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| jayirwin |
 Posted: Tue Dec 19, 2006 3:54 pm |
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DPA DC Staff
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I'll admit it. I come from an anti-psychotherapy family. My dad consistently denigrated the potential of therapy to solve anyone's problems when I was growing up (and still does, come to think of it!).
So I have deeply held suspicions about psychotherapuetic efforts to help people come out of addiction. How is talking about your problems going to help you actually solve your problems, especially if they are largely behavioral? Talk is talk, people.
This article in the New York Times today perfectly summed up this conundrum, I thought. Definitely gives a different perspective on what might work to help people free themselves of their addictive behaviors:
Sometimes, the Why Really Isn't Crucial
The New York Times
December 19, 2006 Tuesday
By SALLY SATEL, M.D..
Sally Satel is staff psychiatrist at the Oasis Drug Treatment Clinic and a resident scholar at the American Enterprise Institute.
''Why do I use drugs?'' I am asked every few weeks by a patient in our methadone clinic.
I take the query as a good sign; curiosity about oneself is usually healthy. But the premise behind the question -- that a person can reliably identify the psychic roots of an addiction, or any other act of self-sabotage -- is highly overrated.
Research psychologists have known for decades that it is very difficult to determine causation in mental life and thus, of behavior. For one thing, we can never perform an experiment. Take my patient Karen, 50, who spent most of the 1990s smoking crack. She is certain that the decade-long binge would never have happened had her mother not died when she was 12. We will never know if she is right because we cannot rewind Karen's life, play it again, and see what would have happened if her mother had lived.
Reconstructing the story of one's life is a complicated business for other reasons. What scientists call hindsight bias kicks in when we try to figure out the causal chain of events leading to the current situation. We may well come up with a tidy story but, inevitably, it will contain large swaths of revisionist history. It's not that we bias ourselves deliberately; it happens because the mind tends to make events in the past appear comprehensible and orderly. We forget the uncertainties that might have beset us as we struggled in real time.
Narratives are shaped also by a natural tendency to focus on information that confirms theories we already hold. These theories -- for example, that molested children are likely to grow up to have sexual compulsions of their own
-- may be imbibed from the media, self-help books or therapists.
If our own accounts of our actions are often so slanted and embellished, is composing them simply a misbegotten quest? Surely not. To a therapist, the attempt signals that patients are aware that they have a problem worthy of attention. And the narratives themselves can help them make sense out of confusion. This, in turn, can diminish anxiety and exaggerated guilt. Such relief might be sufficient in and of itself for some, or, depending on the goals of therapy, it could embolden a patient to make further healthy adjustments.
But the grail-like search for insight can also backfire when it becomes a way for patients to avoid the hard work of change. This was my experience with Joe, a 24-year-old heroin addict. At every session, Joe would talk about his childhood relationship with his father, seeking new clues for how it damaged him and drove him to heroin.
When I tried to change the topic to on-the-job stresses, which he linked to heroin craving, he said he'd rather ''do psychotherapy.'' Joe was forestalling the need to make practical changes. The many-layered drama with his dad doubled as an excuse for using heroin, absolving him of the responsibility to quit. When I proposed that possibility to him, he said, ''Maybe you're right.'' But nothing really changed. He died of an accidental overdose a few months later.
Finally, insight has no guaranteed relationship to change. A colleague of mine treated a 45-year-old woman, Joan, who came for therapy because she hated her chunky body. Joan firmly believed that once she discovered The Reason for her overeating she would stop.
After a few months, Joan told my colleague that her father had developed cancer the year she went off to college.
''You know, I never made the connection until now,'' she announced triumphantly, ''but I started overeating when he began to waste away. It's like I was trying to nourish him through myself.''
A poignant metaphor, yes, but months later she hasn't lost a pound.
It is time to retire the myth that insight is a prerequisite for change.
For the patients in our clinic, change without hard-won insight is the rule. And who has time to wait? Not Natalie. This past month she and I worked on getting an abusive, shiftless boyfriend out of her apartment; finding tutoring for her son; and building a new social network to replace the drug users that she used to hang out with.
At this stage in her treatment, awareness of what she needs to do will get Natalie further than insight. Less chaos in her life means less anxiety and that means less risk of relapse.
Down the road she may ask, ''Why did I use drugs?'' But in the meantime, what's important for Natalie and her son is that she is determined to stop.
Frederic C. Bartlett, a British psychologist, coined the term ''effort at meaning'' to describe the human impulse to make sense of feelings and circumstances. Self-explorers be warned: it is an effort often fraught with distortion and even hazard, when it prevents one from making the changes that need to be made in the present. |
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| weirdharold |
| Posted: Thu Dec 21, 2006 10:48 am |
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Joined: 01 Nov 2006
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Location: Mississippi
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Matthew 6 (King James Version)
Take therefore no thought for the morrow: for the morrow shall take thought for the things of itself. Sufficient unto the day is the evil thereof.
I use this thought |
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Harold W. Ard |
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| Gordmanic |
| Posted: Fri Jul 13, 2007 6:30 am |
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Joined: 24 Jun 2007
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| Well treating addiction has never been an easy thing to do, it's a hard struggle and "patients" need fresh forces to succeed. It is a very powerful psychological matter and in most cases addiction needs time. Fortunately there are professional drug treatments for that but none of them can't guarantee a good result without "patient's" collaboration. |
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| cfranco |
| Posted: Fri Aug 28, 2009 4:39 pm |
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Joined: 25 Oct 2007
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Hey jayirwin, do you want to marry me??
well, it is the thought that counts.
YOur dad is alright, I am a Psychotherapist myself and I don't blame him.
Read Thomas Szasz MD, he is a psychiatrist that will agree with your dad in many things.
The problem is that there is not such a thing as an Addictive Drug. A lot of people have used drugs (even heroin) and a good number of them do not become addicted to them. In fact, a lot more people who try drugs do not get addicted to the drugs, alot more than those who do.
Some of us as humans become dependent on the drug because we like what it does to us. The drug does not addict us, and we are not totally powerless over them. I will explain that last one if you like but I do not want to bore you with to much information at one time, maybe you will not marry me  and that would be a problem  . |
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| rita |
| Posted: Thu Nov 05, 2009 12:37 pm |
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Joined: 28 Jun 2007
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Location: Arizona
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Mandatory treatment fails because it's mandatory. The reality is that most people who use drugs, legal or not, don't want to quit. The reality also is that most people who use drugs do quit, eventually, for reasons of their own; which is how it should be in a free society.
If I had diabetis, would you "provide" insulin and an armed guard to make sure I use it? No? If I had cancer, would you "provide" medical care under threat of imprisonment? No, again. In fact, if I had either one of those diseases, without medical insurance, I would be hard pressed to even get treatment, even though either one of them -- unlike drug addiction -- are fatal if left untreated.
Maybe you should stop worrying about why I'm addicted and start explaining why you, or anyone else, has any right or obligation to force me into recovery. |
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