International Journal of Mental Health and Addiction

, Volume 12, Issue 4, pp 477–490

‘Finding Your Own Place’: An Interpretative Phenomenological Analysis of Young Men’s Experience of Early Recovery from Addiction

Authors

    • Department of Psychological SciencesBirkbeck University of London
  • Jonathan A. Smith
    • Department of Psychological SciencesBirkbeck University of London
Article

DOI: 10.1007/s11469-014-9479-0

Cite this article as:
Rodriguez, L. & Smith, J.A. Int J Ment Health Addiction (2014) 12: 477. doi:10.1007/s11469-014-9479-0

Abstract

Young adults are significantly more likely to experience problematic substance use than mature adults. Identity transformation is known to be a key feature of mature adult recovery, but for the culturally distinct young adult demographic, the links between their identity and their recovery from addiction have not been well investigated. This paper presents a qualitative study on young men’s experience of recovery in Narcotics Anonymous. Processes of change and identity transformation in early recovery are under particular focus. Semi-structured interviews were conducted with four young adult men and the resultant transcripts were subjected to interpretative phenomenological analysis. The results section gives a detailed account of these processes; the findings are then considered in relation to extant literature. The posited suggestion is that through examining the participants’ experience of recovery we can better understand their self-change in light of their journey as young men; proper understanding of which is essential for the creation of intervention programmes that consider the developmental challenges of early adulthood today.

Keywords

Young adultsEarly recoveryNarcotics anonymousInterpretative phenomenological analysis

Young adulthood is a season of life that imposes great challenges on our relationship with the world. Looming ahead is the establishment of a new life-structure that is both appropriate for the self and socially viable (Levinson 1978). Young adults (approx. 20–35 years) thus face patterns of development that are distinct to those of adolescents (approx. 13–19 years) or mature adults (approx. 36–60 years). Chisholm and Du Bois-Reymond (1993) proposed that the deferment of young people’s engagement with the spheres of work, marriage and family has led to the creation of an open social space in which they can construct their own ‘choice biographies’: interpersonal bonding and consumption practices are mostly predominant in the youth and young adult years (Arnett 2005; Harnett et al. 2000). Drug and alcohol consumption plays a significant role in these groups’ dynamics as they create bonds and relationships with peers; this process develops to construct a sense of identity (Moore and Miles 2004; Room and Sato 2002). Young adults are much more likely than adolescents or mature adults to develop high–risk practices and to experience problematic substance use, but they remain an understudied group in addiction research (Arnett 2005; Finfgeld and Lewis 2002; Mason and Luckey 2003). Many young adults are known to then mature out of problem drinking or drug use as a natural part of their life-course (Sobell et al. 2000); if the personal experience and social resources to support this recovery have not been gained in their earlier life-course, however, more severe addictive behaviours can develop (Hser 2007).

Much empirical research has been focused on recovery’s initiation; this is the period with the highest rate of relapse, and the challenges necessary to change addictive behaviours impose great stress on the individuals concerned (Cunningham et al. 2002; Laudet and White 2008; Marlatt and Witkiewitz 2002). The most common situational context of the initial relapse episode differs between young persons and adults. Most young persons report that the initial relapse occurred in a social context, whilst adults more often report negative intra or interpersonal states (i.e. depression, marital conflict) (Chung and Maisto 2006; Cleveland et al. 2007). The treatment experience becomes a significant point of passage, where youth have reported experiencing high levels of emotional distress whilst making the transition into new social networks (Hedges et al. 2003; Kelly et al. 2008). Another prevailing issue has been that of engaging with the treatment process, as the drop-out rates are higher for young people than they are for adults. Participation in Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) has in recent years been increasingly encouraged and incorporated into major treatment schemes for youth recovery in the UK as the groups are easily accessible and provide flexible after-care support (Gossop 2006). Studies in the US have reported positive outcomes for adolescents and young adults that participate in AA meetings (Chi et al. 2009; Kelly et al. 2008, 2012; Vaughn and Long 1999). Kelly et al. (2008) found in a study on adolescents’ views on AA that participants in the early stages of recovery warmed to the supportive group dynamics and the installation of hope. The attendees who benefited most were those with severe drug involvement (Kelly et al. 2008).

