Recovering in Anonymity – Does it Continue the Secrecy and Shame

Recovering in Anonymity – “Does it continue the secrecy and shame?” I ask. “And does that secrecy and shame thwart recovery?”

While anonymity is the cornerstone of recovery for millions, for millions more and often for the public at large, in my opinion, it also continues the secrecy and shame that shrouds this disease, and it is that secrecy and shame that can make the treatment and recovery process difficult.

About the Disease of Addiction

Recovering in Anonymity – does it continue the secrecy and shame?

Recovering in Anonymity – does it continue the secrecy and shame? And does that secrecy and shame get in the way of recovery?

You have probably been told something like, “Alcoholism / drug addiction is just like any other disease.” After which you have probably said to yourself or to whomever made the statement, “Like *!?!#! it is! People with diabetes or heart disease don’t steal money from me or endanger my children by driving while under the influence!”  And, that’s because diseases like heart disease and diabetes are not brain diseases. They do not cause chemical and structural changes in the areas of the brain a person needs in order to think straight and act responsibly.

Addiction and other diseases, like diabetes and heart disease, share common characteristics true of all diseases, however:
– They are chronic .
– They have the potential to result in death if untreated.
– There is a genetic influence associated with vulnerability.
– They involve behavioral factors associated with the onset of the disease.
– They have the potential for relapse if treatment recommendations are not followed.

These similarities AND the fact that addiction is a brain disease explain why effective addiction treatment requires a “disease management”  approach according to the Principles of Addiction Medicine, Fourth Edition, as opposed to an acute care approach (i.e., “28-days and you’re good to go”).  While the components and deliveries will vary, because no single treatment component is appropriate for all individuals at all times,  the overall objectives of a disease management approach to addiction treatment should involve three phases: 1) detoxification/stabilization, 2) rehabilitation and 3) continuing care.

So how did we get so stuck in the acute treatment model?

Secrecy and Shame

How many addicts/alcoholics and/or family members/friends with a loved one who has a problem with substance abuse actually talk about it — talk about it as they would if they or their loved one had cancer?

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 (SAMHSA). 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.

Is it Time to Let Go of Recovering in Anonymity

In my view – if at all possible – in other words, if it does not hinder one’s recovery – “Yes.”

The major inroads just described 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.

Thankfully, the 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! Finally, we can treat addiction (to alcohol or drugs) for what it is — a chronic, often relapsing brain disease. Finally we can treat drug addicts and alcoholics as people – people with a treatable disease. But first, we must TALK ABOUT IT! We must put a face on it so that people know that recovery is possible; so that people know that people with this disease can successfully treat it and go on to live fulfilling, enriched lives.
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Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa is the author of hundreds of articles and 11 books, including "If You Loved Me, You'd Stop!," "Addiction Recovery: What Helps, What Doesn't," and "Secondhand Drinking: the Phenomenon That Affects Millions." She is a national keynote speaker with over 25 years speaking experience, consultant, and founder of BreakingTheCycles.com. She has spent more than 14 years studying 21st century brain research in order to write, speak, and consult on substance use disorders prevention, intervention and treatment; mental disorders; addiction (aka substance use disorders) as a brain disease; adolescent addiction treatment vs adult addiction treatment; effective treatment for co-occurring disorders (having both a substance use and mental disorder); secondhand drinking | drugging; help for the family; and related subjects. In 2015, she founded SHD Prevention, providing training and consulting to companies, public agencies, unions, nonprofits and other entities to address the workplace impacts of employee secondhand drinking and alcohol misuse.

35 Responses to Recovering in Anonymity – Does it Continue the Secrecy and Shame

  1. Excellent post, Lisa. Thanks for sharing such helpful info, always. I agree with you when you write: “Finally we can end the secrecy and shame! Finally, we can treat addiction (to alcohol or drugs) for what it is — a chronic, often relapsing brain disease…” Bless you for all you do!

  2. Angela Giles says:

    I didn’t know so much about addiction. This was a really good eyeopening article.

  3. Mel Scholl says:

    As a woman with 10 1/2 years of sobriety and an addiction counselor, I can tell you from first-hand experience the need to remove the stigma and the veil of shame when addressing this disease.

    I am aware of a new movie, which will be screened in Minneapolis in 2 weeks, that addresses this very issues. It is called “The Anonymous People.” It is on my must-see list.

