Labels – What’s In A Word?

Labels - What's In A Word?

Today's Learning Moment 03-06-23 – Labels – What’s In A Word?

Written by and for people with Lived Experience - Port Alberni Community Action Team - Families Helping Families

There is a centuries-old history behind the labels that we use today to describe someone who is struggling with substance use challenges or is at some stage along their recovery journey. Dr Carl Fisher has an excellent book describing the history of addiction "The Urge: A History Of Our Addiction". Bruce Alexander’s “The Globalization of Addiction: A Study in the Poverty of Spirit” also had much information regarding the history and evolution of the language we use to describe addiction. Raising awareness of the need for a new language around substance disorders is a very good thing. People-centred words should help address stigma, however, it is more than changing language that is needed. It is an empathic understanding of what the language represents.

As a person with lived experience, I have to say that living with the label of “alcoholic” or “addict” is currently like a badge of honour. Within the 12-Step and other recovery communities, these labels are the badge that binds the "fellowship" together. Members identify a sense of connection and belonging through their use of these labels. It is a tag we must continuously repeat in the program for many reasons. One of those reasons is that if we don't repeat the label, we have not accepted our issues aka addiction and are not stepping up to the heart and intention of the program. That alone can be viewed on many levels; For some, it can be stigmatizing, and for others, motivating. It depends on the person. It is up to the individual to find that meaning in the terms. I know I had to dig deep and really open up to the meaning of these words rather than wallow in my own prejudice of the labels.  And when I did, a different world opened up for me.  We don’t expect or want outsiders to redefine the meaning of the labels we use to identify ourselves.

Other labels such as “junkie” are often also used as badges of honour by those who have had experiences with addiction and are in recovery. They imply success with abstinence. They equate with working the program. Currently, regardless of whether one is in 12-Step or other programs, in accepting the label, there is an acceptance of the issues that accompany that label. In recovery, the label is the medal of honour amongst many who are on that same journey. It is a sign of belonging and acceptance by fellow travellers.

In meetings, eyes roll and heads shake in the traditional "fellowships" (a patriarchal term in itself) when others talk about the specific labels of “alcoholics” and “addicts” as stigmatizing. Truth be told, so far I have not heard any conversation within the 12-Step meetings I attend where “other labels" are used. However when there is talk about "people with lived or living experience", "substance use disorder", or much of the currently evolving language that is based on the progress of science, then eyes roll and heads shake. That language does not resonate with those who self-identify with the more traditional-based labels.

Yet, these labels are too often seen by those without lived-living experience either as stigmatizing at best, or with prejudice, disdain and disgust at worst. Our social belief system has assigned negative meanings to these words based on centuries of ignorance, rhetoric and propaganda that exists even today.

I agree that these labels and so many of the "clichés" expressed throughout the recovery community that is founded in the 12-Step belief system are, insensitive, not trauma-informed, misogynistic, patriarchal, and even racist by today's standards. The literature that current traditional treatment and recovery have been founded on is now mostly inaccurate and misleading as science finds its way through the complex world of recovery.

However, these labels are also packed with meaning for so many who are in "abstinence-based" programs. Many, including myself, need to be in an abstinence-based program, though I am a formidable advocate for a spectrum of other strategies and approaches. So far I have personally come to the point in my journey where the "spirit" of the words are more revealing to me than the stigma of the words themselves. Nevertheless, I often battle with myself to bite my tongue at times during a meeting because of the meaning that I believe is being assigned to what has been written or said.

I can’t let my cringe be a barrier to the truth lying underneath a dated and potentially damaging word.

It is when I get curious about the language, and listen carefully with an open mind, I can draw out a deeper meaning. It is there. It is easy though, to see why it is difficult for people to get through the language to the other side. But again, it takes more than just changing the language.

Yes, the words need to be changed and yes, people with lived-living experience, in recovery or treatment must be at the forefront of this change. As we all know, changing the minds of millions and millions of people is going to be a long and extremely difficult undertaking. AA itself is scattered all over the world with participation in the millions and millions. For any change to the body of that program to occur, a majority of that whole body must vote for that change. Remember that AA is at the very core of almost every treatment model out there. Change is happening thanks to the raised awareness about things such as stigma and language. However, as we all know, most change in our world happens excruciatingly slowly.

In the meantime, while advocating for such change, remember to always start where a person is at. It is, after all, their journey. Always start with the meaning behind the word for them. Never, ever assume that the person is attached, indifferent, shamed, or otherwise by the label they use. Instead, be curious as to what the labels mean to them and if permitted to, explore the history and stigmatizing impact these labels can have on our society and maybe even on an individual’s own recovery

Of course, if you do get permission to discuss the impact of stigma and labels etc., make sure you have done your homework beyond your own personal belief system.

This should hold true even if the person using the language is not in recovery or struggling with substance use. Maybe the person has developed their beliefs in a certain way, in a certain context etc. Their perspective must not be judged but rather revealed and critically explored. Of course, this can only happen in a safe and empathic manner; Not with judgment.

The labels, in the community of those without lived and living experience (already becoming another label) is often viewed through the lenses of historically prejudiced world views and the rhetoric that has accompanied them. It is easy to see why labels must be addressed to help quell stigma. In point of fact, I find labels to be divisive, even if based on “good intentions”.

Think about it. Is changing a word for someone who currently understands that word as health, happiness and recovery, helpful? Or is it not perpetuating the stigma of the word itself? “The word isn't okay so therefore you are not okay?”. Hmm. Just a question I thought of while writing this. I think we need to answer this question in our broader debates with others, or at the very least, in our own minds.

Knowing that labels often are associated with negative beliefs, I am willing to change that label to something that fits me better and will cease promoting stigma. But for now, saying I'm an “alcoholic” is meaningful when I am in the 12 step environment. It helps me be accountable and willing to accept and explore change in ways that I had forgotten over the years. It helps me “belong” to a community of connections (aka fellowship). Knowing the intended meaning of that outdated word is more helpful and fruitful for me than trying to fight it and/or get everyone else to suddenly change it. So I deliberate over the meaning of these labels privately and now, here in this article, obviously publicly.

My translation of the term alcoholic is packed with all sorts of meaning for me. The word currently for me has its purpose as I refer to myself. I have never, ever labelled any other person, especially as a substance use counsellor. It was my training, my job, and most of all my responsibility and belief, to allow the person the dignity to see themselves on the most fitting level of their journey at any given time. Just as it is my understanding of this label, at this moment it’s not the label itself, that helps me stay on track.

I have always said, to address stigma will take more than just changing language, it is learning about the meaning underneath the language. That goes for people without lived-living experience with substance use. We must see "alcoholic" or "addict" currently with understanding and empathy, not with disgust or judgment. Then we can express those terms, or any other terms we consider, with dignity respect and curiosity.

The very fact that many of us find the language offensive can actually be stigmatizing to those who may need to identify with these labels at some stage along their journey of recovery. So…don't just change the language, change your mind. Instead of saying "Don't use that word, use this one instead!" - be curious and ask "what does that word mean to you?" That way you invite conversation rather than imposition. That goes for someone like me in recovery and for someone who has no lived experience and misunderstands the language.

Author: Ben Goerner – Ben is a retired counsellor, with-lived experience. He advocates for people with substance or mental illness.

Families Helping Families is an initiative of the Port Alberni Community Action Team. We regularly send out "Learning Moment" articles to help folks understand substance illness. Knowledge is vital in understanding the disorder of our family members. You may copy, distribute or share our articles as long as you retain the attribution. Add yourself to our distribution list by dropping us a note at - albernihelp@gmail.com