Drug Addiction Disorder & Group Therapy as Part of Recovery - Dissertation Example

CHAPTER II REVIEW OF RELEVANT LITERATURE The present dissertation has been supported by the researches already conducted on the same or relevant topics. A therapeutic relationship develops over time, has an emotional connection, is a deliberate, planned professional nursing intervention and is reciprocal. (Potter & Perry 1997) In other words, therapeutic relationship exists between doctors, therapists and the nursing staff on the one hand, and the patients and clients on the other for the recovery of the latter to a standard health situation. To attain a sound therapeutic relationship with patients, therapists exercise their communication skills and utilize them to cure the patients suffering from drug addiction because of different psychiatric problems including mental retardation, emotional collapse, tactile hallucination, paranoid schizophrenia and others. Doweiko (2006) has also discussed the problem of drug addiction and its therapeutic treatment in his famous book “Concepts of Chemical Dependency”. He has analyzed the problem among the adolescents and suggested the individual and group therapy for the cure from drug addiction disorder. He declares modern civilization and technological advancement as responsible for the drug addiction among children. Detachment and distances between the family members, Doweiko estimates, force the young ones to seek the artificial and temporary support from chemicals and drugs. Furthermore, child abuse is one of the most significant causes of chemical codependency among adolescents. Moreover, decline, in the sound family ties and relationships, has also paved the way in this direction. As family is the basic unit of a society and plays primary role in nourishment and socialization of young generation, it is also responsible for the emotional uplift of the children. Decline in the family bondage and ignorance of the religious practices, ethical values and moral obligations, result in the deterioration of the youth of society. Doweiko has discussed the case of young Brittney, who got recovery from therapy. Brittney, a young girl of fourteen years only, had been very bright and graceful student at school. It was surprising for the whole family when she was recommended by her teacher, to a rehabilitation program after being found the drug- user. She was referred to the Alateen, the rehabilitation institute that deals with the cure of adolescents consuming alcohol and other intoxication. It is the platform that offers the young fellows to give vent to their ideas and relate as well as share their life experiences that help the therapist getting acquainted with the original cause that led the children towards intoxication and use of drugs and chemical substance. During the individual therapy, as mentioned by Doweiko, Brittney disclosed the very fact that she started consuming alcohol after the death of her father. It so happened that her mother got too much involved in running the family business and her siblings also accompanied their mother during the course of time. Brittney felt extremely lonely and looked for something that could relieve her tensions and loneliness. Thus, she tried to drown herself in the thick stream of liquor and adopted the way of perversion out of her loneliness. She felt no fear or hesitation due to the fact that she had witnessed her late father and brother drinking. Also, she had to become prey to the criminal assaults of both of the family members in intoxication. In addition, she had observed her mother taking liquor time and again. She misinterpreted a source of relief, therefore she also adopted the same patterns as she observed majority of her family. “The effects of drug use not only on drug users themselves”, observes Marina Barnard (2006), “but also the feelings of anger, sadness, anxiety, shame and loss that are commonly experienced by their extended family.” Doweiko shifted the girl to the group therapy ward, where she heard the stories of other people undergoing the same mental and psychological disorder. It shared the tragedy of the girl, and helped her fight with the uneven situation without relying upon the chemical dependency. Soroka & Bryjak (1995) also have discussed the curse of drug addiction in their work under “Social Problems” and concluded that the ingestion of drugs has become a universal problem, which is being observed in all human societies without discrimination. The authors view it as a highly pervasive nuisance, which has been entrenched in the roots of divergent cultures of the globe. They recommend therapeutic measures at family level on the one hand, and at health and rehabilitation centers on the other for the complete cure of the patient. Although drugs have been integrated into many aspects of every society virtually at one time or another, social groups typically put limits or restrictions on what drugs can be used as well as when, where and what circumstances. Soroka & Bryjak cite Durkheim’s theoretical framework, who is of the opinion that as the moral animals, all the activities of human beings are classified as either acceptable or unacceptable. A major consequence of this moralizing is the designation of drug taking