Case Study of a Significant Learning Experience Involving Addiction
Transformative learning theory, as proposed by Jack Mezirow (1991, 2000), is a useful framework for analyzing the significant learning experiences of adults because it recognizes the importance of the emancipatory process of critical reflection for the purpose of transformative change. The purpose of this paper is to analyze one of my own significant learning experiences (SLE) in order to demonstrate the applicability of Meziow’s theory, strengths and limitations. The SLE that I have chosen is my understanding of addictions. This is significant to me because I currently work as a mental health and addictions nurse. As I began to reflect on my transformative learning process I began to realize that my understanding of substance use has heavily influenced my meaning perspective (habits of expectation that filter perception and cognition) of addiction (Mezirow, 1991). In this case study I will outline the key transition points of my SLE that began in my adolescence and continued into my young adulthood leading to a transformation in my understanding of substance use and addiction. The discussion will begin by first describing the case of my personal experience. This is followed by an analysis of my transformative learning including identifying my assumption and beliefs, reflective process that I engaged in with respect to Mezirow’s ten phases of change, the importance of context, and collaborative thinking, key points in my distorted thinking, significant parties to my change, the concept of collective transformation. This is followed by a discussion of the limitations of Mezirow’s theory and how these relate to the analysis of my significant learning experience. The discussion closes by outlining the significance, strengths and limitations of this exercise.
The Case
I work as a Registered Nurse. I have been practicing in the Vancouver area for the past four years in the area of mental health and addictions. Although my current perspective of addiction embodies a recovery oriented approach, my understanding has been achieved through a long process of critical self reflection throughout my adult life. I have had an evolving understanding of substance use and addictions, especially as they relate to mental health. This has directly impacted my delivery of nursing care, how I view my role and my understanding of the client’s experience. This exercises process of retrospective self-reflection highlights the key transition points in how I arrived at my current perspective, which I feel has become much more developed and inclusive.
The journey of my transformative learning experience begins with reflection of my childhood, where I learned the basis of my understanding of substance use. I will then describe how my original meaning perspective led to conflicting meanings, a disorienting dilemma that I was confronted with in my adolescence, and how these further developed into my understanding of addictions in my young adulthood as impacted by formal and informal education. The story of my transformative process will conclude with my experience in nursing school, focusing on how this changed my meaning perspective of substance use and addictions.
Parental influence.
My understanding of addiction growing up was limited because of the limited information that I learned from my parents. This was through no fault of their own. My parents, were both immigrants, born and raised in cultures vastly different than Canadian and from older generation than the parents of most of my childhood peers. They arrived in Toronto, Canada in the late 1960s and early 1970s. My mother originally immigrated from the Philippines and my father from Czechoslovakia. They were both born during World War II.
My mother is the eldest of five children, the only girl. She grew up in a rural city in the Northern Philippines. She had a Roman Catholic upbringing. At the age of sixteen she graduated from high school and moved to a larger city to pursue a teaching degree. Upon obtaining a Bachelor of Science in Education she worked as an elementary school teacher for ten years before moving to Canada. She arrived in Canada in the early 1970s.
My father was born in Prague, the capital city of the former Czechoslovakia. His father was an academic, his mother died when he was young. He achieved a Masters Degree in geology and geophysics doing research for the former USSR, fleeing communist Czechoslovakia under refugee status after the Russian invasion in 1968. Shortly after my mother moved to Canada she met my father through mutual friends. Although they were from very different cultures and having very different religious beliefs they fell in love and married ten months later, in 1973.
I was born in a Toronto suburb in 1981, the younger of two children. My brother and I attended Catholic school. At the age of 8, in 1990, my father’s company was transferred to Calgary, Alberta which is where I lived until after I graduated from university in 2003. I grew up in the suburbs, middle class and sheltered by my parents. Addiction is not an issue that my family really talked about, although I did observe my father’s regular use of alcohol. My understanding at the time was that daily use of alcohol was normal, something that all fathers engaged in. I never considered that there could be problem behaviour associated with this substance until the age of 10 which is the first time that I recall my father being intoxicated. I recall realizing that this was not his regular behaviour and that my mother was angry at him for being in this intoxicated state. I had no other firsthand exposure to other types of substances except through media and in my formal education.
Primary school and media influences.
