Members of historically disempowered and stigmatized groups (e.g., women, people of color, members of the LGBT community, religious minorities, etc.) have long been subjected to overt aggression from the dominant cultures in which they are nested. Such aggression in the United States has encompassed genocidal campaigns (e.g., the "Indian Wars"), forced sequestration (e.g., Japanese-American encampment during World War II), symbolic assertions of hate and power (e.g., rape, lynching, legally-mandated sterilization), systematized discrimination (e.g., Jim Crow laws), economic and political exclusions (e.g., denial of voting rights), and the forced imposition of socially demeaning labels and images. Recent research has focused attention on more subtle indignities experienced by socially marginalized groups. Referred to as microaggressions, such insults are commonplace; often unintentional within brief social exchanges; and variably manifested in verbal, behavioral, or environmental forms.
Sue and colleagues describe three types of microaggressions: (a) microassaults (explicit epithets, discrimination, or insulting visual displays linked to one's association with a socially marginalized group), (b) microinsults (subtle and unconscious actions or verbal comments that convey rudeness and cultural insensitivity), and (c) microinvalidation (unconscious communications that convey outsider status or that exclude or nullify one's thoughts, feelings, or experience.). Microaggressions across these categories exert negative effects on how members of targeted groups see themselves and are seen by others. The internalized shame induced by repeatedly experiencing such insults creates a hypersensitivity to social judgment, leaving one self-questioning whether perceived slights are real or imagined. Facing overt discrimination is in some ways easier than encountering microaggressions because one's perceptions are easier to validate in the former.This brief communication explores microaggressions experienced by people in addiction recovery.
Addiction-related social stigma has left a trail of worldwide devastation that includes mass extermination (in Nazi Germany), prolonged institutionalization, legally mandated sterilization, harmful and sometimes fatal addiction cures, and broad patterns of political, economic, and social exclusion. The stigma attached to addiction has often been extended to people in recovery from addiction. Such extension has generated multiple forms of overt discrimination against people in recovery, but it also is manifested in various forms of microaggression.
When I recently discussed the microaggressions experienced as a result of addiction recovery with a number of friends and professional colleagues in recovery, they noted situations like the following:
*Constantly being confronted with highly glamorized alcohol and other drug (AOD) images, e.g., pervasive alcohol and other drug advertising and normalized AOD use in television, film, and social media
*Exposure to demeaning language when the subject of addiction arises, e.g., substance abuser, dope fiend, etc.
*Portrayals of the cause of substance use disorders as personal culpability (bad character) rather than biological, psychological, or environmental vulnerability
*Imposed shame, e.g., being explicitly prohibited by one's supervisor from disclosing one's recovery status out of the fear it would harm the reputation of the company
*Stereotyping, e.g., discovering presence ofsex worker note in one's medical record as a result of initial disclosure of prior addiction and subsequent challenges obtaining health, disability, and life insurance despite decades of stable recovery and good health
*Medical mismanagement, e.g., being refused any pain medication following surgery due to presence of past addiction history in the medical record, or the inverse--being prescribed 30 Vicodin following a dental procedure when one's pain could be easily managed with non-opioid pain medication or other alternatives
*Efforts to refute one's addiction/recovery status because it conflicts with prevailing addict stereotypes, e.g., "You weren't really addicted", "Come on, one drink won't hurt you!" "Surely, you don't have to keep going to those meetings after all of this time."
*Jokes related to one's abstinence or recovery status reflecting common social discomfort of AOD users in presence of person in recovery
*Exotification and erotification of addiction experiences (e.g., morbid curiosity about unusual drug or sexual experiences during one's addiction career or assumption of increased sexual availability, particularly of women in recovery) (see related discussion here)
*Assumption of past criminality (e.g., people being guarded and suspicious in one's presence; being the first to be suspected when anything goes missing)
*Assumption of coping fragility (e.g., failure to get a promotion out of concern that one would not be able to handle the stress of the new position)
*Misinterpretation of normal stress responses as signs of impending relapse
*Denial of differences between pathways and styles of recovery (e.g., assuming that everyone in alcoholism recovery is a member of Alcoholics Anonymous)
*Being rendered invisible (e.g., refusal of some people to acknowledge your presence or engage you in conversation)
*Exploitation or testing of one's recovery status, e.g., being invited to social events solely to serve as the designated driver or to be shown off as token person in recovery; being offered alcohol or drugs by persons who know your recovery status.
*Tokenism, e.g., being invited as a person in recovery to a professional meeting or workgroup with no real interest in recovery perspective or contributions
*Confronting public understanding of recovery as someone who is trying to stop using alcohol and other drugs, rather than someone who is successfully living in long-term, stable recovery.
*Patronization and objectification, e.g., excessive gushing over one's noble attempts to change one'slifestyleAnd being related to only as a person who survived addiction
The above list of perceived microaggressions occur when people in recovery interact with others who do not have addiction or recovery experiences, but microagressions can also occur in interactions between people in recovery. When recovery advocates were asked about this category of communications, they noted such incidents as the following:
--Being told by fellow members of Twelve-Step fellowships that he or she was violating the Traditions by being public about his or her recovery (even though such disclosures made no reference to membership in AA, NA, or another Twelve-Step fellowship at the level of press).
--Being told that one is at risk of relapsing as a result of sharing one's recovery story publicly.
--Charges that one is doing recovery advocacy for one's own ego-enhancement or financial gain, e.g., "ripping off the program."
--Being criticized, socially shunned, or denied the right to speak at support meetings due to the use of prescribed medications for the treatment of addiction.
These lists of examples are by no means complete, but they do illustrate some of the more subtle social interactions men and women must navigate as their recovery journeys progress, particularly when those journeys involve recovery advocacy activities. The history of human rights movements reflects a staged focus from overt forms of aggression to addressing these more covert microaggressions. This evolving focus will likely be the path of the new addiction recovery advocacy movement. The experience and voices of people in recovery should be the foundation of any emerging social etiquette surrounding addiction recovery.
Have you experienced other microaggressions specifically linked to your recovery status? I'd be interested in hearing about such experiences at firstname.lastname@example.org