Recovering from Substance Misuse: The Role of Mastery and Unity Revealed through the ‘Life as a Film’

A growing body of research highlights the importance of identity changes to recovery from substance misuse. Current models emphasise communal or self-agentic factors in the process (e.g. Best et al., 2016; Dunlop & Tracy, 2013). This represents a limitation of focus, and there is a requirement for models that recognise the rich interplay of both personal and relational factors underpinning behaviour. Life story interviews of substance misusers indicate key underlying themes (Singer, 1997, 2001), alluding to the benefit of developing a narrative approach, and directs research towards examination of personal narratives in active and recovering substance misusers to uncover dynamic factors supporting either behaviour.

The aim of this project was to develop a new narrative approach to substance misuse recovery, proposing that agency and communion themes, as well as broader narrative forms, are important to recovery outcomes. This objective was addressed by sampling from both active and recovering populations, a methodology lacking in the extant literature, and trialling the ‘Life as a Film’ (LAAF) approach to data collection and thematic analysis, since the model has proved useful in studies of life narrative with related populations (Canter & Youngs, 2015).

Interviews were conducted with 32 participants (23 males, 9 females). All participants interviewed at baseline were retained at six-month follow up. Problems encountered with collection of life story material in marginalised populations were addressed using the LAAF technique, and a repertory grid was designed to compare narrative with personal construct data. A Recovery Inventory (RI) was used to compare this data with indicators of recovery.

A fundamental contribution of this research is in highlighting a relationship between both agency and communion and recovery across several corroborative studies. Significantly, joint agency and communion themes in LAAF narratives were shown to correspond with the best recovery outcomes, either theme with moderate outcomes, and neither theme with poor outcomes, expanding ideas of current social and narrative identity theories. Illustration of a successive agentic path, advancing from effectiveness, empowerment to self-mastery is given, and a communal path, advancing from friendship/love, caring to unity, with improved recovery outcomes, suggesting a new two-dimensional framework of progressive identity transformation. Matching behavioural change with personal growth pathways represents a key theoretical advance, carrying important implications for interventions corresponding with individual narrative presentation.

Further analysis expanded on these findings, revealing two contrasting life narratives, reflective of either recovery or non-recovery: a Victory narrative, showing themes of self-mastery, unity, redemption, healer identity, and happy ending, which corresponded with high scores on the RI, and a Defeat narrative, showing themes of compulsion, avoidance, contamination, escapist identity, and sad ending, which corresponded with low scores on the RI.

The thesis advances the literature in four important ways: (1) introduction and validation of the LAAF model for understanding recovery (2) highlighting the centrality of both agency and communion themes to recovery (3) uncovering distinct agentic and communal growth scales (4) revealing overarching life narratives suggestive of recovery and non-recovery. These contributions follow from the decision to sample from both active and recovering substance misusers and introducing powerful multidimensional scaling methods to the field. In total, the findings lend considerable support to a life narrative interpretation of substance misuse and recovery, combining social identity and narrative identity concepts into a greater appreciation of the complex psychosocial processes important to substance misuse recovery.