Qualitative research on addiction recovery increasingly shows the wide range of individual, social and cultural contexts beyond the treatment environment that appear to promote and facilitate life-style changes (Neale et al. 2005; Rhodes and Moore 2001). Psychological perspectives on recovery have shown its core issues to be based on identity transformation (Buckingham et al. 2013; Hänninen and Koski-Jännes 1999; Reith and Dobbie 2012); the recovering individual’s social network is seen as crucial to the fostering of narratives that facilitate this identity and life-style change (Cain 1991; McIntosh and McKeganey 2000; Rafalovich 1999). The process of recovery encompasses radical changes in a person’s sense of self that emerge through fluctuations of their affective, linguistic and cognitive structure. Research literature has signalled identity issues in adult recovery (Flores 2004; Kellogg 1993; Smith 1998), but the links between identity and recovery in young adults remain under-studied. Further qualitative research is needed to improve our understanding of the processes of early adulthood that initiate self-change and how this is maintained in early recovery; this can then inform clinical practice guidelines for youth and young adult providers (Kelly and Myers 2007).

This study builds upon the small number of qualitative studies published to date on young adults’ recovery. It examines how young men have worked through the process of early recovery from addiction whilst participating in NA, focusing on the transformations in young men’s identity and sense of self, and how they create for themselves a new life-structure. The study employs interpretative phenomenological analysis (IPA). IPA is considered a particularly relevant method for this study as it aims to examine in detail the personal lived experience of participants and how they make sense of their experience (Smith 2004).

Method

Participants

The participants in this study were four young men who have been using NA as their main recovery programme in London, UK for no more than 1 year. Table 1 presents information about their background and the length of their recovery. They were recruited through ‘snowballing’ and their age ranged from 23 to 30 years. NA local offices were contacted by email to inquire about the feasibility of recruiting participants, via presentation of the study at their meetings. A representative of the organization replied stating that it was suitable to present the study in ‘open meetings’ only, which are meetings open to anyone and not only the members (i.e. the actively recovering addicts) of the fellowship. A listing of their meetings was available on their respective websites. The meetings visited were selected by geographical and time oriented convenience. I proceeded with a 5 min presentation of the study at the beginning of the meeting and left flyers for people to contact me after the meeting if they were interested. The participants were given information about the study and they signed consent forms allowing for the interviews to be recorded. All names and some identifying features have been changed to safeguard their anonymity. The study had the ethical approval of the Department of Psychological Sciences, Birkbeck. All interviews were carried out at Birkbeck.
Table 1

Participant’s ethnic background and length of recovery

Participant

Age

Ethnic background

Length & type of drug abuse

Months in recovery

Tom

23

White

Cannabis, 4 years.

5

Dan

29

White

Crack cocaine & heroin, 8 year

9

Mike

26

White

Cocaine & alcohol, 4 years

11

Arjun

30

Indian

Heroin, 5 years

11

Data Collection and Analysis

Data was collected through semi-structured interviews; the first author was informed by an interview schedule, but participants were encouraged to talk in detail about their experience and particular concerns were probed as important topics arose. The interviews were recorded and transcribed verbatim.

The IPA of the data closely followed the four-stage process described in detail in Smith, Flowers and Larkin (2009). IPA has been developed specifically within psychology and it is committed to idiographic inquiry: each individual’s account is examined in great detail as an entity in its own right before a move to more general claims is made through a narrative analysis that includes detailed extracts from the participants’ transcripts (Smith 2004). Initial notes or comments were added upon close reading of the interview transcript and these were then translated into emergent themes. These were interrogated and connections were made between the themes. This resulted in a table of master themes for each transcript within which were nested sub-themes with supporting quotes from the participant’s account. This process was repeated for each interview transcript, resulting in the four individuals’ tables of themes. The second stage involved looking for patterns and themes across these tables. Once a clear and coherent pattern of themes emerged, they were nested within super-ordinate themes in a group table. An audit of the first author’s analysis was conducted by the second author in order to ensure that the identified themes were clearly evidenced in the participants’ accounts (Smith et al. 2009).