as deviant behavior in almost all cultures as well as ethnic, religious and social groups. It is therefore, the political authorities not only impose sanctions and penalties on involving into chemical dependencies, but also arrange a wide range of comprehensive programs in order to eradicate the addiction nausea as well as bring the addicts to the state of normalcy and rehabilitation. The authors declare domestic troubles, disharmony and lack of unity as few of the most imperative reasons behind the chemical dependency. They suggest familial attention and natural harmony between family members as the essential steps towards the recovery of the drug addicts. In addition, the authors view group therapy as the most significant method of rehabilitation. Group therapy contains such an atmosphere where every patient is suffering from the same mental and psychological trauma; it is therefore, no patient feels himself in a state of humiliation or degradation. Furthermore, treatment of the patients, under one roof and in the similar environment, wide opens new horizons of hope and encouragement during the group therapy, and the recovery process certainly becomes easier and faster. Friedman (1989) has defined group therapy as the most beneficial therapeutic techniques being exercised at clinics, hospitals and health centers. He maintains that the vision and information of a therapist observes a remarkable boost to the recovery process during the group therapy. His interaction with different patients, having different nature, background and professions, add to the knowledge of the therapist, which he skillfully applies while treating the drug addicts. Moreover, the writer states that the continuous and constant interaction of the clients and patients with one another is highly supportive in revealing the secrets behind drug consumption. It also helps out the therapist detect the causes behind drug addiction and consequent treatment methodology upon the patients to recover them from the state of chemical dependency. Hence, groups, according to Freidman, give the individual client the chance to model positive behavior they observe in others. Besides learning from each other, the trust and cohesiveness developed within the group can bolster each member's self-confidence and interpersonal skills. Group therapy gives clients an opportunity to test these new skills in a safe environment. (Retrieved in findarticles.com) Communication with the client and exposure of the core of his heart is the main thing which works out in the treatment process of the patient. Faulkner (1998) has declared proper communication with the patient as the most influential tool during the recovery process of the clients. “To be able to communicate effectively with others”, he submits, “is at the heart of all patient care”. The same is the case with the therapeutic process. Though exploration of inner thoughts can be developed during one on one therapeutic procedure, yet the most informative way of exploration is the group therapy, where a keen observation and indirect answers and replies of the patients pave the way towards investigation of the root cause of the disease. In group therapy, Faulkner opines, therapists get an opportunity to be involved into all the things, which are related to the interest of the patients. From examination of the history sheet of the patients to approaching the members of their family, and from consulting their peers to search out their professional life, in order to fill the socio-cultural gap in them, all steps can be observed in individual therapy, but particularly work out in a systematic way in the group therapy. Group therapy, according to Faulkner, leads both the therapist and the patients, understand different cultures, civilizations and religions as well during the interaction with the patients from divergent socioeconomic statuses and religious affiliations. The description of their religious beliefs fills the hearts of the patients with joy and delight, and offers them moral boost, which produces amazing results in preparing the minds to give up the use of drugs and chemicals as a reaction to difficulties, problems and petty issues. Children are the most innocent stratum of society. They try to imitate the footprints of their elders and mould the structure of their life as they observe the senior members of family. Sometimes, such crucial incident, like child molestation, child abuse and sexual harassment, takes place in their life, which is really unforgettable for their innocent thoughtfulness. The child seeks shelter in drugs in order to erase those troublesome feelings from their memories. It is perhaps long and continuous group therapy that works in bringing peace and stability in the mentally retarded and emotionally demolished life of the poor victims to the sexual abuses. Rauch & Jones (1997) accomplished a research on the utility and significance of group therapy especially with reference to the child abuse and their recovery from mental shock under the title “Effective Group Therapy with Male Survivors of Sexual Abuse”. The authors have defined the nature and intensity of child abuse on male children, and their ultimate effect on the personality and growth of the victim. The writers are