought. The debate about free will (and as the prof says ‘free won’t’) gets complicated here. Apparently the conscious part of our brain is about a half second behind imprinted learned behaviours. The lag and its effects are exaggerated in addiction and well learned patterns including cues call the shots over the ‘higher’ brain’s ability to avoid damaging choices. Result: illogical self-harming behaviours continue.

3. Addiction is about 50% inherited, but it’s much more complicated. Genetic and population studies show a strong genetic element for addiction with some folk being more vulnerable than others. It gets complicated because it’s not just about a single gene or even a few, but possibly hundreds, and even then they interact with infinite variations in environment. This is not about ‘nature versus nurture’, but represents a ‘new interactive model of nature via nurture’.

4. Most people with addictions who come for help have other psychiatric problems as well. For those wanting to move away from the medically dominated model of treatment, this is a big obstacle.  75-90% of those asking for help from services have diagnosable mental health problems including depression, social phobia and post traumatic stress disorder. Alarmingly though, many of our big treatment studies have excluded people suffering from mental health problems. For those of us involved in providing help for those wanting to recover, we will need to ensure that mental health needs are not overlooked. On a personal note though: I do hold a hopefully healthy observation that many of the psychiatric labels we pick up as active addicts melt away in recovery without the need for psychiatric treatment.

5. Addiction is a chronic relapsing disorder in the majority. This was the most challenging of the ten findings for me to simply accept. Prof Sellman says that fewer than 10% of those going through treatment will experience continuous long-term abstinent recovery. He does point out that life will be better for many after treatment and that we need to accept relapse as part of the deal for many. Not doing so will prevent folk coming back for help. There is a tension in this for me between instilling hope and optimism and being unrealistically positive. Other research gives more hope for longer term outcomes suggesting more than half will achieve remission.

Coming soon: Part 2

The first blog in this series explored the value and limitations of recovery storytelling as an anti-stigma strategy. We suggested that public storytelling is best wedded to larger recovery community inclusive strategies that move beyond the goal of changing personal attitudes to the larger goal of dismantling the institutional machinery that perpetuates stigma and discrimination. Today, we explore the risks inherent within public recovery storytelling.

Public Recovery Storytelling: Spectrum of Risks

Individuals, family members, organizations, and the recovery advocacy movement reap benefits from public recovery storytelling, but these same parties are also at risk for injury as an inadvertent outcome of such public storytelling.

Individuals and family members may experience the therapeutic effects of their advocacy activities, but there are also accompanying risks of personal embarrassment or humiliation, exposure to acts of social shunning or discrimination, and, at worst, destabilization of personal and family recovery. Moving recovery from the private to public arena entails navigating these risks.

Youth and other individuals at early stages of recovery may be particularly vulnerable for such injuries. The media story of recovery is most often told from the perspective of the recovery initiate rather than from the perspective of long-term recovery. We best represent the story of recovery when we speak from panels representing diverse pathways, styles, and stages of addiction recovery. Young people and others in early recovery possess heightened vulnerability and should be carefully screened for public recovery advocacy activities. They should be oriented to the benefits and risks of public recovery disclosure via an informed consent process and given structure and support when involved in public recovery advocacy. If a person experiences a recurrence of AOD use and related problems who has earlier served as public recovery advocate, their prior experience as a visible recovery advocate can pose a significant obstacle (via shame, resentment, etc.) to recovery restabilization.

There is a zone of service and connection to community within advocacy work, and we must do a regular gut check to make sure we remain within that zone and not drift into advocacy as an assertion of ego. The intensity of camera lights, the proffered microphone, and seeing our published words and images can be as intoxicating and destructive as any drug if we allow ourselves to be seduced by them. If we shift our focus from the power of the message to our power as a messenger, we risk, like Icarus of myth, flying towards the sun and our own self-destruction. To avoid that, we have to speak as a community of recovering people and avoid becoming recovery celebrities—even on the smallest of stages. (White, 2013)

The decision to pursue public recovery advocacy is best made in consideration of family and loved ones. While the zealous new recovery initiate may feel called to this public storytelling role, they must consider the potential effects of public disclosure on family members and loved ones. After considering such effects, some advocates have postponed their roles as public speakers until their children are at an age that minimizes any potentially negative effects upon them. Those involved in public recovery storytelling have found it helpful to orient family members and loved ones on the content of the story, the venues in which it will be shared, and how to best respond to questions that may arise from its presentation. 

The reputations of organizations sponsoring public recovery storytelling and the larger recovery advocacy movement can be injured when speakers are not provided support, guidance, and vetting by the community for suitability and readiness for public recovery story sharing. This is particularly true in the case of the perceived “fall from grace” of a visible recovery advocate. In such circumstances, individuals and families suffering from addiction may be less hopeful and less likely to seek help because of such damaged reputations, and policymakers may be less amenable to supporting recovery advocacy organizations.

Recovery Storytelling: The Risk of Conflicting Agendas

Information related to addiction and recovery is disseminated through a wide variety of public venues: television, film, newspapers, magazines, the Internet, and through a broad spectrum of public and professional meetings. Representatives from these venues often approach recovery advocates for interviews or presentations related to their recovery experiences. Such opportunities are a means of carrying a message of hope to those affected by alcohol and other drug problems and a platform for advocating pro-recovery social policies and programs.

