DISCLOSURE; YOUR STORY YOUR CHOICE?

SELF-DISCLOSURE: YOUR STORY, YOUR CHOICE?

 

“A bold but necessary move, self-disclosure

is a first step toward successfully addressing

the stigma associated with being mentally ill. 

Before we can reveal ourselves to others, we

have to come out of our own dark closets.”

Steele and Berman, 2001

 

This document  represents a first step toward a vocational psychology, (the application of psychological principles to the problems of vocational choice, selection, and training), of Recovery Champions that involves the direct and positive identity development of service users and ex service users,  and that is considered within the larger framework of service users career development.  First, the benefits of disclosure and acceptance to empower identity development needs to be reviewed, followed by a discussion of the vocational issues of (ex) service users and recovery champions  as related both to identity development and to the literature in the vocational psychology of those individuals. This work should then conclude with suggestions for research and practice.

The whole face of recovery from addiction is changing and the benefits of involving and empowering individuals who have ‘walked the walk’  is becoming recognised as one of the most powerful and effective tools in the treatment and support of those who are starting or are on similar journeys of recovery. The power of identification between individuals has long been recognised as a solid foundation between groups of likeminded people who are all striving to achieve the same goal, in this case, to inspire and empower each other towards an improved quality of life. If you are going to find a mentor in any aspect of life, you want one that has experience which is evidence based and preferably tried and tested, giving depth and weight to their suggestion.  I’m not taking the power out of the work done by any trained professional and believe that there are workers out there that excel in what they do, I have the pleasure of knowing numerous individuals who despite the current state of the drug sector have not lost sight of the individuals they have in their care, neither am I saying that in order to effectively deliver a meaningful message you must first have lived the story you are telling, what I am saying is that if you have, and have come out the other side, what better advocacy could there be that recovery is possible than someone who has been to the same places you have, experienced the same pain, emptiness and isolation that you have and has managed to turn their life around. Inspirational and empowering without a word being said sometimes.

  The National drug strategy 2010 ‘Reducing Demand, Restricting Supply, Building recovery: Supporting People to live a drug free life’ has put a key focus on recovery, which is ambitious in it’s aspirations. The key elements that are being worked towards are….

  1. Freedom from independence on drugs and alcohol.
  2. A reduction in crime and re-offending.
  3. Sustained employment.
  4. The ability to access and sustain suitable accommodation.
  5. Improvement in mental and physical health and wellbeing.
  6. Improved relationships with family members, partners and friends.
  7. The capacity to be an effective and caring parent.

Speaking as an individual in recovery, I have seen myself and others around me improve most of the above aspects of their lives by becoming involved in the altruistic recovery movement that has been growing among us for a number of years, but whose benefits have not been recognised due to the traditions which would have those involved remain anonymous for their own protection and for the protection of those that they would support in the vulnerable first stages of their journey that make up the majority of some of those groups.

I’m not saying that most have achieved the perfect lifestyle, nor am I that ignorant to believe that most strive for that perfection. What I am saying is that they are moving towards achieving the aspirations above. And those who I see doing it and living it are surrounded by likeminded people who support and empower each other by sharing their experiences, both positive and negative with each other, open-mindedly, honestly and with each others welfare at the heart of everything they do. They are not driven by greed, financial gain, statistics, policies or the need to impress. They are driven by a desire to promote unity between a group of otherwise culturally and socially isolated individuals who have a  desire to change. The benefits of this and other similar groups or movements are sadly not recognised for their full potential due to them being carried out in groups which, as already stated , tradition keeps behind closed doors in church halls or community centres or other such anonymous delightful places. Recently though this concept has changed and there are more and more people out there taking this to the next level and making their recovery visible. Expanding from the dark dingy halls and backrooms to the streets where their message can be heard by anyone and everyone. From this there is emerging a renewed interest in recovery and the potential for change.

Part of this movement includes recovery champions, which was encouraged in the drug strategy as a way of building communities and support networks outside of structured treatment services. Although Recovery Champion is a term that is in my opinion not ideal, almost creating a hierarchy image in my head within a movement that sees all its members as equal and individual, the concept behind the title is exciting and has the potential to reach out to those within our communities in a way that can do nothing but promote, support and empower individuals towards all the above aspects set out in the drug strategy. One of the common dilemma’s that is becoming apparent within this new movement is that some of the Champions are becoming employed with in the sector and clashing, if you like, with the policies around self disclosure in the workplace. Although I recognise the need for self disclosure policies, both for the safety of professionals and those under their care. I feel that this could, in effect take the power out of the whole recovery champion concept which has it’s roots firmly based in self disclosure and unity. Disclosure or transparency is one of the most powerful aspects that is advocated for within the recovery movement and is one of the most inspirational tools available to those who have no hope in the early stages of their journey, hearing someone else’s journey, both the positive and the negative, can install hope in the individual who at that given time has given up all hope. They say that hope is the currency for the person who has nothing else to bargain with, which my personal experience tells me is true. So any way of replacing that feeling of hopelessness with a glimmer of hope is something that I would most definitely advocate for fully.

