Self-stigma is insidious, and it’s been bothering me recently. Bothering me in the sense that I’ve been engaging in it.
I was interviewed a while back for an article about addiction in academia. The article’s in a high-profile publication. Nature, no less! It’s arguing for greater awareness of the addiction problem in universities and in favour of offering greater support to sufferers. It frames addiction as the ‘last taboo’ in mental health. Sounds like my sort of thing? It is.
You’d have thought I’d be proudly posting it everywhere. But I haven’t. I’ve felt too exposed. My emotional weather hits choppy patches from time to time. Whose doesn’t? I was having a slightly-more-difficult-than-usual episode, right in the middle of which this article came out. As I’d been interviewed for it some months back, I’d almost forgotten about it. What little the journalist used from the long and interesting discussion we had, frames me, not as the super-professional recovery researcher and activist that I like to present to the world, but as the ‘drunk lecturer’ - selfish, irresponsible and out of control. In truth, the thought of the article being 'out there' made me want to crawl under a stone.
So much for my Visible Recovery activism. Hello, self-stigma.
What is ‘self-stigma’? Technically, it’s the subjective internalisation of problematic public attitudes — in other words, the kinds of attitudes decent people would wholly reject, and even speak up against. A good example is the discourse around fat. Most people don’t consciously consider fat to be a weakness or failing. Everyone knows that body-shape is a weapon of the patriarchy and most of us try to avoid explicitly feeding the narrative that ‘thinner’ is ‘better.’ And yet how many of us are privately, and sometimes brutally, judgmental about our own body shape? Another example is mental health. No-one I know would explicitly say that suffering with a mental health issue is in any way shameful. Yet, how many of us are secretly ashamed when we struggle?
Before I get into this any deeper, I want to say clearly that the problem here is not us. It’s not our private anxieties and hang-ups. It's not our minor lapses of ‘perfect’ political correctness. It's not our wonky, self-involved, internal dialogues. The problem is stigma.
Stigma was defined most famously by the sociologist Erving Goffman as a ‘marked’ or ‘spoiled’ identity, which disqualifies the individual from full social acceptance. I first came across the concept of stigma as a teenager when I read Nathaniel Hawthorne’s astonishing novel The Scarlet Letter. Published in 1850 in the United States, it’s a powerful story, that exposes the hypocrisy, cruelty and misogyny of a puritan society. The protagonist, Hester, is required to wear a ‘mark’ of shame, an embroidered letter ‘A’, to show she bears the stigma of ‘adulterer.’ This is how stigma works. The person themselves —their story, their values and struggles — are obscured behind a particular, spoiled and socially unacceptable identity; one judged against ideas of ‘moral rectitude’, ‘ability’, ‘wholeness’, ‘health’, or other vectors of what is considered ‘proper’. Perhaps those who commit serious criminal harm should experience some limited disqualification from social acceptance. The problem though, is that these stigmas become permanent marks. People incarcerated for minor crimes, for poor decision-making, for falling under the influence of malign actors, find they are marked with a criminal record, a stigma that goes on to impact them in multiple areas of life. Many of the other forms of stigma, those that relate to sexual purity, sexuality, gender, race, health, mental health and so on, should clearly have no place whatsoever in a civilised society. They are simply mechanisms of cultural scapegoating on a grand scale. Ways of othering our own shadows.
Patrick Corrigan, well-known mental health researcher and founding editor of Stigma and Health, has much to say about the related phenomenon of self-stigma. He argues that public anti-stigma campaigns about mental health in the workplace or on social media, for all the good they undoubtedly do, unfortunately fall badly short of addressing self-stigma. This is significant, because self-stigma is one of the most powerful obstacles to help-seeking. Corrigan’s work has shown that the only strategy that really moves the dial on self-stigma is people being ‘out and proud’ in numbers, about whatever it is that has ‘marked’ them.
Over time, I’ve come to feel the force of Corrigan’s argument.
