1. Introduction
Addiction is widely diagnosed and treated as a neurobiological disease in clinical settings, but the trauma-informed paradigm has broadened the conceptual category of addiction in its account of social factors in the etiology of addictive behaviour (Dobischok et al. Reference Dobischok, Archambault and Goyer2024; Mills Reference Mills2015; Rosenberg Reference Rosenberg2011). Trauma-informed care (TIC) has become “a necessary paradigm” in social work practice (Rad et al. Reference Rad, Runcan and Kiss2025), which reflects an increasing awareness about the systemic factors that influence traumatic experiences (Levenson Reference Levenson2020), and this is recognized across most health and human service systems (Yatchmenoff et al. Reference Yatchmenoff, Sundborg and Davis2017). Through the inclusion of macro-social determinants like systemic oppression in formulations of trauma (e.g. systemic trauma (Goldsmith et al. Reference Goldsmith, Martin and Parnitzke Smith2014)), the trauma-informed framework holds potential to deconstruct an otherwise implicit ideology centering neoliberal individualism in addiction recovery programming. However, the way in which TIC is folded into the neoliberal logics of the biological disease model of addiction (BDMA) effectively mitigates its resistive potential through the individualist ideology that underpins what Eve Kosofsky Sedgwick calls the “epidemic of addiction attribution” (Reference Sedgwick and Sedgwick1993).
In “Epidemics of the will,” Sedgwick (Reference Sedgwick and Sedgwick1993) raises concerns about the growing trend in which “addiction” is used to qualify an increasing variety of behaviors that are deemed to be socially and psychologically maladaptive. Sedgwick draws on Foucault’s genealogy of the invention of the homosexual to illustrate how the addict was similarly constructed in the late nineteenth century, when changing socio-economic and political relations influenced the discursive classification of behavioral attributes into identity categories (129). Sedgwick’s work illustrates how the inclusion of a growing number of behaviours in the pathological construction of addiction reinforces the identity category of the addict. This musing enlists Sedgwick’s work to examine how trauma attribution in the etiology of addiction crystallizes the affects of trauma and its aftermath around the identity of the addict.
In the context of addiction recovery, TIC is known for its strengths-based dimensions (Ezell et al. Reference Ezell, Pho, Jaiswal, Ajayi, Gosnell, Kay, Eaton and Bluthenthal2023) that frame addiction as an adaptive strategy for managing the affective aftermath of trauma, which arguably includes systemic forms of trauma. However, in settings that utilize institutionalized recovery programming built around the psychopathological and neurobiological logics of the BDMA (e.g. Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or “strong-arm rehab”), TIC is employed to rehabilitate addiction as a psychic and physiological maladaptation that is located in the brain of the individual. TIC is taken up by the logics of addiction attribution in the neoliberalization of addiction recovery through the invocation of the traumatized individual in addiction pathology. Renae Fomiatti, David Moore and Suzanne Fraser (2017) discuss the regulation of the addicted subject through the pathologization of trauma in their study, “Interpellating recovery: The politics of ‘identity’ in recovery-focused treatment.” The authors argue that addiction treatment is used to reinstate order (e.g., productive citizenship) in participants through their interpellation as “disordered” (e.g., deviant, traumatized, or diseased). In institutionalized addiction recovery, trauma attribution functions to reinforce the pathologization of the “addict,” rather than to deconstruct the sources of structural violence that influence maladaptive coping strategies. When trauma theory is institutionalized to diagnose a wide range of behaviors from alcoholism to eating disorders, recovery remains focused on the individual without meaningful systemic interventions. Neoliberal individualism maintains a stronghold on trauma-informed addiction recovery principles through addiction attribution, inhibiting the identification of systemic forms of trauma in recovery spaces that might otherwise mobilize systemic accountability in support of healing for marginalized subjects.
