One of the great lessons I learned in my addiction work was to connect humanely, by listening and being present.
Some people believe in the disease model and therefore find relief in having a diagnosis of addiction. Others refuse the label. Some people have found salvation in religion, others in AA and similar fellowships, others in a life of service to peers who are starting out their own path of recovery. Some people need abstinence, others harm reduction. Some go to SMART meetings, others need therapy. Some have decades upon decades of trauma, others have lived a fairly ordinary life.
We still don’t know why some people can binge on alcohol every single weekend and not become addicts, and why some do. Why some people can engage in chemsex once every few months, and why some can’t live without it. Why someone can try cocaine once and never do it again, and why some can’t stop doing it. There are clues, theories, studies. But no conclusions yet. Even if you can’t understand why someone can’t live without a fix of something, you need to believe that that’s their experience in that moment. It’s not your morality or judgement which will magically change someone’s mind and heart about it. Not even your love sometimes.
Whilst I provided the same sessions to everyone, I never worshiped at the pedestal of any one theory or method. Some people only need to follow one approach, others need to follow several. Some people reach balance fairly quickly, others take countless attempts. There is no one size fits all for anything, especially not in addiction. And it’s important to be honest, and have the integrity and authenticity to say that, sometimes, my own approach is limited. I’m not trained in medicine to be able to understand certain physiological and neurological processes, or even extensively trained in psychological theories. Part of the magic of an arts therapy is that it is a collaborative process. The art form provides a container for whatever trauma, issue, or theme is being explored, and the therapist carefully checks in with the client about each stage of the process. And whilst sometimes art is indeed cathartic and enables people to experience powerful releases, it is also something which provides healing on an unconscious, rather than conscious, level. In short, it is something qualitative, rather than quantitative. For that reason, its effects manifest at a slower pace at the surface, but provide greater potential to transform at a core level and on a long-term basis.
But sometimes, people need results fast, and practical actions now! Often, an arts therapy is not able to do that. But another therapy or approach might. And that’s why treatment shouldn’t only be a collaborative process between client and therapist/practitioner, but also between practitioners. I always told my clients: use the elements of every approach that work for you, and use them for you. You don’t need to like every single thing about AA, but if there are a few elements of it that work, why not incorporate that into your life? Again, the magic pill illusion is strong and pervasive and everyone wants the solution to come from one source only, but the truth of the matter is that the solution is in many different places at once. There is nothing more dangerous to someone’s care than a practitioner’s unwillingness to collaborate with other approaches and colleagues.
Around halfway through my time working in addiction, I read an article by Johann Hari, and promptly bought his book Chasing the Scream: The First and Last Days of the War on Drugs, an impressive account of an investigation carried out over 3 years about the war on drugs. There is also a TED talk you can watch here: https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong. But the book opened my heart and mind not to something new, but to something I already believed and had experienced: the opposite of addiction isn’t sobriety, but human connection. He uses several examples throughout the book to illustrate this, and whilst there are always people trying to debunk theories and experiments for whatever kind of hidden agenda, I deeply resonated to that main hypothesis. And I believe it, because I have felt and lived it as truth, every single time for close to 1000 actual hours of seeing clients in the field of addiction.
And I think this is why I experienced my work in addiction with such depth and power. It was about connection. I’ve shown pictures of archetype cards in Parts 1 and 2 of this addiction series, and I feel that the general archetype of an addict holds so many things for people. Ask yourself: what are your views on addiction? What do you think about addicts? How do you feel about people who become addicted to something? There is such dehumanisation in the label of addict. And “junkie” is even worse. If someone receives that label, there’s absolutely nothing human about them. I mean, I understand the process of using language to dehumanise people. I’ve had that done to me many times because I am gay, and so I find it very easy to recognise the same processes in different contexts. There may be many reasons for it, and people will be triggered by different aspects of the addiction experience, but I feel a great deal is about control. Addicts represent and symbolise this idea of losing control of everything. In societies which rely on the illusion of perfection, having people show and demonstrate the opposite, is quite sacrilegious. Thus, addicts bear the brunt of many of our judgments. We demonise the fact that they have lost control, we demonise the behaviour they engage with in order to get their fix, and we can’t seem to understand why they can’t “just stop.”