I learned about addictions through images in media and presentations given in school. I was born in the 1980s which is when the ‘Just Say No’ campaigns were popular, indicating a socially and politically disseminated zero tolerance policy of illegal drug use. The news programs that my father watched often broadcasted stories about crimes associated with drug use, depicting the drug user as a criminal and deviant. In the 1980s the United States government, led by Ronald Regan was mounting the so-called ‘War on Drugs’ (Grant, 2009). At this time there was much media coverage on the dangers of drug use. For example, the issue of ‘crack babies’, those children born to women who were addicted to crack cocaine, was a media hot topic, depicting women drug addicts as child abusers and their children as a generation of disfigured, developmentally damaged victims (Flavin & Paltrow, 2010). The message given in the news media was clear, if you do drugs then you are a loser, poor decision maker and a morally corrupt person. I also recall watching fictional television shows like Beverly Hills 90210, Degrassi High and Saved by The Bell that presented a similar view of both substance use and addictions. Further, those with addictions issues were depicted as criminals who deliberately hurt their loved ones (Tupper, 2008). These media images helped create a distinctive image of the substance user which was, for me, synonymous with a drug addict.
I also learned about addictions through educational presentations given at my school. These presentations were often given by former drug addicts who had awful experiences like nearly dying from drug overdoses and continued to suffer from the negative after-effects of their drug use. It is clear that in the 1980s and 1990s there was much politically influenced discourse used to create fear about drugs, drug using behaviours and drugs users incorporated in these presentations which were based on the ‘war on drugs’ mentality of the time (Tupper, 2008). These policies were not based on sharing the truth about drugs, in terms of presenting an accurate picture of the pros and cons of drug use, but rather, sought to scare school children into choosing abstinence. A clear message was simultaneously being sent that only bad things happened with drug use and only bad people engaged in drug using behaviour. This compounded my understanding that those who chose to do drugs were inherently bad people seeking to morally corrupt society. I also understood that people who engaged in drug use were not the kind of people I would want to associate myself with. This understanding stayed with me until I gained first-hand knowledge of substance use.
High school experiences: A changing perspective
My understanding of substance use changed when I began high school and gained firsthand exposure to individuals who used drugs and alcohol. My high school experience challenged my perspective on substance use because I found that my friends, people that I trusted, engaged in illegal drugs and underage drinking. Subsequently, I wanted to know if these substance were as dangerous and debilitating as I had been warned about and I began to experiment with substance use, engaging in underage alcohol use and illegal drug use. To my surprise, I found these experiences enjoyable; I did not turn into the image of the addict that I was bombarded with in the media. Similarly, many of my peers engaged in drug and alcohol use without experiencing all the negative consequences I had learned about in my grade school education. I did not see any students in my school who acted like the addicts I read about in the news or looked like the disheveled addicts saw on television. My high school experience normalized what it meant to use substances.
Over the course of my highschool years I became more accepting of drug use in others, understanding that it was a personal choice that seemed to be recreational. Although I did have friends who engaged in daily marijuana use at the time I really did not think it negatively impacted them because my understanding of addiction was the crack or heroin addict that I saw in popular media. Subsequently, I began to question the validity of what I had been taught in school and the applicability of images that I saw on television to my personal experience.
As I progressed through high school, nearing graduation, my perceptions of substance use again changed. I did begin to see the negative impacts that regular alcohol and marijuana use had on some of my friends and did see some of my peers expelled because of negative behaviours associated with drug use. However, I still did not make the association of regular substance use ;with addiction because I had such a deeply ingrained image of ‘the addict’; it seemed that addiction was never something contextualized in my own personal experience. For example, if there was an incident at my school like students being intoxicated in class or someone being expelled for drug dealing the issue was never openly discussed. I did hear about the punitive measures were taken but this was the extent of it, the message that drugs were an individual choice and morally wrong because they were criminal behaviour was continually reinforced but the drug users that I encountered in high school did not match with images of hardened criminals I saw on the television news.
Nearing the end of high school I began to see that some of my classmates and friends who engaged in regular marijuana use were less motivated. I began to label them as losers, fitting the ‘stoner’ image of the heavy marijuana user that I saw characterized on movies and television. I decided that substance was not for me, however I also understood that some of my peers were satisfied with their choice to engage in regular weekend alcohol and drug use. This experience solidified my perception that using substances was something within an individual’s control. I still did not know anyone I would consider an ‘addict’. I continued to view addiction is a very particular way, associating it with criminal behaviour and poverty and characterized as moral corruption and lack of desire or will to be clean and sober.
University years.
