This paper aims to dispel some of the misunderstandings and mystique around the addictive process and to offer you a systematic approach for working with any of its multifarious forms and at any of its levels, from the apparently harmless to the obviously pernicious.
By 'deconstructivist' I mean separating out a complex aggregate
into its constituent parts. My version has an NLP, Grovian and
personal bias. It doesn't pretend to be definitive. (2)
Part I 'Violent Pleasures' (Rapport, Autumn 1999) had two sections:
1. UNDERSTANDING ADDICTION - no one
addiction in particular, but the underlying systemic
structure of them all. I endorsed the view that addiction
is aimed at resolving or distracting unresolved need.
And introduced an exercise to help you learn more about
your own dependencies, particularly if you believe you've
never had any.
Part II has two sections:
1. THERAPIST ISSUES - including 'helping' as
addictive behaviour; positioning; labelling; knowing
yourself; defining; aligning; intervening or
Part III 'The Physician's Provider' (Rapport, Spring 2000) suggests a systematic way of starting to work with addiction in any of its multifarious forms. It unscrambles client assessment and offers a simple information-gathering model applicable to any addictive behaviour under four headings:
1. PERSON - how much of the client is involved,
The material has been compiled from a variety of sources, including my own experience and imagination. A number of people are acknowledged at the end. Others are credited in the text and the notes. All client notes are part-fictionalised to preserve confidentiality.
I said this in Part I and I'll say it again: I was raised to be sexist, racist, homophobic and hierarchic in a society which rewarded my conformity to patriarchal structures of power, separated me from my real feelings and kept me in a state of dependency. This is, I believe, the metaphor - the holding pattern - for all addictions, and the way most of us learn the systemic structure of addiction.
I used to excuse myself as a victim. In fact I was an active volunteer. I gave energy to a system that encouraged me to play victim and persecutor in turn. Thus do co-dependencies perpetuate. (3)
When I use the word 'addiction' in this paper, it is in that political context. I shall be alluding not only to the substance and activity addictions under the opening title, but also to the systemic dependencies which underpin them.
When I use the word 'therapy', I mean to differentiate between traditional psychotherapy, which has attempted to control the codependent relationship with the client through the use of mind-reading, interpretation and suggestion (thereby reinforcing systemic dependency), and postmodern psychotherapy, which aims to enable self-generated change and is an instrument for the transformation of society (4).
And when I use the word 'client' I mean me. You. Any of us who want to accept the limits of our desire for simple answers while remaining free of possession by any of the simplistic alternatives.
A client has to do what a client has to do (figure 1). Growth for me as a therapist has been about dropping my attachment to the client's recovery, just as for addictive clients it is about dropping their attachment to X. Co-dependents thrive on the dependency of others, and withdrawal from a co-dependency with the client will typically be difficult for therapists habituated to institutional status and institutionalised thinking.
That's because helping itself can be addictive behaviour. Needing to feel indispensable; rescuing clients from our personal hallucinations about them; pointing them in the direction we think they ought to travel ... all the while believing ourselves free of any taint of the condition for which we prescribe treatment ... in fact any activity based on external authority, or what 'recovering psychotherapist' Anne Wilson Schaef calls "the illusion of control", is an addiction no different to alcohol or nicotine dependency, where the substance controls the state and is a means of separating the individual from their unique internal information systems.
The postmodern paradigm of therapy is about detaching from this helping codependency with the client. Be warned: the addict's experience of withdrawal is known to include symptoms of self-doubt and confusion - recovery may be slow. Codependency is a normal relationship for psychiatrists and psychotherapists brought up, as most of us were, in families that found it difficult to distinguish between love and control, or love and rescue. As Schaef says, "Psychotherapists ... tend to migrate to professions where they can exercise the skills they learned at home." A therapist rescuing a client from hurt is merely exercising another kind of authority.
A controlling or rescuing therapist is likely to be stuck in second, or other-position, helping maintain victim client in first, or self-position. A therapist striving dutifully to be dispassionate and non-interventionist might be stuck in third, or observer-position. "All it takes to create any codependent relationship," says addiction counsellor Pamela Gawler-Wright, "is for one of the partners to be rigidly placed in any of first, second or third perceptual positions." A motorist in 2nd gear can shift into 3rd or change down into 1st. A therapist will ideally be in all three gears at the same time. (5)
Here's an on-the-spot codependency check I find useful: having sensed that the client is in difficulty am I trying harder? Am I doing more than half the work in this session? I think I should do about 10% and take the agent's fee.
If we model the addiction rather than the individual, we end up classifying people as 'gamblers' or 'sex addicts' in the same way we label 'schizophrenics' or 'depressives'. Mental patients call this punishment by diagnosis. No one addict is like any other yet they tend to get treated the same, which is both insulting and ineffective.
