Addiction recovery is a highly intrapersonal process, but it also can and often does involve a journey between two physical and cultural worlds. Some years ago, I explored the implications of this suggestion in the book, Pathways from the Culture of Addiction to the Culture of Recovery. Here are some key points from that book.
Elaborate cultures--with their own tribal organization, roles, rules, core daily activities, relationship etiquette, language, values, symbols, rituals, music, literature, and art--have evolved to provide sanctuary for people with severe and prolonged alcohol and other drug problems. Such cultures can play important roles in the initiation and maintenance of addiction, and they can constitute a major obstacle to successful addiction recovery. People can become as addicted to a culture of addiction as they are to the central sacraments of that culture. The wide range of needs met within that culture can be as powerful a pull back to addiction as the brain's adaptation to the presence (euphoria, self-comfort) or absence (craving, anxiety) of drugs.
Recovery involves radically altering the person-drug relationship, but it also involves changes in one's relationship to the culture (people, places, and things) that has supported the person-drug relationship. The addiction experience varies to the extent one is isolated from the culture of addiction (acultural style), is involved in both the mainstream and addiction cultures (bicultural style), or lives one's life almost exclusively within the culture of addiction (enmeshed style). For those with significant involvement within the culture of addiction, recovery requires discovery of new ways to meet a vast array of needs once met within the culture of addiction. Failing that, addiction recurrence is as much a return to the culture of addiction as a return to the drug.
People who have escaped the addiction experience have organized parallel cultures of recovery to serve as havens for those with these shared experiences and aspirations. The culture of recovery also has its own tribal organization, roles, rules, core daily activities, relationship etiquette, language, values, symbols, rituals, music, literature, and art. This culture offers an alternative set of people, places, and things that support recovery initiation, recovery maintenance, and enhanced quality of personal and family life in long-term recovery. The recovery experience varies to the extent one is isolated from the culture of recovery (acultural style), is involved in both the mainstream and recovery cultures (bicultural style), or lives one's life almost exclusively within the culture of recovery (enmeshed style). As with addiction, these styles of cultural affiliation can vary across the stages of recovery.
People with enmeshed styles of addiction may need a period of decompression and parallel enmeshment within a culture of recovery to achieve successful recovery stabilization and maintenance. They may need guides to assist them on this journey, e.g., the peer assistance found within recovery mutual aid societies, culturally competent addiction professionals, or within new recovery support roles (e.g., recovery coaches). What has changed since first writing Pathways is the exponential development of the culture of recovery in the United States. Recent history has witnessed the growth and diversification of the culture of recovery via the growth of secular, spiritual, and religious recovery mutual aid societies; a new addiction recovery advocacy movement culturally and politically mobilizing people in recovery and their allies; new recovery support institutions (recovery community centers, homes, schools, industries, ministries, cafes, and sports venues); development of new recovery-focused language, art, music, literature, theatre, and film; and the growth of technology-based recovery support via the Internet. The culture of recovery in the U.S. has never been more fully evolved, diverse, family-inclusive, geographically accessible, and financially affordable.
In an era that continues to be dominated by acute care models of addiction treatment, treatment that focuses almost exclusively on neurobiological stabilization (e.g., short-term detoxification, medication with minimal if any sustained psychosocial support), and treatment that views recovery as a primarily physical and psychological process, it is helpful to again remind ourselves of the role of culture in the processes of addiction and recovery. If recovery is for many a journey between two worlds, then there is a need for a fully developed culture of recovery available across geographical and cultural contexts. That development is one of the major stories of recent decades. Also needed are roles filled by persons with a profound depth of knowledge of the cultures of addiction and recovery to serve as guides in this transcultural process. That has yet to be achieved, and the rise of new services and support roles aimed at speeding recovery initiation (shortening addiction careers) and supporting long-term personal and family recovery is in part an attempt to fill this void.
In writing Pathways from the Culture of Addiction to the Culture of Recovery, I tried to provide a travel guide through which addiction professionals and recovery support specialists could serve as effective guides in this cultural journey from addiction to recovery. Since then, both cultures have undergone profound changes. I hope others will carry forward this work of cultural exploration and its service and recovery support implications. Addiction treatment and peer recovery support outcomes may be determined as much by the presence and vitality of healing communities (cultures of recovery) as by the vulnerabilities and assets of individuals in need of such healing. Many have written eloquently about the role of culture and community in recovery, but perhaps none more eloquently than that found in the words of Joseph Campbell.
"We have not even to risk the adventure alone; for the heroes of all time have gone before us; the labyrinth is thoroughly known; we have only to follow the thread of the hero-path. And where we had thought to find an abomination, we shall find god; where we had thought to slay another, we shall slay ourselves; where we had thought to travel outward, we shall come to the center of our existence; where we had thought to be alone, we shall be with all the world." --from The Hero with a Thousand Faces