When I entered university I began my sociology and psychology degrees. My area of specialization in sociology was crime and deviance; in psychology I specialized in social psychology. Through my progression through this program I began to take classes in abnormal and personality psychology and inequality in Canada. I quickly began to learn of the multiple social and biological factors that contributed to how individuals develop addictions issues and, equally as important, how the addict is socially constructed as a social deviant behaviour of illegality of substance use and the stigma attached to addictions issues. I learned about how the stereotypical image of the ‘addict’ was reinforced through media images to align with the political agenda of the US government ‘war on drugs’ campaign. I learned about how illegality of drugs was connected to racial inequality. I also began to learn more about mental illness and how this contributed to the further marginalization of individuals suffering from addiction.
Despite all this changing perspective on the meaning of substance use and addictions I maintained a distinct separation between illegal and legal drugs. Concurrently, when I began university I began to engage in regular alcohol consumption. After I turned eighteen I would drink socially with friends at the university bar. I found that drinking behaviour was very common; there were two bars on the university campus and multiple bars within walking distance from campus. Recreational drinking seemed a widely accepted social activity as seen in my daily social environment at school but also on movies, television and in print advertising for alcohol. This normalized alcohol consumption and drinking behaviour. Binge drinking behaviour also became normalized for me because most of my friends were men who binge drank on weekends.
A large part of my social life was trying to ‘fit’ in with the boys, which entailed going to the university pub regularly throughout the week and engaging in binge drinking behaviour. Looking back, this behaviour was problematic because it involved excessive alcohol consumption, but at the time it changed my perception of what normal alcohol consumption meant. This image of the fun-loving drinker was reinforced through media advertising I saw on television and in bars. Drinking throughout the week was not considered substance abuse, it was socially acceptable behaviour because it was how I perceived average university students behaved. Although I knew from my classes that the physiological effects of alcohol on the brain were the same was illegal drugs my understanding of addiction remained focused on individuals who used illegal drugs, those who had lost everything. As a middle-class university student who worked part-time I did not fit into the picture of what I continued to picture as a typical addict.
Life beyond university.
After graduating from university in 2003 I moved to Vancouver. Living in Vancouver allowed me my first introduction to seeing drug addicts. I experienced firsthand the Downtown Eastside, where many homeless individuals with addictions publicly occupied the streets. I was also exposed to individuals very publicly engaging in illegal drug use; I saw people shooting-up heroin in alleyways, but also peers snorting cocaine off kitchen counter tops at parties. Again, I associated the down and out person living on the street with problematic drug use, those were the addicts, while the person snorting cocaine at the party was simply a recreational drug user.
When I returned to Calgary in 2005 I began volunteering at The Women’s Centre, a drop-in centre for women located in the inner city. The Centre provided access to different programs like the Foodbank and also facilitated social interaction through various classes and workshops. In this volunteer position I met women from diverse walks of life, some of whom had active addictions issues. I began to relate the theoretical knowledge gained in my undergraduate degree with the practical experience I was gaining, realizing that women with addictions issues had multiple factors that contributed to their position in life. I began to see that women with addictions issues were not so different than me, they were not all like the images I saw in the Downtown Eastside Vancouver alleyways. The women I met were mothers, wives and sisters, compassionate people. My image of the drug addict was no longer confined to deviant criminals, but extended to women coming from different walks of life.
Nursing school: A changed meaning perspective.
Three years after graduating from my first undergraduate degrees I decided to enter nursing. Nursing allowed me to learn about client’s life stories. In nursing I met people with addictions issues and began to hear about their experiences firsthand. I firmly solidified my understanding that individuals suffering from addiction were the product of individual choice to first engage in substance use but also powerfully influenced by environmental circumstances out of their control. Additionally, I began to understand addiction from a public health perspective rather than as an individual choice that seemed to blame the victim or from an illness model that constructed addiction as a lifelong burden. The changes that took place were my formal education in university but also the experiences that I had as an undergraduate nurse. My nursing experience gave me the opportunity to be exposed to a marginalized population. The nursing perspective was also different than the one that I adopted in my sociology degree.
As I progressed through the program and entered my first mental health rotation I learned about the harm reduction model that was promoted by Health Canada that sought to reduce the harms associated with drug use (Public Health Agency of Canada, 2003). I also learned about the recovery model which approached addictions issues from a holistic perspective, building on the strengths of the individual to create healthy coping mechanisms. From this perspective addiction is viewed as a transitionary state rather than as a lifelong battle. My experience in mental health challenged my previous illness model perspective. As I listened to the stories of the patients I cared for and learned from the nurses I worked with I began to solidify my belief that individuals with addictions issues were from all different walks of life, addictions was a social issue that encompassed much more than a decision to engage in drug use and that addictions could successfully be recovered from.
