In a break from the traditional blogging style, I recount my experience in residential addiction treatment, Spring 2017. I witnessed a number of different types of discrimination: racism, sexism, homophobia, and ableism during my time. It had been a long time since I’d been out of my bubble where overt discrimination is rare, even on my Twitter timeline (because I very carefully curate.) It was a real wake up call. I wanted to share some of the things I observed as they relate to the concepts and theoretical frames of whiteness, model minority stereotypes, and addiction treatment. This is written in the academic style, but hopefully still accessible and with limited jargon.
In 2017 I checked myself into a small residential addition rehabilitation center in the Blue Ridge Mountains of North Georgia. I observed micro and macro aggressions that exemplified the white racial frame written about by Rosalind Chou and Joe Feagin extensively.
The pressures on Asian Americans to assimilate by US dominant culture, including damage to psychological welfare to those trying to navigate that whiteness as a protective measure, were apparent in many interactions between white residents and anyone coded as Asian by white clients. Treatment spaces are overwhelmingly white, upper middle class, and male. Of only two Asian American residents there during my tenure, one was particularly and repeatedly pressured to assimilate as discussed in The Myth of the Model Minority (Chou and Feagin 2015: Ch. 5).
Chou and Feagin (2015:142) write that individuals of color are repeatedly made to bear ridicule, humiliation and exclusion. I met J. my third week. His mother and father looked worn out and scared like other loved ones who brings their children, parents, siblings, or friends to rehab.
“Javi” was the nickname imposed on him by the white men who seemed to have “trouble” pronouncing his name. His second or third day he began to attempt finding a place in this closed community. The name “problem” was a persistent obstacle to his assimilation and an unacknowledged tool of exclusion used by the other men to remind him he was “other.”
Referencing Sue (2007), Jennifer Gonzales (2014) writes about the lasting impact repeated mispronunciation could have on students of color…or anyone of any age who has a name not coded as “white”. While white America has no problem with Galifianakis, somehow a man’s name with five letters is too difficult to pronounce for both credentialed professionals at a mental health facility and the clients in their care.
Gonzales (2014) has a category for both the professionals and the clients who gave the nickname. “Arrogant manglers” who continue on with their mispronunciations after repeated corrections, and “nicknamers” who just don’t care enough about another human being to say their name correctly. This is due to the implicit belief that the person is less than human and therefore their name is of little importance. Each of these categories were evident as “Javi” had his name repeatedly mangled for at least his first week. (I continue to reference this pseudo-nickname in the interest of anonymity.)
J. made multiple attempts and strategies to gain entry into this white space. He “excelled” at rehab (a condition, also nicknamed, known as “making an A in rehab”). He never missed meetings or groups, always had a cigarette to share, played corn-hole with all comers, and made conversation with the worst offenders. When overt racism was apparent, he laughed it off. This is explained in an interview with Lara in the The Myth of the Model Minority. “Ignoring the issues and always just trying to be better than the people around me so…they didn’t have anything over me” (Chou and Feagin 2015:145). It’s impossible for me to know if J.’s attempts were propelled by a need to do “better than” in a facility that caters to those outside the boundaries of social acceptability, or if he was just trying to survive, or both. Regardless, the outcome was the same.
Naturally, overt bullying was also a strategic tool used. During large group meetings it was common for clients to respond to the head count with silly or inappropriate answers. Several young white men began to say “Allah Akbar” — nevermind that none of these men had confirmation of J.’s religious beliefs or recognized that he wasn’t Middle Eastern. I assumed the reason they chose that particular phrase was to the adjacency to the US public’s understanding of terrorism. I am certain they lacked and understanding of the diversity and magnitude of the Muslim population. There was no care to discern whether or not J. was Christian, Hindi, or a non-believer in any faith. These outbursts were often followed by garbled versions of another Arabic phrase to further associate any person assumed to be from Persia, the Middle East, India, Pakistan, or Afghanistan with terrorism.
