Compulsion and Recovery (Addictions)

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Compulsion and Recovery

Compulsions and Recovery Affie Adagio PhD Research Outcomes

(For the sake of brevity only surnames without titles are mentioned in here)

ABSTRACT

When I began the Compulsion & Recovery Research Project in 1992 I did so in response to the schism between professionals who were leaders in the addictions
recovery field. Known as The D&A Debate, this schism resulted in changes in government policy, funding and service provision, causing great confusion to people suffering with addictions. It was described by the media as ‘addiction treatment now a battleground’. The battle was between professionals favouring controlled drinking as a treatment option compared to those who were convinced that abstinence and the Alcoholics Anonymous 12 Steps program was the successful treatment. Before the conflict, government funded bodies ran detox units which included an abstinence program and attendance at AA meetings on the premises. During the conflict, government funded service providers supporting the harm minimisation concept, began negating the abstinence and AA method of recovery. A person making a commitment to reduce their drug intake now appeared to have succeeded in the program more so than one who had been committed to abstinence and perhaps risked relapse. So, detox units could show a higher success rate with the harm minimisation policy (National Drug Strategy 1985), although it was argued by some that this was a life threatening risk.

As a family therapist specialising in addictions recovery, I became concerned about this battle between leaders in the recovery field and its impact on the community. I had experience in running halfway houses for people recovering from addictions and knew that abstinence with AA worked. I was confused about professionals negating this recovery program which worked but I was curious about their rationale for controlled drinking/harm minimisation. I embarked on a research project which used a dialectic/narrative inquiry method, interviewing leaders in the conflict and others who contributed progressive ideas to recovery. This inquiry was influenced by my experience and the information gained from the previous interview to the next, growing and evolving into a structure which I called the thesis – case for abstinence, antithesis – case for controlled drinking/harm minimisation, and synthesis – case for diversity of approaches to recovery. This process aimed at ensuring that there was validity, rigour and ethics in the research process.

The interviews took place within Australia and overseas in Europe and USA where people from different countries participated. Finally, on a panel with some of the protagonists in The Debate I presented my findings so far, in the Addictions Session of the Australis2000 Humanist Congress in Sydney which was attended by scientists from here and overseas.

Through the interviews the protagonists of the conflict clarified their stance whilst remaining committed to their own worldview. The majority agreed that there was not only one way to deal with compulsions, something that the media and service providers had neglected to acknowledge.

As a result of this research I have developed a praxis that involves a client centred modality involving a diversity of approaches (synthesis) informed by the 26 methods mentioned in this thesis. This diversity of approaches is aimed at personal development and recovery from compulsion.

As can be seen in more detail in Chapter 6, these are:

  1. Cognitive Behavioural Therapies (CBT)
  2. Motivational Interviewing (MI)
  3. Rational Emotive Behavioural Therapy (REBT aka RET)
  4. Rational Recovery (RR)
  5. Secular Organisation for Sobriety – Save Our Selves (SOS)
  6. SMART Recovery Groups
  7. Hippocrates Personality Types (Typology)
  8. Jung
  9. Gestalt
  10. Neuro Linguistic Programming (NLP)
  11. Process Oriented Psychology (Process Work)
  12. Psychodrama
  13. Transactional Analysis (TA)
  14. Psychotherapy/Family of Origin Work
  15. Twelve Step Facilitation (TSF)
  16. 12 Steps Program/Model
  17. Visualisation, Affirmations, Hypnosis, Self-Hypnosis, Mindpower
  18. Yoga, Relaxation, Breath Awareness (Rebirthing), Meditation
  19. Life Education
  20. Kings Cross Medically Supervised Injecting Centre (MSIC)
  21. Berne (Switzerland) Medically Supervised Injecting Centre (MSIC)
  22. Stockholm (Sweden) Drug Free Society Program
  23. Amsterdam (Holland) Progressive Drug Programs
  24. Client Centred – Whatever Works (Krivanek)
  25. Client Responsibility & Self Determination (Available Choices)
  26. Life Coaching Website

This praxis provides interested persons with an education process to enable them to assess their own situation and to identify which method they would find more useful in achieving their required outcome. As a practitioner my responsibility is to ensure that they are aware of the risks they are facing in making those choices or not choosing certain options. Furthermore, my aim is to provide an efficient and effective service to such persons.

Importantly as a result of this inquiry I came to believe that The Drug & Alcohol Debate (The D&A Debate) protagonists need not dogmatically defend their own model to the point of being in conflict, as all their treatments work, and it was valid to concede that different models work for different people in different stages of their recovery – “whatever works works, and not to be judged by others” (Nicotine Anonymous The Book 1992:113).

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