Towards the end of my nursing program I chose mental health as my area of concentration. My final clinical placement was at the Calgary Young Offender Centre. During this placement I had the opportunity to do shadow shifts at the Calgary Remand Centre, Spyhill Prison, Alberta Forensics and several community based programs for youth under probation orders and youth with conditional sentencing. I began to see children as young as 13 in the criminal justice system, kids with parents in adult corrections, kids with addictions issues stemming from the horrible circumstances of their lives, in part because of the decisions that their parents and caregivers made. As I conducted assessment interviews and learned about each youth’s history I gained clearer understanding of triggering factors for addictions to begin, the lack of support in the social welfare system to adequately address this and the ramifications of political decisions about ongoing criminalization of individuals with addictions. From my experiences in nursing school I decided that I wanted to specialize in mental health and addictions.
My new understanding of addiction is complex. Addiction is a greatly misunderstood issue. I now believe that addiction was not about choosing to use substances, but about choosing an ineffective coping mechanism to deal with life meaning any individual has the potential to suffer from an addictions issue. Addiction is a personal issue but it is also a social issue as individuals who suffer from addictions come from all walks of life. I now realize that addiction is treatable, but those with persistent addictions issues need support from a public health perspective. Although substance use is a choice addiction is not. Lastly, I now understand that a person is more than their addiction because no one chooses to have an addiction; addiction is a symptom of a bigger issue.
Meaning Perspective Profile
The following table summarizes my meaning perspective before and after my significant learning experience.
Profile 1: I believed that...
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Profile 2: After the SLE, I believed that...
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substance use is a personal choice
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there are only harms that result from substance use
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addiction is a public health issue
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a single use of an illegal substance like cocaine or heroin can lead to fatal addiction
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once someone is addicted they lose everything worthwhile in their lives
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My nursing perspective is holistic, looking at the entire individual rather than an isolated piece such as an addiction issue or a mental health diagnosis.
The Transformative Journey
According to Mezirow (1991) transformative learning involves an enhanced level of awareness of the context of one’s beliefs and feelings, critical reflection of one’s assumptions and premises, the assessment of alternative perspectives and the incorporation of these new perspectives into a persisting way that that they experience life. Mezirow (1991, 2000) suggests that development in adulthood occurs because of transformative processes indicating that as I progressed from my adolescent years to my young adulthood I developed a changed understanding through my own development. I believe that the significant learning experience that led to my current understanding of addiction was a transformative process that involved a changed meaning perspective.
Challenging assumptions and beliefs.
The transformation process occurs through becoming critically reflective of our assumptions and aware of their content. As I entered high school I began to challenge my beliefs about substance use and create an understanding of addiction, but it was not until I entered university and began my sociology and psychology education that I began to gain clearer understanding of my taken-for-granted beliefs about addiction. I took for granted that the views of my parents, friends and images that I saw in media and learned about in school were the objective truth. I also took for granted the social acceptance of alcohol use as a legal drug, failing to question why something with similar psychoactive and potentially negative effects as many illegal drug was not only condoned, but in many ways celebrated, in North American society.
Phases of Change
My SLE did progress through the ten phases of change that Mezirow outlines. Mezirow acknowledges that these phases do not necessarily occur in a stepwise fashion which was reflected in the reality of my case because I experienced multiple disorienting dilemmas before finally transitioning through the final phase. My impressions is that I remained at the phase of provisionally trying on new roles as I continued to experience disorienting dilemmas a key transition points when I entered high school, as I progressed through high school, in my initial undergraduate university years, post graduation and finally upon returning to university in a different program. I did not transition through phase nine and ten (building competence and self-confidence in new roles and relationships and a reintegration into one’s life on the basis of conditions dictated by one’s new perspective) until I gained firsthand knowledge working with individuals who had additions issues and learned of the recovery model which helped solidify my newly formed understanding of addiction.
Changing meaning perspective: An incremental process.
As my newly formed perspective emerged from critical self-reflection, is lasting and has changed the way I engage with others I believe that the type of learning occurred through subjective reframing. I applied a reflective insight from the perspective of different professors, nurses and individuals with addictions, those from someone else’s narrative, to my own experience. Additionally, my transformative change occurred at a greater systems level because there was conscious raising that occurred in the movement of drugs from a war mentality to an illness mentality to one that embraces a recovery oriented model. This distinction that this was a changed meaning perspective is clear because the process involved my intensive and difficult emotional struggle as my old perspectives became challenged and transformed. My understanding is a true perspective transformation because my life is now lived from this new perspective.
