Getting Wrapped Up In Labels

We spend an inordinate amount of time and effort talking about what we're going to call the people we interact with. "Patient" and "Client" have been deemed too clinical and we're not supposed to be clinical. We're trying "Recoveree" and "Participant" on for size, but it's a little too inaccurate and imprecise for my taste. Many people I've dealt with find it silly. We're caught in the uncomfortable position of awkwardly using one term when speaking among ourselves and then reverting to "patients" or "clients" when interacting with clinicians and doctors. They're not my patients for reasons that should be obvious nor are they my clients as this is not a financial transaction. Participant? Not all of them. At least not always willing and maybe not yet. Recoveree? By whose definition and by what standard? Where on the spectrum of desire and abstinence should they fall to merit that label?

Personally, I refer to them as "people" or more commonly "my peeps." That seems to pretty much cover it. And when I talk about "those people" to clinicians and doctors, I refer to them by their name.

I recently received an email addressing a movie title using the "J" word. The apparent horrid, offensive, and taboo "J" word. It came on the heels of a hyperbolic tweet by a self proclaimed voice of the community admonishing the title. The author of the subsequent email suggested that words like "alcoholic" and "addict" should also be eradicated from our vocabulary. How about "sober?" Should we get rid of that too? It's defined in a variety of ways and has been the topic of many heated debates about what exactly constitutes sobriety, being sober, and who among us has the right call ourselves sober. It's brandished as a prize and used as an insult -- a gauge of success and failure depending on its use and tone.

There's a 14th century definition of "Sober" that I came across a while ago that has nothing to do with inebriation, drinking, or drug use, but it's the definition I shoot for. By that definition, comparatively speaking, maybe I am. There's even a t-shirt.  

Click to see shirt on redbubble

Back in the day, labels like "queer" and "Suffragette" were pejorative and deeply hurtful. They were used as a means of attack. In response, the targets of those attacks embraced those labels, made them theirs and used them as a giant eff you to the haters.

As Katy Steinmetz of "Time" writes in a terrific piece:

"So instead of ignoring it, many women decided to reclaim a word that their opponents tried to use to insult them, much like the LGBT community has adopted queer, Democrats have embraced Obamacare and women now proudly rap about being bad bitches. Their success is partly evident in the fact that, over time, people have forgotten the controversial connotations of the word, using it to describe any supporter of women’s suffrage in any country. The word has become much more generalized in memory."

That history should not be forgotten or ignored.

In an article, "Why Words Die,"  from the March 2017 publication of the Economist, the author postulates that many words lose their place in the lexicon due to lack of use, their having only regional appeal, and it could be said, lost historical significance. "The smaller and more local a word, the more danger it faces of dying out."

The word "junkie', much like the word "sober" doesn't have its roots in drugs, drug use, or drug users. It doesn't refer to people being compared to junk nor to junk being shot up, snorted, or sniffed. The term was coined in the early 1900s, around the time of the Great Depression, referring to people (there's that word again) who collected scrap metal and other waste for cash. Initially to feed their families and later, in the case of Opium, Morphine, and Heroin users, to feed to their habit - the name stuck.

Let's face it, when it comes to the "J" word, Hunter Thompson would never have written, "You never see a person with a substance use disorder smile, you never see a person with a substance use disorder laugh, the gig is too serious."

It's not the same sentiment, It's not the same tone. It doesn't evoke the same feeling. It doesn't force the reader to feel the level of compassion required to get through that sentence. Thompson's original quote requires you to care about another human being's suffering and know the weight of their desperation no matter who you think they are. The simple yet denigrating and pitiful tone says it all. It says it all because words do matter. And depending on how they're used have the power to move and maybe change people.

As it happens, while we spend an inordinate amount of time and effort talking about what we're going to call the people we interact with, it turns out that a majority of those people don't care what we call them. Thanks to a just-published study by Dr. John Kelly and colleagues of the Recovery Research Institute, there is compelling data to address that and related issues.

William White writes in his recent blog post about these findings, noting:

People who had resolved an AOD (alcohol and other drug) problem who never saw or presently do not see themselves “in recovery” offered several reasons for not embracing a recovery identity: 1) self-perceived lower problem severity, 2) self-perceived ability to function in spite of AOD problems, 3) ability to stop AOD use without peer or professional help or, for some, success in decelerating use to escape AOD-related problems, 4) seeing AOD problem resolution as a past chapter of their life—a past decision—and not a present struggle, and 5) a desire to avoid the “sickness” label.

Of equal importance, quality of life indicators did not differ across the three groups (current recovery identity, rejection of recovery identity, once embraced but now reject recovery identity). It turns out it doesn't matter what label you use, people are going to keep peopling.

The fascination with -- and time we waste talking about -- the words we use and how we label, relabel, and unlabel people, not to mention the contortions we perform to avoid terminology that we deem offensive, while the people we're presumably protecting from those words not only don't care, but find the conversation silly makes it all seem like a wasted effort. An effort that would be better spent doing what we presumably do best: helping people who are suffering be reduced to a quiet condition (sober). 

Here's William White's post