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Self Discipline

A drug addiction recovery process

 Coming out of an addiction and into a new normal happens in phases. We do not simply put the chemicals down and then find ourselves as a central figure in our perception of what normal really looks like. We come out of the fog of war and into a therapeutic environment, but at that point we are not in recovery, we are in treatment.

Recovery can only start to develop as and when we leave treatment and we start to play our part on planet earth, on life’s terms, where everyone around us can start to relax around us, without substances to support or comfort us. Too many people want what they believe to be normal from the moment they put the chemicals down and this desire for immediate gratification via the path of least resistance, usually manifests itself in some very damaging behaviours:

  1. Going into romantic relationships ‘falling in love’ during treatment.
  2. Going into high pressured employment positions straight after treatment.
  3. Going into addiction counselling positions as an extension of their own treatment program without ever really contributing to the demands of the workplace outside of a therapeutic environment.

Where many people relapse and/or go on to find themselves in situations that they are not emotionally mature enough to handle with integrity, I would argue that ‘self-discipline’ is the missing character attribute in most, if not all of these false realities and more.

Self-discipline says, ‘well yes of course I would love to be happily married, earning mega-bucks and helping people’, but at this stage of my development, if I was asked; ‘would you marry, employ, put your life in to the hands of a person like you right at this moment in time’ – I would have to concede, ‘no, not yet’.

Self-Discipline

From a very early age children spend much of their time alone or with groups of other children, under distant supervision rather than individual direction. Instead of being managed, they are expected to manage themselves. Instead of depending on enforced obedience and external controls, their behaviour has to depend upon voluntary obedience and the internal controls that we call the ‘conscience’. If parents want to cultivate self-discipline in their children but are trying to do so in the growth medium of that ‘good disciplinarian’, it is not surprising that they are finding it an anxious struggle.

Self-discipline in the child is a slow growing plant with roots in identification with the parents/parental figure. Learning to behave and to be comfortable behaving that way depends upon parental influence rather than power; on the warmth of the relationships that adults offer the child rather than the clarity with which they issue orders. Children need to be shown what they should do and prevented from doing what they should not do and they need honest explanations for each piece of the everyday snippets of advice and instruction.

Shepherding (counselling) means being there to praise and reproof so that they can generalise from one tiny incident to the next, gradually incorporating clusters of behaviour into a vast jigsaw puzzle of values which will stabilize the ethical and moral framework within them – welcome to recovery, at this point, from a stable internal character compass, you may get married, have kids, hold your own in any workplace, possible even earn a fortune, but most importantly, really help the people around you.

Read more about the treatment of drug addiction.

Social Disease

Coming from an emotionally honest, loving and stable background, my 12 years of intravenous heroin addiction with over 6-years in 27 different prisons, confused everyone.

Visits from and interviews with Doctors, Psychiatrists, Social Workers, Probation Officers, Addiction Counsellors and even clergy, left me convinced that my state was not only hopeless because it was without definition, but that I was hopeless as an individual because it was me who was carrying this thing around.

As and when I said ‘I just don’t believe addiction is a disease’ I was quietly told that this was all a part and symptom of the addiction and its characteristic denial. My quiet conclusion was ‘well in that case, if it is a disease that tells its victim that it is not a disease, everyone suffers from it’!

I looked around me and all I could see was unemployment, broken marriages, single parents, criminal activity and a persistent niggle of discontent.

I attended between seven and nine meeting a week for four years at NA and/or AA, identifying myself with “I’m Jack and I’m an addict” or “I’m Jack and I’m an alcoholic” – simply because that  was the way things were expected to be done. To question ones diseased status was treated as being in ‘denial’ and in many instances, met with a could shoulder because you must surely be ready to relapse.

The Minnesota Model of addressing my addictions really brought life changing attitudes and beliefs into my view of the world and the role I had to play in life, and its proponents told me that my addiction was a disease – so it must be true, it had to be true, it must be a disease. But still, the niggle would not leave me that I was polluting a really healthy family line by just blending in and becoming like the people I mixed with – just like in my addiction, but I simply did not know that there could possibly be another ‘diagnosis’ to consider. Today I do.

The Socio-Cultural Influence

A very healthy idea within 12-Step recovery circles is one of each individual taking personal responsibility for the use, abuse and addiction to chemicals and for the corresponding consequences of that addiction. We have learned over the process of many years, working with street kids, down-n-outs and with the wealthier members of society, that addictions are not what we originally thought them to be and that each and every addicted individual person we came across has a wide variety of contributing factors outside of themselves which played a significant role in the problem at hand.

Within each individuals family and personal context we inevitably find attitudes and behaviours which have socially shaped the individual in our care. The nature of society itself plays a significant role in determining the manner in which the individual and his peer group relate to social conditions. The family, the circle of friends, and the environment around them are crucial in both starting and maintaining substance use and abuse. It is under the influence of these primary structures that each individual’s attitude to drugs is developed and at the beginning of the road to ruin of chemical dependency, the chemical supply comes almost invariably from within the immediate social circle.