“Rocking the boat” was not an option for J. (Chou and Feagin 2015:169). In a total institution these same men were his roommates, his small group therapy members, and his companions for games, outings, and social smoking rituals; speaking up was not available to him. Not if he expected to finish the program.
At one point he or possibly another client did complain. The rumor mill began to grind immediately. “Someone” was “offended” and “they were just joking”. While the offensive responses to roll call stopped, the same phrases continued, even escalated in the “free” spaces. These spaces are incredibly important where clients create intimate relationships. Close relationships with at least one other person is usually a necessary component of success. In other words, exclusion can quite literally prevent a person from maintaining sobriety and from gaining full use of the tools provided therein. This is another example of how racism impacts health and healthcare outcomes.
SImilar to Coates’s (2015) discussion of the ways Black Americans have limited bodily autonomy, J. repeatedly endured restrictions, in the back and front stages, on his person. This was evident when it came to his dietary needs-his autonomy over what went into that body. This is an example of exclusion, othering, and unrealistic expectations (Chou and Feagin 2015:142). Clients and staff believed that J. should put his faith-based dietary needs on hold in order to accommodate the facility. If he did not meet this expectation, he could assume backlash.
On a Saturday while an outdoor activity was held, I read on the couch in the common space. A male admissions staff member was speaking loudly to the nursing team. He was complaining about religion and having to respect the beliefs of others. “Just because you believe in some Big Sky Fairy shouldn’t mean that we have to accommodate your food!”
There was only one resident who required dietary accommodations for religious reasons.
When I mentioned his volume and others, including clients, would be able to hear, the response was one of categorical disinterest. After a very short discussion on appropriateness and professional behavior, I was told that I was “taking this too seriously.” A later conversation with the head of the clinical team ended with a clear instance of rescuing whites. The admissions professional didn’t “mean to offend me” (Bracey 2011). He completely missed the point that it wasn’t me who was owed an apology or, more pressing, a change in practice. Whiteness, my whiteness, was the important factor. I was talked to, humored, and placated. No meaningful conversation about race, religion, and bodily autonomy in a supposed spiritually grounded program was ever considered.
The instances of racism I observed in five weeks really began with the problem of the total lack of racial and ethnic diversity. Neither the clientele nor the staff demographics were in any way inclusive. I saw only four people of color during my stay. The only other Asian resident, a Vietnamese woman, suffered similar racism as J., but coped differently. She utilized her woman-ness to create connections with other women and separated herself from younger clients, who were more likely to overtly target her.
Still, slurs like “slant eyes” were heard numerous times. It was suggested that it would be helpful to have people on staff with a more broad understanding of inequality and social factors that intersect with addiction. These were brushed aside in favor of a “what have you done to escalate conflict” gaslighting response. This was another disheartening example of how racism works in both the medical and mental health institutions, and how therapy can often do more harm than good for those outside the dominant class.
Substance use disorders affect almost 20 million Americans. It has huge costs to family, friendships, financial stability, and mental health outcomes. Systemic racism in healthcare is just one of many ways this country fails its citizens. We must address oppression in all arenas of care or we continue to exacerbate the very problems we seek to solve.
Book suggestion for further reading not cited here: Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present By Harriet A. Washington. Published 2007, Anchor Books
Bracey, Glenn. 2011. “Rescuing Whites: White Privileging Discourse in Race Critical Scholarship” Paper presented at the annual meeting of the American Sociological Association Annual Meeting, Caesar’s Palace, Las Vegas, NV, Aug 19. http://citation.allacademic.com/meta/p506887_index.html Retrieved January 11, 2017.
Coates, Ta-Nehisi. 2015. Between the World and Me. New York: Spiegel & Grau
Chou, Rosalind and Joe R. Feagin. 2015. The Myth of the Model Minority. New York: Routledge.
Gonzales, Jennifer. 2014. “How We Pronounce Student Names, and Why it Matters.” Cult of Personality. https://www.cultofpedagogy.com/gift-of-pronunciation/ Retrieved April 6, 2017.