Results

A summary of the main results is given in Fig. 1. Three main themes emerged from the analysis: ‘Challenges of beginning the recovery process’, ‘maintaining recovery’, and ‘changing sense of self’. They described the initial challenges of their recovery process in NA and followed to reflect on how their lifeworld had changed and on the strategies that were helping them to sustain their recovery. All participants referred to a transformation of their sense of identity as their recovery process ensued.
https://static-content.springer.com/image/art%3A10.1007%2Fs11469-014-9479-0/MediaObjects/11469_2014_9479_Fig1_HTML.gif
Fig. 1

Summary of the themes and sub-themes emerging from the participants’ accounts

Challenges of Beginning the Recovery Process

‘But the Other Part of Me’: Ambivalence

All participants made reference to their early days in recovery as a time when their principal concern was to maintain abstinence. Added to this were the challenges of leaving behind their life-style as drug users whilst beginning to learn about NA’s recovery programme. Participants experienced ambivalence towards disclosure when they started to reveal more covert aspects of their life, both to fellows in NA meetings and to old peers of their drug-taking scene, due to an enhanced consciousness of their sense of self in the light of their recovery:

Tom: It is really difficult being in this fellowship’ cause I kind of want to tell everyone…but there are times when I don’t want to tell anyone. But it’s like I want to tell everyone, like I’ve found this way of life and its really great and its really helping me. But the other part of me doesn’t want people to say why do you do that and say’cause I was very f…unhappy.

Mike: If I’m pissed off with my job that kind of stuff or this has happened in my family, personally I don’t do that stuff in meetings. I know I have to share this stuff, but I’m in a meeting to carry a message. I might say do you know what things are really difficult, I’ll share that kind of stuff, but I don’t share that kind of stuff at meetings not the specifics of what’s going on for me.

Sharing, in NA’s terms, constitutes an act of self-disclosure that facilitates an identification process between its members and a shared acknowledgement of each one’s story of drug use. Participants’ ambivalence displays distress over being authentic about their new life-structure, wondering if their new self-presentation will be accepted by others. Mike suggests that he is uneasy about disclosing certain details of his life as he wishes to display himself as congruent to his ‘in recovery’ identity. Participants show great ambivalence and worry around how they would be perceived upon honest disclosure of their stories:

Arjun: My fear is of being judged as someone who is lesser, as someone who is not worthy…it’s other people, my fear is that other people won’t accept me yeah so that often makes me feel that I must be careful about being honest. It’s trusting people that part is still difficult.

‘I’m Really Nothing Like These People’: Conflictive Identification with NA Group

As the participants explored NA’s recovery programme, they were cautious about how people in the meetings would respond if they were to reveal aspects of their drug use and would often not engage actively with the group members. Their ambivalence towards disclosure seems to be related to a conflictive identification with the group:

Mike: [In the early days] I was just sort of floating around different meetings often not sharing what was going on for me.

Dan: I was very suspicious…I knew from the way they were talking, they were, they’d used drugs like me, but they looked so well that I was suspicious…they sort of held eye contact and they spoke politely and they were, and didn’t seem to be full of fear and it was quite overwhelming actually. I remember having sleepless nights just going over the stuff in my head that I’d heard.

Tom: I didn’t like the fact that there were a lot of similarities…They were using hardcore drugs, you know what I mean, I’m from a quite nice middle class background. And that makes me sound really snobby but that’s the truth. You know, I’m nothing like these people. I’m really nothing like these people…but when they were speaking I was kind of hearing what they were saying and didn’t share, I just, I couldn’t open my mouth on that one.

Tom and Dan’s ill-ease upon recognition of their similarities to the people at NA shows that conflict is produced through the process of comparison. In Tom’s case, the other NA attendees appear to reflect essential elements of his identity but he cannot easily correspond with the more severe side of drug-user culture. As the participants gradually start to hear more stories and experiences they can relate to, however, they begin to reinterpret their drug use in light of NA’s discursive framework. More significant identification with NA people then takes place as participants feel acceptance and relational ease whilst disclosing their own experiences. Tom illustrates this process of coming to appreciate his new ‘addict’ identity:

I can go into a room, into the ‘rooms’ and say I’m f… crazy and someone will say it’s alright, I’m f… crazy too…it seems like, from talking to the people that I’ve met in these fellowships, we seem to use substances to solve problems and we can all relate to each other really easily.