In spite of the potential benefits of public recovery storytelling, public recovery disclosure as we have noted can pose risks to multiple parties. A starting point for risk management related to public recovery story-sharing is the recognition that the interests of the multiple parties involved in such events may be congruent or in conflict.

Requests for interviews or presentations often come with hidden agendas—planned narratives that meet the interests of those doing the inviting. Those inviting our stories may distort them to support agendas and talking points incongruent with the goals of recovery advocacy.

For example, distorted media coverage of active addiction fuels social stigma and contributes to the discrimination that many people in recovery face as they enter the recovery process. When media representatives interview people in recovery, they often want the most dramatic, traumatic, and sensationalist details related to one’s addiction but seek or report few details on the actual processes of recovery or the regenerative and transformative effects of long-term personal and family recovery.

It is said that if you are not at the table, you are on the menu. This has never been any truer than with the use of our stories. We must have pointed dialogue about how our narratives are used while having meaningful discussions across our diverse community on the messages we are trying to convey. These discussions must include how our stories can have unintended consequences and we must work together to ensure that our stories serve our common interests and our shared vision of an inclusive world free from stigma and discrimination.

This is all a way of saying there is much to consider in the decision to share our story, our decisions on how that story can be best presented to different audiences, and how we can best protect ourselves and other parties through this process.

Link to Bill White Post HERE

Coming Next: The Pillars of Stigma and Recovery Storytelling

Reflecting back this morning of some very early lessons in my recovery journey and what I have grown to understand about the power of gratitude. Full disclosure here – I am not inherently a positive person. My inner voice can be quite negative with great frequency and intensity. Negative thinking, lists of things that have gone wrong and projected catastrophic future events play out without effort and multiply when I focus there even for a moment. I call this my Eeyore brain; it can hijack my day when my eyes first flutter open. Nothing is good, everything will sour, woe is me. This is the inner Eeyore whom I can ill afford to entertain.

Negativity was a dominant thinking pattern in my early life. Addiction started in my early teens and my use spun out of control before age 20. It was recovery or die for me and sought help in the middle of my 21^st year on earth. It is quite ironic that the year it was legal for me to use one of my drugs of choices (alcohol) was the year I ended up getting into recovery. Eeyore ruled my brain and that negative inner voice told me with all certainty that my life was over, bridges burned could not be rebuilt, the trajectory was all downhill with no social life and the substances that helped quell the pain now off limits.

This was all of course, untrue. Wise people I had the great fortune to meet early in recovery suggested I look deeper for things that I could be grateful for.  I made gratitude lists in my head, sometimes hourly to get through the long minutes. The minutes added up and my gratitude list lengthened.  I learned that the inner Eeyore was not my friend nor an accurate inner soothsayer of what lay ahead. The deep truth is without learning how to be grateful early on, I am quite confident I would not have made it to 30 and yet, here I am a formerly young person still in recovery at 55. The power of gratitude.

Shifting a few decades forward, truth be told, 2020 has been by far the most challenging year of my recovery since that very first one in 1986. Challenges have come from all directions, personal, professional, from the pandemic and other societal disruptions playing out across our world. I have found that social media can be a tool to develop gratitude and connection and also unfortunetly an amplifier of my inner Eeyore if I allow it. I have had to dig deep, reflect longer and focus on gratitude and things that help restore me. I suspect I am not alone and many readers also have experienced these dynamics. Many of us in recovery are struggling, yet we also have some powerful tools we picked up along the way.

We know a bit about gratitude. Science and philosophy reflect on the value of gratitude. As noted in this article from Harvard Health Publications, “gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.”  According to this paper published in 2004 by the Oxford Press, positive-emotion-focused techniques help individuals create an internal environment that is conducive to both physical and emotional regeneration, including physiological aspects such as heart health and digestion.  The practice of gratitude is present from the very earliest 12 step fellowship writings, and in most world religions. It is reflected in the writings of Western Philosophy such as that of Epictetus who said “He is a wise man who does not grieve for the things which he has not, but rejoices for those which he has.” Eastern Philosophy also reflects gratitude including Confucius who said “It is better to light one small candle of gratitude than to curse the darkness.”  Let’s light our candles now.

So this is my meandering Thanksgiving day blog post. I am grateful to be here, now. Life experience tells me that I am a poor forecaster of negative future events and I consistently underestimate my own resiliency and some of the positive elements operating in the world around me. No sugarcoating here, the world is indeed a mess, yet it is so very much more than that if we dig a little deeper. Thanks be to my mentors and for all those who have crossed so far in my path on this earth. I am grateful for you who have read this far. I add you the reader to my Thanksgiving Day 2020 gratitude list.  May you find the kernels of positivity in the field you stand in and sow them to find inner abundance and bounty.

I sincerely hope that you have a long gratitude list this Thanksgiving Day, especially if you battle with the inner Eeyore as well.

Bill Stauffer