For many years, I didn’t share the fact of my addiction history with anyone but close friends and family. However, the growth of the UK Visible Recovery Movement in the 2010s caused me to think differently. This movement was fuelled by a fierce commitment to anti-stigma campaigning, taking its lead from LGBTQI+ Pride. The movement did a great deal to shift the public’s perception that addiction is a health, rather than a moral issue, and it went some way in getting the voice of lived-experience into policy conversations. As my recovery grew more stable, and as any real negative consequences of me being at-least-a-bit-more honest about ‘my past’ began to recede, inspired by this movement and considering myself to be part of it, I began to tell some truths about myself in slightly more public spaces.
It started with simply acknowledging that I was ‘a person in recovery’ whenever I gave an academic presentation on my recovery research. This meant I was going some of the way to meet a basic ethical requirement for transparency in qualitative research. It has to be said that I wasn’t going far. In no way did this mere admittance of identity amount to the deep practice of reflexivity that is the norm in qualitative research. But I was at least introducing a fact that I’d kept hidden previously. Knowing this about me as a researcher and author, would empower, to some extent, those consuming my research to question it.
"Hey. You know what? When you speak derogatorily or dismissively about people
with addictions, you are speaking about me."
Fast forward to the early 2020s, and I began advocating for Recovery-Friendly Universities. I realised, with some shock, quite how ill-informed some university leaders were about the presence of people in recovery in university communities, and I felt under increasing pressure to name my own experience as part of my advocacy. When you know the private struggles of staff and students, it’s hard to sit in meetings where the significance of the challenges faced by people living with addictions/seeking recovery are questioned, and NOT to say, "Well, this is how it was/is for me!" So, I began to do just that in HE sector meetings. I was angry that it had come to this — that I couldn’t see anyway forward but to say, "Hey. You know what? When you speak derogatorily or dismissively about people with addictions, you are speaking about me." But, as a strategy, it was remarkably effective. Corrigan was right.
That said, I still wasn’t telling my story publicly as such. That was to change in 2022. I was invited by my own University to give an online and publicly available International Women’s Day talk about recovery. I was at this point 17 years sober and I’d recently come out the other side of a 6-month long relapse of clinical depression that had been some years in the making. But I was, for the first time in a long time, on the up. I believed I was in a good place in terms of the mental health support I’d secured, and I felt that I’d attained enough stability for it to be safe to take more risks in terms of leveraging my own story for political ends. What’s more, there is something about feminist events like IWD that I receive as a call to dig deep. So many of the freedoms I enjoy have been won for me by women in previous generations, and indeed my own, who have dug deep. It felt like this was the moment to ignore the internal and external voices telling me that for all sorts of very good reasons, it is better to keep this stuff private. This was the time to go ahead and risk telling some actual stories about my experience of addiction and recovery in the context of the university.
The stories I told in that talk were ones I’d long been telling in the private spaces of recovery groups and relationships. Those safe spaces are governed by norms and practices that secure protection from the forces of stigma that prevail in the outside world. Inside those spaces, the truth becomes progressively easier to tell. In fact, truth-telling takes on a wonderful, transformative purpose. It’s the mechanism by which 'denial' is overcome, for both speaker and listeners, thus establishing the necessary conditions for recovery. This kind of storytelling offers a way to redeem a painful past. It answers, at least in part, the question, ‘how do you live with yourself in the aftermath of all that?’ An honest account of harm done builds community, identification and connection, and one’s stories become priceless to others on the same path. It’s a powerful and mutually-healing experience to see the relief in the eyes of another person who is, like you once were, wrestling with addiction-feeding shame, despair and isolation, as you explain that, yes, you have caused similar harms yourself and, yes, there is indeed no moral difference between you, and, yes, shame does have the power to kill you, but, yes, you can overcome it.
Telling those same stories in public spaces, however, serves different purposes.
If I don’t speak up, stigma and it’s horrible relative, self-stigma, strengthen their grip.
