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“Secrets keep you sick”: Metalinguistic labor in a drug treatment program for homeless women

Published online by Cambridge University Press:  13 October 2006

E. SUMMERSON CARR
Affiliation:
University of Chicago, School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60615, [email protected]

Abstract

This article demonstrates how cultural ideologies of language, and the semiotic processes that mobilize them, manifest in contemporary American drug treatment. Drawing from an ethnographic study of an outpatient program in the Midwestern United States, it focuses on therapists' claims about what constitutes “healthy language.” It is argued that these claims both stem from and actively reproduce an “ideology of inner reference,” which presumes that “healthy” language refers to preexisting phenomena, and that the phenomena to which it refers are internal to speakers. By formally discouraging talk that could point outside the parameters of the individual psyche, the treatment program effectively insulates itself from clients' critiques and challenges. A broad attempt is made to elucidate the connection between a language ideology that enjoys wide cultural circulation as well as significant currency in contemporary clinical practice, and a particular political effect called “institutional insulation.”My thanks to Barbara Johnstone and two anonymous reviewers for their insightful, critical comments on an earlier version of this article. I am especially grateful to James Wilce for his keen advice on how to refine central elements of the argument and his guidance toward relevant, fruitful literature. The following people contributed significantly to the essay's development (though its remaining flaws are very much my own): Giorgio Bertellini, Webb Keane, Daniel Listoe, Beth Reed, Douglas Rogers, Michael Sosin, and Sarah Womack. I'd also like to thank the University of Chicago Anthropology Department, Center for Gender Studies, Committee on Human Development, and School of Social Service Administration for opportunities to present (and rethink) earlier versions. The research reported here was conducted with the support of a training fellowship from the National Institute of Mental Health and various grants from the Department of Anthropology, the Institute for Research on Women and Gender, the Program in Women's Studies, Rackham Graduate School, and the School of Social Work, all at the University of Michigan. This essay is for “Lila.”