Questioning the status quo. I had a specific meaning perspective through which I filtered my understanding of substance use that influenced how I perceived addiction. Why would sources that I trusted such as my parents, teachers and friends lie to me? My meaning perspective originally consisted of the belief that substance use was an illegal activity therefore morally wrong. However, as I grew older, experienced substances use and substance users firsthand, learned about the social and psychological factors of drug use and addiction I began to see the problems in my existing frame of reference, thus I expanded my frame of reference by generating opinions and interpretations that were more inclusive and justified.
My transformative process was incremental, meaning it was a progressive series of transformations in related points of view that culminated in a transformation in habit of mind. My transformative process began in high school when I became friends with those who engaged in substance use. Through this experience I saw firsthand that not all substance users lacked moral fortitude. These repeated experiences challenged by previous meaning scheme that substance use and addiction were one in the same.
As I progressed through university, taking psychology and sociology classes I became more aware of how substances affect the brain and behaviour, as well as the social causes of addiction. In my sociology courses I saw how deviant acts, like the criminalization of certain substances were arbitrary decisions solidified through creation of laws. For example, there was nothing inherently good or bad about heroin, cocaine or alcohol it was the laws government created this distinction. My meaning perspective was transformed in my nursing program, as I learned about alternative perspectives to addictions such as public health, the recovery model and concepts like harm reduction. When I encountered individuals suffering from addiction and learned about their recovery process this change my understanding away from an illness model to a recovery model where addiction is not who a person is but a temporary states that can be recovered from with proper support.
Explaining the reflection process
Reflection is the process of critically assessing the content, process, or premise of our efforts to interpret the give meaning to an experience (Mezirow, 1991). Reflection only occurs when a roadblock is met in terms of negotiating the appropriate action in an experience or to when difficult occurs in understanding a new experience (Mezirow). Critical reflection occurs when one questions the validity what they consider the truth. One must resolve these conflicting issues of understanding before they can continue to learn. Reflection focuses on the description of a problem and also reflects on the strategies and the procedures of problem solving as one examines the life decisions they have made. Through the problem solving process one reflects on their experience to find similarities and differences between current and prior learning, engaging in cognitive processes to organize the meaning of this situation and make decision about how to act. In my reflection process I explored my understanding of substance use and addiction at key points in my life as influenced by informal and formal learning because my current understanding at the time did not fit with my new experiences. My taken-for-granted meaning schemes and meaning perspective did not allow me to adequately integrate what I was learning in my new experiences. Something had to change.
Reflection involves the critique of assumptions about the content or process of problem solving (Mezirow, 2000). Reflection is more than simple awareness. According to Mezirow there are two types of reflection, 1)process reflection involves both reflection and critique of one’s perception, thinking, judging, feeling, and acting, and 2) premise reflection involves awareness and critique of the reasons for one’s actions. In my case I engaged in both as I critically reflected on how I viewed substances users and understood addiction and also began to reflect on how my actions impacted my nursing care and interactions with clients. I had gained critical insight into how my previously constructed image of a addict
Changing Points of View
Points of view change by trying on different points of view, looking through a different lens (Mezirow, 2000). As one moves through life they have new experiences that may be influenced by educational interventions. In order to arrive at my understanding of addiction today I did have to try on other points of view. For example, after challenging my previous understanding of substance use and addiction as one in the same I viewed addiction through an illness model, where addiction was a chronic and persistent condition. However, learning about different perspectives of addiction led me to my current belief and understanding of addiction from a recovery oriented approach where addiction is a transitional state that individuals may encounter as a negative coping mechanism but may recover from. From this perspective addiction is not something that an individual carries with them for the rest of their lives. I looked through the illness model lens and then recovery oriented lens before adopting the one that felt most inclusive and appropriate for my understanding, ultimately influencing my meaning perspective.
Changing meaning perspective.
Mezirow’s (1991) research shows that although the transformation of meaning schemes through reflection is an everyday occurrence, it does not necessarily involve self-reflection. The transformation of meaning perspective occurs much less frequently, it is more likely to involve our sense of self and always involves critical reflection upon the distorted premises sustaining our structure of expectation (Mezirow). My SLE is an example of a perspective transformation because I actively engaged in the process of becoming critically aware of how and why my previously held assumptions constrained the way I perceived, understood and felt about the world. Through the transformation of these structures of habitual expectation, my deeply ingrained image of the ‘addict’ was drastically changed, making possible more inclusive, discriminating and integrative perspective.
