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Anonymity As a Way of Managing Stigma: The Case of Narcotics Anonymous

posted by:Catarina Frois // 08:47 AM // April 19, 2006 // ID TRAIL MIX

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I would like to take this opportunity to talk a little about the use of anonymity as a way of managing stigma, specifically in the case of the association known as Narcotics Anonymous. The saying “once a Junkie, always a junkie” used by NA members, is closely related to three ideas that I presently address: stigma, anonymity and addiction. Narcotics Anonymous are a non-professional self-help association conceived for individuals with drug-related problems. They follow a model known as the 12-Step program, consisting so many stages or principles which individuals must follow if they are to successfully engage in a process of abstinence from drugs instilling on members a “life philosophy” that will be useful to them in all the areas of life.

The oldest register I found for Narcotics Anonymous in Portugal, dates back to 1983: the first group was started in Lisbon, and today, according to the data made available by the association’s portuguese website, there are 164 groups distributed throughout the country. The research included here relates specifically to a nine month period of participant observation in two groups of the Lisbon area. Each of these groups had an average of 20 members, with ages ranging from 25 to 45, an with a ratio of 60% men to 40% women.

Members in this association describe themselves as “addicts”, that is, people suffering from an illness called addiction, which is not merely a dependency of toxic substances and alcohol but a disease with underlying behavioral problems of which obsessive-compulsive and self destructive behavior are symptoms. The 1st Step, which states: indicates that they believe that abstinence is only possible when someone is ready on one hand, to acknowledge that they are powerless toward their use, and on the other hand, that they can recognize themselves as addicts.

Therapy is based mainly on the exchange of common experiences among participants during the course of reunions arranged for this purpose – the meetings. This event lasts approximately 90 minutes, during which those who have gathered there speak of their drug-related problems, past and present. As an association made up exclusively of people afflicted by the same problem, not by professionals, they act on the conviction that “the therapeutic value offered by one addict to another is irreplaceable” and thus members experience what they call “identification” free of judgment and prejudice. Everyone present admits having lost control of their lives due to drugs and their need to seek a solution for this problem through the sharing of their experience.

If initially persons seeking help think of themselves as failures, as “bad” people with no principles, as soon as they get acquainted with NA philosophy and with other people sharing the same problem, they realize that they were not responsible for their behavior under the influence of drugs. They are no longer junkies; they are people with a disease. At this point there is a whole transformation in the way members define themselves ant their relationship with others. This starts in the first moment a person introduces him/herself in a meeting stating his/her first name and acknowledging their situation: “Hello my name is Pedro and I am an addict”.

The idea of illness is to some extent, a way of denying responsibility for past actions and releasing a burden of shame and guilt which everyone points as those feelings which were prevalent when they first joined this association. According to NA philosophy, drug abuse and addiction are in fact two different concepts. For NA members drug abuse refers to a person who is still actively using toxics substances and who may or may not be an addict, since addiction implies an illness that is more than just a question of drug use. An addict’s obsessive compulsive behavior reveals itself in different area of a person’s life, such as his work, relationships, etc.

A drug abuser is a junkie, someone who society rejects and condemns. It has an immediate negative connotation. An addict on the other hand, is a sick person who has no responsibility over his conduct “under the influence” but who has a responsibility to keep cleat of that influence. How does this distinction relate to stigma and anonymity? Erving Goffman (1963) speaks of stigma as a condition of difference and distinguishes two types of stigmatized persons: the “discredited” and the “discreditable”. The discredited is someone bearing a visible stigma, which is evident at first glance and which, according to this author, has an immediate influence on the way interaction occurs.

This is the case, for example, of someone with a visible physical deformity, or of the junkie wee see begging on the sidewalk. The second type, the stigmatized discreditable, will be someone who has a stigma which is not immediately visible to others, and which will only become “discredited” from the moment he reveals his condition to others. This is the case of an “addict” attending to NA.

To NA members a recovering addict will only reveal without restraint his/her stigma within a meeting: outside the group he will omit his/her problem, including his/her membership. This is where anonymity, the last idea mentioned in the opening paragraph, plays its role.

Anonymity is one of the rules of this association and it is observed both within meetings and outside of them, as a way of protecting the legal identity of individuals. As such, within one meeting members identify themselves merely as addicts, concealing all other identifying elements – family name, address, profession, etc. – and outside the meetings members will keep their membership, as well as other’s anonymous. Revealing their membership to non-members is tantamount to revealing their stigma.

