Dirty work and courtesy stigma

vicious-cycles-logoWe talk a lot about the effects of stigma on addicts and policy. However, other than policy ramifications, like poor funding, we do not talk much about the effects of stigma on treatment professionals and their field.

How does stigma shape our thinking? Our behavior? The ways we treat each other? The ways we interact with the public? The was we treat addicts and their families?

In a brief but thought provoking post, Bill White explores this issue, including a long list of the dynamics forms and/or influenced by stigma. It’s the kind of post that I find impossible to pull from–it must be read in whole.

Here’s a teaser. Read the whole post here.

The field of addiction treatment illustrates the complex dynamics flowing from addiction-related stigma and its accompanying courtesy stigma and dirty work designations.  Examples of such dynamics include:

  • Inadequate social resourcing of socially designated dirty organizations and dirty workers on grounds that the dirty people served do not morally qualify for greater resource allocation.
  • Organizational instability resulting from ineffectual boards, insulated leaders, and oft-changing organizational structures and ownership.
  • Inter-organizational competition resulting in exaggerated claims of effectiveness (“Our way is THE way”) as a means of status assertion.
  • Organizational isolation, inter- and intra-organizational conflict, and isolation from larger professional and social arenas as strategies of taint management (e.g., treatment and mutual aid organizations as “closed incestuous systems”[White, 1997]).
  • Organizational/workforce hypersensitivity to 1) external attacks on the field, 2) addiction-related casualties of treated patients, and 3) successful recoveries whose sources appear unrelated to professional treatment.
  • Workforce instability (problems of recruitment and retention) influenced by social perception of addiction treatment as “dirty work.”
  • Alternating media portrayals of the addiction treatment workforce as rescuing angels one day and a mix of hustlers, con artists, wanna-be-messiahs, and incompetent or impaired castoffs from other professions on the next day.

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