Type
Research Article
Copyright
© 2006 Cambridge University Press

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References

REFERENCES

Anderson, Kathryn, & Jack, Dana (1991). Learning to listen: Interview techniques and analyses. In Sherna Gluck & Daphne Patai (eds.), Women's words: The feminist practice of oral history, 1126. New York: Routledge.
Baker, Phyllis (2000). “I didn't know”: Discoveries and identity transformation of women addicts in treatment. Journal of Drug Issues 30:863880.Google Scholar
Bateson, Gregory (1971). Steps to an ecology of mind. New York: Pantheon.
Bauman, Richard, & Briggs, Charles (2003). Voices of modernity: Language ideologies and the politics of inequality. New York: Cambridge University Press.
Benveniste, Émile (1971). Problems in general linguistics. Coral Gables, FL: University of Miami Press.
Berenson, David (1991). Powerlessness – liberating or enslaving?: Responding to the feminist critique of the Twelve Steps. In Claudia Bepko (ed.), Feminism and addiction, 6782. New York: Haworth.
Biernacki, Peter (1986). Pathways from heroin addiction: Recovery without treatment. Philadelphia: Temple University Press.
Borden, William (1992). Narrative perspectives in psychosocial intervention following adverse life events. Social Work 37:135141.Google Scholar
Bourdieu, Pierre (1991). Language and symbolic power. Cambridge, MA: Harvard University Press.
Brandes, Stanley (2002). Staying sober in Mexico City. Austin: University of Texas Press.
Bruner, Jerome (1990). Acts of meaning. Cambridge, MA: Harvard University Press.
Cain, Carol (1991). Personal stories: Identity acquisition and self-understanding in Alcoholics Anonymous. Ethos 19:210253.Google Scholar
Capps, Lisa, & Ochs, Elinor (1995). Constructing panic: The discourse of agoraphobia. Cambridge, MA: Harvard University Press.
Carr, E. Summerson (n.d.). Signing sins and the confessional iconicity: The terrain of reference in the performance of truth. Ms.
Carr E. Summerson (in preparation). Flipping the script: The politics of clinical language in a drug treatment program for homeless women. Ms.
Cohn, Carol (1987). Sex and death in the rational world of defense intellectuals. Signs 12:687718.Google Scholar
Cook, Mary Ann (1995). Substance-abusing, homeless mothers in treatment programs: A question of knowing. Contemporary Drug Problems 22:291316.Google Scholar
Crapanzano, Vincent (1996). “Self”-centering narratives. In Michael Silverstein & Greg Urban (eds.), Natural histories of discourse, 106130. Chicago: University of Chicago Press.
Denzin, Norman (1987). The alcoholic society: Addiction and recovery of the self. New Brunswick, NJ: Transaction.
Derrida, Jacques (1993). Points … interviews 1974–1994. Stanford: Stanford University Press.
Desjarlais, Robert (1997). Shelter blues: Sanity and selfhood among the homeless. Philadelphia: University of Pennsylvania Press.
Duranti, Alessandro (1997). Linguistic anthropology. Cambridge: Cambridge University Press.
Durkin, Elizabeth (2002). An organizational analysis of psychosocial and medical services in outpatient drug abuse treatment programs. Social Service Review 76:406429.Google Scholar
Fingarette, Herbert (1988). Heavy drinking: The myth of alcoholism as a disease. Berkeley and Los Angeles: University of California Press.
Finkelstein, Norma. (1996). Treatment programming for alcohol and drug dependent women. International Journal of the Addictions 28:12751309.Google Scholar
Fish, Vincent (1993). Poststructuralism in family therapy: Interrogating the narrative/conversational mode. Journal of Marital and Family Therapy 19:221232.Google Scholar
Foucault, Michel (1978 [1976]). The history of sexuality. Vol. 1, An introduction. New York: Random House.
Foucault, Michel (1988). Technologies of the self: A seminar with Michel Foucault. Amherst, MA: University of Massachusetts Press.
Foucault, Michel (1993 [1980]). About the beginning of the hermeneutics of the self: Two lectures at Dartmouth. Political Theory 21:198227.Google Scholar
Gal, Susan (1991). Between speech and silence: The problematics of research of language and gender. In Mircela Di Leonardo (ed.), Gender at the crossroads of knowledge, 175203. Berkeley: University of California Press.
Goffman, Erving (1974). Frame analysis: An essay on the organization of experience. Cambridge, MA: Harvard University Press.
Goffman, Erving (1978). Response cries. Language 54:787815.Google Scholar
Haaken, Janice (1993). From AL-Anon to ACOA: Codependency and the reconstruction of caregiving. Signs 18:321345.Google Scholar
Hanninen, Vilma, & Koski-Jannes, Anja (1999). Narratives of recovery from addictive behaviours. Addiction 94:18371848.Google Scholar
Hasenfeld, Yeheskel, & Gidron, Benjamin (1993). Self-help groups and human service organizations: An interorganizational perspective. Social Service Review 67:217237.Google Scholar
Hendrickson, Sybil (1992). Women's voices: A guide for listening to chemically dependent women. Women & Therapy 12:7385.Google Scholar
Hill, Jane (1995). Voices of Don Gabriel: Responsibility and self in a modern Mexican narrative. In Dennis Tedlock & Bruce Mannheim (eds.), The dialogic emergence of culture. Urbana: University of Illinois Press.
Hill, Jane (2000). “Read My Article”: Ideological complexity and the overdetermination of promising in American presidential politics. In Paul Kroskrity (ed.), Regimes of language, 259292. Santa Fe: School of American Research Press.
Irvine, Judith (1989). When talk isn't cheap: language and political economy. American Ethnologist 16:248267.Google Scholar
Irvine, Judith, & Gal, Susan (2000). Language ideology and linguistic differentiation. In Paul Kroskrity (ed.), Regimes of language, 3584. Santa Fe, NM: School of American Research Press.
Johnstone, Barbara (2000). The individual voice in language. Annual Review of Anthropology 29:405424.Google Scholar
Kaskutas, Lee Ann (1989). Women for Sobriety: A qualitative analysis. Contemporary Drug Problems 16:177200.Google Scholar
Kaskutas, Lee Ann (1992). Beliefs on the source of sobriety: Interactions of membership of Women for Sobriety and alcoholics. Contemporary Drug Problems 19:631648.Google Scholar
Keane, Webb (2002). Sincerity, “modernity,” and the Protestants. Cultural Anthropology 17:6592.Google Scholar