There is a world in every word. The word 'addict' comes imbued with such massive cultural suppositions that using it indifferently could make us party to a self-fulfilling prophecy. We should save that for buying into the promise of 'Flash', 'Jif' and 'Vanish'.
A client referred by a psychiatrist told me in no uncertain terms, "I have periods of highs and lows, I'm not a manic-depressive." What he sought was escape from judgment. Freed from their wisdom of others, he could begin to know (and treat) himself.
Judgment is the inevitable outcome of a prescriptive society in
which illness is thought to be bad for you, whereas illness is of
course a great opportunity for self-exploration and growth. This is
still a revolutionary notion for most G.P.s, who continue to diagnose
people with dependency problems as addicts and hook them into a
medical support system which itself is heavily dependent on drugs.
Treatment with drugs can relieve some of the symptoms, but inevitably
reinforces the systemic structure of addiction by generating further
dependency (see figure 2).
Addiction is individual and specific. A therapist classifying a client is quite different to a client naming themselves. Jesus said, "The truth shall set you free." Let's assume he meant a subjective 'your truth' rather than some catholic 'the'. It wasn't until I articulated my own addictions - some twenty years after my psychodynamic 'analysis' had ended - that I could even begin to think of myself in recovery. It's entirely possible for a person to label their X-dependency and take responsibility for their X-behaviours without believing their whole state of being is wrapped up in X. 'To know that you are more than your dependency', as a transpersonal therapist might put it.
If you did the Part I exercise in understanding addiction, you'll know the worst that can happen after confronting yourself is having to give up any notion of knowing what's best for your client. You might then find it easier to work with the individual rather than the addiction. Addiction, after all, is a concept. I`m not sure how you help concepts change. Indeed most of the concepts I know don't want to change, and I wouldn`t know how to help one if it did.
A therapist colleague of mine worked with a woman for over a year before discovering she had an alcohol problem. He realized he had worked conscientiously to help his client develop a strong enough sense of herself so that she was finally able to confront her prolonged denial, but he was personally devastated by the discovery and immediately formed an outcome for her of total abstinence with AA support. In doing so he almost certainly made an involuntary structural connection to his own family history of alcoholism. Stepfather, mother and sister had all been to AA. The neural sequence probably went something like:
The therapist's subjective experience may or may not have not included evidence that it's possible for people taught sensible drinking when young, or for those in the early stages of addiction, to learn how to control their drinking. He may simply have formed a reasoned belief from his prior knowledge of the client that her consumption was out of control and amenable only to quitting. I'm not saying he was right or wrong. (6) I am saying that when it comes to addictions therapists should know themselves particularly well. The conditions for dependency are present in all of us, and can evoke any number of counter-transference issues that other client conditions may not.
Working in clean language has built-in safeguards against unconscious projection by client onto therapist or therapist onto client. "There is no transference or counter-transference", says David Grove, "because the locus of attention is in the (metaphoric) space. It is the space that is going to be interrogated by the therapist and the client and there is not much going on conversationally between the two of them ... it is a subtle shift in the relationship but philosophically it makes a lot of difference." (7)
You may have an internalised definition of addiction which isn't helping, so first check out, not what, but how you define.
Do you go along with this W.H.O. definition of addiction: 'An uncontrollable craving with increasing tolerance (8), physical dependence, and harmful effects on the subject and society'? You may or may not agree with the definition, but how did you characterise your defining? Did you dispute the definition? Go along with it? Accept it? Perhaps you even feel attached to it. Look again at those expressions:
go along with
feel attached to.
What have they in common? They are all metaphors. Our everyday language is riddled with metaphor (there's another just popped up - oops, and another). It`s unlikely you will have generated yours randomly. Your personal metaphor for defining will contain important information about your deep-structural pattern for processing, and that's pretty much guaranteed to be different from your client's.
I hope the implications are obvious. Know your own metaphors. And please don`t intrude them into your clients'!
If you're unfamiliar with clean language your first ethical safeguard might be to align your defining with the client's. Agree at the start what you and they mean, for example, by 'quit' and 'control'. There's more about quitting and controlling under Client Issues.
If your client simply wants to control their X behaviour, but your personal belief about optimal client outcome states that quitting is 'better', is it ethically justifiable to continue working with that client? It might be if your views are held lightly, or if you're prepared to come clean with your client and remind them of their right of referral. Some client-centred therapists expect to share their personal preconceptions with the client as part of their own 'congruence' in the relationship. A classically client-centred therapist who believed in no intervention whatever in client process would, I suppose, find it very difficult indeed to say anything about themselves (indeed, say anything at all, or even blink) without influencing the client.