    Thank you for this insightful article.

  4. MarVeena says:

    Thanks for sharing some great ideas!

  5. All people are to be loved, no matter what their life path is and how they walk through it.

  6. You know I’m loving this! It does hinder the recovery because it’s seen as a weakness character. I know better and am always grateful that I never developed the problem. Thanks for your work and bringing the awareness! I’m a huge fan!

  7. Karla Campos says:

    You are right people are very ashamed to talk about their or a family member’s addiction. I have a friend who is a life coach, I actually met him on the internet and his story is that he used to be an alcoholic but broke free from alcoholism and is now a life coach. Many people still look at him badly because he mentions the fact he was an alcoholic. I wish people would understand each other more, the world would truly be a better place if they did.

    • Oh that’s rotten, Karla, and unfortunately not all that uncommon. Thankfully, there are some wonderful groups working to change this – Faces and Voices of Recovery is one – the more we can put a face on recovery and the more we can raise awareness about the facts of the disease, itself, the more people will understand it (similar to the way we finally understand HIV-Aids, as an example). But as you said, the best solution is if people would try to understand and not judge each other. Thank you for your comment!

  8. Excellent post Lisa. Recovery from an addiction is hard enough without dealing with the stigma that it brings. It is good to know that there are real changes in the way addiction is viewed in the professional community.

    • Thanks so much, Meryl, and I agree – it’s wonderful that views of addiction within the profession are shifting to recognizing it as a brain disease and treating it using the 3-pronged disease model approach.

  9. Herby Bell says:

    Now THIS is interesting stuff, Lisa Frederiksen.

    A pro NBA player, “comes out” today….Not so coincidentally, I purchased stamps at the post office this morning with Rosa Park’s likeness honoring her unfathomable courage. While neither of these two acts of dignity involve a brain disorder and disease, your suggestion that addiction recovery IN anonymity FROM a brain disorder and disease might be a significant part of the problem–is spot on in my experience.

    The psycho-spiritual liberation and freedom of recovery must come out of the closet in a much more robust way. And it’s only when people who are not cloaked in roles and lives of who they are not, can come forward AND talk about it, that we’ll see the courage of others coming forward, recovering and THRIVING.

    I’ve heard of many reasons for anonymity in addiction recovery. It just never worked for me as I attribute my “open book” living to a big part of why I am alive today.

    An important and courageous! post, Lisa. Thank you.

    • Herby! Thank you so much for your comment. I’ve always admired your willingness to put a face on recovery. You are a prime example of a person who tackled their brain disease of addiction, healed it and moved on to live an amazing life in recovery as a doctor, surfer, husband and father. Not only all of this, but you are giving to others through your business, Recovery Health Care – Blueprint for Recovery™ (BFR) program. [For readers information, it’s a 90-day wellness intervention program that starts during or immediately after acute or intensive outpatient addiction treatment.] I have to give you and BFR a shout out for your “holistic approach incorporating exercise, diet, and cognition practices to help your patients learn to move, eat, and think in ‘recovery friendly’ ways that are clinically relevant to addiction treatment and founded in evolutionary biology and evidence based research.” It’s an awesome program, Herby. Thanks, again, for being a Face of Recovery!

  10. Tom H says:

    Lisa,
    I don’t know very many alcoholics or addicts, so your article was interesting to read. Based on your comments, it appears that many people know or have been affected by addiction.

    • You’re absolutely correct, Tom H. It is estimated over 23 million Americans struggle with addiction, yet fewer than 10 percent are getting treatment (Source: The Addiction Project – NIDA, NIAAA, Robert Wood Johnson Foundation, HBO). By comparison, cancer prevalence for all types of cancers [which is the term used by the American Cancer Society to define the number of of living people who have ever had a cancer diagnosis] totals 12,549,000 – roughly one-half the number of people struggling with addiction. Another disease comparison is HIV. The CDC estimates that more than one million people are living with HIV in the U.S. This is not to say that any one disease is more important than another but rather to draw attention to what secrecy and shame can do to effectively treating | preventing a disease. In the United States, the following compares numbers of persons affected by disease type:
      Addiction = 23.2 million
      Cancer = 12.5 million
      HIV = 1 million
      Diabetes = 25.8 million

      As for those affected by someone’s addiction, more than one-half of American adults report one or more of their close relatives has a problem with drinking (NIH) and one in four children is exposed to a family member’s alcohol abuse or alcoholism or both before the age of 18 (NIH).