Participants enter into a social-relational context where their identity as drug users begins to be displaced, initiating a process of identity change in light of NA’s discourse on ‘addiction as a disease’. This also illustrates a key transformation in participants’ attitudes towards NA. Whilst their approach was initially detached and exploratory, they soon became more thoroughly involved with NA’s recovery programme.

Time in Early Recovery

This theme captures the participants’ subjective experience of time as they build a new life-structure around recovery. During the first days and weeks of abstinence, Mike and Tom experience an enhanced awareness and anxiety in relation to time; also, they do not necessarily know how to reorganize their lives:

Mike: it was important for me to be on the move, definitely in the early days…I had sort of 2 weeks off work, it must have been a month ago I thought fantastic I’ve taken 2 weeks off, and I found it really quite difficult at points just having nothing to do…It’s just for today cause what I’m gonna do is do this college and do that and this, then and once I’ve done all that it’ll be alright you know looking towards the future…that’s really helped me that thing about life’s about a journey not the destination…it’s about experience what I’m experiencing.

Tom: I’m constantly subject to daydreams that I think about like when I’m 50, I can get pills again, when I get everything that I want, but that’s why I think the message is keep it in a day because as I soon as I start thinking it gets all messed up.

Mike introduces NA’s saying ‘just for today’ to explain how he manages his concerns about the future. He emphasizes the importance of the present for him, suggesting that changes in his sense of time help him to make initial steps towards reorganizing his life-structure. Tom portrays how his sense of time and social life was tangled up with his previous life experiences, constituted within a drug user identity. Arjun and Dan show how they organize their time around NA meetings as a coping strategy:

Arjun: I have weekly commitments within the running of the fellowship, the running of the weekly meetings, I take two meetings, I volunteer on NA helpline once for a couple of hours I, if somebody asks me to do a chair say in a meeting I never say no. I try and make sure I don’t have anything else on or I’ll rearrange my life around recovery and NA.

Dan: I try to go to a meeting a day I don’t always these days, but I do about four or five a week and I stay close to my new association.

NA seems to offer a recovery structure that gives the participants a sense of orientation through facilitating daily activities to make use of their time. The meetings also offer a space that smoothes the transition into a new social world without using drugs, promoting the development of new relational bonds that can sustain their identity transformation.

Managing Recovery

This theme conveys the strategies that the participants employ to sustain their recovery. Their coping strategies involve changes in their social and recreational contexts, and also engagement with self-care activities suggested by NA, such as writing and praying.

‘It Gives That Feeling of Belonging’: NA’s Support

Participants assert that feeling supported is a key feature of their recovery. They go on to establish an insightful distinction between the support they receive from family and friends, and the support they receive from NA members:

Mike: The main source of support is the fellowship because as much as family and friends will support me they don’t know what I’m up against, they don’t know about this disease of addiction.

Tom: You get support in the rooms whatever. Like that’s what’s really nice, that it’s unconditional…you’ll not get on with everyone, that’s a natural thing but a lot of the things that you share someone else will have something that they can relate it to, so it feels good, it feels really good when you hear someone saying something and you get him saying thank you for sharing, it feels good when you say it and when someone comes to you and says thank you. It gives that feeling of belonging.

NA’s ‘rooms’, or group meetings, are experienced as a safe environment. The significance of NA’s support is founded on a sense of belonging due to a shared group experience of addiction. Participants portray a relational context where recovering members respond to one another with care, facilitating feelings of unconditional acceptance and trust. This trust within the group dynamics enables the re-appraisal of difficult experiences that are received as a positive contribution to the process of the whole group. NA’s support is also experienced through setting up mentor relationships between new entrants and more experienced recoverers:

Arjun: Damien is the closest friend I have, my sponsor, knows everything that’s going on I don’t need to do that anymore I just need to know that he’s there when I need him it’s so amazing. I don’t actually have to do anything on a kind of continued basis to make sure that the relationship doesn’t go wrong and that’s great that’s freedom, so I used to believe that I had to put energy and footwork into every important relationship in my life.