Intervening and interfering
It seems to me you have to decide how much of an interventionist you are, and to work within your own congruence. Addiction specialist Alistair Rhind sums it up this way: "I say as little as possible until I want to say a lot." Even in minimally interventionist clean language mode there are times when a Grovian therapist may want to try a few 'generic musings', as David calls them - wondering out loud, offering ever-so-slightly-dusty thoughts to the ceiling while pondering the next clean question.
There's a distinction between generic musing and suggestion. Suggestion, whether indirect or benign, is interference. A compensatory belief that your purpose is worthy isn't worth a teaspoon of salt. The moment any of us implies that we know what's right for another person we are on the slippery slope, wittingly or not, to controlling behaviour.
And controlling behaviour is addictive behaviour, as we have seen. It mimics the effects of any drug taken as compensation for unresolved need.
It can be tough sometimes, eh? I have to keep asking myself: do I think this client should quit X? Do I want them to quit X? Do I hope they will quit eventually? Want and hope easily shade into expectation, expectation into desire, and desire into will. I remind myself constantly of the political context of my work. My relationship with this client may be unique, but it's not taking place in a vacuum. Do I see my job as patching people up to send them back into an addictive society? To be free of one addiction only to be hungry for another? Well, yes and no.
It's worth repeating: a client has to do what a client has to do. Write yourself a note and put it under the pillow.
If you don`t form a conscious outcome, you`ll certainly form an unconscious one, and unconscious outcomes are likely to be laden with unwanted baggage.
My belief is that everyone knows what`s best for them at some level, so my conscious outcome is simple: to enable (in the sense of create the conditions for) clients to access that knowledge and move naturally towards well-being with the least possible interference from me. Which means separating my unresolved needs from the client's by wholly participating with the client's outcome and allowing the client political power. The rigour of metaphor therapy or symbolic modelling helps this considerably by requiring - nay, obliging - me to model the individual rather than the addiction. (9)
I wish I could say I always achieve this worthy outcome. It's easier if I restrict myself strictly to clean language. It's enormously difficult if I don't.
For an unwanted behaviour to become an addiction it almost certainly has to take hold at an identity level. "I am a guy who smokes, drinks, does wild stuff," a rock band manager client told me, "and my wife wants me to be a guy in a suit." He wanted to give up dope but not the rest of the wild stuff because, as he said, "I'm scared who I might turn out to be if I do some heavy change".
Most addicts identify intimately with their addictive behaviours and organize their lives around them. Have you ever wondered who you would be without your particular X? "I'm a workaholic." "I'm a woman who has to watch her weight." "I'm a man who likes a flutter." Without a secure sense of ourselves, our security often derives from what we do, or from things outside us - a new laptop, a lover, a packet of fags and a Bic lighter. My colleague who discovered after a year that his client was an alcoholic had been supporting her during that time to develop an in-dependent sense of herself (in- = within, internal; thus independent = reliant on internal resources). Only then was she capable of acknowledging and facing her erstwhile dependency on an external 'resource', in this case alcohol.
Every case is different, and we can generalize. Here are four
typical addiction-related presentations. They have a certain
progression. Which comes nearest to your client's?
Don't ignore the obvious. When Sue Barker asked Roger Black, "What does Jamie Baulch have to do to win this 400 metres, Roger?" Roger said, "He has to run very fast."
So why is this take-it-or-leave-it client here? What does your commonsense tell you? That they're probably concerned in case they can't take it or leave it. The compulsion to clean the cutlery every half-hour might be under control, but if there is an underlying structural issue the client hasn't resolved the compulsion may grow.
A reminder of the addiction continuum in the Part I model:
Stage 1 BAD FEELING
Stage 2 DOING X, FEELING BETTER
Stage 3 DESIRE FOR X
Stage 4 NEED FOR X
Stage 5 X IN POSSESSION.
Where would a statement like 'I can take it or leave it' place this client? In Stage 3, perhaps, DESIRE. Not quite shading into Stage 4, NEED. Or is it? In tracking back to a time when the original bad feeling became entangled with X you'll probably come across a belief that X actually fixed the original bad feeling - which it almost certainly didn't. So this is not a simple desire!
As you and the client track back you'll get a sense of likely places for intervention. Meanwhile I'm drawn to deconstruction: What kind of 'it' is 'it'? (We can't make assumptions.) Is the first 'it' the same or different to the second 'it'? (It may not be.) And symbolic modelling: That's a 'take it or leave it' like what? What is a symbol for 'take or leave'? (Aimed at eliciting a metaphoric container for the problem and making the information available at a more accessible level of organization.)
