This week I’m preparing to go to the 10th National Harm Reduction Conference (which I’ll be reporting on for TAC), and also reading for the first time David Foster Wallace’s Infinite Jest. The conference and the novel offer strikingly different narratives of addiction and recovery–both of which are gaining cultural ground in different ways.
So far (I’m on about page 640 of this 1000+ tome) Infinite Jest is deeply embedded in the 12-Step world. In this narrative, addiction and recovery are basically spiritual. Forgive me for drastically oversimplifying a novel I’m loving, but in IJ addiction is often an enslavement of the will or an escape from the self. Recovery is even more insistently spiritual. You recover by giving up and doing as you’re told: Unconditional surrender is the only path to personal peace. If you don’t learn humility through obedience and accept total transformation through surrender to some kind of obscure Higher Power you will destroy yourself and everything you care about.
“Of course–the Crocodiles dig at each other with their knobby elbows and guffaw and wheeze–they say when they tell Gately to either Hang In AA and get rabidly Active or else die in slime of course it’s only a suggestion,” to quote a line which I, as they say, Identified with pretty strongly.
This view of addiction and recovery is all over the place nowadays. From semi-experimental bestsellers to laugh-track CBS sitcoms, a standard “recovery voice” is emerging: voluble about amends and humility, vague or even shifty on the subject of God, wryly submissive and terrified of relapse. (The Sergeant-at-Arms section of Infinite Jest will hit a lot of people very hard.)
You can hear this narrative in this snippet from The Harder They Fall: Celebrities Tell Their Real-Life Stories of Addiction and Recovery–emphases added:
There are some common threads that weave through these often stirring narratives of recovery: initial success fueled by various stimulants, the inevitable crash and burn, and then somehow, often at the last possible moment, against all odds and having been dragged kicking and screaming into a rehabilitation program, finding redemption in the quiet, steely disciplined, deeply personal process of healing the self, making peace with inner demons, and finding a renewed way to live.
The fact that this book exists is a sign of the highly 12-steppy moment we’re all in.
In this narrative addiction and recovery are sublime experiences. They involve moral and spiritual concepts we have a hard time articulating today: Helen Andrews wrote the key essay here, noting,
The irony is that the aspects of AA that seem to resonate with them are the things they hate about organized religion: the admission of powerlessness, the submission to authority, skepticism about the value of thinking for yourself, the rote repetition of phrases that to an outsider seem vapid, sentimental, or silly.
There’s another narrative, though, which is emerging at sites like The Fix and Substance.com. This is a gradually-coalescing worldview, which typically includes but isn’t limited to “harm reduction” properly understood: “Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs. ”
In this emerging narrative addiction is better understood as a medical problem than as a spiritual one. (No “personal demons” here.) This narrative reminds us that most illegal drug use isn’t addictive use. Most people who do abuse substances (using what I think is the most useful definition, compulsive use of a substance or behavior in spite of detrimental effects on one’s life) recover without rehab or AA or any other kind of specific help; most people just grow out of it. Lots of people moderate their substance use. You (…for certain values of “you”) really can cut back. And even for those who need to abstain from drugs or alcohol completely, demanding total abstinence up front is more likely to produce despair than compliance. Offering an identity as more than a drug user, in this worldview, is the best way to help somebody become no longer a drug user.
This narrative includes various corollaries: Humiliation, surrender, and obedience are often excuses for abuse of power; participation in spiritual programs like AA shouldn’t be coerced via legal threats, or required by any treatment center which takes health insurance; simply having recovered from addiction yourself doesn’t give you the expertise needed to shepherd others, so a degreed and credentialed counselor who’s never experienced addiction will probably help you more than a sponsor whose only qualification is his Qualification.
The two narratives have differing views of authority: The 12-Steppy model comes across as authoritarian, and can definitely be used as an excuse for cruelty, but it also has an anarchic respect for the wisdom of ordinary people. It attempts to turn followers into leaders through personal guidance. What I’m (again, super-reductively) calling the harm reduction model is simultaneously much more individualistic, and much more reliant on medical expertise. The expert-layperson hierarchy is in many ways more rigid than the sponsor/sponsee relationship. The harm reduction worldview tries to avoid the problems of class- and education-hierarchies by soliciting as much participation as possible from people on the ground, current drug users. “Nothing about us without us” is a slogan of the harm reduction movement, and one with which I agree… but it’s not a slogan AA ever needed, because AA’s whole genesis and development was by “us,” the alcoholics.
The harm reduction model is typically much more comfortable with the idea that different approaches to recovery are valid for different people. There’s much less pressure to force everybody into one method, goal, spirituality, and language.
On a policy level I usually agree with the harm reduction movement (although I don’t make the strong separation they tend to make between spirituality/religion and mental health/medicine). And we desperately do need to accept that there are many different paths to recovery; the one-size-fits-all approach kills people. On a personal level you can probably hear that my own recovery was heavily influenced by (though not strictly within) the 12-Step model. I read David Carr, Stephen King, David Foster Wallace, and I think, Yes, that’s what it’s like.
The increased prominence of the dramatic 12-step narrative, what I’m calling the narrative of sublime recovery, may make it harder for us to accept that anything else is “real” recovery at all.
Maia Szalavitz, a truly invaluable journalist whose work I’ve recommended here before, recently asked, “Most People With Addiction Simply Grow Out of It–Why Is This Widely Denied?” Part of the answer, I think, is that the growing-out-of-it type of recovery is invisible–and it’s invisible because it’s boring. It’s banal. As far as I know there are no novels or sitcoms about banal recovery, because it looks like staying basically the same. You get to keep the self-image you started with: You can keep thinking you’re smart, good, and competent, able to handle whatever life throws at you. You’re able to keep mislabeling your luck as “Good Choices I Made,” if that’s a thing you do.
But this banal recovery, this recovery in which you get to hang onto your ego and keep all your fantasies of competence, makes certain things possible. I know a lot of people who went from destructive use of drugs and alcohol to moderate use, and what that made possible for them was friendship, marriage, babies, honesty, wholehearted religious participation. And these experiences are sublime. People who managed to avoid the unconditional surrender of sublime recovery have so many other, more beautiful paths to surrender.
Marriage is humiliating, parenting is humbling, friendship is a school for gratitude. The fantasies and ego will be burned off by love. Banal recovery makes possible a sublime everyday life.
That is the goal of real recovery.
Eve Tushnet is a TAC contributing editor, blogs at Patheos.com, and is the author of the recently-released book Gay and Catholic: Accepting My Sexuality, Finding Community, Living My Faith.