of the view that immediate and timely group therapy is the only way to save the sentiments and feelings of the young victims; otherwise they can become the prey to the circumstances and cannot lead a normal life at all. The sad memories prick their hearts and minds, and they try to retaliate with the individuals against that mishap by committing crimes of different types against society. Since males serve as the sign of protection and security of the family, their insecurity and mental imbalance brings unusual disturbance for their family. The writers vehemently recommend that criminals, sexually exploiting the males must be dealt with an iron hand. In addition, they view that though such males, undergoing mental trauma because of sexual abuse in childhood, should be treated in group therapy, yet their identity and privacy must be kept in utter secrecy, so that his emotional prestige could not meet another humiliating shock. The group is composed of five to six men: gay, bi-sexual and straight. We find that the meeting of this population from all areas of sexual orientation is the most restorative in each and every one's sense of their commonalties as men. This permits respectful exploration of the issues regarding sexual behaviors and sexual preference. (Quoted in yesican.org) Zaidi (2007) has also referred to a case of almost the same nature, while being engaged in a group therapeutic relationship for one month with a client suffering from paranoid schizophrenia. The patient, a young man of 35, had been taken to the ward for treatment. He was experiencing auditory, visual and tactile hallucination. The writer continuously spent eight hours a day with him and attained lot of experiences that were also new for the writer. The patient was extremely upset in the beginning and did not talk frankly to the therapist even in one on one session. He used to request the writer many times to remove unnecessary persons, sounds and articles from his ward, which actually did not exist at all. The writer had to convince him that he had accomplished everything according to his instructions, which made him satisfied and happy. After one week fruitless treatment procedure, the patient was shifted to the group therapy session, where he got chances of listening to the fears and sufferings of the others. It really helped him a lot in disclosing the very facts about life, which had also dragged him towards the dark world of chemical dependency subsequently. During the group therapy, the patient sometimes complained the indifferent behavior of his family and friends towards him. He used to rebuke his father and ex-wife on not complying with his requests and desires. He told the author that his wife had gone westernized even she was a Muslim. In such an utter state of disappointment, he started using drugs. But still there was vacuum in what he intended to say. The writer adjusted him with another patient of the same age group, who had experienced severe sexual assault at the hands of some nefarious young men. On listening to the sorrowful details of that drug addict, he also disclosed his story of childhood, where he had also met the same fate. The unabated care and encouragement of the therapist brought them at the stage of recovery within the treatment of three and half months only. Not only words, but also the conduct carried weight for the reconciliation of patients. “Counseling skills include various verbal and non-verbal communication skills, as well as factors such as listening skills, empathy, self-disclosure and patient management skills. (Scammell, 1990; French, 1994) The patient, above-mentioned by Zaidi, had become habitual to wine before treatment and it was strictly against the social as well as religious point of view. The therapist successfully convinced him during the group discussion that wine was not allowed in his religion, as well as in all the three Abrahamic religions, and it was only one of his weaknesses in his personality traits that had dragged him towards a state of uncertainty. Very often, during the one on one therapy, the patient cried to relieve him from the flow of ants creeping on his body, which the therapist cleared by falsely dusting the bed and assured him that no ant could climb the bed again, but it seldom happened during the group therapy. The insistence of any matter to be done might infuriated him a lot, which he disclosed one day that during his childhood, he was sexually exploited and molested by the owner of the motor workshop, where he worked as an under-training mechanic. And it was the dynamic environment of group therapy, which forced him share his miseries and come out of three decades long sad memories of sexual abuse. Rauch & Jones (1997) also allude to the consequences of incestuous sexual harassment of innocent children, which not only tell upon their feeble nerves, but also lead their personality to the state of utter deterioration. Dorothy Allison, the famous American feminist writer and analyst, has very courageously submitted the sensitive case before the world and brought to the limelight how the small children of both sexes, especially the girls from the lower stratum of society, are deflowered by family members, teachers, neighbors and other community members