A classic NLP approach would be to explore an aspect of the client which might be objecting to a commitment to dealing with the problem. What is its positive intention and how can that be reframed? (10)
OK, so why are they still here? Is this an example of addictive logic obscuring reality? Or does the client have an intuitive sense of another issue that the addiction is masking? What kind of change do they want? In what kind of way? My guess is that clients who talk this way have already begun to look into themselves. They may be at Stage 4, NEED FOR X, and getting concerned. 'Mirror-model' questioning would give them more on which to reflect. (11) What else is there about any time you want? How do you know you can stop? What would be the effect of stopping? Conversational questioning may be enough to shift a client's perspective if the questions are genuinely open. Leading naturally into a more structured process if, for example, a client metaphor for the problem comes up unforced. "It's like I'm on a motorway ..."
Is the client in denial? AA calls alcoholism 'cunning, baffling, powerful ... and patient'. Or perhaps the client is right by their own definition. What do they mean by 'hooked' (or an equivalent 'at the mercy of X', 'devoted to' etc)?
On the 5-stage model the client is probably at Stage 4, NEED FOR X, perhaps on the threshold of Stage 5, X IN POSSESSION.
A client can be so deeply immured in the secret world of their addiction that they hide it even from you. Beware the addict who claims to have marriage problems not dependency problems. Do you want to challenge the deflection, or work with the other issues first? Look out for the addict who switches from one addiction to another to prove they're not addicted. Or the bemused client who comes back saying, "I find myself eating for the same reasons I used to smoke." An available aspect of them has come for something, an unfamiliar aspect stops them acknowledging it, and an inaccessible aspect is preventing them from getting it. (12)
I've been working with Ralph for a couple of months now. He's an entrepreneur. Clever, sharp and charming. He has identified "smoking and overwork" as problem behaviours, and claims not to be hooked on either. What smoking and overwork want for Ralph, he discovers, is "self-respect". Yet whenever Ralph gets a fleeting glimpse of himself with self-respect, something else butts in and stops him having it. What is this thing and what does it want? Each time Ralph sees the person he wants to be, he loses concentration and starts to think about work - at which stress kicks in and he "closesdown". Sometimes he can't continue the therapy and has to go outside for a smoke. This 'closing down' seems to be an even stronger habit than smoking and overwork, but refuses to give up its cover.
Gradually, grudgingly, over eight two-hour sessions of therapy, it allows him to name it. And its name is 'negativity'. So secretive and disapproving has 'negativity' been throughout Ralph's life that whenever he has started to open up and feel good about himself, he has found himself involuntarily closing down. And the paradox that has held all this in place emerges: 'negativity' has had a positive historical intention for him - an attempt to protect him from sickening violence and abuse when, as a child, he was naturally open and vulnerable.
We discuss paradox below and also later under Duality Thinking. Meanwhile with 'I'm not hooked' or its equivalent you need more information and a sense of the client`s deep-structure representations of their experience. Meta-model your client`s linguistic constructions (13). Or go a stage further and explore their symbolic sense of the addiction ('hooked', 'at the mercy of', 'devoted to' are quite meaty metaphors).
The classic Cartesian dilemma at the heart of many, perhaps most, dire dependencies. Here's a client trapped in the narrow strait controlled by those sea-monsters Scylla and Charybdis. Escaping the jaws of one leads only to one thing - being devoured by the other. A perfect paradox. 'Can't give up X' means the client is possessed by the monster. 'Must give up X' means they're still possessed.
Definitions first: does the client's can't mean 'don't want to', 'choose not to', 'unable to', 'don't know how to' ... ? Does must mean 'should', 'have to', 'need to' ... ? It could make all the difference.
And what kind of beliefs are operating here? Addicts and their codependents may be convinced that there is only one way of being in the world. From a biological generality that presumes people to be male or female, and a philosophical fancy that supposes the universe to be mind or matter, we have derived a cultural absolute: a duality value that says we must be one thing or the other. Right-brained or left. Stupid or smart. Well or ill. And creative scientists, transexuals, metaphysical-materialists and occasionally psychotherapists - anyone who's a bit of both, or can't decide, is outside the pale.
Excessive internal conflict can be created by these incessant 'must/can't' dualities. An enormous amount of energy is required to hold them in place. The resulting tension builds to a crisis that is usually resolved by the 'I that must give up' following the path of least resistance and giving up to the 'I that can't give up'. At which point a further paradox rears its ugly head, as addiction evokes the very affect it has been seeking to prevent: isolation, fear and pain.
The solution is now no longer in the presentation of the problem, the solution is the problem! Get out of that! (We shall.)
First indications of a client's outcome will be contained in their early statements. There is an enormous amount of information to be gleaned from a client's first words. (14)
Therapist: "And what would you like to have happen?"
Client (coughs): "Well I feel I've got to a certain point with my drinking,
now I want to go further without making any effort at all."
What do we know from this, and where can we go with it?
