By Roger Sharpe
For a “disease” that was unknown anywhere in the world until the beginning of the 20th Century, addiction has made short work of becoming the most arguable and most confusing of all modern ailments.
There can be little doubt that we live in a society in which a range of substances (activities?) – drugs, alcohol, food, etc., are viewed as a major means to relieve pain, fear and boredom.
Alcohol ranks as the third most prevalent health problem and each year thousands die prematurely from tobacco related diseases. One in seven adults takes tranquillisers at some time during the year. Apart from problems related to legal drugs, the popularity and availability of illegal drugs has ensured that the “new” problem is never far from making headlines.
With traditional approaches to “cures” being centred around hospitals, psychiatrists and prisons, it is encouraging that increasingly academic research and clinical practices are combining to undermine the disease and deviance models. Traditionally, drug and alcohol use has been separated from other compulsive behaviours, but increasingly, dependency, tolerance and withdrawal, (the traditional cornerstones of addiction) are also to be found in a range of other human activities, where no chemical is present.
Every New Year’s Eve, millions of people resolve to put an end to “bad” habits, only to break their resolution within weeks or even days. Bad habits are hard to shake off, hence the notion of relapse – giving up a pleasurable activity for most is a painful experience. It may trigger a process of loss and mourning.
I’m suggesting that dependence is primarily a psychological state and is best considered as a state of sadness (depression?), loss, anxiety and craving. Loss is perhaps the most intensely painful experience a human being may experience.
While I’m suggesting that mourning and loss is where the psychotherapist’s work begins, I would not want to underestimate the sometimes painful physical effects withdrawal can bring – witness anyone giving up nicotine. Giving up is one thing, maintaining the change, staying off, is usually a much longer process. It is at this point the medical model has little to offer. Treating people like cars requiring an oil change (detox) does little to help them adjust, but research shows that therapy which perceives dependency as the presenting problem and enables clients to explore the full range of feelings that emerge, have higher rates of success.
Could it be then, that positive outcome depends on our response to and working through of grief? And, where might patterns of behaviour emerge from? …
Melanie Klein suggests there is a close connection between normal mourning and the early process of the mind in the infant and that this early mourning is revived whenever grief is experienced later in life. The earliest experience of depressive feelings, during and after weaning, are as a result of the lost object being mourned.
The object being the mother’s breast, and all that the breast and milk have come to stand for in the infant’s mind, namely: love, goodness and security. All these are felt to be lost because of the infant’s uncontrollable greed and destructive fantasies and impulses against the mother’s breast.
In the infantile neurosis, the early depressive position finds expression, is worked through and gradually overcome. This is an important part of the process of organisation and integration that characterises the first few years.
Normally, the child passes through this in order to arrive at a good relationship with people and reality. The satisfactory relation depends on having succeeded in this struggle against chaos inside, and having securely established its “good” internal objects. It might be that one’s feelings towards mother, the source of original nourishment and love, is similar or becomes similar to one’s feelings and attitudes towards the new object of nourishment, e.g. the bottle (alcohol – not milk, etc.) When the source ceases to provide sufficient nourishment (tolerance has developed), it becomes a source of threat to one’s life, e.g. when it becomes physically dangerous or impossible to carry on.
These feelings of sorrow and concern, with fear of losing them, and longing to regain them, result in feelings of victimisation and persecution (by bad objects) and the usual defenses against it. There is also a pining for the loved object.
That human beings are not merely weak willed, but instead experience varying degrees of grief when making great transitions, may enable counsellors and psychotherapists the opportunity to explore within their own therapy, some of the dependency issues that disturb them! Addiction does not happen overnight, it is not a search for “kicks”. It is instead, a retreat into a comfortable, predictable experience. ‘There’s no gain without pain”.
Roger Sharpe trained at the Minster Centre, London and works as a trainer/counsellor in West London.