Arjun’s mentoring relationship gives him a source of motivation and moral encouragement sufficient to sustain his efforts whilst facilitating a rite of passage into a new relational context without using drugs.

‘I Don’t See Any of My Old Friends’: Developing a New Social Network

Participants have to manage feelings of boredom and an enhanced self-consciousness regarding their opportunities to socialize as young people. Now that they are missing out on the drug-infused social scene, they have to develop new friendships:

Mike: I find it a bit difficult, I’m young and everyone’s sort of drinking [and] that kind of stuff, and I sort of think I’m missing out and I feel a bit self-conscious.

Tom: Like to be fair, people in recovery they look good, but all of a sudden and really quite all of the sudden, I don’t see any of my old friends. Like you know what I mean. I see them here and there, I go to the odd party and that but I don’t go and just go on Tuesday into the pub and get drunk. It’s that sort of thing that you kind of, you’re out of the loop…I’m trying to build friendships within the fellowships.

Dan: I have sort of three groups of friends. The ones that drink and take drugs…and I do mind if they are having a drink but take drugs around me they just don’t do that. Now I do other things like go to a gallery, go for coffee, I’ve become a connoisseur of cappuccinos.

Dan seems to be more at ease managing different groups of friends, but also demarcates that part of that balancing act is engaging with other social activities to compensate and create new relational scenarios without drug using. As each participant creates a new social-relational network, however, the difficulties and the intimacy issues of relating without the mask of intoxicants come into focus. Learning how to interact with young people without drugs or alcohol enhances participants’ awareness of the developmental task of young adulthood. The next extract shows Arjun’s struggle to find balance with other interactions within NA:

I’ve had my issues around becoming attracted with, becoming attracted to female members in NA…I did the hard thing, which was to actually stop seeing that person or those persons as much as I was because I realized I was fixing myself on being around them…I was honest about it, look I have to…all of this was brand new.

Self-Care

As participants engage with NA’s recovery activities, such as keeping a diary and praying, they are introduced to practices of self-care. Dan and Tom use writing to gain insight into their drug use:

Dan: Being able to talk about powerlessness and the manageability was very helpful at the start…seeing that stuff written down what happened it’s there…I sat with my sponsor, I’ve read it out and it’s like God that’s not make believe, this is real.

Tom: It is a nice thing to do writing you know, writing just about things, like getting stoned and driving, I did drunk-driving a couple of times. But you know it only takes one accident to f…up and ruin someone else’s life…To write questions like, in what ways have you tried to control your addiction…it’s just not nice to admit those sorts of things, it’s helpful in terms of working the programme, but it’s not, it’s not very pleasant to have to write it down. It brings a lot of stuff.

Writing provides a cognitive appraisal of NA’s concepts in light of their life story, and works towards the participants assimilating the discourse on addiction as a disease. Dan’s expression ‘this is real’ facilitates insight and a sense of acknowledgment necessary to self-disclose. Writing is an act of disclosure that facilitates self-examination; reading it to a sponsor makes this a shared experience. The participants recognize the value of going through this painful but beneficial experience. The importance of gaining self-knowledge and the true worth of disclosing their drug use and drinking stories are both reinforced.

Praying becomes part of their daily routine:

Dan: I went to a cathedral, in fact I got on my knees and I just said a prayer of gratitude and a prayer of thanks and I just said please protect the ones I love from harm and pain…it’s a weird thing I don’t know I used to shudder when I heard other people use a prayer, it’s the experience of that, it’s a beautiful thing really. It’s just getting in touch with a higher conscience…It’s trying to sort of hear the words, speaking out loud the words that are personal and getting them out there, I can’t put it into words really it’s, it carries a power you know.

Mike: The prayer really helps me because it sets me up for the day, the start of the day, it sets me up…it gets me in contact with God.

