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One of the benefits of being located within the field of philosophy, theology and religious studies is that one develops an especial appreciation of the arts of critique. “A critique”, Foucault suggested, “does not consist in saying that things aren’t good the way they are. It consists in seeing on just what type of assumptions, of familiar notions, of established and unexamined ways of thinking the accepted practices are based”.
Insofar as recovery scrutinises professional and popular assumptions, received knowledge, and the various material practices of “treatment”, it can be regarded as a multivalent social critique of extant modes of provision – an attempt to to ‘disrupt the taken-for-grantedness of the present and to show how things could be different’.1
With a penetrating appraisal, “recovery” discloses the stagnant politics of prevailing institutional practices. Recovery reveals the correlated discursive production of myriad addict identities. Recovery challenges the hegemony of expert knowledge, strips naked a finely arrayed body of truth-claims and lays bare its emaciated, desiccated physique.
Above all, recovery resists. Recovery resists the powers of domination and subjugation that produce governable order out of ungovernable chaos – the forces that regulate disorderly misuses of pleasure and mold, shape and transform the most unproductive members of the population into compliant and docile bodies.2
Those entering drug treatment programmes are subjected to potent disciplinary biopower mediated by miscellaneous institutional actors and framed within the logic of harm reduction and risk management – from rigourously controlled substitute prescribing regimes where subjects become “violently, physically disciplined – if not fully controlled – by manipulations in their dosage levels”, 3 to the surveillance of drug consumption through NDTMS/ TOPS monitoring, to the use of cognitive behavioural therapies (CBT) as a “psycho-social intervention” to foster neoliberal ideals of productive self-efficacy and personal responsibility.
In the UK, although harm reduction initiatives emerged locally as a site of resistance against the dominant ideologies of the time, they rapidly became subsumed by the apparatuses of government. This was largely due to the consonance between harm reduction and the preventative approach of public health, the HIV/ AIDS crisis of the eighties, and the emergence of post-welfare, neo-liberal economics which shifted the burden of responsibility for being a healthy, autonomous citizen from the State to the individual.
As a consequence of this institutionalisation, many proponents of harm reduction became assimilated into the very system of power they were trying to overcome.4 For those exploring the ideological horizons beyond harm reduction it’s vital to acknowledge and learn from this historical point.
The mental health recovery movement has retained an authentic grass-roots spirit of resistance whilst simultaneously informing policy and engaging in expert discourse. Similarly, the success of AA/ NA can be attributed in part to the organisational consistency (codified in the “12 traditions”) which insists upon complete independence from all statutory/ voluntary services and organisations. One doesn’t have to become institutionally anonymous to engage in an ongoing project of reflective practice – however, one should always be able to step back and critique one’s position. This is especially true for those recovery activists currently shaping and forming the field. Failure to resist administrative assimilation means we’ll simply replace one regime of institutional truth with another: a net gain of zero.
Stephen Bamber, March 10th, 2010
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- A. Petersen & R. Bunton, Foucault, Health and Medicine, Routledge, London, 1997, pp. 3-4. ↩
- According to Foucault, a docile body “is one that may be subjected, used, transformed, and improved… and that this docile body can only be achieved through strict regiment of disciplinary acts”. ↩
- Phillipe Bourgois, “Disciplining addictions: The bio-politics of methadone and heroin in the United States”, Culture, Medicine, and Psychiatry, 24, 2000, p. 183 (pp. 165-195). ↩
- See Brent L. Pickett, “Foucault and the Politics of Resistance”, Polity, Volume XXVIII, Number 4, 1996, p. 447 (pp. 445-466). ↩
{ 14 comments… read them below or add one }
Great blog Stephen. Issues of ‘assimilation’ lay heavily on my mind at the moment and I find myself constantly reflecting on my ‘position’ within newly emerging networks. Feeling a little uncomfortable I think, but on the whole, I think it’s healthy! Thanks again. Recovery resists. I do like that.
Thank you Alistair – you’re most welcome.
Yes – feeling uncomfortable is not *necessarily* a bad thing….
I think in your position, and the fact that you are already reflecting on these issues is a good sign re. the success of your endeavours. Getting the balance of these things has to be a natural process too. After all, a glass of muddy water needs time for the sediment to settle down and the water to become crystal clear…
Take care,
- S.