Critical perspectives on addiction disrupt the hegemony of the BDMA (e.g., Gomart Reference Gomart2002; Fraser and valentine Reference Fraser and valentine2008; Vitellone Reference Vitellone2010; Weinberg Reference Weinberg2011), trouble how addiction discourses (e.g., recovery programming, self-help literature) promote self-responsibilization as an obligation and moral imperative (Keane Reference Keane2002; Fomiatti et al. Reference Fomiatti, Moore and Fraser2019; Race Reference Race2009), and trace the historical development of addiction as a socio-political construct (Levine Reference Levine, Granfield and Reinarman2014; Granfield and Reinarman Reference Granfield and Reinarman2014). Feminist interventions into trauma discourse examine how trauma is figured within the Western medical model of addiction in a way that reinforces gender bioessentialism (Muzak Reference Muzak2009; Haaken Reference Haaken1996; Marecek Reference Marecek1999; Lamb Reference Lamb1999). Critical and decolonial theorists conceive of trauma theory as a “colonial invader” (Clark Reference Clark2016) and a construct that produces traumatized subjectivities (Stevens Reference Stevens2009). The way in which trauma attribution has been shaped by the BDMA through colonial and clinical frameworks invites further inquiry about how addiction is experienced in the context of systemic oppression. For queer subjects undergoing recovery, how does addiction attribution interface with structural forms of trauma?
Employing a theoretical framework combining feminist affect theory and critical addiction theory, this musing examines how the critical potential of a trauma-informed framework is filtered by neoliberal individualism to sustain the pathologizing function of the BDMA. It advocates for a queer politics of addiction recovery through the analysis of a contemporary portrait of queer addiction and codependency in the Netflix mini-series, Feel Good (Martin and Hampson Reference Martin and Hampson2020). The discussion enlists the work of Matilda Hellman (Reference Hellman2021), and Suzanne Fraser, David Moore, and Helen Keane (Reference Fraser, Moore and Keane2014) in critical addiction studies, which invokes new materialist, post-humanist, and affect theories. Together with the work of Eve Kosofsky Sedgwick (Reference Sedgwick and Sedgwick1993) and Ann Cvetkovich (Reference Cvetkovich2003) in queer studies, I consider how trauma discourse shapes queer ontologies of recovery in neoliberal times.
2. Neoliberalism and the BDMA
Neoliberalism refers to an imbrication of economic and cultural projects characterized by the fusion of market and state imperatives, individual responsibility as a cultural ideal, and a shift from the welfare state to the privatized, carceral state (Jakobson and Bernstein Reference Jakobson, Bernstein, Bernstein and Jakobsen2022; Harvey Reference Harvey2007; Saad-Filho and Johnson Reference Saad-Filho and Johnston2005; Rose Reference Rose1999). Institutions that uphold neoliberalism like health care and the carceral system have employed the BDMA to the effect of absolving institutional responsibility for addictive behaviors by focusing on individual neurobiology (Granfield and Reinarman Reference Granfield and Reinarman2014; Levine Reference Levine, Granfield and Reinarman2014; Gowan and Whetstone Reference Gowan and Whetstone2012). Critical addiction theory considers how neoliberal discourses, values, and systems equate health with normativity and productivity, locate disease in the individual, and hold the individual to account for their moral failings as a deflection from the failure of the social safety net. The work of critical addiction theorists like Harry Levine (Reference Levine, Granfield and Reinarman2014), Robert Granfield and Craig Reinarman (Reference Granfield and Reinarman2014) illustrates how the BDMA locates the problem of addiction in the brain of the individual through the employment of neurobiological explanations for a lack of self-discipline. Genealogies of addiction examine how the BDMA developed out of a history of puritan temperance advocacy that identified addiction as a malady of moral deficiency, which emphasized self-responsibility and the ability to contribute to society as indicators of recovery (Granfield and Reinarman Reference Granfield and Reinarman2014). Both of these indicators remain prominent principles of institutional recovery programming today.