Praying, as a ritualized deed, enables the participants to prepare a mind-setting for engagement with the world. Praying seems to enhance in the participants a sense of well-being that comes with gratitude, whilst ameliorating feelings of anxiety through the verbalization of suffering.

Changing Sense of Self

Participants’ recovery evolves through significant changes in their sense of self and identity. They ponder on authenticity and satisfaction in their self-identification which is unfolding in accordance with their new social status as young men in recovery.

‘Being Me and Doing What I’m Doing’: Authenticity

Tom: Recovery is like finding your own place in the world and actually being happy with it.

Mike: My experience now is being me and doing what I’m doing it’s enough now…I’ve stopped searching for that thing, if I had enough money or if I had a new girlfriend or if I die I’d be alright now. It’s like I am alright you know that’s what I’ve got you know.

Dan: It’s like when you see a rocket going into the sky and then as it breaks the atmosphere and the bits fall off it and you just see the fuselage…I’ve seen myself change, I’ve seen other people looking at me differently and they’re happy that I’ve changed, there was someone who said to me something, she said you’re growing into yourself.

Participants refer to an experience where finding more ease in being, in the now, facilitates engagement with the world as a joyful experience. Dan’s reference to a rocket communicates a sense of a dramatic and rapid self-transformation, whilst implying that only a fuselage of his previous self can be glimpsed. The changing sense of self is related to or even dependent upon other people’s perception and approval—participants’ self-awareness is reflective of their social world. Tom portrays his self-change as an ongoing process of coming to terms with being authentic through contrasting, different ‘selves’:

Tom: The ideal self is funny, funny, easy going you know pretty cool, pretty switched on, pretty aware. I don’t know…That’s how I can be at times. But I don’t know it’s, all humans are bipolar kind of [laughs]. Like you know…I’d like to be more patient, I’d like to be less judgmental. I’d like to be thinner. Perhaps to be more healthy…But like it’s insane that sometimes I feel all those things anyway and sometimes I don’t know how to describe myself. If you weren’t an addict and I wasn’t an addict and you just asked me to describe myself, I’ll be like, yeah I’m pretty easy going, I love most types of music, you know I don’t drink’cause I don’t like it very much, I’m into opera, I like drum and bass, I like to read a very good book. But it’s like how I am, I’m like f…, insane, neurotic and emotional. I’m, I’m. I don’t know.

He refers to experiencing a self which contains various potentialities of being. In his lived experience of recovery there unfolds a more fluid and normalized sense of self; he then drops into a more fixed identity as an addict to make better sense of the difficult aspects of the self. Similarly, Arjun illustrates a changing sense of self and authenticity through trying to entitle his own existence:

I’m very capable, I have potential, but I’ve got in my own way…I feel like I’m doing it, I felt like I’m standing up for myself, I felt like I’m taking responsibility, I’m looking after me, I’m putting value back in me.

In being committed to caring for himself he is able to express agency, resulting in an enhanced sense of self-worth. Participants’ awareness of the changing nature of their sense of self seems to facilitate hope of further possibilities and a greater sense of ownership over their lives.

Addict Identity

One key feature of the participants’ experience of early recovery is encountering NA’s ‘recovering identity’ and reframing their stories of drug abuse within the discourse of addiction as a disease. Participants enact an addict’s identity in order to understand and explain their struggles:

Tom: I don’t know if I knew that I was an addict or not because that’s something that I’m just finding out.

Mike: I’ve just come to accept that I’m an addict basically, I can’t put any drug inside my body whether be alcohol whatever I’ve got enough experience to tell me what happens when I do that you know it’s just a fact of life.

Dan: Since coming to recovery I realized that I’m an addict, I thought it was just about drugs but still I was drug free and still having addictive tendencies creeping into my life. Just the obsessional behaviour you know it’s so, it helped me to see that I’m an addict.

Participants put on view a temporal trajectory of their identity change. Their identity as drug users has to be displaced and substituted with an addict identity in order to initiate an identification process that facilitates their recovery alongside other recovering people. This identity transformation also seems to be crucial to the process of socialization within NA’s discursive framework and the 12-step principles. Participants’ identity is mediated by NA’s concept of addiction as a disease; this is sustained on the principle that once people are addicts, they will always be addicts. Mike’s addict identity gives him a discursive framework to make sense of the resurgence of his addictive tendencies. This exemplifies the influence of the 12-steps on participants’ sense making process, which situates them in a position where they can explain their addictive behaviour congruently with their recovering status.

