Week of May 6th

The writer of Unbroken Brain: A Revolutionary New Way of Understanding Addiction clearly writes drawing from her personal experiences with addiction and treatment of addiction. Without reading the book, I gather from the article that the writer focuses on psychosocial treatment methods that draw on moralistic and political grounds for rehabilitation, that is love or hate in a social context. An alternative view to these moralistic approaches that utilises the same principles without necessarily drawing on “dogma” is the psychoanalytic view of addiction that works by evoking some form of desire or by guaranteeing satisfaction of some desire. In this approach that draws primarily from Lacanian psychoanalysis, recovery is a process of interpellating - bringing into being or giving an identity to an individual - by motivating the patient to assume a particular subjective position, for example, the sinner or the addict etc in 12 step programming. The key to the new identity formation is in the discourse surrounding the patient. As such, treatment depends greatly on the social identifications the individual possesses and can draw upon in order to work through the process of interpellation. Thus 12 Step and other moralistic or political discourses give patients a position from which to begin re-imagining their desires. Whether it is by offering love or hate these discourses convince the patient to take up a position from which they can begin to act as subject. Any cultural or systemic code that gives the patient a new desire leading away from the desire to misuse drugs works in recovery. The key is to connect the patient to the code and cultivate a new desire which draws its significance from social systems (generally, culturally, professionally, etc). Discourses that work are those that demand from the patient that they give up old desires for new socially bonded desires that will help them reconnect with family, friends, and society. I think this is a more positive way to look at programmes such as 12-Step because it’s not so much the dogma that matters but the desire that dogma inspires in the interpellation of the patient.



References:

Aston, S. (2009). Identities under construction: Women hailed as addicts.Health:, 13(6), 611-628.

Canabarro, R. D. C. D. S., & D'Agord, M. R. D. L. (2012). Drug addiction and social discourses. Revista Latinoamericana de Psicopatologia Fundamental,15(3), 482-496.

Malabou, C. (2008). Addiction and Grace: Preface to Felix Ravaisson’s ‘Of Habit’’. Of habit.

Unbroken brain by Maia Szalavitz gives us a broad spectrum of knowledge about addiction and how we should consider addictive patients as professionals. Addiction to substances or activities can sometimes lead to serious problems at home, work, school and socially. Users may not be aware that their behavior is out of control and causing problems for themselves and others. "Addiction doesn’t just happen to people because they come across a particular chemical and begin taking it regularly,” she writes. Rather, “it is learned and has a history rooted in their individual, social, and cultural developments.” People compulsively use drugs, gamble, or shop nearly always in reaction to being emotionally stressed, whether or not they have a physical addiction. As she describes in the book, when it comes to “hitting bottom”, the focus of the addiction isn't what matters; it's the need to take action under certain kinds of stress. Treating this kind of addiction requires an understanding of how it works psychologically.

I disagree with the viewpoint of this article almost in its entirety. As someone who has worked in an inpatient drug rehabilitation center for adolescents, I have seen the difference in treatment between someone who really desires help and someone who was forced to be in treatment by either the state or a parental figure. The difference between these two individuals is that the person desiring help attends group counseling sessions, contributes meaningfully to the discussion, and really tries hard to deal with their issues. In comparison, the adolescents that were forced to be there not only refused or minimally participated, but refused to admit that there was anything wrong or harmful about their recent behavior. Although I do not feel that "hitting rock bottom" is absolutely necessary for treatment to be effective, the addict must have something important to them being threatened by their behavior. This could mean anything from the loss of support from a family member to their future aspirations being jeopardized by their current behavior. It was the addicts who had nothing to lose and refused to admit their behavior was harming them, who continued their drug addiction (usually worst than before) and met traumatic ends after leaving rehab. Although empathy is important in talking with addicts, there is a fine line before empathy becomes enabling. This is what many family members and friends of addicts struggle with. In my experience, empathy is necessary in order for an addict to open up about the issues they are dealing with that have led them to seek drugs. However, addicts must also receive "tough love" to realize that what they are doing to themselves and others through their drug behaviors is not right. I also disagree with Maia Szalavitz’s comment that addiction is "learned and has a history rooted in their individual, social, and cultural developments.” A large majority of the patients I was responsible for came from families that did not condone that type of behavior, and whose environments did not expose them to that type of behavior. To me, that statement is simply a statement of justification for drug addiction. It completely disregards that as humans, we all have a choice - a choice to self-medicate with drugs or to not.

In Maia Szalavitiz's book; Unbroken Brain: A Revolutionary New Way of Understanding Addiction, she explains that an addict it ready to clean up their life and change when they have hit 'rock bottom'. She also goes onto explaining that AA facilities should create a 'rock bottom' experience for the patient in order to help them change. I don't agree with this concept. I do believe that in life when one's hit rock bottom they normally do change their life for the better and learn a valuable lesson. When these changes happen, many people never go back to where they were, because they know how hard they have worked to become that changed individual.
Creating and causing psychological damage for one to hit rock bottom and change, will only cause future damage and may not even help the person with their addiction. Humiliating someone who already have issues, can lead to more problems for them in the future. Breaking someone who is already broken will not help heal wounds. So pouring salt into an open wound, can cause the patient more damage!

The article “The Tragic, Pseudoscientific Practice of forcing Addicts to Hit Rock Bottom” is trying to educate readers that there is no absolute formula when treating a person afflicted with addiction. Instead of persecuting people with addictions, society should embrace them with support and empathy.

I do understand addiction is not a “moral shortcoming.” When an abuser repeatedly keeps choosing to participate in careless behavior that could result in harm to those around them, some negative consequences should occur. I am not in support of the harsh methods of starving, sexual humiliation, or attack therapy. Instead we should make it mandatory for them to attend outpatient treatment with a mental health professional. We must find other innovative ways to help the addicted person see that choosing this undesired behavior is more detrimental then beneficial. Instead of ostracizing those struggling with addiction, we have to support them through their illness to avoid inflicting long term negative psychological effects.