In “Making the criminal addict: Subjectivity and social control in a strong-arm rehab” Teresa Gowan and Sarah Whetstone (Reference Gowan and Whetstone2012) situate addiction recovery programming in the context of American strategies for crime control in the contemporary neoliberal era of “hyper-incarceration” (Reference Gowan and Whetstone2012, 69). Through an ethnographic analysis of interviews held with participants at a strong-arm rehabilitation program, which refers to a publicly funded drug treatment program that serves the criminal justice system as an alternative to incarceration, the authors illustrate how these programs draw on the BDMA to enforce a morally imbued biologization of poverty and race. The authors’ findings reveal that neurobiology is referenced in diagnostic practices to determine eligibility for rehab programming, but that it rarely informs therapeutic techniques in the rehabilitation process.
Although vital for the court “diagnosis” (Whetstone and Gowan Reference Whetstone and Gowan2011), bio-chemical etiology lay very lightly on the [rehabilitation] process. The central determinant of both the client’s past and his future was his moral orientation. Just as pathological “pathways in the brain” had been created by the deviant practices of the past, the key to a drug-free future lay not on the level of brain chemistry but via a radical modification of “behaviors” and “criminal thinking.” (Gowan and Whetstone Reference Gowan and Whetstone2012, 78)
In the effort to address “criminal thinking,” participants were cautioned against blaming their addiction challenges on their experiences of poverty, racialization, or any other form of oppression because this was perceived as deflecting from one’s sense of personal responsibility. Gowan and Whetstone’s study shows how the BDMA neutralizes experiences of oppression through the neoliberal mandate of self-responsibility that works to deflect accountability for structural violence.
Critical addiction theorists like Suzanne Fraser, David Moore, Helen Keane, kylie valentine, Nicole Vitellone, and Matilda Hellman conceptualize addiction beyond the neoliberal paradigm through a post-humanist lens that highlights the importance of reframing the role of the environment in the conceptualization of addiction. Fraser and colleagues (Reference Fraser, Moore and Keane2014) write, “[r]eifying the human as the source of all action and meaning is particularly problematic in relation to addiction discourse, which draws its power and influence in part from its invocation of the self as the site of disorder and health” (13). The biomedicalization of addiction functions through trauma theory to isolate the individual from their environment. In institutionalized recovery settings, meaningful interventions into systemic forms of trauma are circumvented by the neoliberal treatment of self-responsibilization as a panacea. While conversations in support groups may address the impact of trauma on behavior (in fact, they are often unavoidable due to the common invocation of testimonial methods in recovery spaces: Meiners and Sanabria Reference Meiners and Sanabria2004), they will seldom stray from a focus on trauma at the micro-social level, as related to individual experiences. Even in spaces that claim anti-oppressive politics explicitly, the validation of participants’ experiences of systemic trauma will be performative when solutions remain limited by institutional parameters enforcing self-disciplinary processes of reification as best practice.
3. A queer politics of addiction recovery
Depathologizing marginalized subject positions is central to the work of critically intervening into neoliberal addiction discourse. Ann Cvetkovich (Reference Cvetkovich2003) seeks new language for lesbian experiences of trauma that combats the pathologization of queer subjectivities, and that creates space for complicated queer affects. Cvetkovich writes,
As a name for experiences of socially situated political violence, trauma forges overt connections between politics and emotion. Sexual acts, butch-femme discourse, queer transnational publics, incest, aids and aids activism, grassroots archives—these are some of the sites of lesbian public culture where I have not only found the traces of trauma but ways of thinking about trauma that do not pathologize it, that seize control over it from the medical experts, and that forge creative responses to it that far outstrip even the most utopian of therapeutic and political solutions. (Reference Cvetkovich2003, 3)
Cvetkovich’s work takes up the concept of trauma beyond the confines of pathology. She intervenes in the structural violence of pathology in clinical discourses about trauma, while asserting the value of trauma-informed analysis and queer forms of knowledge production. Through this lens, the recovery meeting can be understood as a site wherein politics and emotion overlap and the affects of “socially situated political violence” circulate. Recovery meetings have the potential to facilitate queer interventions into the pathologization of trauma, particularly as spaces of witnessing, caregiving, and collective grieving. At the same time, they may reproduce dominant mythologies and psychopathologies by invoking trauma to promote moral self-surveillance. Given the work of Fomiatti et al. (Reference Fomiatti, Moore and Fraser2017) and Jeanne Marecek (Reference Marecek1999), when TIC frameworks are employed in these settings, they can be seen to reinforce trauma recovery as an individual responsibility while also symptomatizing experiences of abuse and political violence. As Marecek (Reference Marecek1999) argues, “trauma talk” can subsume the particularities of a survivor’s experience into abstractions (e.g., “trauma,” “abuse”) and reduce lived experience to discrete, encapsulated symptoms such as flashbacks or revictimization (165).