In order to transform my habit of mind I had to become critically reflective of the premises in defining the problem of addiction, questioning the validity of assumptions supporting the concept of substance use and problem substance use in the first place, rather than focusing on individuals who had particular characteristics. This understanding led me to see that substance use was not inherently bad and that any individual could suffer from addiction. In my case when I learned that addiction was a public health issue that involved individuals from all walks of life rather than a criminal act engaged in by a deeply ingrained stereotyped image of the ‘addict’ I began to reflect on the problematic view that I engaged in.
Context
Human beings do not live in isolation. Our realities are inextricably connected to those of others; our life histories and language are bound with those of others. Within this context we form our understanding of the world. Similarly, there are no fixed truths (Mezirow, 1991). The context of adult learning is key to understanding a SLE. There are multiple contextual factors in my experience that influenced both my understanding of addiction before and after my transformative learning experience. The historical, political, social and cultural context all must be explored to achieve optimal understanding of this case.
I grew up in the 1980s and 1990s. When I was a child television was one of my main interests; I would watch the evening news with my dad when he got home from work and the popular American produced teen shows of the time such as Beverly Hills 90210 and Saved by the Bell. The War on Drugs was the invention of the American government as a tool to depict drug use as a criminal offense (Grant, 2009). The War on Drugs was also used to perpetuate stereotyped views of minorities in the United States as issues like ‘crack babies’ were pushed to the forefront of news media (Flavin & Paltrow, 2010). This model helped to construct the image of the addict as a criminal, an outsider. In Canada the model today for addiction is harm reduction (Grant; Public Health Agency of Canada, 2003).
These images were readily available in the news media, but also echoed in fictional television. I eagerly watched episodes of teen dramas that reinforced the message that only losers chose to engage in drug use and that only stupid people chose drugs. The media images popular at the time promoted the idea of addiction as a individual choice and the choice to engage in drug use as immediately leading to addiction. As an influential youth I readily took in this information to build my meaning.
Collaborative Thinking
Mezirow (2000) discusses the notion that Western culture conspires against collaborative thinking and the development of social competence by conditioning us to think in oppositional dichotomies such as winning or losing and right or wrong. This is a conflict oriented approach that permeates throughout our society. In the case of addictions this means that there was a culturally imposed norm that placed abstinence and addiction in opposition, representing good and bad respectively with the addict as morally corrupt while the person that chose abstinence was morally virtuous. However, this is complicated by the fact that only those substances that are deemed illegal are considered ‘bad’. Alcohol is a legal mind-altering substance, yet deemed socially acceptable indicating how deeply legally defined rules guide collective understanding.
Stemming from the notion that North American society is characterized by an argument culture is the idea that the quality of information that we receive is compromised (Mezirow, 2000). For example, the message in media is clear, alcohol use led to heightened social experiences yet the damaging effects are worse than all illegal drugs. As I progressed through university and questioned the the legal ramifications of legal versus illegal drugs I also began to question the positive and negative effects of both illegal and legal drug use. For example, if there are good things that happen with alcohol use it seemed possible that there are similarly good things that are achieved with use of illegal drugs. My understand increased to include the idea that illegal drugs could also be used recreationally which went against the socially and politically promoted understanding of illegal drugs but fit into the public health approach.
Consensus building. The goal of transformative learning is consensus building (Mezirow, 2000). This is an ongoing process meaning one’s best judgement is always tentative until additional evidence, arguments, or a different perspective are presented (Mezirow, 2000). Aligned with Mezirow’s perspective I did seek out viewpoints that challenged the prevailing norms of the dominant culture in order to better inform my perspective. For Mezirow, the key to consensus building is in discourse. The role of discourse is not based on the adversarial mentality prevalent in North American society because it involves reaching consensus through trying on other points of view, and reframing.
The role of discourse.
As I engaged in discourse with others who had different understanding and views of substance use and addiction I began to gain better understand of the meaning of my own experience. Through lecture, reading textbooks, watching videos, exposure to clinical experiences, hearing the opinions of nurses and doctors and other interdisciplinary professionals I was able to make the transformation in my understanding of addiction. As my own understanding became more solidified I began to more clearly see the contrast between my new perspective and my old one; my distorted thinking became apparent.
Distorted Thinking
Adults have a tendency to try and simplify or generalize their experiences (Mezirow, 1991).