For me, there are two reasons for telling those stories in public. The first one is obvious, and Corrigan said it. The only reason culture has (in some, limited, geographical places and some, limited, cultural locations) stopped othering sexual minorities, is because of the activism of people willing/able to self-identify publicly. I’m sometimes hesitant to compare having an addiction history with being a member of a sexual or gender minority. Gay and gender non-conforming people face so much prejudice they are four times more likely to experience violent victimisation than cishet people. I might have an addiction history, but, for all the legitimate resentments people might have against me, no-one, as far as I know, wants to beat me up, slash my face or shoot me for it. However, the comparison does work to this extent: If I, with all my privilege of stable recovery and professional security, cannot ‘come out’ about my experience of addiction, I leave all those whose recoveries are more vulnerable, or who have less social capital than me, thoroughly mired in stigma. That stigma, left to flourish by the silence of privileged people like me, means false ideas about people with addiction histories continue to circulate, public attitudes harden, support for recovery becomes a low voter priority, and already marginalised people are more likely to be left completely abandoned. If I don’t speak up, stigma and it’s horrible relative, self-stigma, strengthen their grip. At best, self-stigma prevents help-seeking. At worst, it kills people. Those realities figure in my thinking as a significant motivation, a driver even, to tell my stories as loudly as I can.
The second motivation is a more intimate one. It’s one I’ve only become aware of more recently, having retired and gained the mental and emotional space to begin to indulge more creative energies. This motivation is the fundamental human desire to write for the purposes of exploration and connection. For me, it’s a desire to try to find words and images to articulate those private experiences that are structured by small ‘p’ political forces. The kind of experiences I’m talking about are things like belonging within nature in a time of climate crisis, being embodied and alive in a patriarchally repressed civilisation, the experience of moral complexity in a world prone to polarising, and the joy of recovery and the liberation of present-moment-awareness in a society whose drug of choice is capitalism. I know when I read or hear those kinds of words, in songs, stories, essays or poems, or when I write them myself, I feel less lonely. I feel closer to what feels like a vibrant hum at the heart of things. There’s a post heart-attack voice inside me that seems to be saying, "Look. Life is short. I have some distinctive stories to tell about my life, (about addiction, recovery, intergenerational trauma, love, loss, joy, and other things) and my telling them will connect me to others. It might help them. It will help me. It might be some kind of contribution."
..an addiction story, like a recovery story, is never a story about one person.
However, as well as serving different purposes, telling those stories publicly comes with a whole other set of liabilities. It’s one thing to tell them in the private spaces of recovery communities. It is quite another to tell them in public. Out in the wild, those stories are much less safe. They can have all kinds of unintended and unforeseeable negative consequences. I don’t only mean negative consequences for the person at the centre of the narrative. I might have apparently noble motivations about ‘coming out’ and fighting stigma, but unless I’m extremely careful, I can implicate others connected to my story. If what I’m saying is that the individual is less responsible for their addiction than our atomised, individualistic, produce-or-fail culture would have us believe (and I am saying this), then I am saying that others have played a part in my addiction. Almost all of them have done so unintentionally, and almost all of them have impacted me the way they have because of the processes of trauma playing out in their own lives. But the fact remains that an addiction story, like a recovery story, is never a story about one person. It’s hard, if not impossible, to tell it meaningfully, without talking about other people. This makes addiction stories, the true ones, so difficult to share publicly.
Another difficulty is that consumers of these stories only want the classic narrative arc, that of suffering and failure followed by overcoming and redemption. They don’t want works in progress. They don't want ‘recovering.’ They want ‘recovered’. They want ‘respectable.’
