Identity and recovery

By Matthew Burpee via flickr

Healthland has a post on the relationship between identity and health:

When is a label a badge of honor, and when is it a harmful stigma of sickness or deviance? This question is of critical importance to public health…

But what does any of this have to do with health care? One of the best ways to change health behavior, it turns out, is to change a person’s self-identity. When a smoker begins to view herself as a nonsmoker or a teen sees binge-drinking as something “people like me” don’t do, behavior change is typically more lasting than if the person’s sense of identity is not invoked.

Research on everything from exercise, eating behavior and sexuality to political action and drug use suggests that having one’s identity wrapped up in a particular behavior is a crucial motivating factor to sustaining it. Once you see yourself as a runner, not running becomes far harder to do, for example.

There are also overwhelmingly negative issues associated with identity and labeling, however. The most obvious example would be a person whose identity and sense of self are tied directly to unhealthy behaviors — for example, viewing oneself as a “dope fiend” whose life purpose is to seek heroin or other drugs. If you believed that this identity was immutable or desirable — for example, if you use drugs as a way to rebel against conventional life — the possibility of change may be precluded before it is even truly considered.

She discusses the double-edged nature of identity a little further:

Once people see themselves as sick, they often limit themselves based on their view of what illness means.

In some cases, though, a “sick” identity can be liberating. For example, if a child learns that she has Asperger’s, which helps explains why social interaction is so difficult for her, she might stop blaming herself for being “weird” or “antisocial” and discover a whole community of similar folks. Similarly, people who suffer from depression, who find out that their miserable sense that everyone hates them or that nothing is any good is a treatable chemical state, can be empowered to seek positive change.

Whether a sick identity is a motivating power for change or a limiting stigma often depends on individual perception. Some people would rather be “sick” than “bad,” for example, and having a disease that explains otherwise undesirable behavior without placing blame will often allow the person to absolve his “weakness” and ask for help. In contrast, others view the idea of sickness as a cop out that denies a person agency and, therefore, dignity.

I’m convinced that identity is a critical element in making maintaining changes over the long term. I’m also convinced that whether the identity is helpful or harmful depends on what the identity offers. Does it offer hope? Community? Recovery? Or, does it offer despair and isolation?

The post is in response to TEDMED 2012. It will be very interesting to see videos of the talks as they are released.

2 thoughts on “Identity and recovery

  1. So, do you not think addiction is really a disease? I thought this article – – did a really good job of explaining why addiction is truly a physiological disease.
    Perhaps it’s not great for people to think of themselves as “sick,” being realistic and confronting problems is a huge part of recovery. If addiction is a disease, and the people who are afflicted need certain treatments, shouldn’t they understand the true nature of that disease?

  2. I do believe it’s a disease. And, I believe that identifying as an addict is an important step in recovery. This identity offers community, hope and a course of action. It is I find it interesting that, for other illnesses like mental illness, it often seems to be disempowering and lead to an identity of being disabled.

    I’m also interested in the power of identity, particularly that people make decisions based on identity–even decisions that do against their own interests. I’m convinces that identity is an important component to maintaining any change over years and decades.

    So…in the post I was trying to play a little with illness, identity and what makes an identity helpful or harmful.

    Here are some related posts:

    Thanks for reading and commenting!

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