Many errors that lead to distorted thinking are logical and methodological meaning they involve the process of reasoning, fallacies in the principles of logic and violations in the rules of interference (Mezirow). It is clear that in the 1980s and 1990s there was much politically influenced discourse used to create fear about drugs, drug using behaviours and drugs users incorporated in these presentations which were based on the ‘war on drugs’ mentality of the time (Tupper, 2008). These policies were not based on creating sound logical arguments, providing research evidence and sharing the truth about drugs in terms of presenting an accurate picture of the pros and cons of drug use but rather, sought to scare school children into choosing abstinence. I learned that alcohol was acceptable and that illegal drugs were bad, yet in my psychology degree I learned that alcohol was a psychotropic drug just the same as illegal drugs. This logic was flawed. I also learned that bad people use drugs and especially bad people misuse substances, yet when I entered high school I saw that my friends, people I knew were not inherently bad, engaged in substance use. I learned that it only took one time to become hooked on drugs and spiral out of control yet I saw people using illegal drugs recreationally, leading to me to question that logic. Further, my belief was the those who were “addicted” were much different than me, yet when I began to meet people suffering from addictions issues in my nursing career I began to see that addiction was far from a calculated choice of those who were deviant, those patients that I encountered were just like me and the people that I had close in my life.
Language based distortions.
My distorted thinking also stemmed from linguistic fallacies. The arguments that I held were corrupted by ambiguous use of language, for example shifts in meaning, imprecision or vagueness, or incorrect use of words (Mezirow, 1991). Those who engage in drug use were labelled “addicts” but not everyone who used substances was addicted to them. The values and implicit ideologies embedded in the discourse used to describe drug addicts was apparent in my understanding of addiction as criminal activity. For example, terms such as wasted, stoner, crackhead, junkie and more all have specific connotations that communicate the value that those who engage in drug use are outsiders and deviants. Similarly, the illness perspective of addiction also contains values and behavioural expectations that addiction is a lifelong label that individuals cannot escape from. Language-based distortions are connected to the metaphors that are created to describe the world, since the very logic of communicative learning is metaphorical. Meaning is what we can agree upon or at least accept as a working basis for seeking agreement about the concept at hand.
Distortion through selective perception.
We only see what we prefer to see. The current ideology or frame of reference is protected against challenging perceptions and points of view that do not fit, they are deemed irrelevant (Mezirow, 1991). Social roles are frames that direct how, under circumstances, and how much we give our attention to the role players (Mezirow). Throughout my young adulthood it was easy to block out those individuals who did not share my point of view about binge drinking as I chose to surround myself with like minded friends. Further, it was easy to ignore that my friends engaged in problematic drinking behaviour because this did not fit with my perspective.
Strategic fallacies.
The third category of fallacies that Mezirow (1991) describes as leading to distorted thinking are strategic fallacies. These are arguments presented in ways that appeal to people’s prejudices, biases, loyalties, fears, and guilt. This type of For example, the arguments posed by the US government, the “War on Drugs” was an argument built on prejudice for a particular group of people and cultural fear. I learned that there is nothing inherently bad about substances, it is how they are perceived in society and how they are misused that lead to problematic results.
Significant Influences in my Transformative Change
The significant parties involved in my transformative change are divided into those that led to the incremental changes in meaning schemes and those that contributed to the larger change in my meaning perspective. The friends that I had in high school facilitated my first disorienting dilemma about my meaning schemes of substance use and addiction. The next major influence were the professors in my university experience, primarily those in my sociology classes because they helped facilitate my learning about the different social factors that contribute to how substance use and the issue of addiction is constructed in mainstream North American society. However, it was not until I had meaningful interaction with individuals suffering from addictions issues and learned from those who used a recovery oriented approach to care that my meaning perspective transformed.
The next major player in my transformative change was the women that I both worked with and served at the Calgary Women’s Centre. The experience I gained in my volunteer position led me to a different understanding of social inequality and allowed me to opportunity to meet firsthand women impacted by addiction, allowing my to apply and adapt the theoretical knowledge I gained in my undergraduate degrees. The most significant parties in my transformative change were the nurses I encountered in my mental health nursing experiences. In my undergraduate nursing experience my mental health clinical nursing instructor who had an extensive background in Assertive Community Treatment and Forensic Mental Health introduced me to a new way of seeing addictions, a public health approach that focused on recovery rather than illness. This new perspective was solidified in my time in correctional nursing I saw marginalized individuals.
Collective transformations.
Mezirow (1991) believes that perspective transformations occur not only in isolated individuals, but also in people involved in groups and social movements. Perspective transformation is a social process often involving points of view expressed by others that may initially be rejected but later recognized as integral in understanding experiences (Mezirow). For example, social and political shifts were occurring in Canada that differentiated the framework used to guide care of individuals with addictions issues. In Canada addiction was positioned as a public health issue rather than as a criminal justice issue (Public Health Agency of Canada, 2003). In the early 2000s the harm reduction movement starting gaining popularity in Canada. There was an ideological shift in health care from the need for abstinence as the only goal to reducing the overall harms associated with drug use (Public Health Agency of Canada, 2003). The greater collective social and political movements that occurred and progressed simultaneously as I progressed through university were integral in my transformative change. Through the case study analysis process I was able to better understanding my own transformative journey.