since their childhood when they are not even familiar with the words and concepts like sex, rape, exploitation and abuse etc. She (2005) also admitted the very fact that she underwent child molestation at the hands of her step-father at the age of five years only. It not only created a constant fear against the entire male stratum, but also changed his mind from entering into any type of emotional or sexual relations with any man throughout her life. Absence of financial resources and proper care turned the mind of Allison from the normal feelings of opposite gender orientation to the torch-bearer of homosexual rights. Her unwed mother used to seek relief in drugs to forget the pains and sufferings being inflicted upon her and her innocent illegitimate daughter. Child abuse or ill-treatment of children includes all curses imposed on children i.e. physical torture, sexual abuse, psychological affliction, as well as common medical and educational neglect. Allison was an illegitimate child of an unwed mother and was raped by her stepfather for the six long years from the very small age of five only. She was molested, battered and abused continuously and got so annoyed with the male gender that the feelings of liking and love for the individuals of the same sex created in her mind and heart during her teen age, the time she was entering her adolescence. But she least cares about her own misfortunes, and is ambitious enough to rescue the whole society from the ugly clutches of cruelty and ruthlessness. “There was no meaning”, she (2005: 218) declares, “in what my stepfather did to me; but the stories I have made out of it do have meaning.” In later years, she found herself a completely homosexual woman i.e. a lesbian. She does feel no hesitation or indignity at all in exposing her sexual inclination as well as homosexual tendencies. Rather, she is determined to struggle for the cause of homosexuals to protect the community from the hatred and exploitation of the heterosexual majority. She expresses her worries on the misbehavior regarding homosexuals and stresses to perform great that should be far more than mere the survival of homosexual community. She emphatically motivates the gay and lesbian writers to give significant time and priority to their obligation in their writings and expressions. “I need you”, she comments, “to do more than survive; as writers, as revolutionaries, tell the truth, your truth in your own way.” (2005:216) The same has been described by Doweiko (2006) while elaborating the case of Brittney. Brittney’s case is highly precarious one. She had been brilliant student and paid attention to her studies. In the life of her father, she must have been attended properly by the family. Therefore, she remembered her deceased father. Somehow, his sexual advances during intoxication badly told upon her delicate nerves, which is hard for her to forget. Further, the parents must be aware of the company as well as the activities of the children so that any untoward event could be avoided. The education and training of the young ones is one of the most critical procedures and demands unabated, unconditional and comprehensive attention from family, friends, peer group, teachers, tutors and society. The therapist must be careful of the case because the girl had to suffer an extremely uneven condition when her own father who should have been source of constant relief, affection and protection. In the same way, her brother also proved himself completely lost while taking alcohol and followed the same patterns as committed by his father. Hagan (1987) has discussed the relationship of deviant behavior aid socialization by citing the reference of control theory. Control theory tends to regard deviance as the result of bad or inadequate socialization process on the one hand, and unforgettable childhood mishap on the other. The writer has suggested the four elements of social bondage including attachment, commitment, involvement and belief, which keep the individuals far away from indulging into chemical dependency. While discussing these elements, it becomes evident that unabated feelings of attachment arouse emotions to sensitivity and sense of security and protection fills the hearts of the members of family to the great extent. Remaining attached to the parents, siblings, peers and friends is very beneficial for the proper upbringing and personality growth of the individuals. On the contrary, the state of alienation instigates man towards deviance and perversion, leading him towards seeking relief in materialistic objects and chemical dependency consequently. While narrating commitment, Hagan declares it as the investment of time and energy for the attainment of culturally defined goals. As an essential part of a normal and adequate life, an overwhelming majority of individuals require sufficient articles, sound reputation and bright prospects, which are dependent of commitment to oneself and the people around. And absence of which shows them the artificial path of addiction of many kinds including drug addiction, sex addiction and chemical bondage. Similarly, involvement also plays an important role while keeping the individuals absorbed and engaged, mostly in creative tasks, which protects them from