Discussion

The participants in this study show conflict in relation to the new sense of self and identity that emerges through early recovery. In participants’ expressions such as “I’m missing out” and “you’re out of the loop” we can see an experience of loss and disorientation within their relational world. As they depart from an identity that has failed them, they are challenged with the creation of an identity that is congruent with their new social world.

Participants experience this identity-ambivalence when they start to reveal more covert aspects of their life, both to fellows in NA meetings and to old peers that belong to the alcohol or drug scene. Recent studies on young adults’ health behaviours suggest that contradictory demands and expectations are related to young people’s common confusion around their sense of identity (Amos et al. 2006; de Visser and Smith 2007). The struggle between the need for sociability and awareness of the negative consequences of risk behaviour is complex but endemic in young adults and their now normalized combined rituals of intoxication and socialization. During the contemplation stage of change, the addict can still ponder the pros and cons of recovery. Miller and Rollnick (2002) contend that ambivalence takes the form of a conflict between two courses of action for the recovering person, each of which has perceived benefits and costs associated with it. When the opportunity for change is embraced, the expression of both sides of the ambivalence impasse can help the individual towards an acceptable resolution, which in turn can help to sustain his or her self-change. Similarly, Harrist (2006) suggests that the challenge faced in experiencing ambivalence is centred on managing emotional distress and internal conflict until a resolution of their conflictive feelings can be reached.

The participants in our study have developed a new way of looking at themselves: as recovering addicts. The transformation of identity that members undergo in 12-step groups has been documented before (Cain 1991; Denzin 1993; Swora 2004), as the group dynamics and activities within the ideological background of the approach provide the materials to support members’ efforts to forge new identity projects (Kellogg 1993; Kelemen et al. 2007; Rafalovich 1999). The relational easiness imbued in NA’s meetings seems to help the participants to envisage new images of themselves and of how they would like to be perceived in a way that fits their status as young adults and men. The programme encourages the development of a relationship with a sponsor, which has been relevant for some participants, as they can forge mentoring relationships that facilitate the practice of new relational settings; these role models can support the work of self-transformation. Indeed the most potent influence of 12-step meetings appears to be found in the social group dynamics, where deeper sharing of previously humiliating emotional spectra is received positively amongst great mutual respect (Kelly et al. 2008). The social changes facilitate stimulus control without the presence of drugs or related cues, facilitating recovering role models and access to local low-risk social activities (Moos 2008; Kelly et al. 2012). Kelly et al. (2008) suggest that continuous reminders, in conjunction with positive abstinence experience and vicarious learning processes, serve to continually re-motivate individuals that are still only just tipping the decisional balance towards recovery. In that realm, 12-step meetings have similar mechanisms to self-help groups and group therapy dynamics; they work to enhance self-efficacy, coping skills and facilitate adaptive social networks, even if they might be transitional for some of the participants (Humphreys et al. 1995; Moos 2008).

Shifts in the experience of time appear to have been widely overlooked in studies of addiction and recovery, though there is evidence of the importance of changes in subjective time when developing a new sense of self (Brown et al. 2001; Reith 1999). Being busy with NA meetings and activities sets the participants’ social time accordingly with their new recovering status, whilst a new sense of temporality is introduced through NA’s maxim ‘just for today’—this acts to shift their sense of subjective time. NA’s philosophy creates a time awareness that systematically changes the relative importance of members’ past-present-future schema, cutting down the manageable time of abstinence into smaller fractions in order to facilitate a focus on the present (Klingemann 2000). According to Melucci (1998), during the event of a disease, disequilibrium between ‘social time’ and ‘inner time’ is generated and the individual’s subjective sense of time is disjointed. Social time is the more linear time of collective events, characterized by the continuity and uniqueness of daily happenings. Inner time, however, is deeply personal and experiential (even if it reflects their social relations). For the participants in this study, their subjective sense of time started to shift its focus, changing its orientation first towards the present and then towards the future; a healthier manipulation of time also helped them to gain perspective on a more fluid understanding of self.