To address the current issues surrounding disclosure and non-disclosure I feel that both sides of the coin need to be looked at in a sort of cost benefit type analysis. So firstly I’m going to look at the positive aspects.

  1. The transparency that is supported by the Recovery Champion movement is altruistic in nature and is based on the therapeutic value of one addict talking to another.
  2. The need for advocacy and support  which is based on an evidence based therapeutic model that has worked through mutual aid fellowships since 1935 has never been matched in it’s outcomes.
  3. A realistic approach to the issues that surround those living with addiction and it’s surrounding issues based on life experiences is unparalleled in it’s ability to inspire and empower.
  4. There is something comforting and reassuring about talking to someone who you know has lived through the same things that you are currently struggling to cope with, it gives hope and inspiration.
  5. It makes recovery seem achievable and realistic to hear that someone who’s path was similar to your own has come out the other side and is managing to maintain a sustainable level of manageability in their live.
  6. It helps to over come the initial fears that come with such a huge change of lifestyle just knowing that it is possible. And hence, may inspire the individual to take risks and try new things that have been proven to bring about positive change.
  7. It promotes self esteem, self worth and a sense of belonging or unity between those embarking on the journey together, whatever the relationship between the two.
  8. Gives a better and more comprehensive understanding of the possible tasks  ahead and the reality of the hardships that may be faced while at the same time promoting that it is indeed possible.
  9. Gives an unlimited level of support via both personal experience and gives another perspective on the issues at hand.
  10. Self disclosure addresses stigma at both a personal and professional level and promotes feeling of being a part of rather apart from.

The stigma associated with addiction is one of the most persistent problems individuals face. It is fundamental to discrimination in housing, employment, and insurance. It prevents treatment, and it impedes recovery.

Research on addressing discrimination and stigma has shown that individuals’ attitudes improve when they have direct contact with persons who have been through the same or similar issues in the past and when they can get to know people beyond labels and myths. Labels also including, but not exclusive to those within their support network or care pathway.

For contact strategies—that is, getting to know people living with addiction personally— to work, individuals need to self-disclose or identify that they have received support and guidance through their own problematic periods during their lives and through accessing specific services were given a first footing on the journey of recovery. This must also be clearly stated as being a small but significant part of their journey and only the beginning. Self-disclosure has advantages such as not having to worry about hiding experiences and hence being overwhelmed with feelings of shame and guilt , finding others with similar experiences, and helping others understand addiction  issues, which may even promote one’s own recovery process.

Self-disclosure may also have risks. A person must make a number of considerations when deciding whether to disclose. These might include personal considerations such as how well one feels he or she can handle maintaining a secret, confidentiality, anonymity,  prior experience or discrimination an individual or colleagues have experienced, or one’s sense of self-esteem. Considerations involving potential or actual employers, and the societal climate at the time one is considering disclosure, might enter into the decision process. The overall decision, once all of these aspects have been considered should lie firmly with the individual who is disclosing., being respectful of those who may be affected by disclosure.  A number of individuals who are professionals in the drug field have themselves received support from services. These professionals have offered a variety of strategies about disclosing in general and disclosing to consumers with whom they work. One such professional offered, “I’ve asked many of my patients what it has meant for them to know about my history, and there is one consistent and resounding refrain: HOPE!” If a person feels that the therapist has made progress with his or her own addiction issues, disclosure by the recovery worker may be beneficial to the consumers. A number of individuals not associated professionally with the drug field also have written about their disclosure experiences. Much of the literature indicates that disclosing to others about one’s own recovery is positive, although difficult.

Many people find disclosing their substance use history or other illnesses or personal situations gratifying, beneficial to their own recoveries, and often helpful to others. It appears that the more open one can be and the more people disclose, the more possible it is to overcome discrimination and stigma in the greater society.

Recommendations

1.  Services should support  workshops, meetings, and seminars to address self-disclosure in further examining the pros and cons to disclosure and offering a dialogue for other consumers to hear how and when individuals have disclosed.

2.  On the basis of these findings, Services should develop guidelines on self-disclosure that will inform persons with substance issues about the pros and cons of disclosure. the guidelines should help individuals learn how and when to disclose in a way that is comfortable and beneficial within employment, social, family, and other arenas.