Having recently done some personal work with David Grove in which he'd ignored everything I'd said and asked me about an 'um' I'd uttered somewhere along the line, I decided to go for the inconspicuous and asked this client about her little cough. And after a few more clean questions it took her back to a time long before any drinking began, to a time of unresolved need (for being held by her mother), for which many years later the drinking became an imagined solution; and in a time further back still she discovered a remedial resource (the radiance of the sun and the benefice of nature) which she was able to bring forward many years to apply to her need for inner warmth which she had tried to meet through drinking.
There's further information to be gained from exploring the client's own definition of their state and behaviour.
At this point you really need to suspend judgment about meaning and note their actual words. Don't paraphrase. Here are a few examples of addiction-related defining from my own client notes. Literal expressions like these never fail to entice me.
Strongly attached (smoking).
A physical craving (smoking).
An emptiness and a need to fill myself like a garbage can (chocolate).
Finding an escape (alcohol).
Blotting out (alcohol).
Running round in circles (idealism).
There's like a wall around me (anger).
Metaphors again. There`s no escape. Don`t try. Each phrase holds key information that can open huge doors to change. As Grove says, "Metaphor mediates the interface between the conscious and unconscious mind." These symbolic expressions of the clients` structural relationship with their addictions are plump with potential for self-generated change.
As you explore first statements and definitions with your client, what happens to their outcome? Do you begin to get a sense of what they actually want? To confront X by quitting? Or to sidle up on X through some kind of control? Would that quitting be all at once or gradually? Controlling in small steps or big?
Or does your client just want to sit back and assess - ie think about wanting to do something, or consider whether to do something? Is the real desire for change present yet? If so, is the will? These distinctions may change over time as new information is recognized - you might like to think of that as re-cognized, or known again by the client - and re-enters their bodymind system.
Some alcohol and chemical dependency specialists consider that when consumption is 'out of control' or a person has reached 'rock bottom', the client's only option is total abstinence. Relationship and eating addictions are hardly amenable to total abstinence if you believe we must eat and relate to survive. The question then becomes what kind of control?
The issue of control should be approached with some caution. There are many accounts of recovering alcoholics who attempt a return to controlled drinking and fail, and few accounts of those who succeed. 'Controlled X behaviour' might only be a painful extension of the addiction if it sustains the client's expectation that X will resolve their underlying need.
There are questionnaires to help therapist and client make a subjective assessment of 'out of control', but the only way a client can form a reasoned outcome is to acknowledge the extent of their dependency for themselves. (15) Alistair Rhind quotes one alcoholic: "Am I drinking because of the wife? No, she left me. Am I drinking because of the job? No, I got the sack. Fuck, it must be me."
Outcome setting is unlikely to be the linear exercise taught on NLP trainings. For the metaphor therapist it is less a sequential elicitation procedure than a relativity modelling process. The therapist models the client's subjective self-patterning in relation to their symbolic sense of space, time and perception - as opposed to their 'real' sense of space, time and perception - a qualitively different experience to the logical (and still in many circumstances enormously useful) linear NLP procedure.
Remember: a client has to do what a client has to do. Subjective modelling of what a client wants is really only effective in clean language. The therapist can question any part of a client's presentation in a way that allows the client to explore their ultimate goals intuitively. You may have to monitor the evolution of the client's outcome throughout, but it saves you trying to work out for yourself what it is they want, or feeling the compulsion to interpret what they say they want, or even, God forbid, kidding yourself that you have the slightest inclination of what they or anyone else might want in a month of Sundays. Clean language modelling inevitably increases the likelihood of the client getting what it is they really really want. (16)
In any model of therapy the client's outcome will almost certainly evolve. Particularly if the addiction is related, as it almost certainly is, to other issues.
Brian is a barman who when first asked what he wanted said, "To sort myself out, there are a few things going on for me." "What kind of things?""My girlfriend had an abortion a few months ago, I've had kidney problems for 3 or 4 years, I'm depressed, I have a rashon my leg and back, light-headedness, flu, general ill health, I can't deal with people in crowds, I'm drinking too much, my girlfriend gets jealous when I talk to other women, and I`ve always felt alone." Apart from that no problems, I nearly said.
From this individual mixture of guilt, worry, depression, anxiety, agoraphobia, dependency,frustration and isolation, Brian eventually identified his priority as "To give up drinking." In the second session this evolved to "Controlling the depression." And in the third (by which time we were working in metaphor process): "Clear thinking. A filter for the impurities." He was able to identify that a filter for the impurities would lead to clear thinking, which would help lift his depression, which in turn would give him less cause for drinking. It didn`t matter to him which had come first - all he wanted was a strategy for getting better.
Taking the client through a well-formed outcome process or asking the standard Grovian opening question (And what would you like to have happen?) may lead to the unfolding of any number of issues. After all, the client is likely to be doing X as a substitute for authentic human connection, the lack of which could relate to any aspect of the human condition.