I find myself agreeing with all of that except that it is like liberation theology – a radical left interpretation of what is essentially a right wing ideology. Recovery is promoted by the most reactionary politicians in the UK – why? because it is cheap self-help which actually poses no threat to the existing social order. It is conservative with all sizes of ‘C’.
What does it mean to say that your aim is abstinence when you live in a street where deprivation is so great no one is abstinent from prescribed medication, alcohol or illicit drugs for any extended period of their adult lives? What does it do to stigmatise people who use drugs as a reaction to their scial condition.
The challenge for recovery is ‘recovery to what?’ – to the existing social conditions? Taking mind and mood altering substances is a rational reaction to some personal and social situations.
Hi Jack,
Great response – thank you. Your raise some important issues – some of the elephants in the recovery drawing room, so to speak. I’m planning on writing more on this in the near future – so watch this space.
Firstly, its very difficult to parse down the multitude of interests involved in the emerging recovery movement in the UK.
Yes, there is a (big “P”) Political element – and it’s disingenuous or naive to suggest there isn’t. Then there’s the bureaucratic element. We also have local politics, careerism, internecine conflicts, institutional self-interest, personal self-interest, economic interests…
I disagree it’s necessarily a party-political phenomenon: both the Cons. and Labour have embraced neoliberalism, and therefore have a fundamental interest in reforming economically unproductive bodies.
So yes – for many – recovery is synonymous with social reintegration: what people “recover to”. Don’t forget – Problem Drug Users [PDU's] and Prolific and Priority Offenders [PPO's] are perceived as a chronic drain on the UK’s fiscal resources. So there will always be a significant bureaucratic impetus to tackle this. “Recovery” ticks enough boxes for it to be swiftly embraced by the administration and opposition. More so for the latter, perhaps, as they can afford a more vocal rhetoric.
For me, the most interesting and exciting developments in recovery occur on the ground – the institutionally anonymous grass-roots movements. Mental health recovery movements are gloriously diverse and retain, as I mentioned in the piece, that ethos of resistance and a commitment to authentically acting in the interests of their members. I also find the notion of communities being transformed from the ground up a compelling one.
Thanks again,
- S.
@Jack — I can remember, many, many years ago now, mentioning that I was contemplating coming off my methadone script to a senior probation officer. His response to me was, ‘What would you want to do something like that for?’ My answer: ‘So that I can have a salary and a standard of living like yours!’
Traditionally, I think that Harm Reductionists have self-identified as leftist/radicals and people/services with an abstinence focus have tended to be identified as conservative/reactionary. Back in the 80′s, this made some sense because at the time, almost all services had an abstinence focus and there was very little in terms of choice. People fighting for access to opioid substitution therapy/needle exchange were actually fighting for increased choice, not for the inherent superiority of one treatment over another. The people on the other side were anti-choice — and that remains the same today, as people like McKeganny and Gingell argue for the imposition of time limits on treatment, etc.
The problem, as ever in drug treatment, is that so many people are unable to view the problem from outside of the grid of their own experience. I think that the other thing we’re seeing at the moment is a grab for increased resources on the part of the conservative faction.
Here in Sefton, we’re witnessing the emergence of a recovery community that *is* genuinely diverse and includes people at all stages of their drug using career. It looks very different to other localities, where they are dominated by people who are abstinent, often through 12 step fellowships, and the needs of those who most need the support of a community are the very people who are denied that support. But the model that we’re adopting probably won’t find quite so much support with the ideologues of recovery and their insistance that unless you’re working the steps, that your recovery is somehow inauthentic or excessively fragile, and so you need to get yourself to a meeting and do some praying before the devil reinvokes your spiritual malady.
mcdermott – I think it’s incredibly helpful to be reminded that:
“People fighting for access to opioid substitution therapy/needle exchange were actually fighting for increased choice, not for the inherent superiority of one treatment over another.”
When you frame recovery discussions in terms of “choice” (and also “quality of service”), it’s remarkable how much common ground suddenly appears….
- S.
Thanks mcdermott.
The issue for me is about choice and having a range of services and supports. We can look to Scotland and we can see the possible future of services down here – ‘recovery focus’ simply interpreted as treatment conditional on a plan for abstinence, time limits on treatment and people being moved off programmes so that new people can be inducted onto them to meet waiting list targets.
Your initial comment reminds me of that joke by Doug Stanhope (from memory):
“If you want to win the war on drugs, then attack all those that make my life so miserable that I want to escape from it”.
- S.
