Beauty, Hunts Point. Courtesy of Chris Arnade. Click image for more in his series.
Cassie Rodenberg’s blog has had a couple of heartbreaking posts recently. They look at the lives of women in the culture of addiction–prostitution, pimp boyfriend, sexual assault, having to provide sex for a place to stay, etc.
It brought back Bill White’s book, Pathways and his discussion of sex within the culture of addiction. Not only does the use of sex as a vehicle to maintain access to drugs or other needs within the context of addiction detach sex from pleasure, intimacy and love, it also is a consequence and contributor to the objectification of others–people become objects to be used or avoided.
All of this got me thinking more about a post a while back where I discussed a post from Bill White on the need for “recovery spaces” and how the concept was getting some push back. DJ Mac (who is supportive of the concept of recovery spaces) titled his post, Does recovery space equal recovery ghetto? Much of the discussion seemed to be between people who are culturally empowered, mobile, do not live in a ghetto and have never been trapped in a ghetto.
Cassie’s posts reminded me that, for some, ghetto isn’t just a metaphor–it’s their world.
These people need more than harm reduction.
They need more than MI, CBT or 12 step facilitation.
They need Recovery Management.
Bill White calls on us to raise our expectations of ourselves and the system while focusing on recovery and the community as the locus of healing. [emphasis mine]
Addiction treatment must always adapt to the evolving context in which it finds itself. Such redefinition may push treatment toward the experience of retreat and sanctuary in one period and toward the experience of deep involvement in the community in another. I would suggest that the focus of addiction counseling today should not be on addiction recovery-that process occurs for most people through maturation, an accumulation of consequences, developmental windows of opportunity for transformative or evolutionary change, and through involvement with other recovering people within the larger community. The focus of addiction counseling today should instead be on eliminating the barriers that keep people from being able to utilize these natural experiences and resources. Our interventions need to shift from an almost exclusive focus on intervening in the addict’s cells, thoughts and feelings to surrounding and involving the addict in a recovering community.
Over the years Bill shifted his language to emphasize “community renewal”:
A major focus of RM (Recovery Management) is to create the physical, psychological, and social space within local communities in which recovery can ﬂourish. The ultimate goal is not to create larger treatment organizations, but to expand each community’s natural recovery support resources. The RM focus on the community and the relationship between the individual and the community are illustrated by such activities as:
- initiating or expanding local community recovery resources, e.g., working with A.A./N.A. Intergroup and service structures (Hospital and Institution Committees) to expand meetings and other service activities; African American churches “adopting” recovering inmates returning from prison and creating community outreach teams; educating contemporary recovery support communities about the history of such structures within their own cultures, e.g., Native American recovery “Circles,” the Danshukai in Japan;
- introducing individuals and families to local communities of recovery;
- resolving environmental obstacles to recovery;
- conducting recovery-focused family and community education;
- advocating pro-recovery social policies at local, state, and national levels;
- seeding local communities with visible recovery role models;
- recognizing and utilizing cultural frameworks of recovery, e.g., the Southeast Asian community in Chicago training and utilizing monks to provide post-treatment recovery support services; and
- advocating for recovery community representation within AOD-related policy and planning venues.
It’s worth noting that, over the years, Bill has written about recovery employment, housing, education, etc,
It can be overwhelming. But, the alternative is despair.
UPDATE: This post was re-titled based on reader feedback.