going astray including using drugs and remaining disturbed and mentally retarded. If a person is engaged in performing conventional activities, there will be very little opportunities to deviate or get stressed. Lastly, Hagan defines belief as the fourth element that serves as the safeguard to protect the individuals from going into the hands of dejection, disappointment and frustration; subsequently towards deviation and perversion. Strong belief in religious teachings, social norms and cultural values keep individuals as firm as rock while facing the chains of failures as well as mountains of hardships. Drug consumption is looked down upon in all parts of the world, due to the very reality that substance consumption and drug usage completely damages man’s mental health and causes grievances, humiliation and hatred for him in society. Drug addicted families have to bear social and emotional costs. They not only lose physical and mental health, but also are deprived of the recognition of respect for the honor and prestige of family and its members. The families where uncles, family friends, neighbors and even fathers and brothers of the young boys and girls commit sexual assault on the poor children, the child goes into the arms of addiction. In addition, drug and wine addicts are often blamed for committing incest during the state of unconsciousness and intoxication. They forget altogether how worse effects their act could leave on the innocent mind of the small children, who are their blood relation and honor of the family too. The effects of drug use on family dynamics and relationships are really horrible that may cost the solidarity of the whole society. A large preponderance of the addicts longs for leaving the curse of drug addiction, though it becomes very hard for them to refrain from this awful habit. Drug consumption tells upon reputation, honor, prestige and respect of the family. O’ Neil (2003) suggests that drug addiction should be considered as a developmental disorder due to the very fact that consumption of wine, chemicals and drugs develops disorder, retardation, stress and troubles particularly on the brains of young addicts. (Retrieved in query.nytimes.com) The author refers to the words delivered by Dr. Chambers regarding the after effects of drug consumption. Taking drugs as the method to evade troubles and worries, he submits, badly tells upon the neural balance of the young users and disturbs the standard performance of their brain. In addition, natural motivational system also witnesses a serious set back, and man starts losing innate immunity existing in body. Since it is the brain that regulates each and every activity of the body from head to foot, artificial and unnatural stress on brain as a result of temporary mental relief, weakens its performance and gradually destroys mental capabilities of human brain. Consequently, drug user appears to be unable to perform his responsibilities in a proper way. Hence, the drug user is unable to pay due heed to his duties and obligations in a proper way, and his brain observes a downward trend in respect of showing a usual performance even. Not only people are deprived of physical fitness and substantial power, but also there are evident chances of drop out of financial stability too. The trend of chemical support is seriously spreading its ugliness in young community. If parenting is strong enough to offer the child emotional support, he can be come out of the nausea. Otherwise, professional help and medical therapy are required to save them from the curse of addiction. The advancement in technology offers variety of treatment plans that give complete and swift rehabilitation to the patients. For this purpose many governmental and non-governmental organizations are working. Psychiatrists and counselors are especially trained and appointed to provide services to the patients. The role of family and parents is the most significant one in this respect. They must provide the complete case history of the child addict and give the details of the chronicle of events leading him towards the path of substance abuse. It may help the counselor while offering complete counseling services and psychoanalysis of the patient to protect it from mental and physical disorder. Among the ethical obligations and moral duties of the counselor include that he must pay due heed to the patient, and never display such a behavior that can create feelings of shame and humiliation in his mind. Further, a counselor should analyze the situation in which the patient uses drug and seeks emotional support. The counselor must ask the members of the patient’s family to reveal each and every thing regarding the mental situation and habits of the patient. A child usually involves in addiction, which belongs to the broken family, or a family who is either contains addict members or obtains criminal background. The counselor can guide the child on the basis of morality. Many theories have been articulated and schemes have been devised regarding detoxification and comprehensive treatment. As in Brittney’s case, the counselor applied group therapy that healed the girl to return to her normal health and routine work. Jones et al. carried out a psychological research on group