3.  Once these guidelines have been established, educational programs should be supported to further understand the significance of contact strategies on reducing discrimination and stigma. educational programs should be peer led and peer driven with the goal to encourage and teach individuals how and when to disclose appropriately.

4.  Professional and provider groups should join with peer and family advocates in developing strategies for individuals with or who have had substance misuse issues to self-disclose.

5.  Resource site should be put together in some way shape or form to address Discrimination and Stigma. And this information should offer Web site information and training in disclosure.

6.  Other similar organizations should promote dialogues on the topic of self-disclosure. these dialogues will provide vital information to individuals receiving or delivering substance misuse services who are contemplating or preparing to self-disclose and support to those who have already done so.

  Some benefits of disclosure open to discussion  include….

■ Not having to worry about hiding personal  experiences and being more open about day-to-day affairs and ways of dealing with those affairs.

■ Finding others who express approval, including those with similar experiences and sharing ‘best practice ‘ around techniques used to enhance recovery.

■ Finding someone who can provide assistance and guidance in the future, a mutual bond.

■ Promoting a sense of personal power and acting as living testimony against stigma and discrimination.

 

  Some costs discussed include….

■ Encountering disapproval of history or current status or your disclosure, including the risks of social ostracism and gossip.

■ Being discriminated against in employment, housing, and other opportunities.

■ Having increased anxiety due to perceptions that people are thinking about you or pitying you.

■ Thinking that future relapses may be more stressful because others will be “watching”

■ Experiencing anger from family members, colleagues and others because you self-disclosed.

Corrigan and Lundin,  Mental health proffesionals, discuss two levels of disclosure: selective and what they call indiscriminate disclosure. Selective disclosure refers to choosing who specifically to tell about your experiences and when to tell. Indiscriminate disclosure, requires a change of attitude by the person who no longer conceals their experiences in general. They suggest that  “you have successfully changed your attitude about disclosure when talking about mental illness no longer evokes a sense of hesitancy or shame’’

“It freed me from the burden of having to hide

a part of me, and it freed me from the shame

that comes from  feeling as though you have

to hide and keep secret the illness.”

—interviewee response

 

 

 

 “Another benefit of disclosure is that it promotes

one’s recovery process by allowing one to

form or join a self-help group and begin the

relationships and conversations needed to

reconstruct one’s self-image in a positive light.

the more open one can be, the more possible

it is to overcome stigma and discrimination in

the greater society.”

—Daniel fisher, m.D.

Self-Disclosure in Employment

A strategic analysis is important for a person receiving support services when making a disclosure decision, some considerations may be useful in the strategic analysis:

A.  Personal Considerations

■ How well you feel you can handle prejudice and discrimination

■ Prior experience or discrimination that you or colleagues experienced

■ Your sense of self

■ Your employment history

■ How well you feel you can handle maintaining a secret—and sometimes having to lie to do so

■ Sense of disability pride or identity

■ Other identity issues—including race, gender, culture, and age.

 

B.  Considerations Involving a Potential or Actual Employer

■ Type of business (e.g., whether prejudice is more or less likely)

■ Size of employer (e.g., large company vs. small mom and pop business)

■ Whether there are other persons with similar issues, historic or current,  employed there

■ Whether it appears the employer has adequately accommodated similar individuals.

■ Whether staff or supervisors make positive or negative comments about people with issues in general, including those with psychiatric disabilities.

■ How competitive the employment position is

■ How competitive the profession is

■ How much expertise you bring to a particular job

■ Whether the particular accommodation request will be seen as problematic or as matter-of-fact

■ Whether staff and supervisors seem to be friendly to one another and to you and open minded enough to address the issues surrounding your disclosure, supporting you to address stigma.

C.  Societal Issues

At the time you are considering disclosure

■ Has there been anything in the news or the media that might result in a period of increased prejudice or support your disclosure?

■ Has there been anything in the news or arts that might result in a period of decreased prejudice?

If and when you decide to disclose, taking into account the above considerations, an individual should determine how specific to be about the topic of disclosure and should provide additional information accordingly:

■ Be very general: deferring from euphoric recall and war stories.

■ Be a little more specific: when discussing the solution.

■ Give an exact and direct outcome when closing down the conversation.

Be aware that….

You cannot avoid abandonment by a judgmental person, but you can decide to

share less with those people who may appear judgmental.

You should educate yourself about your condition so that you can educate others

as needed.

the most important thing to remember is that you are in control of how much you tell;

do not let anyone manipulate you into sharing more than you feel comfortable sharing. 

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