There's some debate about whether addiction is always a mask for other disorders or whether other disorders are a mask for underlying addiction. Academic. There's a simple answer to these chicken-or-egg questions: start somewhere! Finding out more about the chicken is your royal route to the egg, and vice versa. I wouldn`t worry which came first, or you'll be retracing your steps up your own ad infinitum.
And remember 'meta-outcomes': for what purpose does the client want their addiction-related outcome? What will getting that gain for them?
Anyone who speaks in terms of must have or always do is probably well into Stage 5, X IN POSSESSION, convinced that their internal state is governed by, or dependent on, the external thing: substance (such as heroin) or activity (such as gambling). Their X-related behaviour is outside their control.
In fact what is happening is that a number of different events in the brain -
- is being experienced near-simultaneously, leaving the client no time for consideration and choice. And this produces the illusion of no control.
Every client whose outcome implies more choice will sooner or later have to learn to separate the external stimulus from the internal state from the external X, so that one is not in thrall to the other. Neuro-linguistically we have learnt to disconnect a (neutral) stimulus from a (negative) state in order to anchor a new (more positive) connection. In the addictive equation we need to go further and disconnect the (negative) internal state from the (expectation of positive) external X.
This separation is not in itself the resolution, but is the key to change in almost all cases.
What is it that actually connects the client's state of mind-body and X when they seem inseparable? In terms of the Part I model you could characterise it as an involuntary interaction of neuronal groupings in the brain acting on the primary motor cortex that sends impulses to certain muscles prompting specific behaviour. Or if you prefer: the client feels bad, does X. Which in the early stages of addiction, at least, leads to feel good.
You will eventually be able to intervene in this sequence of body-mind interactions, but meanwhile the client who, step-by-step, can simply
their addictive behaviours is already taking significant steps towards sorting them out. In some cases it could be that simple. In many cases we need to go further.
The jaws of paradox grip many addicts. The dilemma of being caught between the polarities of aversion and attraction is the most typically addictive bind and the one most resistant to deconstruction. (17)
Eleanor is a manager in the middle of a painful divorce. Her first statement to me is, "I can`t give up my anger towards my husband and I have to if I'm to stay sane." An explicit 'can't/ must' polarity. Her aversion to giving up her anger is probably equal and opposite to her attraction to giving up her anger. Clearly Eleanor's addiction to anger is a mask for other issues. It doesn`t come from nowhere. But can I assume even that? Before I can intervene she continues, "I`m running round in circles." A confirmation of the bind. She pauses. I guess she's running in another circle right now. "And you`re running round in circles," I acknowledge. I stop to think. I could ask her what kind of circles, or what kind of running, or even what kind of 'in'. I suspect she's been stuck for some time, and hopes I have the answer. So my first outcome is to help her acknowledge the stuckness as hers, not mine, by reinforcing it. "And you`re running round in circles ... and you`re running round in circles ... and you`re running round in circles ... and when you`re running round in circles, what happens next?" "I don`t know. I can`t get off."
Well, an element of the metaphor has moved minutely and Eleanor has more information. If she can learn something about what she`s on (wheel? racetrack? orbit of the earth?) that she can`t get off, she may find a solution at a symbolic level that her unconscious will process and the dilemma may resolve. Meanwhile I can't even assume that she wants to get off - these circles may take her on a magical journey to riches beyond my imagination. And I suspect there may be a lot more running to do.
Binds like Eleanor's and Ralph's (the closing down client in 'I'm not hooked') have been in place for many years, have been well maintained and are functioning perfectly - as binds. Suddenly they metamorphose into a theoretically more accessible form - and what happens? Can they now resolve freely? If resolution is what they want. Some fear freedom more than the binds that tie them. Others yearn desperately for something to unpick their tangled patterns.
An obstacle many of us have to surmount before the mind-binds of paradox may resolve is our Western tradition of dualism. Two hundred years of faith in the Cartesian creed that said mind was immaterial and absolutely distinguishable from the body have led us to oversimplify our chaotic universe into elementary alternatives of Right or Wrong, True or False, Cause or Effect, etc. We have identified ourselves (thoughts, actions) as one or the other. We may on occasion cross from one side of this philosophical divide to the other - from being one thing to being the other - but this only gave us the illusion of freedom without the reality.
Duality thinking is addictive behaviour. Not surprisingly, given our addictive society. Duality thinking maintains our dependency on the systemic structure of the presentation of the choice. A structure that is both institutional and linguistic. Penny Tompkins says, "People will language choices for themselves until the cows come home."
Duality is a linguistic lure. Language evolved to describe the mundane experiences of daily life, not the infinitely subtle and fluid experience of Life itself. Which has gotten us into another fine mess, as Hardy might have said to Laurel, for not only do we use language crudely to express thought - to our occasional benefit - we also allow it crudely to define thought - to our frequent loss. We are caught in a complex of cognition that is language-led.
