The lexicon of recovery is thick with vocabulary that is robust and visceral and evokes strong responses in people. One of those words that are common in recovery circles is the word relapse. In professional circles, the term relapse is used to describe a return to drinking or drug use following a period of abstinence by those who have a history of problems with alcohol and drugs.
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Some in the field of addiction, especially those in recovery advocacy, have made contention that the language in the addiction, treatment and recovery areas needs to be changed. Those in favor of changing the “language” argue that words like relapse are rooted in moral and religious frameworks and not medical frameworks. Because these kinds of words are rooted in moral and religious contexts, advocates feel that stigmatization has been perpetuated over time.
The Argument for Changing the Language of Relapse
In an article published on the Faces and Voices of Recovery website in 2010, William L. White and Sade Ali make the argument of how the current language of addiction–especially concerning the terms lapse and relapse—is outmoded and perpetuates stigmatization. As stated earlier, lapse and relapse are seen as having religious and moral roots.
As White and Ali state in the article, these words imply a moral failing and a neglect of one’s personal and/or social responsibilities. With a lapse and relapse, there is a return of bad habits and a deviation from accepted standards as a result of a lapse in judgment. In the realm of alcohol and drug abuse, the lapse/relapse verbiage emerged during the temperance movement. Backsliding into addiction was seen in public view as being deceitful and of low moral character.
Those who were drug free were seen as being clean, thus being good, innocent and righteous. On the other hand, those who relapsed were seen as dirty, or being tainted and immoral. As White and Ali state, the moral connections associated with other illnesses such as cancer, tuberculosis and schizophrenia slowly lost its strong bond as the origination and course of these disorders became more clearly understood.
Gauging the use of Lapse/Relapse Terminology
By using internet search engines, White and Ali compared the frequency of the use of lapse/relapse terminology in addiction-related disorders. For comparison, the authors also used search engines to gauge frequency of lapse/relapse terminology in regards to diseases (such as cancer, diabetes, etc.) The authors found that the frequency of lapse/relapse terminology was applied with more frequency to addiction related disorders (especially alcoholism). In regards to other chronic disorders, it was noted that the frequency of that terminology was not as prevalent. According to the authors, that was due to the fact that the lapse/relapse usage was being replaced by more medically precise terminology.
Furthermore, it was argued that the use of lapse/relapse terminology in the field of drug and alcohol addiction suffers from definitions that are vague and implies that people may think of outcomes in terms of either complete success or complete failure with no thresholds or continuum to gauge pathology. The use of these terms, as stated before, were seen to perpetuate stigmatization and may further the concept of the self-fulfilling prophecy in those who struggle with drug and alcohol issues.
The Move to a More Neutral Recovery Language
Ultimately, the authors suggest moving towards a more morally neutral language. This new recovery language would have to work on personal, family, professional and societal levels without distortions or shifts in meaning. Terms that are created would capture the essence of what is addiction entails for the individual, family and other support structures. This move to a more neutral language, as suggested by White and Ali, would meet multiple criteria.
First, it would help individuals, families and other support structures understand that relapse and recovery is a process and not so much as an event that has moral baggage embedded in its meaning. Secondly, it should encourage individuals to assume personal responsibility. Also, this new language should reflect understanding of other factors such as family and the social environment as well as reflect the fact that use, abuse, and recovery lie on a continuum rather than absolutes.
Even though a move towards a more neutral language to describe and understand drug and alcohol use and recovery would help in removing long seated stigmas, the issues lie on the broader level. While addiction is being seen through disease paradigms as well as social and environmental contexts, the perceptions and definitions of what people perceive still have strong moral roots. In order for the language to effectively change, the perceptions must change at the macro level.
For those who are in recovery, those experiences while in the throes of addiction are very real no matter how long and fruitful the clean time. The language of recovery needs to be real in addition to reflecting more neutral terms. White and Ali stated in the article that people need to use and language and frame their experience they can easily understand. Being “real” and upfront with those experiences and the accompanying language is a solid first step in creating a new recovery vocabulary.
Tim Powers—bald, tattooed, business professional by day and rocker by night. Sober since the 8th of May in the year of our Lord 2003. Sharing my stories and myself in order to pay it forward. Follow me on Twitter @tpowersbass42