How do we talk about addiction when no one is watching?

This week marks Addiction Awareness Week, a campaign first launched in the UK by the Princess of Wales in 2021, on behalf of the #Forward Trust and their Taking Action on Addiction initiative.

As the campaign rightly says, addiction thrives in silence and recovery begins with a conversation. So, throughout the week, I've been thinking about some of the conversations that have shaped my own understanding of addiction and recovery.

About some of those raw, unscripted moments when awareness breaks through stigma, when kindness overcomes judgment, when someone's humanity becomes impossible to ignore.

In this week’s article I’ll share with you three of those conversations that came to my mind. Each taught me something different about what makes transformation possible.

Mia

I was barely two months into my internship at psychiatric hospital in Bucharest, still trying to figure out what all this clinical psychology field is about, when I found her sitting on the hospital stairs. She was crying with those gulping, chest-heaving sobs of someone who has run out of hope.

The detox unit staff had turned her away. She'd nearly overdosed, they'd stabilised her, and now she was someone else's problem. "We've done what we can," they'd said. "She needs to want help."

I should have walked past. I was exhausted, my shift had overrun, and I had nothing to offer her that the experienced emergency team hadn't already tried. But something made me sit down beside her on that cold concrete step.

"I'm not going to last much longer," she said, not looking at me. "And nobody cares."

I didn't have any wise words or advice to share. I just sat with her. And slowly, between her tears, a story emerged, A story of someone who had been turned away so many times that wanting help had become a kind of torture. Every door closed felt like confirmation: you are the problem. You are unworthy. You are too much.

That conversation didn't save her life in some dramatic fashion. I gave her the number for a charity I was working with, made sure she had somewhere safe to go that night, and we parted. But something shifted in me that I've carried ever since: the understanding that stigma isn't just an attitude problem or a communications challenge. Stigma kills. It sits in the space between a person in crisis and the help they need. It speaks through well-meaning professionals who've learned to protect themselves by creating distance. It whispers that some people are beyond our care, that some suffering is somehow deserved.

What made that conversation possible wasn't my clinical skill, I had precious little at the time. It was simply sitting down. Not standing over her, not speaking from behind a desk or through the authority of my role, but meeting her where she was. On the stairs. In her pain. In our shared humanity.

The awareness that crystallised for me that night was this: addiction thrives in isolation and shame, but a single moment of genuine human connection, of being truly seen and not turned away, can plant a seed that might one day grow into recovery.

Linda and Bob

Years later, now living and working in the UK, I was sitting across from two exhausted parents in a family meeting, I recognised that same isolation wearing a different face. Their son was in our residential service, and they were doing everything they believed love required: calling multiple times a day, bringing money "just for essentials," planning his return home despite his team's concerns that he might leave the service too early.

They were terrified. And in their terror, they were keeping him stuck.

This conversation required a different kind of courage. The courage to speak a truth that might feel like judgment, to suggest that their instinct to protect was actually preventing the very growth they desperately wanted for their son.

"Tell me about the last time you felt peaceful," I asked them.

The question seemed to catch them off-guard. The mother's eyes filled with tears. "I can't remember," she said. "It's been years. We're always waiting for the phone to ring, always afraid of what comes next."

We talked about co-dependency, not as a flaw, but as a natural response to loving someone in pain. We explored how their constant availability, their financial support, their willingness to smooth every rough edge had inadvertently communicated to their son that he wasn't capable of managing his own life. That someone would always catch him before he fell.

"Not enabling doesn't mean not loving," I told them. "It means loving in a way that makes space for him to discover his own strength. And it means recognising that you matter too. Your wellbeing, your peace, your lives…they don't have to be casualties of his recovery."

The father sat very still. "We thought we were helping," he said quietly. "We thought if we just loved him enough..."

"You do love him enough," I said. "Now you need to love yourselves enough too."

This conversation shifted the focus from what they were doing wrong to what was possible when they approached both their son and themselves with compassionate awareness. It acknowledged their exhaustion, their fear, their profound love, and it offered them permission to lay down burdens they were never meant to carry.

What made this conversation possible was safety. Creating a space where they could be honest about their struggles without fear of judgment. Where we could acknowledge that one can be both helping and harming, that love can be both powerful and insufficient, that recovery is a collective journey that requires everyone to do their own work.

The awareness at the heart of this conversation was about interconnection: that families are systems, that recovery happens in relationship, and that sometimes the kindest thing we can do is to step back and trust the process, and trust the person, enough to let them fall and get up again.

Rebecca

The third conversation I want to share here happened late one evening, after a particularly long shift in a prison’s recovery wing. A colleague sat in my office struggling to find words.

"I don't think I can do this anymore," she finally said. "I give everything I have, and today he called me a..." She couldn't repeat it. "How do I keep caring when they hate me?"

I've had versions of this conversation more times than I can count. With team members who take every harsh word personally, who measure their worth by whether clients are grateful, who believe that good care should somehow protect them from being hurt.

"He doesn't hate you," I said gently. "He hates what he's feeling. He hates withdrawing, he hates the shame of needing help, he hates feeling vulnerable and exposed. And you're the one standing closest, so you're the one he lashes out at. It's not personal, even though it feels devastating."

We talked about the strange balance required in this work of ours: to be fully present, to genuinely care, to invest your heart, while simultaneously holding everything lightly enough that you can receive someone's pain without it destroying you. To understand that early recovery is a time of profound emotional volatility, that people who are hurt often hurt others, that kindness sometimes looks like absorbing anger without retaliating or withdrawing.

"We have to keep giving our all," I said. "But 'our all' must include protecting ourselves. It must include boundaries, supervision, time away, the ability to separate their journey from our sense of competence. We can hold space for their anger without holding onto it ourselves."

What made this conversation possible was timing. Catching her before she made an exhausted decision that she might regret; before the accumulated hurts calcified into cynicism. And it was about naming a truth that too often stays unspoken in our field: that this work demands everything and gives back in ways that aren't always immediate or obvious. That we need each other to process the weight, to remind each other why we started, to hold the hope when our clients can't yet hold it themselves.

The awareness here was about sustainability: that we cannot pour from an empty cup, that self-compassion isn't selfish but essential, that the way we treat ourselves sets the tone for how we treat others. If we cannot extend grace to ourselves when we stumble, how can we authentically offer it to those we serve?

What Makes Conversations Matter

These three conversations might seem disparate. But they share common threads that speak to what the Taking Action on Addiction’s campaign means by "the conversation that changed everything."

Each required awareness: seeing clearly what was actually happening beneath the surface chaos. The girl on the stairs wasn't refusing help; she was drowning in shame. The parents weren't failing their son; they were suffocating him with misplaced protection. My colleague wasn't weak for feeling hurt; she was human.

Each demanded that we overcome stigma, both external and internal. The stigma that says people with addiction don't deserve care. The stigma that says asking for help makes you a bad parent. The stigma that says professionals should be impervious to pain.

And each leaned heavily into our shared humanity: the recognition that we are all vulnerable, all learning, all capable of both causing harm and creating healing. That there is no "us" and "them", but only us, trying our best, needing each other.

What if this week, we each committed to having one honest conversation? To sitting down on the stairs, metaphorically or literally, with someone who needs to be seen. To speaking truth wrapped in compassion. To building the kind of world where no one must go through tough times alone, where families can heal together, where helpers are supported to keep giving their all without losing themselves.

Because the conversation that changes everything isn't always dramatic. Sometimes it's just sitting down. Staying present. Choosing to see someone's humanity when the world has decided they've forfeited the right to be seen.

Sometimes it's as simple, and as revolutionary, as not just walking past.