"The mind is linguistically structured," says philosopher of consciousness John Searle. "For all but the simplest thoughts, one has to have a language to think the thought."
Without words I can be aware of the experience of sitting here at my computer, but I cannot think that I am in Ontario by Lake Kashagawigamog (yes) in a cottage rented by my wife, or that we plan on going canoeing later, or a thousand other connections to being here, without the words to describe these thoughts. To all intents and purposes language is defining my experience.
Take a thought-expressed such as 'I must give up X'. It would seem perfectly lucid to the thinker-speaker. This person probably thought they knew pretty much what they meant when they said it, and there's nothing here to say it's not entirely possible for them to do. Now separately take the thought 'I can't give up X'. Equally lucid. Neither of these thoughts may be simple, but both are fully functional. If independently each is feasible, how is it that together they become somehow insoluble?
Simon is a computer wizard addicted to overwork and unable to enjoy his own talents.
"I can't stop working," he might have said (OK, so what?).
"I must stop working," he might have said another time (OK, go ahead).
What he actually says is "I can't stop working and I must stop working." (insoluble bind).
Simon didn't need words to have a vague experience of exceptional difficulty, but 'thinkwording' it has meant making a huge number of mindlanguage connections in order to say the experience ("I can't stop working and I must stop working - dammit") - and thus to think that he knew that he had it. Result: a self-made prison of paradox.
In a metaphor process Simon identifies a 'twist' in his stomach. Elements of this 'twist' appear in other symbols. It is a recurring pattern. For homework Simon is invited to look up the word 'twist'.
At the start of the next session he reports on a Middle English derivation he has discovered - not of the noun, surprisingly, but of the verb. 'To twist' originally meant both dividing into two' and 'combining into one', which to the Middle English may have seemed perfectly logical, but isn't to Simon. To be both dividing and combining himself at the same time is an impossible bind. And if 'twist' is an activity (a verb) to Simon, how in his metaphor can it also be a thing (a noun)?
In the next session, Simon suddenly remembers the extreme difficulty he has as a seven-year old at junior school holding himself back academically so that he doesn't have to go to classes two years ahead of his friends. And over the next couple of sessions it comes to him: to combine with his peers he has been dividing himself - separating the gifted one who was intellectually superior from the social one who didn't want to be. He identifies this as a pattern in other areas of his adult life. Well, if that's the problem, what's the solution?
What assumptions does this last question, and the question before it, and the question I posed just before the example, make that makes them seem very troublesome, even irresolvable? The answer is the same as our philosophical tradition has long assumed - that categories of body and mind, matter and consciousness, thing and no thing, can't and must, want and not want, solution and problem, and all such apparent dualities, are mutually exclusive.
So what's a better question? Can Simon be freed from the limits of his desire for the obvious answer? And if he is, will he transcend the compelling logic of his bind?
The third and final part of this series is for those who like
concrete outcomes. We will consider SEVEN WAYS OF RESOLVING DUALITY
admitting third options
changing the rules
So Simon is going to be OK, I hope. And we shall go through an ADDICTION AUDIT, a simple information-gathering and preliminary changework model for use in early encounters with any dependent client - whatever their dependency - whether to substance, activity, person, institution, or the codependency edifices of society itself.
This assessment model may be all you ever need to treat an addictive client. By the end of it the client should be treating themselves.
© 1999 Philip Harland
Thanks to James and Penny and my partner Carol Thompson for their creativity, support and suggestions.
(1) Adapted from a client quotation in an article by Gillian Riley, The Therapist Autumn 1997.
(2) The addictive process: Anne Wilson Schaef, John Firman, Tina Stacey, Pamela Gawler-Wright and Alistair Rhind are among those I have come across who have done interesting original work on addiction. If you want more references still check Whitakers Book Bank CD-ROM, which comes up with 1,800 titles.
(3) More about the victim-persecutor codependency in Part I of this paper, Rapport Autumn 1999.
(4) My definition of postmodern psychotherapy: a new paradigm untrammelled by current established (antiquated) scientific, psychological and socio-political beliefs, assumptions and methods. My example is self-generated change via the clean language questioning of Grovian metaphor therapy, originated by David Grove and further developed as symbolic modelling by Penny Tompkins and James Lawley. The therapist communicates with the deep structure of the client's non-conscious process without contaminating (attributing, characterizing, interpreting or attempting to control) their subjective experience. For a series of articles about how it works see back numbers of Rapport or The Developing Company's website at www.cleanlanguage.co.uk/.
(5) NLP Perceptual Positions are well introduced by Joseph O'Connor and John Seymour in Introducing NLP, The Aquarian Press 1990.
