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[ Staff Picks ] [ Opinion ]

Who Helps The Helpers?

Born with the genetic predisposition to addiction, coupled with an ADHD diagnosis and an overarching defiant nature, I was headed for a seat in a Twelve Step meeting, long before I knew what one was. I always knew that I would end up in the helping profession from the time I was a child, but also knew that I could not help anyone else until I helped myself. Fast forwarding past addiction to the good life, I am now clean and sober, and have graduated with a master’s degree in social work. I have been working in the field of addictions for the past six years, and have been attending NA meetings for the past ten years.

Working in the recovery world, in many different capacities, has been rewarding as well as disheartening. In the midst of the opiate epidemic that is affecting our community at astounding rates, I am beginning to see treatment providers and NA groups as a whole, filled to capacity. A part of me is overcome with joy when I see a client that I helped at one point in time sitting in a seat of a meeting “sharing and caring the NA way.” Another part of me feels a sense of fear that my own recovery status will be exploited, or that I am engaging in what the National Association of Social Worker’s Code of Ethics could consider a “dual relationship.” The NASW states, “Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. (Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.)”

My NA home group was a place that I could go to see my friends in recovery every Sunday, take a chairing commitment, and share about my personal dilemmas, achievements, and struggles in my recovery journey. Throughout my career in the field of addictions and my educational pursuits, I have overcome many personal obstacles. Recently, I decided to end a tumultuous relationship with a fellow addict that was toxic for me, and I reached a crippling level of professional and personal burnout, which translated into somatization, and eventually multiple medical ailments including autoimmune disorders and cervical cancer. Through all of these issues, I have not felt safe enough to share such personal issues on the floor of any local NA meetings or my home group, but had a few trustworthy supports in my corner. My NA home group has been infiltrated by the enemy- a former client from years past. A part of me is sincerely happy for him that he has managed to get off of a methadone maintenance program, and seems to have a much brighter demeanor and outlook than when I first met him. The other part of me feels essentially ostracized from the group, unable to share anything personal, and did not feel it was ethically “correct” to even receive my annual NA coin due to his attendance.

This is not the first occurrence of seeing former or current clients in NA meetings, and I have begun to feel a sense that they are equally as uncomfortable as I am sharing or participating. My professional duties have included working for the child welfare system and testifying as an expert drug and alcohol witness, as well as working with the probation department. I have managed to separate my professional duties, and what I hear in meetings, even though the two often intertwine. What is shared in meetings is to remain anonymous, even if it potentially conflicts with my duty to report, and is helpful knowledge to the court system or child welfare system. When fellow addicts run up to me outside of an NA meeting inquiring about their child welfare case or probation issue, I quietly grow more resentful, and spout out my generic response that the conversation is inappropriate for me to engage in, and places me in a poor position. This translates into mental turmoil for me, as a clinician and an addict in recovery. I’ve been in meetings where I have felt unsafe due to a previous testimony on behalf of the court system against a fellow addict that resulted in their children placed in state care. I have sat in silence when “old-timers” have collected their multiple year key tag, with knowledge that they have recently relapsed and entered into treatment. What was a simple program for complicated people, is now a complicated program for an even more complicated and conflicted person.

When contacting the ethics board with general questions regarding my role as an addictions professional intermingling with my role as an addict in recovery, the response from multiple committee members was as follows:

“This has been a theme and concern through the ages. I have known recovering therapists who have been asked to do their lead as they have had much success in recovery and their stories have been inspiring. I think that if the recovering clinician is comfortable with sharing their lead and current or previous clients may be in the audience, this would be acceptable. But also knowing that when the lead is done, they keep healthy boundaries in conversations after the meeting. But if the recovering clinician needs to be able to share to seek help, support or guidance at a meeting, they may want to seek a meeting without clients or work on this with their sponsor. I think that there are times recovering clinicians are not able to escape seeing a current or past client at a meeting, but how they handle conversations and discussion becomes the focus. They are not there to counsel.

I think that for those “new” in recovery and also “new” in the field find it is very difficult to maintain professional boundaries in and outside of a 12-step program and their work place. It is a conflict of interest especially if you are employed as a CRS or CPS. Through trial and error, they often learn what is best when it comes to self-disclosure even if it happens in an anonymous program. Although recovery is personal and one must take responsibility for it, in most cases, only those with substantial clean time, substantial work history and really good work ethics are able to maintain professional boundaries, if they go to the same meetings clients go to (if they go at all). It is a real slippery slope that most recovering people dare not go down. At the end of the day, although personal recovery and employment are equally important (with recovery being THE most important because it allows for employment), meetings are everywhere and that is why it is suggested to get a sponsor and build a support network because some feel that everything isn’t for group level anyway. As it pertains to the Code of Ethic: Is sharing at a 12 step meeting a “dual relationship”? Is what happens after what is shared at a 12 step meeting a “dual relationship” and what happens will be the sole responsibility of the professional who made the decision to disclose at a 12 step meeting. For the professional who does share at meeting where clients may attend, it is important for them to question their motives for the disclosure, as they would do in a professional setting. If they answer honestly, they probably would not use the meetings to get what they need because they would realize that there are better, safer and more appropriate avenues they could take that would keep them clean, but more importantly, keep them employed. What is safe? Find another meeting, turn down a commitment and leave THOSE meetings for the clients.”

I have learned that not only do my clients see me in a professional capacity, but other addicts are starting to attempt to utilize me as a case worker, therapist, psychiatrist, activist, legal counsel, or interventionist. The overwhelming and constant “need” from other addicts (without reciprocation) has left me with a sense of feeling used, pigeonholed into a role, (rather than being seen as a fellow addict), and resentful. I now unfortunately view a lot of NA members at meetings as habitual and professional con artists that have given new meaning to the term “learned helplessness.” An old co-worker cynically termed the local meetings to be “an echo-chamber of chronic victimhood, shared toxicity, and denial.” My sponsor had begun to utilize me as a crisis hotline, and rationalized her behavior by stating two of the old NA adages, “the therapeutic value of one addict helping another” and “sponsorship is a two-way street.”

Unfortunately, I am left with the unanswered question of “who helps the helpers?” For this helper, I am learning to revert back to my toddler days of saying “no” when I feel a sense of being taken advantage of, or when a resentment is more than likely to form. I have received a lot of backlash from members, and my close peer group has abandoned me since I left the chairs of NA and moved my program to AA and other resources. I’ve been told that the problem is me, I lack humility, I need to focus on my own problems, and I’m focusing on the differences rather than the similarities. I guess I struggle to see many similarities besides the commonality that we shared a once crippling addiction to substances. Perhaps I’m growing intolerant of their intolerance?