How might queer narratives challenge the neoliberalization of recovery and the pathologization of addiction specifically? While they may have subversive potential, queer narratives can still be susceptible to the ideological imperative of neoliberalism, as we will see.
4. Feel Good
The Netflix series, Feel Good (Martin and Hampson Reference Martin and Hampson2020), created by and starring Mae Martin, resonates as a testimonial of queer attachment and addiction recovery. As a semi-autobiographical portrayal, it represents both a reflection and a re-visioning of a queer experience of addiction and codependency. The show is inspired by Martin’s life experience and has been commended for its originality and nuance in depicting “a relationship dynamic rarely shown” (Gilmour Reference Gilmour2021, para. 1). Feel Good wrestles with a slippage between the definitions of drug addiction and codependency as the protagonist, Mae, questions if they are addicted to their girlfriend in the same way that they are addicted to cocaine.
4.1 Defining (queer) codependency
The term codependency typically describes an interpersonal attachment that involves unreciprocated caregiving (Krestan and Bepko Reference Krestan and Bepko1992, 226), and that is organized around the core concept of self-neglect (Hughes-Hammer et al. Reference Hughes-Hammer, Martsolf and Zeller1998), which facilitates self-sacrifice for the purpose of merger (Thurston Reference Thurston2022, 59). It has been criticized for being a pseudo-diagnosis and for lacking “any systematic research basis” (McGrath and Oakley Reference McGrath, Ann Oakley, Oakley, Knafo, Madhavan and Sloan Wilson2012, 53). In accordance with addiction attribution, it has also been referred to as “love addiction” (Wright and Wright Reference Wright and Wright1991, 440). Addiction attribution resonates in Mae’s discovery that their attachment to their girlfriend, George, reproduces the same affects as their drug addiction. This realization is portrayed as running parallel to the processes of queer self-discovery and self-disclosure that the characters undergo throughout the series. Mae struggles with internalized transphobia as they question their gender identity, while George battles internalized homophobia as she grapples with the pressures and anxieties of coming out in her homophobic social circle. The combination of queer self-discovery and codependent attachment heightens anxieties about their relationship and exposes their vulnerabilities as queer people in queerphobic contexts.
In episode three, both characters’ insecurities come to a head when George brings Mae to a party but refuses to introduce them as her partner because of her fear of coming out to her friends. The tension culminates when Mae pressures George to come out, and George responds defensively, accusing Mae of being neurotic, “just be confident, why don’t you dance? There’s nothing less attractive than someone who is too neurotic to dance at a party…” Mae responds, “Of course I don’t want to dance in front of people who would have bullied me in high school, and you’re too ashamed to touch me. If you want me to feel confident, hold my hand!” (00:17:00) In this scene, the mutual projection of queer shame provokes escapism in both parties, prompting Mae to seek romantic attention from another admirer, and moving George to drink to the point of blacking out. Their codependent attachment is queered by the affective residue of oppression (e.g., gay shame: Halperin and Traub Reference Halperin and Traub2009) that is reflected in the scene’s references to shame, insecurity, and alienating coping mechanisms. The emotional disconnection that Mae and George experience in their relationship is depicted both as features of codependency and as related to internalized homophobia and transphobia.