I think what’s been written highlights for me the big need to engage in ‘Recovery’ irrespective of political positions. As has been noted, vested interests will bend it to their agenda and attempt to claim ‘Recovery’ as theirs. I don’t think it is about left or right, it’s about power. If you start from the principle that each individual should be supported in defining their own recovery you open up a huge diversity of pathways.
If we leave this to the ‘Right’ they will inevitably frame ‘Recovery’ as abstinence and continued stigmatisation of those who sit outside of prescribed ‘norms’. ‘Recovery’ for many others however will be (is) about the generation of ‘Recovery/Social Capital through community empowerment and liberation from institutional oppression. Both ‘left’ and ‘right’ share a tendency to shape language to their ‘reality’. I might be stretching it, and perhaps it’s a tendency of mine, but I believe that ‘Recovery’ (and there are problems with the word as identified early on by Larry Davidson from the US mental health Recovery Movement) has the potential to challenge ‘right’ and ‘left’ authoritarian paradigms. Which is all very well and nice to debate, but speaking as a someone who was a worker and senior manager within drug services and as someone who has self-defined themselves as ‘Recovering’ from a mental health condition what draws me to the Recovery Movement is its hope and idealism. Maybe I prefer ‘participative transformation’ as a term. I’m not going to leave ‘Recovery’ to authoritarians wherever they sit on the political spectrum or within established groups. Time for a change I think.
Can one ‘regime of truth’ ever be preferable to another? If so, on what grounds? For example, if one regime implies punitive prohibition and its replacement institutionalizes harm reduction, then the net gain is not zero. It is likely to be seen in the saving of millions of pounds and innumerable freedoms with a reduction in imprisonment, as well as in the prevention of thousands of unnecessary deaths and infections. The absence of any disciplinary control may be ideal. But given a choice between the iron fist and the velvet glove, I know where my preference lies. Then (to extend this Gramscian metaphor to breaking point), the problem becomes – first – how to separate fist from glove and –second – how to eventually free ourselves from the disciplinary hand of the state. This throws us back, as some of your comments have suggested, to the problem of how to change social norms and support solidarity. We are not going to achieve this by suggesting, as many Foucauldians do, that all claims to knowledge and all ‘regimes of truth’ are equally to be resisted.
It’s not so much the state that concerns me but the pervasive, penetrating forces of the free market. For bureaucrats – this is what recovery is all about: transforming economically unproductive citizens into productive ones. This is one answer to Jack’s question – “recover to what?”
The political interest in recovery stems from the fact despite the huge investment in drug services, we haven’t been particularly good at facilitating that transformation.
I suspect we’ll be seeing increasing freedom from the hand of the state over the next few years, Alex. I further expect that most of us won’t find that freedom especially palatable when it eventually happens. As Jack says, Scotland provides a fairly convincing model of the dystopian future that potentially awaits us.
“I’m not going to leave ‘Recovery’ to authoritarians wherever they sit on the political spectrum or within established groups. Time for a change I think.”
I’d find your protestations more convincing, Alistair, if I didn’t see so many in the Recovery Movement making common cause with most reactionary forces of the Conservative Party at the moment. If I didn’t see some of the most vocal representatives of that movement making kissy face with people who are proposing some of the most reactionary drug policies I’ve witnessed in my lifetime.
I hear talk about change, but what I see is the same sort of self-interested pursuit of power and resources that has always characterised this field.
But I’d love to be proved wrong.
I would imagine the ardour between elements of the recovery movement and the “reactionary forces of the Conservative Party” has cooled somewhat now the outcome of the general election is no longer as clear cut as it appeared 6-9 months ago.
I can see where you are coming from McDermott and indeed there’s a lot of “Kissy face” going on. However I’d question how many in the Recovery Movement are doing it. Of course a lot of the big treatment lot are ‘at it’ as will be quite a few of the NTA/DAT/ADP people and those within institutionally embedded ‘established’ groups. I guess I’m suggesting that there is a movement growing, made up of people who have not in the past been “vocal representatives” (just have a look at Wired In) and certainly the slowly emerging UK Recovery Federation (plug for its conference on the 7th of May!) is looking to do something new, i.e. build from the ground up. I’ve been bruised and battered a wee bit in the past and a year or so ago might have expressed exactly the same sentiments as you. But I’m clinging to one of the central foundation stones of ‘Recovery’; hope and optimism, and I suppose aiming, as part of a new social movement, to prove you wrong.
“We make the path by walking it”
Take care.