The decision to do this is referred to as “breaking anonymity”; in other words, revealing their identity as someone who has had a drug-related problem makes their stigma visible to others, exposes them to judgments made on the basis of this information. This brings us back to the difference between drug abuse and addiction. NA members share the idea that other people view drug users as “criminals”, as untrustworthy people who are capable of acting in bad faith and incapable of change; “Once a junkie, always a junkie”. Because of the weight this stigma bears on the image of drug users, as soon as someone breaks their anonymity and reveal themselves as somebody with a drug problem, they will immediately be identified by others as a “junkie”.

Anonymity is therefore a choice, a useful instrument for managing stigma. In such a context, a person is free to choose what is revealed, and who it is revealed to. Thus, anonymity is a kind of empowerment for those who use it.

Catarina Frois is a PhD student in Anthropology at the Institute of Social Sciences, Lisbon University, Portugal.

Comments

Annonimity is defintly a choice, but im here to tell you im a proud member of na and its first meeting was held in Van Nuys,Ca. what that program has done for my life is irreplacable. and so na is a part of me but your correct i will not tell my place of employment for fear of loosing my job. thank you for your research

Posted by: valerie at May 25, 2006 03:40 AM

Anonymity is something that most people in na cant adhere to. Unfortunately their mentality is stuck as high schoolers and my boyfriend (who has been in na for about 15 years) always jokes that if you want something spread around just tell someone in na and ask them to keep quiet about it and it will spread like wildfire. He's even tested this out by telling one person something that he will know that no one else will be aware of, and someone will most assuredly approach him to question him about the info that they heard... You cannot have an organization run by drug addicts wholely and expect it to run cleanly. na has no graduation, in 10 years if you go back to the same spot you will most likely see a lot of the same people, living the same life... na gives them the security that they don't have to look for a job, or go to school, and na should come first before family... na is their family. Their true family has to come second as long as they're in na, which will be for the rest of their lives... no matter how long they are clean... don't forget "hello my name is @@@%%%% and I'm an addict... say that every day of your life... and you will come to believe that you can never leave na and lead a normal life in society. The truly healthy people that go to na are the ones that get on with their life, have a healthy respect for the drugs, but also realize how unhealthy na is and move on once they don't need it as a crutch in their life the ones that see how unhealthy na can be. Ok, I'm off my soapbox for the night, can you tell I've seen too much...

Posted by: Sydney at May 29, 2006 11:05 PM

Interesting view of the use of Anonymity by NA and other 12-step programs. I personally view it from the perspective of the Traditions of NA. Specifically, 11 and 12(see below). Addicts by nature are self-centered and struggle to remain spiritually based on a daily basis meet our responsibilities head on. Therefore gaining the freedom from active addiction. By using personal names and stories, ego and 'who is better than,' not to mention who gets the royalties for ads, etc are avoided.

Another point that I wish to make is that your research has left an impression that addicts are not responsible for their actions under the influence of drugs/alcohol, you failed to follow this up with the basic premise of the program, which is to take responsibility back from the disease through a process called the 12-steps. By doing this, an addict is introduced to a power greater than themselves and their addiction. This kind and loving power has the ability to provide strength, guidance during times where life is hardest. The spiritual princples guide addicts to a better, more productive way of life that helps to heal the 'stigma' as you refer to.

11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.

12. Anonymity is the spiritual foundation of all our Traditions, ever reminding us to place principles before personalities.

Posted by: Stefunni at June 20, 2006 04:46 PM

I am an addict who is just starting his recovery back to a normal life. I am glad to hear from Sydney the comment about being a NA lifer. My goal is to forget the ugliness of my past drug life and make amends by returning to the person I was before my addiction. To me nothing would make me happier than to see someone escape from the horrors of addiction and put their life back together. When I mention about my desire to leave NA after completing my recovery, NA members come down on me saying that it isn't possible. I say, what good is it to constantly remind ourselves of a time in our life we would'nt wish on our worst enemy. The meetings I attend have people who have been clean for 10 to 20 years and they still go to almost daily meetings. They act as though if they miss a meeting that they will be back using in a second. I beleive they continue their addictions to meetings to replace their drug addictions. It is great that they bring their wisdom and through sharing help others in the process of recovery. But to me, constantly reminding myself of my abuse puts me in a depressed state of mind which triggers my abuse. One differance I have noticed is that I have never had to attend a rehab. program either by force or by choice. The members I listen to at NA all seem to "speak" the same language learned at institutions of recovery. They all brag about their years clean, but I sense a sadness they convey when bringing up past abuse that seems to me to be counterproductive to moving on to a better way to live. Please pray for recovery and thanks for letting me share something I would'nt be able to comfortably share at a meeting.

Posted by: DJ at December 22, 2006 03:28 PM

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