“Struggling”
By Kevin Doyle, EdD
NOTE: This was published for the Hazelden Betty Ford Foundation’s monthly Recovery Advocacy Update. If you’d like to receive our advocacy emails, subscribe today.
In the arena of substance use disorders treatment, recovery and counselor education, “struggling” is a common, seemingly innocuous word, but it’s one of my least favorite. Why? Because it’s a subjective word often used paternalistically to describe people with substance use disorders even after they’ve begun or progressed significantly on a path to recovery, and often without knowledge of their particular situation. Used so broadly and generically, it can send the signal that recovery is always a tenuous dance on the brink of relapse, even when that is not the case for many, and contribute to pessimistic views about recovering people’s ability to work in certain jobs and successfully navigate the world.
How many times have we heard “so and so was struggling with addiction” or phrases like that?
The problem, as a I see it, is threefold.
First, of course: how does anyone other than the individual person, and perhaps their treating professionals or partner, know if anyone is indeed struggling? With addiction, just as with any other chronic condition or disorder, there will naturally be times of stability and even strength and other times that are more difficult or challenging. Too often, outsiders — i.e. well-meaning friends or family members, the media, or nosy neighbors — jump to conclusions without any real facts to support the unfortunate label. The recent death of Matthew Perry, for example, led to a long line of people with little-to-no knowledge of the particulars using the word to describe his personal recovery journey.
Second is the issue of paternalism. There is the false belief that any person in recovery is always on the brink of relapse or return to active use, when this far from the truth. This plays out in a number of ways, perhaps well-meaning, but nonetheless damaging and misleading. People in recovery are sometimes prohibited from working in certain occupations, from handling sensitive or high-pressure jobs, or from being around alcohol for fear that they will succumb to the environment and take or use that first drink or drug. Nowhere is this high-wire act portrayed more pervasively than in television shows or movies where scene invariably focuses on the individual and the bottle, the camera cutting back and forth to heighten the dramatic moment when the individual either walks away or takes what seems to be the inevitable drink. Scenes from the recent Netflix series Daisy Jones and the Six (2023) and the Denzel Washington movie Flight (2012) come to mind — but there are many, many others. Yes, it is sometimes a daily struggle (I am reminded of a former patient who spoke of how difficult entering a store that prominently displays beer can be), but in reality, many recovering people navigate the alcohol-filled (and drug-filled) world successfully and routinely nearly all of the time.
Finally, there is the general lack of discussion or mention of when people are not “struggling.” Rarely do we hear, outside of the “rooms of recovery” perhaps, of the many millions of people who have successfully overcome their substance use disorders and are now in what has been called by the illustrious William White and others “long-term recovery.” Without this accurate portrayal, it seems to me, everyone is seen as struggling, even when that is clearly not the case. Yes, it is highly important to maintain one’s vigilance as part of recovery from a substance use disorder, of course, but to overlook the fact that for many recovery is characterized by stability, growth, and routine, is a major mistake.
So, next time you think of using that word, “struggling,” to describe someone in recovery, think twice about whether it is accurate and appropriate, or whether another word might be better.
Kevin Doyle Ed.D., is the president and CEO of the Hazelden Betty Ford Graduate School of Addiction Studies in Center City, Minn.
