PSYCHOLOGICAL STRESS, STIGMA AND IDENTITY CONFUSION AMONG PATIENTS IN REHABILITATION CENTERS FOR ADDICTION AND SUBSTANCE ABUSE

Abstract

This study examined the way in which the patients enrolled in the drug rehabilitation centers in the Arab community experience psychological stress, stigma and identify confusion during recovery. It identified the sources of those variables & the way in which they interact with each other to shape the patients’ rehabilitation experiences.

The phenomenological qualitative approach was adopted through conducting semi-structured interviews. The purposive sample consists of 31 participants. Those participants include: 20 patients recovering from substance use disorders, 6 staff members, and 5 mental health specialists in rehabilitation centers.

Data were analyzed through conducting thematic analysis. Frequencies and percentages were calculated. Based on the findings, psychological stress is reported by 17 patients (85%). The patients described psychological stress as an ongoing burden throughout the whole rehabilitation process. The most frequently reported sources of psychological stress include: uncertainty about the future after being discharged, fear of relapse, difficulties in re-building family relationships, and concerns about social acceptance. Many patients confirmed that psychological stress was more intense during moments of self-reflection, future planning and social interaction.

Stigma was reported by 15 patients (75%). The manifestations of external stigma include: rejection, judgment, or distrust from the society or family. The manifestations of internalized stigma include: feelings of self-blame, and shame, and reduced self-worth. Several patients reported that stigma persisted even after entering the center. They added that stigma undermined their sense of progress and reinforced their negative self-perceptions. Staff members and specialists confirmed that stigma frequently affects the patients’ motivation level and willingness to engage fully in treatment.

Identity confusion was evident in 14 patients (70%). Patients reported difficulty in redefining themselves beyond past behaviors and addiction-related labels. Many patients added that they lack a clear, stable sense of who they are becoming during their recovery process. Identity confusion was often accompanied by self-doubt, emotional instability and fear of social reintegration.

The three variables are deeply interconnected and affect one another. The process of recovering from addiction is multidimensional and requires going through major social and psychological transformations.