Strengths and Limitations of the Case Study Analysis
In my current job as a mental health and addiction nurse I encounter critical situations with individuals suffering from addictions issues on a daily basis. When others learn of my career choice they often comment about the difficulty of the job. Prior to this exercise I had never fully reflected on how my worldview influenced my career choice nor how my perspective had changed throughout my adulthood. The case study process allowed me to gain insight into how I had come to my current understanding of addiction.
While I appreciate the opportunity to reflect and write about this transformative process I feel as though there are challenges with retrospective exploration of a SLE. In some ways I feel as though I am speculating about certain pieces of my childhood and development that led to the formation of my original meaning schemes and meaning perspectives. For example, I am making assumptions about what I likely saw on news media from the 1980s because of my understanding today about the ‘War on Drugs’ and the specific design of tools for educating youth about drugs in the 1980s and 1990s however there is no way I can really verify that I saw these images. In some ways I feel like I must assume that I can make generalizations that the social, political and historical context impacted me in a certain way indicating that the retrospective process may be flawed as a method of accurately understanding the intricacies of one’s transformative learning process.
Limitations of Mezirow’s Theory
One of the major limitations of Mezirow’s (1991, 2000) theory is the emphasis on the importance of higher education as necessary for facilitating significant transformation. Mezirow fails to include the importance of learning that takes place through informal experiences, indicating a bias towards formal education and the role of the educator in helping facilitate the transformative process. In my case, I felt that my experiences in higher education did contribute to my critical reflection process, but, I felt that my life experiences when I moved to Vancouver for the first time, my volunteer experience and work experience were more impactful in my transformation.
I believe that formal education at the university level provides and important component for learners to become engaged in the transformation process, but it is not a necessary prerequisite; further formal education does not guarantee that the learner will engage in transformative change. Another limitation of Mezirow is his assumption that academic freedom permits anyone to be critically reflective of established cultural norms of viewpoints (p. 15). Mezirow seems to ignore that cultural norms can be quite restraining within higher learning, actually reinforcing said norms rather than encouraging them to be challenged. Mezirow's writing indicates an ethnocentric view of transformative change, as defined and explained from the perspective of mainstream North American society. While Mezirow acknowledges that cultures and societies differ in the degree to which critical reflection and discourse are encouraged, he does not explain in great detail about how this may be addressed with respect to impacts on transformative change. For example, in societies that promote and celebrate conformity and collectivism higher education may not have the same function of emancipation as in more individualistic cultures.
Another major limitation is rooted in the notions that, while Mezirow acknowledges that the learner must be aware of the inequality in which they exist to fully understand and take collective action to ameliorate inequality, multiple social factors constrain the ability to do this. Mezirow seems to place too much emphasis on the role of the adult educator as a change agent. For example, he acknowledges that marginalized groups like the homeless, threatened, sick or frightened adults are less likely to be able to participate effectively in discourse to help others better understand the meaning of experiences. He states that this is the reason why, “adult education is dedicated to social justice,” (p.16) but this seems an idealized view because not all adults have equal access to education, nor is the focus of adult education always created for purpose of transformative learning. In my case, I never had exposure to the marginalized groups that formed my original meaning perspective of addiction in a meaningful way; I did not gain greater understanding of their experiences until I actively sought them out.
The final major limitation I have found with Mezirow’s (1991) transformative theory is that he used a very vague definition of adulthood. According to Mezirow, “an adult is commonly defined as a person old enough to be held responsible for his or her acts,”(p.24). He used the context of democratic societies, where the assumption was made that adults are able to understand the issues, and thus will make rational choice as socially responsible, autonomous agents, sometimes, free to act on them.
Conclusion
The purpose of this paper was to analyze one of my own Significant Learning Experiences (SLE) in order to demonstrate the applicability of Meziow’s theory, strengths and limitations. The SLE that I chose to explore was my understanding of addictions. This is significant to me because I currently work as a mental health and addictions nurse. As I reflected on my transformative learning process I realized that my understanding of substance use has heavily influenced my meaning perspective of addiction. I outlined the key transition points of my SLE that occurred in my adolescence and young adulthood that led to a transformation in my understanding of substance use and addiction. Through analysis and discussion of my case I was able to clearly outline the strengths of limitations of applying Mezirow’s transformative theory to a specific SLE.
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