This study shows that ambivalence in the participants is a manifestation of both the ambiguity of identity experienced as part of the process of self-change and the challenges of maintaining a sense of authenticity. Some participants could embrace a sense of having simultaneous social scenes whilst keeping the right balance between different groups of friends; for others, socializing with distinct groups of friends challenged their sense of authenticity. The importance of authenticity has also been noted in adult recovery studies (Koski-Jännes 2002; Larkin and Griffiths 2002; Reith and Dobbie 2012). Recovering individuals can develop more genuine self-expression as they create for themselves a more wholly satisfying life-structure—one that is not limited to social expectations (Koski-Jännes 2002). The issue of authenticity acquires significance in light of the participants’ development as young men. Harter (1998) describes how young people develop false-self behaviours due to inappropriate experiences of validation and acceptance by significant others. In adolescence and early adulthood, issues around the question ‘Who am I?’ are in the fore; some might experience a split between their inner sense of self and their various social identities or ‘masks’, thus experiencing a sense of inauthenticity. Tom’s efforts to try and describe himself vividly illustrate the difficulty of him establishing a cohesive self-understanding.

Most research literature acknowledges identity transformation as a key component of recovery (Biernacki 1986; Denzin 1993; Kellogg 1993; Koski-Jännes 2002; McIntosh and McKeganey 2000). Research shows that the development of a nonuser identity predicts a positive outcome after treatment, whereas the lack of such development predicts relapse (Buckingham et al. 2013; Moos 2008). Biernacki (1986) suggests that the needed identity transformation could take place either by reverting to an old identity, by identity extension, or by developing an emergent identity. A central underlying process in recovery from addictive behaviours is the successful public renegotiation and acceptance of the recovering user’s new, non-stigmatized identity (Biernacki 1986). Koski-Jannes (2002) states that when ceasing to indulge in addictive behaviours one has to acquire a self-schema that is in line with one’s new life-orientation. This initial change in self-schema is then often followed by more far-reaching identity projects that help to make the resolved state more meaningful and rewarding for the individual. For many individuals, addictive behaviours are inseparable from their self-schema and learnt coping mechanisms; giving up these behavioural strategies poses profound identity issues for them to solve.

Conclusion

This study presents an in-depth look at young men’s experience of early recovery as they engage with NA’s recovery programme. Although exploratory, this qualitative inquiry, with the use of IPA as a methodological approach, enhances our understanding of the nuances and complexities inherent in the participants’ recovery journey. Changes in the participants’ relational context, ambivalence, and identity are illustrated as key issues. The outstanding therapeutic element for the participants was the social compensation the meetings could offer them as their previous life structure collapsed in the early days of recovery. NA’s recovery activities provide them with practices of self-care to develop insight into their addiction, whilst also functioning as a cognitive reminder of their commitment to recovery. The study illustrates how authenticity is a significant issue for the participants as part of their identity transformation and psychosocial development as young adult men. Findings also suggest that the ability to manage ambivalence when working through a rapidly changing sense of identity in early recovery is crucial to maintaining abstinence.

The sample in this study is small, limiting the scope for more general claims to be made of the findings. Young men willing to participate in this study seem to have active roles within their fellowships, thus, they might have emphasized more positive features of their recovering experience in NA. Similarly, given that the participants’ focus was on maintaining their abstinence, it cannot be concluded that they will continue to participate in NA once other issues of recovery become more prominent for them. Qualitative studies with larger samples and different groups of young adults (i.e. gender, different lengths of recovery and/or recovery stage) participating in 12-step fellowships are recommended. Given the centrality of shifting identity in participants’ recovery, it would be opportune to conduct longitudinal studies that follow specific cohorts of recovering young adults to further examine their identity change in light of their progress. Further research is also called for on how young people manage NA’s addict identity in the context of the rest of their lives and whether their recovering identity will endure as the years pass by.

Copyright information

© Springer Science+Business Media New York 2014