Compulsive destructive drug use is much more common in poor and underpriviliged communities. These are the people with very little if any prospect of adequate education or material advance, whose families are broken and splintered and who are frequently exposed to criminal behaviour. They have very little to look forward to, very few social skills and inter-personal relationships have very few if any points of inspiratrion and they see no reason to admire or aspire to the values of the affluent whom they see on televison or in the big car driving by.

The Socio-cultural belief, in full agreement with Peele’s comment in his ‘Social Disease’ theory; ‘addiction in its various forms is an adaptive mechanism widely resorted to by normal individuals in society – by all of us, perhaps. It constitutes a search for something external and secure to give reassurance in the absence of a deeply felt connection with life’ (The Experience of Addiction).

Having now worked in some of the world’s harshest prisons, with the homeless and within the private clinic environment with addicted individuals from the affluent sector of society for many years, I have found the similarities are striking. During the process of exploring the dynamics of addictions across the social spectrum, relevant to each personal context, a state of anomie has inevitably proved prevalent where individuals ‘pursue their own goals with little concern for the common good’. The chemicals used may have varied from the extremely cheap home-made booze to the very expensive crack-cocaine and ecstasy, but the social conditioning of the contrasting cultures produced the same results, treatment for chemical dependency, and the need for the 12-step recovery programme.

Behavioural Models

Psychological Models:

A lot of people seem to conclude that their loved ones need a psychiatrist and/or clinical psychologist in order to have their addicted loved counselled back to normality. We respectfully disagree. So what is the difference between Addiction Counseling and Clinical Psychology?

Traditionally, the main difference between counseling and clinical psychology is down to their perspectives and training.

Cherrywood House fully understands the essential need for addressing psychological issues, but only those resulting from an addiction, whilst simultaneously keeping a trained eye on pre-addiction history for signs and symptoms of what might be described as any psychological in-balance.

At Cherrywood House we work with Clinical Psychologists and Psychiatrists where needed. We do work with Dual-Diagnosis, and co-morbid disorders.

Psychological models within addiction treatment can be subdivided into four main areas of approach:

  1. Psychoanalytic
  2. Behavioral
  3. Cognitive
  4. Social Conditioning

Psychoanalytical explanations: In order to simplify, this approach promotes the idea that (addictive/anti-social) behaviors are the results of interactions between external events and repressed emotional and mental processes. These repressed dynamics remain hidden from the client until psychoanalytical counseling and group therapy sessions expose and interpret them.

Once upon a time, these principles lay at the foundation of most addiction treatment facilities but this is not so much the case these days. Cherrywood House regularly explores the psychoanalytical process within the group process format, supervised by therapists with decades of experience.

To focus on and/or modify surface behavior, 9 times out of 10, is a complete waste of time because the internal struggles within the clients continue and a relapse is inevitable.

Behavioral Models: Now we start to venture into the arguments for the ‘nature v nurture’ debate where terminology like ‘conditioning’ becomes very popular.

Much along the lines of Pavlov’s Dog (ring the bell feed the dog, ring the bell feed the dog, ring the bell the dog expects food) – through that same process, a variety of elements within drug saturated areas can create triggers and cravings within chemically dependent people. In South Africa, Rugby triggers craving for burning coals, cooking meat, lots of masculine connection and alcohol.

Intravenous heroin addicts can get so fixated by the ritual of cooking up the heroin for the injection that when times of drought arrive addicts have been known to go through the ritual to satisfy that craving even to the extent of going so far as injecting water.

Within Cherrywood House our team uses behavior observance in order to help the client recognize that which causes the most emotional and psychological reactions within them. Megan, for example, is calm and compliant all week but starts to pick fights in the community every Friday afternoon. Why? Because (a) she is not really trying to find recovery from her addiction she is simply complying to look good and (b) its Friday afternoon and she really wants to go to town and use, cruise booze and lose.

Cognitive Theories: Once again, whilst we as a team recognize and respect the concept of Cognitive Behavior Therapy, we are reluctant to accept that it actually that much of a role in the treatment of addictions. The general consensus of Cognitive Behavior Therapists seems to be that the self-esteem is defined as the sense of contentment and self-acceptance that stems from a person’s judgment of his or her own worth. Appraisal for achievements therefore becomes the foundation of the individual’s identity, and too many suffering addicted people are therefore told, ‘believe something else and you will get different results’. However, in our experience, rather than tell a shy person that they must overcome their shyness, we would rather just accept the shyness and walk with the shyness and get the client to walk in harmony with it. We are who are, and that has to be acceptable. Trying to ‘think’ our way in to a new way of life, in our experience, only ever really creates a false sense of who we are and this is just another way of trying and camouflage the shyness, low self-esteem, fear, anger, loneliness.

Next Steps

We hope that you found this article about behavioural models helpful and encouraging. If you are struggling with an Addiction or know someone who is. Please feel free to contact us and we can help you with your next steps.

Cherrywood House is a rehabilitation centre for people suffering from substance and other addictive disorders. It is situated in the tranquil, semi-rural environments of Constantia, Cape Town, South Africa. We offer  Residential Programmes, Aftercare Support Services, Outpatient Programme, Family Support Groups. For more information. Visit our Website Here.