Secrecy and Shame Surrounding Addiction Keep Us Stuck
In my opinion, the secrecy and shame surrounding addiction – now understood to be a chronic, often relapsing brain disease – are what keeps us stuck in the old ways of treating, intervening and preventing substance abuse and addiction.
The Historical Reasons
When Robert Smith and Bill Wilson (Dr. Bob and Bill W.) co-founded Alcoholics Anonymous (AA) in 1935, the concept of alcoholism as an illness began to take hold in the United States. It would be decades before a similar view of drug addiction surfaced.
Prior to 1935, much of society viewed individuals who had a problem with their drinking as weak-willed. People believed those individuals lacked the moral fortitude and willpower to get their drinking under control. They believed those people consciously chose to drink, in spite of the physical, emotional or financial costs to their families and friends.
Those beliefs caused “treatment” to consist primarily of a stay in a sanitarium and/or efforts to make the person drink less – not to abstain entirely but to drink less; to get it under control. And as far as society was concerned, it was up to the family and friends to make that happen if the “drinker” could not. It was up to the family members and friends to keep it under wraps and to cover-up the fall out, such as making excuses to the boss for a loved one’s absence from work – again.
And when the family member or friend could not reform the drinker or hush up the problem, they felt shame of their own; shame for not being important enough for their loved one to want to stop. This shame often turned into anger, sadness and hopelessness as family members and friends made one failed attempt after another to get loved ones to change their drinking patterns.
Struggling to control the perceived cause – alcohol – led American citizens to rally behind the Temperance Movement in the 1800s. Eventually, the movement convinced a nation that ridding society of alcohol would rid society of drunkenness. And so the United States ratified the 18th Amendment to its Constitution in 1920, making it illegal to possess, consume or sell alcohol.
It was known as Prohibition, but restricting a person’s right to drink did not go over well in a country that prides itself on the rights to free speech and to bear arms. Thirteen years later Prohibition was overturned, but the fall-out continues today. Much of society still views public attempts to talk about problems related to alcohol as “code” for wanting to take away a person’s right to drink in whatever manner they so choose to drink.
Recovering in Anonymity Continues the Secrecy and Shame
The founding of AA provided the first wide-spread effort to view excessive drinking as something beyond a “lack of willpower” and to approach treatment from the perspective of abstinence – not drinking any alcohol. Its fellowship viewed alcoholism as a “combination of physical, psychological and spiritual causes,” a combination that made alcoholics different from non-alcoholics.
AA provided a guide for how a member of its fellowship could achieve abstinence and a joyful life through its 12-steps and The Big Book. It proved to be life-changing then and continues to be life-changing now for the millions who grapple with alcoholism – today understood as one of the diseases of addiction. However, AA could not overcome the shame in which society had so thoroughly shrouded the problem, a shame so powerful it forced alcoholics to recover from their disease in anonymity, hence the name, Alcoholics Anonymous.
Treatment options for drug addictions took even longer. Narcotics Anonymous (NA) meetings patterned after AA did not appear until the early 1950s, and its guidebook, Basic Text, was published long after that.
Not until the early 1980s, with the co-founding of the Betty Ford Clinic by Former First Lady Betty Ford, did seeking treatment at a residential facility for alcohol and drug addictions gain public recognition. Today, there are more than 11,000 addiction treatment programs in the United States, according to the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Awareness Services (SAMHAS). And organizations, such as the American Medical Association, the National Institute on Drug Abuse, the World Health Organization and the National Institute on Alcohol Abuse and Alcoholism, are making significant advances in the prevention and treatment of alcoholism and drug addiction.
Yet, these major inroads have not been enough to overcome the secrecy and shame in which society has so thoroughly shrouded the problem. As a consequence, alcoholism and drug addiction continue to be misunderstood diseases. They continue to be diseases people try to conquer on their own or to recover from in anonymity for fear of the reprisals they may face socially, at school, in the workplace or within their extended families.
Unfortunately, people still try to recover in anonymity, today. But new brain and addiction-related research is exploding our long-held beliefs about alcoholism and drug addiction being a matter of “choice.” Finally we can end the secrecy and shame!
The forgoing is an excerpt from my latest book, Loved One In Treatment? Now What!, available on Amazon.com and BarnesandNoble.com.
Lisa Frederiksen
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