therapy program with reference to African American veterans. African- Americans face grave mental shocks because of the prejudiced behavior of the white majority in the USA. The blacks are ridiculed, hated and looked down upon in the social set up. The biased white majority refuses to offer the black equal job and work opportunities and leave no stone unturned to humiliate the blacks. There are least opportunities of equal growth open to the blacks. Such type of ethnic and racial prejudice finds no solution of the uneven and unpleasant situation. The black community seeks relief either in arranging protest demonstrations or expressing their feelings through media and writing or agitating against the misbehavior of their white rivals, though no step stops the white majority teasing and molesting the blacks. The black women and children suffer sexual abuses and the law and order regulatory authorities seldom care the sentiments of the black victims. Under such precarious circumstances, the blacks find only one way to get forgetful of social injustices and atrocities committed by the whites. They drown their troubles in liquor and drugs to get rid of the feelings of inequalities exercised by the so called white humanists. Jones et al. provide relief to such black victims through group therapy for their recovery from the mental retardation and chemical dependency on permanent basis. Jones commenced a comprehensive rehabilitation program under group therapy for the blacks and Caucasians under one and the same atmosphere in order to mitigate the reactionary emotions of hatred prevailing in the minds of the black addicts for the white majority. The program has provided weekly group psychotherapy sessions since 1984. In 1995 the program expanded to include a second, geographically separate psychotherapy group for African-American veterans in Tacoma, Washington. This report describes only the format and experience of the Seattle group. (Retrieved in http://psychservices.psychiatryonline.org/cgi/content/full/51/9/1177) The program has been being conducted in a highly professional way, where the prejudiced behavior and biased ness are taken to account and censured. The authors have very successfully handled the psychiatric mental disorders developed because of racial discrimination by providing treatment under their self-designed therapeutic programs where individuals belonging to diversified ethnic group are treated to recovery. Carl Rogers the first psychological theorist to build up person-centered therapy at a clinic, recommend his technique highly effective one for launching the recovery process in a successfully way, though this type of counseling has not been planned for a specific age group or gender only. He lays interest in the fact that if there exist intimate relationships between two people, it becomes far easy to provide better treatment to the patient. Rogers discovered, Kovel (1991) notes, an actualising tendency that' is inherent in all organisms - this is the basic drive towards wholeness of the organism and actualisation of its potentialities. Person-centred approach concentrates on core conditions, empathy, positive regard, congruence and the actualising tendency, while Psychodynamic approach lays stress on unconscious, including transference, counter- transference and defences. The former approach obtains sympathetic attitude towards the patient in order to soothe his worries and depressions, while the later one seeks unconsciousness as a source of relieving patient’s sufferings by finding out the hidden complications in the thick curtain of sub-consciousness. Psychodynamic approach states the very fact that individual’s personality growth as well as liking and disliking etc lie on the foundation of past experiences. Freud is the father of modern psychoanalysis theory. He opines the reality that man acts and reacts according to the commands hidden in his subconscious. These may be unfulfilled desires and longings as well as his deprivations and disabilities. Psychodynamic Theory, Freud states, is laid on the foundation that human behaviour and relationships are fashioned by both conscious and unconscious effects. These effects support in shaping the personality. Psychodynamic counselling more emphatically concentrates on the impact of past occurrence on individual’s development and his performance while behaving with others. These memories of past experiences remain present in man’s sub conscious, which remain pricking him setting his mind and developing the personality traits. Freud is of the view that none of the human behaviours is accidental at all. Object Relations Theory is determined to explore that man is in constant contact with the memories of his childhood and therefore, psychoanalyses are developed to absolutely focus on an individual’s past memories. The childhood bonds, Fairbairn argues, remain forever in mature as well as old years of man in his personality. (Quoted in Grotstein, 1994 135) REFERENCES: Allison, Dorothy. Survival is Least of My Desires. An Extract from “Skin: Talking About Sex, Class & Literature. Firebrand Books, 2005. Allison, Dorothy. Mama. An Extract from Trash. Firebrand Books, 1988. Barnard, Marina. 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