A Fresh Look at the Topic of “Recovery Orphans”

Back in 2021 I wrote a post consisting of four separate essays, each approaching the topic of “Recovery Orphans” from a different perspective.

I coined the term “Recovery Orphan” some years ago after struggling with various events I’ve witnessed across the decades of my career. And while struggling to make sense of various things concerning people being “in recovery” or “not in recovery” as they or others claim.

Below I provide a list of simple realities that can help us inventory our work and perhaps strive to do better. For each item on the list, I also share a bit of my thinking. We might be better off carrying the questions these present, rather than being so sure of our answers.

Being Discounted Improperly. I’ve seen this happen when a person seems to be in very, very rough shape and perhaps even doing their worst. And yet, on the inside, the person has just had or is having, their best moment of clarity in years and years. In moments like that, a distant, judgemental, burned out, reflexive, or otherwise incorrect person claims that person “isn’t” or “can’t” be in recovery. Aside from the accuracy or inaccuracy of the statement, the person being talked about can sense the denigration and retreats, perhaps back into their illness with years of life lost as a result. To me, such a person is an example of a “Recovery Orphan”. They were just starting their recovery, and were orphaned, so to speak, by “helpers”.
Being Affirmed Improperly. The inverse of the above example also happens. In this scenario the person has been doing wonderfully. They are looking and acting great for years, with sustained sobriety. But no one knows they are at the height of their false self, and frankly hiding significant pain. The person does not share vulnerably, nor does anyone in their fellowship circle or in any other meaningful relationship with them really check on them or bring accountability. The person is struggling in the worst way, doing worse and worse over time – and no one knows. This person may be lost to suicide, or return to use with years of functional life lost. To me, this is another example of a “Recovery Orphan”. They were appearing to be in recovery, but were in fact orphaned, so to speak, by their “helpers” or fellowship partners who didn’t even know.
Before “Pre-Contemplation”. In the Stages of Change model “Pre-Contemplation” is the first stage of change. And it’s the stage where the person is fully in the problem, is okay with their situation, and doesn’t even realize they have a problem. But to me, this is an artificial starting point. I wonder what comes before Pre-Contemplation. To me, by not looking at what happens before Pre-Contemplation we might be creating Recovery Orphans. Could it be that the person is undergoing a process of closure? Does that present the reality of an earlier phase than Pre-Contemplation? If so, does that present us with an opportunity? If we meet someone who seems to be closing off, should addiction professionals advise them to “do more research”, or can we do better than that? Do we ignore and orphan people who are before Pre-Contemplation?
After “Maintenance”. Similarly, the Stages of Change model ends with “Maintenance” – the continuation of doing well. Some will point out that the Stages of Change model actually ends in “Relapse”. But to me, both “Maintenance” and “Relapse” are artificial end points. By contrast with maintenance and relapse, I wonder what else may occur? During maintenance, can a false self start to creep in and dominate their well-being? Can they begin a long, slow process of closure? Have we seen some people start to orphan them self, seemingly on purpose, from their recovery and their support system? Relationally? Functionally? Or both? Do we ignore people who are after Maintenance?
“I’m in recovery when I say I’m in recovery”. TRUE OR FALSE? To me, we can Orphan the person with either answer. We can make a mistake no matter which answer we give. First of all, each person is one whole person, so their illness and their recovery are only parts of them. Secondly, no one has access to the whole interior of anyone else, and no one can see their entire self correctly and fully as it is. Either way we reply, are we mistaken about their claim? Can we entirely discount their “pre-recovery” beginning when they are at their worst? Can we support their claim when it’s their disease making the statement inaccurately? Either way, how would we know for sure for us to be “right”? And do we accurately consider the results of our statements? Or do we unknowingly help bring about a Recovery Orphan by the way we reply – either way we reply?
Data, or experience? Pick one. Another way I’m concerned we can bring about Recovery Orphans or contribute to their formation is by artificially splitting the objective and subjective from each other. And then trying to force one of those to be “better” than the other. For us to know if we should accept the claim that someone is in recovery, should we rely more on objective facts or their subjective personal experience? To me, splitting these two sources apart is artificial. And both should be preserved and considered. The person is a whole person. Do we orphan some people by only considering one of these sources of information, and not the other?
What is “No Recovery”? Sometimes I’m concerned that we miss the obvious thing that we should tackle first. Sometimes I want us to define “No Recovery” first. Sometimes I think defining “No Recovery” first might be a clearer starting point to then assess gradients of recovery. When we don’t have a clear “No Recovery” concept, we might fall into any kind of error and not even realize it. (By the way, if we do define recovery, who have we orphaned?) Clinicians are familiar with the term “Diagnostic Orphan”. That’s someone who falls short of the sufficient minimum number of criteria to be diagnosed with a disorder, but who does have some criteria rather than none at all. I’m concerned that relative to recovery, without a defined zero point, we orphan some people and don’t even realize we’re doing so. In this scenario, we’re asking a question, and yet have no scale or tool or method to make the determination. When that’s the case, what might the impact be? Years of life lost to a continuing struggle? Or worse? Or are they just orphaned?
Zooming out too far, or in too close. If we take the 60,000 foot view, so to speak, we might see general improvement. Do we stop there, assume we’re correct, move along, and leave the person vulnerable as a Recovery Orphan? On the other hand, if we take a super-detailed and up-close view like a microscope, aren’t we likely to see flaws, errors, problems, and empty spaces? If so, do we conclude that’s all there is to the person and their so-called “recovery”? And do we entirely discount them and their claim based on our method? Sometimes I wonder what the sweet spot of perspective is or should be. Or if all perspectives should be put to use and a composite view assembled before we make up our mind. In the meanwhile, does our limited vantage point help us to lead ourself astray and set the stage for the person to be Orphaned?