Darren McGarvey - author of the painfully revealing 2018 work, Poverty Safari, has spoken more recently about what he calls the ‘Trauma Industrial Complex’ in which people with so-called ‘lived-experience’ of addiction, poverty, abuse and adversity, become commodities in wider capitalist projects that whitewash (recovery-wash?) institutions that are competing for reputation. He points to a debasing ‘reveal-all’ culture that has developed alongside the rise of social media. He warns about the collateral damage that can follow when the lived-experience voice is apparently valued and celebrated, but actually leveraged in a marketplace that now has to appear to be ‘trauma-informed.’ It’s not only institutions that leverage the lived-experience voice. It’s also us. Those of us with the lived-experience. One way of construing McGarvey’s own work, as he himself fully acknowledges, is that he’s successfully monetised his story of terrible adversity. He’s acquired high profile speaking gigs (it doesn’t get much higher than The Reith Lectures). He’s got repeat book and TV deals, and a considerable following. And money is not the only currency. It's seductive and emotionally intoxicating for vulnerable people with lived-experience to be told that their story is ‘brave’, or that they are ‘strong,’ or that they are in some other way exceptional. People are being ‘nice’ of course — but this niceness can be double-edged for vulnerable people who are starving hungry for positive feedback, acceptance and social legitimacy, and who are prone to attaching unhealthily to those people and institutions that offer it. Ask me how I know! Of course, some other people are far from ‘nice’. And some people have very good reason to respond to your release from addiction not with ‘you’re so brave’ but with, ‘have you any idea of the harm you caused?’
In a recent lecture to The Royal Society of Edinburgh, McGarvey explained that those of us invited to share intimate details of our lives on public platforms are ‘not always as well as we believe.’ There is research that demonstrates that people who are in five years or more abstinent recovery are ‘better than well’ and score more highly on quality-of-life measures than the average population. But it’s also true that people with addiction histories carry with them the damage done by, and to, them in addiction, and the legacy of the causes and conditions for having developed an addiction problem in the first place. Most of us in long-term recovery have comparatively good lives. If we stick around recovery communities we tend to have friends, a precious sense of purpose, and an immense sense of gratitude for what we have. But McGarvey isn’t wrong when he says we are not always as well as we believe, even if we aren’t any longer drinking or using other drugs. We live in a digital world where the distinction between private and public has been badly eroded, and the tenor of public discourse has become harsh. McGarvey is right to wonder about the consequences when we, perhaps already a little wobbly ourselves, ‘decant our traumas into a rowdy, unforgiving and radioactive public square, where once disclosed, cannot be undisclosed.’
When we tell difficult stories about our pasts, we risk the false implication that our presents are pristine, and our motives entirely pure and unselfish. Also, because ‘we’ are at the narrative centre, when we tell those stories, they tend to be stories of adversity overcome, rather than of lasting damage wrought. The moral content of both narratives might be ‘true’ — but audiences, and the causes that are dear to our hearts, always require the sanitised happy ending!
As soon as we take these stories out of the private realm of recovery communities and into the public square, we exponentially increase the risk of the phenomenon known as ‘spiritual bypassing.’ The focus can so easily shift towards image-management and away from humility, awareness, and personal inventory, the qualities and practices that enabled the establishment of recovery in the first place. One only has to look at the life of a ‘person in recovery’ like Russell Brand to see what public sharing looks like when coupled with questionable personal values and pandering to a fickle and politically malign audience. It is for very good reason that some recovery communities emphasise the careful practice of the spiritual discipline of anonymity. Brand is a cautionary tale for how the credibility of recovery is brought into question when people (high-profile or not) publicly identify as being in recovery and following a spiritual path and leverage that to their own ends. Brand may be a manipulative and dangerous egotist. But none of us is ego-free.
These are the thoughts that have been playing on my mind since that article has come out. I’ve been unable, til now, to sort out my motivations with enough confidence to know whether to promote it or not. It’s here, if you’re interested. https://www.nature.com/articles/d41586-024-04218-z. There is a PDF if you don’t have access.
You may read the article and say “What are you worried about? In fact, you’re barely mentioned in it at all! And all this bad stuff happened more than 20 years ago!”
Funny you should say that.
In fact, I’m celebrating my 20 years sober birthday this very week.