      Thanks for your comment, Tom H.

  11. Anita says:

    I believe the answer to this is personal. I think for some folks, anonymity has to be…no matter what the cost. I do think people can recover without shame and be anonymous ..It just wasn’t how I done it 🙂

    • I absolutely agree, Anita – it is personal and for some it must be anonymous. However, for those who can share their recovery experience (just as those who can share their recovery experiences from other diseases), they provide the “proof” that people can and do recover and often point a direction to follow that can help someone struggling. Thanks for your comment.

  12. MamaRed says:

    It is, of course, an individual’s choice and it grieves me when anyone lives with shame and doesn’t feel they can ask for the help they need to take their next step.

  13. Great article! I think there are always going to be people that judge one another. When I was 18, I had a friend that was a methamphetamine addict and I used to go with her to meetings for support. The closest one to her was an AA meeting and the people there turned up their noses at her and were not supportive because she was a “drug addict” and in some way their alcoholism was not as bad. I think it is important for people to own up to their addictions, so they can deal with them, but there will always be those people that have a problem with others, no matter what the circumstances.

    • I’ve heard that same thing, Daniele – as if there’s a ranking of addictions – often it’s because people don’t really understand the brain disease aspect of addiction because of they did, they’d know the substance isn’t the issue when it comes to treating the disease. That is so wonderful you were willing to go with your friend to support her – I hope she was able to find recovery. Thanks for your comment!

  14. Sharon O'Day says:

    I’ve learned so much about alcoholism — and the physical brain alterations that alcohol causes — and it’s given me an entirely different perspective on the topic. Thanks for opening my eyes, Lisa!

    • That’s wonderful, Sharon!!! It’s so great to hear this, for as you know, helping people understand the science of these interrelated issues and outcomes and how to use that information for self and others is my objective. I really appreciate your comment!

  15. Tim Cheney says:

    Great article! What many people in recovery do not understand is that you can lend your voice to elevate societal awareness without violating 12 step traditions. People can say they are in recovery without mentioning their specific 12 step fellowship just as cancer survivors do not mention their specific treatment. It is not how you got there that is the focal point but rather that you are in recovery and that recovery works and there is hope. Addiction is a chronic brain disease. It is not a moral nor a criminal issue.

    “In the year 2020, we will look back in horror and shame at our social misconduct and ignorance. Society will realize that our treatment of these individuals has been comparable to prior periods in history (Salem Witch Trials, Holocaust, etc.) when ideology and ignorance dictated social policy and treatment of specific populations.”

    • This is so important to understand. Thank you, Tim, for sharing this as it just may help others see it’s OK to seek and be open about recovery. Addiction is a brain disease and one that needs treatment – whatever form that treatment may take: 12 step program, cognitive behavioral therapy, exercise, nutrition, treatment of a co-occurring mental illness or combinations thereof and with others. I so appreciate your comment and wisdom.

  16. Tim Cheney says:

    So how did we get so stuck in the acute treatment model?

    Acute treatment is a 21 billion dollar industry and projected to reach 34 billion next year. Approximately 80% of addiction patients relapse within one month of discharge. The answer to your question is simple – follow the money.

  17. Wonderful post Lisa and a huge ongoing concern as we know…I agree that this does keep one as “sick as their secrets” yet something does come to mind. I am aware of many professionals pushing the addict to assume the reality of what personally fits prior to their comfort level…This is something that we ( as professionals) need to help work on as well w/ our clients, so they can get past that fear of judgement and understand this is the greatest thing they can know of themselves to then hopefully share w/ others…
    I believe that the role of aftercare ( or continued care) and all the holes that are growing larger after initial residential treatment, could be the ticket to creating a comfort level as to positive changes unavailable when active in their disease…Sometimes the detox phase becomes the “fix” for the client and family…Hence: The cycle begins again!

  18. […] And to the point of “Cancer is a Disease” – I’d like to leave you with two more shared posts. They have to do with the shame that surrounds the disease of alcoholism (addiction); a shame that perpetuates the misinformation about the disease; a shame that keeps people from seeking the help they need. Thanks for reading, “Help Shatter the Shame of Addiction | Share the Facts,” and “Recovering in Anonymity – Does it Continue the Secrecy and Shame.” […]

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