(6) Many recovering addicts swear by Alcoholics Anonymous ('the biggest support system in the world'), and some therapists agree to work with alcoholic clients only if they concurrently commit to AA. AA arguably plays the systemic dependency game by encouraging clients to swop one dependency (alcohol) for another (the support programme) - it doesn't teach you how to get out of the game. NLP trainer and addiction counsellor Tina Stacey has designed a 12-step - or '12-state' - substance recovery programme as an alternative to the AA approach. SOS (Secular Organisation for Sobriety) has developed a non-religious programme for people with alcohol, eating and gambling disorders. For recovering alcoholics who wish to avoid or face relapse there's certainly no substitute for AA's ongoing (global) support system, something no other counsellor or organization I know of can offer.
(7) Transference: from David Grove, Problem Domains and Non-Traumatic Resolution through Metaphor Therapy, 1998. You can read the rest of this paper on the Metaphor and Clean Language website (see note 4). Of course whenever two human beings come together there's likely to be some transference or projection of unresolved feelings. What clean language does is minimise its inhibitory, obstructive or intrusive effects. I suggest there's no such thing as counter-transference, by the way. It's not counter to any transference or projection of the client's, and there's nothing special about the way therapists do it. Some psychotherapies attempt to make the best of this by incorporating transference and 'counter-transference' into the work , which must put their practitioners in a dilemma: if they acknowledge that they may project feelings onto the client derived from the past, this surely undermines their raison d'etre as objective interpreters of the past.
(8) Tolerance has been defined as what happens when an addict seeks refuge from the pain of addiction by moving further into the addictive process. In other words, needs more to achieve progressively less.
(9) Clean language modelling. To be more precise, the therapist co-models with the client the unique internal information the client has about themselves and facilitates the client's self-discovery of internal sources and solutions, enabling the client's healing to be purely self-generated.
(10) See Richard Bandler and John Grinder, Reframing: NLP and the Transformation of Meaning, Real People Press 1982. Reframing an addictive so-called 'part' may be difficult if the client manifests what B & G call 'sequential incongruity', where the therapist has access to a sober, non-X 'part' of the client (which wants to change), but no access to the X 'part' (which almost certainly doesn't). B & G take you through a technique for changing 'sequential' into 'simultaneous' by separately anchoring X and non-X states, firing them simultaneously and forcing them to co-exist. Needs care!
(11) Philip Harland, The Mirror-model, a guide to reflective questioning, Rapport Autumn 1998. A model of conversational change which can be used to help clients stuck in a Present frame of reference shift their attention and learning into Context, Past, Future, Higher and Metaphor frames.
(12) New addiction replacing the old: Tompkins and Lawley, after Ken Wilber, would describe this as translation, not transformation. The story remains the same, it just gets told in other words (my metaphor). As Penny says, "A person may have to go through a series of translations before being ready for transformation."
(13) For the original book on the NLP Meta-model of linguistic challenge, see Bandler and Grinder, The Structure of Magic Volume I, Science and Behaviour Books 1975.
(14) More on deconstructing first statements in Tompkins and Lawley, Symbolic Modelling and the Emergence of Background Knowledge, Rapport Spring 1998. More still in my Autumn 1998 article on The Mirror-model. Both are on the website (see note 4).
(15) Assessing 'loss of control': BeeLeaf Communication Training (020 8983 9699) include a comprehensive questionnaire in their Addiction training manuals. Others are available from specialist addiction agencies.
(16) In NLP terms outcome forming is a cognitive process. The outcome is always expressed positively (ie is not something the client doesn't want), is within the client's control, has built-in evidence and monitoring procedures, and a systemic and ecological check which explores the possible costs of achieving the outcome against the possible benefits of not achieving it. The NLP therapeutic process is conditional on having a well-formed outcome at the start, and this outcome becomes a later measure of success or failure. In Grovian or symbolic modelling terms the outcome evolves continuously and non-consciously as an integral element of the therapeutic process, which means that the client will only get what they truly want.
(17) I use polarity in the sense of having two
contradictory qualities. I use paradox loosely in its (Longman
Dictionary of Contemporary English) sense of an improbable
combination of opposing ideas, and ask you to include in that its
earlier (OED) meaning of a seemingly self-contradictory statement. On
occasion I use polarity and paradox interchangeably with
dilemma (a choice containing two unfavourable alternatives),
contradiction (a state of opposition in things compared) and
bind (an unwelcome tie of two things together). You can
experience theoretical and embodied work on paradox, bind, conflict,
dilemma and impasse in Part III of The Developing Company's trainings
in Symbolic Modelling.
To contact Philip either write to 40 Palace Road London N8 8QP England or fax (UK) 020 8340 2534 or email firstname.lastname@example.org
Other articles on this site by Philip Harland:
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