4.2 Defining addiction
Martin’s depiction of addiction reflects a clear position in the discourse on addiction attribution in its aim to intervene in traditional thinking about substance-specific addictions. The series is inspired by Gabor Maté’s definition of addiction (Wiseman Reference Wiseman2020), which is informed by a trauma-informed theory of addiction attribution (Maté Reference Maté2008, Reference Maté2022). Maté (Reference Maté2022) defines addiction as,
a complex psycho-physiological process that is manifested in any behavior in which a person finds short-term pleasure or relief and therefore craves; from which they suffer long-term negative consequences, whether physical, mental, social or economic; which they are reluctant or unable to give up despite negative consequences; and which, on suddenly ceasing, leaves them with intense craving, irritability and dissatisfaction. (432)
He argues that childhood trauma, in particular, “creates the distress addiction temporarily and inadequately soothes … [and] shapes the brain, impairing the healthy development of the endorphin circuits of pleasure and reward” (433). Throughout Feel Good, the influence of Maté’s neurodevelopmental trauma theory can be felt in the portrayal of addiction as related to the protagonist’s traumatic history of sexual assault, and as an affective relation that is transmissible to a codependent attachment.
In season one, episode two, Mae attends a NA meeting wherein the question of the definition of addiction is raised, provoking an inflammatory response from the group. Mae points to the behavior of other participants, “I just feel like, Kevin, how much sex do you have? And Karen, how much do you compulsively lie? Whatever it is, cigarettes, our phones, we have habits so how can we say that we’re not addicted?” The facilitator attempts to intervene, “I don’t think this is a helpful conversation,” but another participant reacts defensively, “I think it’s fucking bullshit, because I’ve been clean for 54 months!” Mae continues, “My girlfriend … went away for one night and I lost my mind. And it was all the same feelings: craving and withdrawal and relief and obsession. We’re just swapping one addiction for another.” A participant protests, “Does anyone else think she’s talking grade ‘A’ baloney?” Another exclaims, “I was told this was a safe space” (00:18:52). In this scene, the idea that the affects of addiction are transmissible to attachments beyond substances implies that abstinence from substance use may not solve the afflictions of the NA participant. From within the NA culture, this position is perceived to undermine the recovery of other members.
While the series presents a queer perspective of the intersecting interpersonal, political, and mental health factors that may affect addictive behavior, it ultimately frames addiction as an individual pathology through the logic of addiction attribution. Reflecting Maté’s trauma-informed theory of addiction, Mae’s position is presented as a challenge to the hegemony of the NA meeting space. However, in this space, Mae’s intervention risks reinforcing, rather than subverting, the neoliberalization of addiction recovery. When Mae proposes that “we’re just swapping one addiction for another,” another participant, Maggie, interrupts objections from the group by recounting her own experience of longing and despair in relation to her estranged daughter. Aligning herself with Mae, Maggie describes how addiction-related affects compel her to engage in stalking behavior. Her share culminates in a declaration that is at once self-defeating and self-affirming: “I can’t help it, I am an addict!” (00:19:50). Here, the affects associated with addiction are depicted as fluid and transferable, yet the pathological construct of addiction remains intact.
5. Queering addiction and codependency
Resisting hegemonic modes of knowledge production is imperative to a queer politics of addiction recovery. Fraser et al. argue, “If we think of addiction as a set of relations between human and non-human objects, techniques, locales and practices, it is no longer a pathology chained to a regulatory ideal of freedom of will” (Reference Fraser, Moore and Keane2014, 12). In recovery spaces like AA, NA, or strong-arm rehab, the mandated admission of pathology through identification with a stigmatized and loaded term (“My name is ___, and I am an addict”) vitiates alternative narratives and frameworks for understanding substance use (e.g., testimonial invocations of queer forms of ontology, relations with non-human agents, or experiences of structural violence). An intervention that validates these alternative formulations and affective relations has the potential to subvert the neoliberal reproduction of the identity category of the addict. Feel Good intervenes into some of the limiting aspects of the BDMA, but the series reproduces neoliberal logics of identity that employ trauma attribution to pathologize addicted subjects.