Kearney, Robert (1996). Within the wall of denial: Conquering addictive behaviors. New York: Norton.
Kroskrity, Paul (2000). Regimenting languages: Language ideological perspectives. In Paul Kroskrity (ed.), Regimes of language: Ideologies, polities, and identities, 134. Santa Fe, NM: School of American Research Press.
Labov, William, & Fanshel, David (1977). Therapeutic discourse: Psychotherapy as conversation. New York: Academic Press.
Lemanski, Michael (2001). History of addiction and recovery in the United States. Tucson, AZ: Sharp.
MacIntosh, James, & McKeganey, Neil (2000). Addicts' narratives of recovery from drug use: Constructing a non-addict identity. Social Science & Medicine 50:15011510Google Scholar
McDowell, David, & Spitz, Henry (1999). Substance abuse: From principles to practice. Philadelphia: Brunner/Mazel.
Monk, Gerald (1997). Narrative therapy in practice: The archaeology of hope. San Francisco: Jossey-Bass.
Nelson Woods, Michele A., et al. (1995). Twelve-Step program use among Oxford House residents: Spirituality or social support in sobriety? Journal of Substance Abuse 7:311318.Google Scholar
Nelson-Zlupko, L.; Kauffman, Eda; & Morrison Dore, Martha (1995). Gender differences in drug addiction and treatment: Implications for social work intervention with substance-abusing women. Social Work 40:4554.Google Scholar
Nye, Catherine H. (1994). Narrative interaction and the development of client autonomy in clinical practice. Clinical Social Work Journal 22:4357.Google Scholar
Ochs, Elinor, & Capps, Lisa (1996). Narrating the self. Annual Review of Anthropology 25:1943.Google Scholar
Paolino, Ronald (1991). Identifying, treating, and counseling drug abusers. In Robert Coombs & Louis West (eds.), Drug testing: Issues and options, 215235. Oxford: Oxford University Press.
Passerini, Luisa (1996). Autobiography of a generation: Italy, 1968. Hanover, NH: Wesleyan University Press.
Rapping, Elaine (1996). The culture of recovery: Making sense of the self-help movement in women's lives. Boston: Beacon.
Rasmussen, Sandra (2000). Addiction treatment: Theory and practice. Thousand Oaks, CA: Sage.
Reddy, William (2001). The navigation of feeling: A framework for the history of motions. New York: Cambridge University Press.
Reed, Beth Glover (1985). Drug misuse and dependency in women: The meaning and implications of being considered a special population of a minority group. International Journal of Addictions 20:1362.Google Scholar
Roman, Paul, & Blum, Terry (2002). The workplace and alcohol problem prevention. Alcohol Research & Health 26:4958.Google Scholar
Sands, Roberta G. (1996). The elusiveness of identity in social work practice with women: A postmodern perspective. Clinical Social Work Journal 24:167186.Google Scholar
Silverstein, Michael (1976). Shifters, linguistic categories, and cultural description. In Keith Basso & Henry Selby (eds.), Meaning in anthropology, 1155. Albuquerque: University of New Mexico Press.
Silverstein, Michael (1979). Language structure and linguistic ideology. In Paul R. Clyne, William F. Hanks, & Carol L. Hofbauer (eds.), The elements: A parasession in linguistic units and levels, 193247. Chicago: Chicago Linguistic Society.
Silverstein, Michael (1981 [1998]). The limits of awareness. In Alessandro Duranti (ed.), Linguistic anthropology: A reader, 382401. London: Blackwell.
Silverstein, Michael (1985). Language and the culture of gender: At the intersection of structure, usage, and ideology. In Elizabeth Mertz & Robert Parimentier (eds.), Semiotic mediation: Sociocultural and psychological perspectives, 219259. Orlando, FL: Academic Press.
Silverstein, Michael (2004). ‘Cultural’ concepts and the language-culture nexus. Current Anthropology 45:621645.Google Scholar
Silverstein, Michael, & Urban, Greg (1996). The natural history of discourse. In Silverstein &Urban (eds.), Natural histories of discourse, 229252. Chicago: University of Chicago Press.
Skoll, Terrence (1992). Walk the walk and talk the talk: An ethnography of a drug abuse treatment facility. Philadelphia: Temple University Press.
Tompkins, Silvan (1995 [1963]). Shame-humiliation and contempt-disgust. In Eve Sedgwick & Adam Frank (eds.), Shame and its sisters: A Silvan Tompkins reader. Durham, NC: Duke University Press.
Wallace, John (1996). Theory of 12 step oriented treatment. In Frederick Rotgers Daniel S. Keller & Jon Morgenstern (eds.), Treating substance abuse: Theory and technique, 1336. New York: Guilford.
Walters, Glenn (1994). Escaping the journey to nowhere: The psychology of alcohol and other drug abuse. Washington, DC: Taylor & Francis.
White, Michael, & Epston, Dwight (1990). Narrative means to therapeutic ends. New York: W.W. Norton.
White, Robert K. (1998). Family intervention: Background, principles, and strategies. In Robert K. White & Deborah George Wright (eds.), Addiction intervention: Strategies to motivate treatment-seeking behavior, 720. New York: Haworth.
Wilce, James (1998). Eloquence in trouble: The poetics and politics of complaint in rural Bangladesh. New York: Oxford University Press.
Wilce, James (2004). To “speak beautifully” in Bangladesh: Subjectivity as Pagalami. In Janis Hunter Jenkins & Robert J. Barrett (eds.), Schizophrenia, culture, and subjectivity: The edge of experience, 196218. Cambridge: Cambridge University Press.
Winick, Charles; Levine, Arlene; & Stone, William A. (1992). An incest survivors' therapy group. Journal of Substance Abuse Treatment 9:311318.Google Scholar
Wilcox, Dennis M. (1998). Alcoholic thinking: Language, culture, and belief in Alcoholics Anonymous. Westport, CT: Praeger.
Wittgenstein, Ludwig (1953). Philosophical investigations. New York: MacMillan.
Woolard, Kathryn A. (1998). Introduction: Language ideology as a field of inquiry. In Bambi N. Schieffelin, Kathryn A. Woolard, & Paul Kroskrity (eds.), Language ideologies: Practice and theory, 103122. Oxford: Oxford University Press.
Young, Allan (1995). The harmony of illusions: Inventing post-traumatic stress disorder. Princeton: Princeton University Press.
Young, Iris (1994). Punishment, treatment, empowerment: Three approaches to policy for pregnant addicts. Feminist Studies 20:3358.Google Scholar