I’m so grateful to be two decades on from what some recovery communities call ‘the madness’. However — and perhaps only people with certain types of recovery will identify with this — my sobriety is, I believe, contingent on a practice of keeping those experiences of 20 plus years ago alive in my awareness. I don't let them slip into unconsciousness. It might be twenty years ago - but in a very real way for me - it was yesterday. I don't have the luxury of imagining that I am no longer that person who was out of control in the workplace, in a position of responsibility for young adults, chairing symposia in blackout, or hiding my addiction and homelessness from bosses and colleagues. Some people might say "You were that person. You are not now." But one of the main recovery-assuring qualities that must be developed is humility. As those who’ve written about the relationship between memory, narrative, and recovery (like Zetta Kougiali), have shown, the way temporality figures in how we tell our recovery stories to ourselves and each other is critical. Of course, it would be counter-productive if I were mired in retrospective self-hatred for how I behaved. But it would be equally problematic if I went to the other extreme and thought my past behaviour was so far in the past that it no longer mattered, and anyway, I just have super-fabulous qualities now, don’t I? (halo emoji!). It would be very bad indeed if I forgot what I’m capable of.
One of my employers, the University of Chester, is named in the piece. Another, where I worked during the height of my active addiction, is not. One reason the piece makes me uncomfortable is that it potentially (if mildly) implicates others for their lack of awareness of what was going on with me. Let me say as strongly as I can — I alone am responsible for that. People trying to hide an addiction are extremely motivated and skilful. They extend every scrap of energy they have to that end, and they’re pretty damn good.
My discomfort here is a little hint of the kinds of unanticipated pitfalls of telling an addiction story in public. There’s always going to be bystanders. When you tell your own story you cannot help but tell the story of others. In the characteristically harsh yet accurate words of Darren McGarvey, you really do need to have your ducks in a row before you do it.
One thing the piece doesn’t say is that the University of Chester has made great strides, along with only three other universities in the UK, in addressing the needs of staff and students in recovery. The article is absolutely correct in stating that this issue is the last taboo in mental health. It is also the next frontier in Widening Participation. I am beyond proud to be associated with a university that is leading the way in rolling back on damaging, out-dated and stigmatising ‘zero-tolerance’ policies, and actively celebrating the presence of people in recovery, studying, working and enjoying themselves within the university community.
I guess the truth is my poor ego is a bit bruised that as well as failing to mention the extraordinary anti-stigma work my University has done and continues to do, the article doesn’t say anything about my recovery, my professional contribution or my activism.
It just paints a sketch of a messed-up drunk in the workplace.
But that’s what I was and, in some important sense, am. The only way to move the dial on self-stigma, for self and others, is to ‘come out.’ So, here I am. coming out from under the stone I’ve been under for the last few weeks. It’s not pretty, but that’s the whole point.
References
Collins, A. & McCamley, A. (2018). ‘Quality of Life and Better than Well: A Mixed Method Study of Long-Term (Post Five Years) Recovery and Recovery Capital’. Drugs and Alcohol Today 18, no. 4 (3 December): 217–26.
Corrigan P. (2005) On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. Washington DC, American Psychological Association.
Corrigan, P. & Rao, D. (2012). On the self-stigma of mental illness: stages, disclosure, and strategies for change. Canadian Journal of Psychiatry. 57(8), 464–469.
Corrigan, P. (2022). Coming out proud to erase the stigma of mental illness. World Psychiatry, 21: 388-389.
Goffman E. (1963). Stigma: Notes on the Management of Spoiled Identity. Hoboken NJ: Prentice Hall.
Hawthorne, N. (1850). The Scarlet Letter. Boston, MA: Ticknor & Fields
Kougiali, G. (2015). Reordered Narratives and the Changes in Self-Understanding From Addiction to Recovery. In: Piazza, R., Fasulo, A. (eds). Marked Identities. London: Palgrave Macmillan, London.
McGarvey, D. (2018). Poverty Safari: Understanding the Anger of Britain’s Underclass. London: Pan Macmillan.