But this is what I saw in most of my clients: trauma and abuse. I’ve said it before in a different post, but the scale of childhood sexual abuse or sexual violence in this population, shocked me. Also, as I said before, I’m always curious about causes. Why and how? What happened? When? With whom? By whom? As sobriety is not the opposite of addiction, so is addiction not about the drug of choice. That’s why drug treatment services get it so wrong sometimes: it’s not just about removing the drug. The drug is used to hide something. That something is the issue. All these programmes of 8 or 12 weeks are only useful up to a point. Yes, the client has reduced their use, reduced the harm caused to themselves and others, and maybe achieved abstinence, but now what? Goodbye and good luck? No wonder “they always come back”, as that clinical psychologist said in that life-changing meeting. The system has created a structure which puts bandages on life-threatening wounds and bleeds. Addiction is the opposite of connection, because the connections that exist in active addiction are broken, toxic, dangerous, and life-threatening. You can remove the drug, but if no one takes a look at those broken, toxic, dangerous, and life-threatening connections, you’re damn right “they always come back”. And yes, sometimes people do need to come back because they are not ready to face “the thing” they’re trying to escape.
This is why and how my work became less metaphor-based and more realistic. I needed to provide enough hope and enjoyment that clients would feel motivated to be in recovery, but I also needed to work on their expectations that 12 sessions could get them out of a cycle that some of them had been in for decades! Not months or years, but decades! What kind of short-term intervention do you think can help in the long-run? The only clients who have managed to remain abstinent for long periods of time were clients which needed to go through the system several times. People don’t change when you want them to, they change when THEY want to. That’s why no one can save anyone else, but themselves.
Ultimately, this is the lesson: I don’t have many answers. In fact, the only answer I have is that it is imperative to re-humanise addicts, if that even makes sense? No treatment will ever be successful if the person does not have the experience of being treated like a person, with valid thoughts, feelings, life stories, and if they’re not allowed to try new things without fear of failure. More importantly, no recovery from addiction will be successful if a person is not given the time and space to heal relationships and how they connect to others.
How did my sessions help?
In spite of the confusion people normally project onto Dramatherapy, I always tried to run sessions that were quite simple in their structure and intention:
1. Mindfulness exercise – the intention was to help clients have greater awareness of their bodies, minds, and hearts in the here and now.
2. Checking in – allow each person to share about their week, day, or current moment, without interruptions
3. Creative activity – this could be based on the themes of the check-in or the continuation of whatever work we might have already started in previous weeks. No rules in this section. No right or wrong. No good or bad. The intention here was to try, to be present, to connect, to be creative, to imagine new things.
4. Reflection – sometimes equally, sometimes more important than the creativity itself, this section was about making connections between the creative process and the real-life process. The focus was on insight and on finding practical solutions.
5. Checking out – any final reflections, insights, feelings, thoughts, or questions they may have at the end.
6. Mindfulness exercise – same as above, but with the addition of focusing on something positive they could take away from the session that was helpful and hopeful.
Every single one of my sessions follows this structure. In a world of constant chaos, this provides clients with a stable, safe, and reliable structure. And so, generally, this structure alone helps clients in a myriad of ways:
- Awareness of self: body, mind, and heart
- Reflective processing: not just about relaying what happened, how, and with whom, but also focusing on their feelings about people, places, and things. Making connections between outer and inner worlds.
- Sharing authentically and vulnerably with others
- Being challenged on patterns in a compassionate, healthy manner
- Developing healthy boundaries
- Increasing sense of self-confidence, self-esteem, and self-compassion
- Building positive relationships and healing relationship patterns
- Using active imagination, being creative, having fun whilst helping themselves and others
- Changing perspectives and ways to look at things
- Finding practical solutions: translating therapeutic insights to real life actions.
As I said above, these things wouldn’t necessarily all happen in one session, and certainly not with each client. And also not all at the same level. Every now and then, I bump into clients on the street years after our sessions and I often hear: “I finally get it Ryan!” And that’s enough for me. I go through that all the time as well! In fact, sometimes I still remember things I did years ago and think “Oh, so that’s what they meant by that!” There are always exceptions, of course, and some clients never connected at all. But this list was my own personal guide to keep me focused on my role and responsibilities. I see each of these items as a seed, and I see my sessions as an opportunity to plant these seeds. Whichever way they grow is not something I can control.
And then specifically, there were real instances of making changes in someone’s life which I cannot share in detail, but they range from helping someone to gain an insight about certain relationships, whether it’s neglect, abuse, or even actual love and care – you’d be surprised at how many people cannot recognise love and care! Or coming to terms with death, severe trauma; releasing anger and rage for the first time; understanding how they had hurt someone; finding redemption and forgiveness; recognising shame; accepting joy and love; embracing hope.
Thus, my main focus was to help them feel their life experiences, love themselves, find growth from their trauma, and connect to others with healthy boundaries. Everything I did, had these four main intentions as a foundation. My final lesson from this experience is: meet people as people, remove judgement or morality from the interaction, listen to their needs as they perceive them, feel with them, be authentic, be open and creative, offer suggestions, let them choose, tell yourself that you’re no different from them, smile from your soul, with your heart and body.
If this resonates, feel free to share with friends, family, and networks.
Thank you. xx
Ryan Campinho Valadas
HCPC registered Dramatherapist