Feel Good may leave something to be desired as a critical reading of addiction, but it is an accurate portrayal of the tension produced by the implication of the queer subject in the reifying and regulatory processes of the neoliberal institution. This tension is represented in the meeting scene as the queer protagonist disrupts the established order of the NA space with their assertion that they are addicted to their girlfriend. Queer experiences of addiction, codependency, and recovery expose the limitations of the neoliberal paradigm that enforces individualism over systemic interventions and collective healing because their entanglement invites an intersectional and systemic analysis. When seen through trauma theory, the testimonials of addicted subjects who are marginalized at intersections of oppression arguably pose a challenge to neoliberal individualism insofar as they reflect experiences of systemic trauma that require responsive recovery strategies. Mae’s realization that they are addicted to their girlfriend has the potential to initiate conversations about trauma and affect, and to intervene into the neoliberal paradigm governing recovery spaces. The way in which their queer identity intersects with their experiences of addiction and codependency offers the possibility of bringing a systemic analysis into the recovery process. Yet the series shows how this potential is mitigated by the pathologizing function of neoliberal ideology that undergirds institutionalized recovery programming.
Theoretical orientations at the intersection of critical addiction studies and feminist affect studies create space for queer approaches to addiction recovery beyond neoliberalizing frames of self-responsibility and identity development. Matilda Hellman (Reference Hellman2021) observes the current paradigm shift from late modernist epistemology to “assemblage-like ontology” in addiction discourse. She advocates for an increasing focus on processes of being and becoming, and the affective relations between “bodies, things, ideas and social institutions” (Hellman Reference Hellman2021, 2). Trauma-informed theory can align with this approach in acknowledging how traumatic events animate a subject’s interpersonal, systemic, and ideological orientations, producing affective relations between subjects and their attachments. It is also conducive to conceptualizations of addiction as intimacy (Keane Reference Keane2004), as assemblage of interacting entities (Fraser and valentine Reference Fraser and valentine2008), and as affective attachment (Vitellone Reference Vitellone2010) that serve to intervene into limiting and marginalizing formulations.
Queer narratives and representations of addiction hold the potential to bridge trauma-informed theory and praxis through the mobilization of critical and affective orientations to addictive attachments, but the extent to which addiction recovery can be “queered” within the dominant systems offering rehabilitation programming will be limited by hegemonic discourses and neoliberal logics. As a semi-autobiography that narrates the affective relations of addiction through queer embodiment, Feel Good illustrates the neoliberal subjectivization of queer subjects in addiction recovery through the use of trauma attribution as an access point to queer ontology and a throughline connecting affective experiences. A queer politics of addiction recovery must contend with the complicated ways in which queer attachments materialize in neoliberal systems—ways that both challenge and reproduce individualist ideologies. Post-humanist and new materialist formulations together with trauma-informed and queer narrative interventions have the potential to highlight the affective mechanisms by which the individual holds the tension of an oppressive system that refuses accountability by mandating individualized forms of responsibility. They also serve to expand our understanding of addiction in its many forms, while revealing the inadequacy of neoliberal frames to support marginalized people through the ongoing machinations of systemic trauma.
Acknowledgments
The author extends gratitude to Professors Eva Karpinski, Frances Latchford, and Michele Johnson, whose feedback on earlier versions of this work contributed to the musing in its final form. The Government of Ontario funded this work through the Ontario Graduate Scholarship. Support from the Jean Harvey Essay Prize awarded by the Canadian Society for Women in Philosophy also contributed to its completion. The author reports there are no competing interests to declare.
Hilary Thurston is a Research Associate at Re-Vision: The Centre for Art and Social Justice at the University of Guelph, and a PhD candidate at York University in the Department of Gender, Feminist and Women’s Studies. Her research interests include queer attachments, affect theory, and psychoanalytic feminism. Hilary’s professional experience working in mental health and addictions services in Toronto informs her academic pursuits at the intersection of theory and practice.
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