Here is a familiar example of this phenomenon: an alcoholic/addict initially asks someone in the program to be his/her A.A./N.A. sponsor and then never calls that sponsor: the disease has apparently convinced the addict/alcoholic that the sponsor is not necessary after all! 

The medical literature sometimes quotes low success rates for 12-Step meetings, while including in its statistics addicts/alcoholics who have only attended a few meetings in their lifetime or who have not followed most of the suggestions offered by successful members of the program. This is like judging insulin to be an inadequate treatment for diabetes because the patient has refused to take it. In other words, non-compliance is not the same thing as ineffective treatment. 

What is passive-aggressive behaviour? Simply put, in this context, it is the sabotaging of one’s Recovery while giving the appearance of wishing to be compliant. 

There are many forms of treatment resistance/ ”defiance”/ passive-aggressive behaviour. For the purposes of this blog and for the sake of brevity, I will focus on just one problematic behaviour: chronic tardiness (to medical appointments, meetings, etc…). While punctuality shows respect for others and demonstrates a sense of responsibility and commitment to Recovery, consistent lateness may indicate passive-aggressive defiance and recalcitrance, sometimes masquerading as helplessness and “terminal uniqueness” – conforming to standard norms does not apply to the “terminally unique” passive-aggressive addict/alcoholic. 

While occasional lateness needs to be distinguished from habitual lateness, the latter may indicate that the patient is struggling, that he/she is failing to prioritize Recovery. Lateness in this context may be a sign of defiance, an important indicator that Step 1 has not been thoroughly accepted. This patient has not yet realized that Recovery from addiction (a lethal disease) needs to take precedence over anything else. 

Of course, each addict/alcoholic must be evaluated on an individual basis and there may be various reasons underlying each case of habitual lateness; nevertheless, a deep-seated ambivalence to treatment can often be deduced as the underlying factor in chronic tardiness, and certainly the most important one to consider at this stage if progress in Recovery is to be achieved at all. 

How does one confront this kind of behaviour? A delicate balance must be struck between glossing over it on the one hand and appearing judgmental. It is important to emphasize that the disease, not the person, is being attacked. The treatment providers need to point out that consistent lateness is disruptive and chaotic; it is living life on the edge. Running out of time and being late can be exciting and energizing, but also destabilizing. The disease of addiction thrives on this kind of instability and mayhem. Much of this operates on a subconscious level; the patient is most likely not even aware of the underlying dynamics of his/her disease which is subconsciously sabotaging the patient’s treatment and Recovery program. All this needs to be pointed out to the patient gently but firmly. At first, the patient will probably not accept nor fully understand these comments and therefore he/she should be invited not to react but to reflect and process these comments over the next few days. Follow-up and further discussion of this important issue is essential. 

Chronic tardiness may be a cry for help. It may indicate one manifestation of passive-aggressive behaviour; it often represents a failure to prioritize Recovery from addiction (a lethal disease). The underlying causes for consistent lateness should be explored and may be used to highlight the patient’s possible ambivalence towards treatment. If the patient can accept this and change her/his behaviour, progress in Recovery is then possible. 

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