I I | i l H i l l l l H l | m l i l | l l l l H a | l | | l D | W l l | l | l | | | l | | H | | l | | | | | | | | | | | | | | | | | l l | | | | m

Journal of Contemporary PSychotherapy Vol. 6, No. 1, pp. 69-72 Summer 1976

Relating to the Abuser as a Human Being

R O B E R T A R N O L D

l ' n thinking over how to best approach the Subject of relating to the sut~stance • abuser, I decided that the best way to go about it would be for me to briefly review

my qualifications to discuss this subject. Professionally, I am a counselor at the Park Slope Family Reception Center in

Brooklyn--a job which brings me into daily contact with adolescents and multi- problem families whose lives have been deeply affected by substance abuse at every level. In addition, I have worked with a cross-section of substance abusers at the Postgraduate Center for Mental Health, where I received my training as a counselor; the alcohol detoxification unit of Cabrini Medical Centre which serves as the of ficial police department detox; and the Bowery Residents Committee,

At a more personal level, I am a former heroin addict, as well as a former bar- biturate, cocaine and amphetamine abuser. I am also a recovering alcoholic. For twenty years of my life, roughly from the time I was 14 to the time I was 34, I was physically and emotionally addicted to one or more substances. To support my habits, I was at varying times a thief, a cheap hoodlum, a street-hustler, a pornographer, a gossip columnist, and a press agent. People are always telling me that I should write my life story, However, I 'm not convinced that there is a market for 20 years of tawdry incidents.

My final credential to discuss this subject--and to my mind the most important one--is the fact that I am a human being. I wish to stress the fact of my humanity, because, for me, the frightening recognition and admission of the fact that I was human and the unqualified acceptance of this fact that I received from some rare counselors was the key tomy recovery and growth.

It is to this issue of the substance abuser's humanity, and the way that we relate to it, thatI would like to direct the rest of my remarks.

If there was one emotion that characterized my attitude towards myself throughout

70 JO URNAL OF CONTEMPORA R Y PS YCHO THERAPY

the period that I abused narcotics and alcohol, it was that somehow or another I was an outsider, a misfit, a loner. Somehow or another I was lacking and less than human. I can remember feeling at times as if I were deformed by my loneliness. It seemed impossible to me that anyone could accept what I considered to be my ex- traordinary need for caring or, more importantly, my tremendous fear of reaching out |br other human beings--for contact, or relatedness, if you will.

The idea that the experience of anxiety is a universal attribute of the human condition seemed completely unacceptable to me at that time, given nay own over- whelming anxiety. Anxiety was something to be defended against at all costs--with denial, grandiosity, will power and all other forms of available magic. Therefore, it was easy once I discovered the magic in alcohol and narcotics to use these substances to defend myself against my anxiety. Also, in the process of defending myself against anxiety, it became possible for me to experience that distorted form of relatedness with others that the alcoholic and drug addict seeks constantly in the pattern of his abuse.

Lest my remarks be construed as being merely a description of my own personal pathology, I wish to stress the point that in the past few years I've listened to hundreds of alcoholics and drug abusers tell basically the same story. In each case, although the details have differed, the core problem of experiencing oneself as an outsider, a misfit, has been the same. And always, alcohol or drugs have been first turned to as a magic solution--a magic defense against overwhelming anxiety about one's needs for caring and dependency and one's ability to make contact and relate to other human beings in any kind of thshion.

Relatedness Available to the Abuser

I think that it is also important for me to stress the point that the alcoholic and drug abuser is seeking a form of relatedness in his or her abuse. That he or she is, to borrow an apt description from Howard Becker's biography of a female heroin ad- dict, joining a "fantastic lodge." This is what the way of life of the streets and bars and bottle gangs represents--a form of human relatedness and a career in Erving Goffman's sense of the term, the only form of relatedness available to the abuser, given his conception of himself as less than fully human and society's consistent reinforcement of this conception.

In this regard, I think it is no accident that the highest incidence of substance abuse is directly related to poverty, ethnicity and race, for it is the poor, the minorities and the blacks whom this society defines as being less than fully human. However, I think that by this time we should also all be clear that the problems of drug abuse or alcoholism are not purely and simply the result of poverty or prejudice and that they will not be legislated away.

I feel that the anxieties involved are much more universal and much more deeply rooted--that they, in fact; are shared by all of us. They seem to involve the devastating realization of how terribly alone, how lOnely most of us really are, ho~ frightened and dependent we are and how ineffectual our will power is in aiding us to relate to each other.

In this regard, I find that most.of the literature on drug abuse and alcoholism is next to useless because it fails to deal with the central problems of loneliness and

ABUSER AS A HUMAN BEING 71

dependency that trap the substance abuser. Instead of focusing on these issues, the literature goes on endlessly about things like the manipulative character of the abuser, his hostility and grandiosity, without seeing the function of the manipulative and sometimes unbearable arrogance as a defence against intolerable loneliness and unfulfillable dependency needs.

As a resuit, all too often we counselors attack the symptoms, the arrogance, etc., with our own verbiage about will power, only to end up reinforcing what Gregory Bateson has called the substance abuser's "false cpistemology of thc self."

Personally, I've found much more that is insightful in the literature on the psychotherapy of schizophrenia that relates to the problem of substance abuse than I've tbund in the literature on alcoholism or drug abuse. In particular, I would recommend the papers of Dr. Freida Fromm-Reichman, particularly her paper "On Loneliness", and the papers of Dr. Harold Searles, as well as Dr. Searles' remarkable book, he Non-Human Environment, and Dr. Harry Guntrip's classic, Schizoid Phenomenon, Object Relations and the Self. Time and again, these authors bring the reader back to Harry Stack Sullivan's point that, despite diagnostic labels, we are all simply more human in our shared anxieties than otherwise.

This is a point that I feel is often ignored in the counseling situation with substance abusers and one which accounts tor much of our bad luck. We talk about the manipulative character of the abuser, about his immaturity, his needs for in- stantaneous gratification, his low frustration tolerance, his hostility, his grandiosity, etc., while forgetting that he is simply a human being, who like ourselves is very often frightened~panic stricken, in fact--because he's found no viable way to relate his needs to another human being and to have those needs and those fears accepted.

Abuser as a Hum an Being

I wish to stress the word accepted and to differentiate it from concepts like "identifying" with the abuser, getting down there and talking the language or "loving" him. The latter concepts seem to me, at least, to lead us down a primrose path to failure by demeaning and further dehumanizing the abuser. I, for one, have met few if any junkies or drunks who need to be "loved," "identified" with or talked down in pseudo-hip patois because they were junkies or drunks. On the other hand, I've met many people in the past few years who need to have the fact that they are scared shitless, as I once was and still often am, accepted.

I think when we examine the success of programs like A.A. or Synanon in its early days, this is what we find at the Core of these programs' approach to the abuser, (1) an unqualified acceptance of the fact that it is all right to be frightened, (2) that it is human to be frightened, and (3) that tear can be overcome through entering into relationship with one's tellow man and abandoning will power and "lhe falsc epistemology of self." I think that this is also what we would lind were we to examine those counseling relationships that work.

Having mentioned A.A. and Synanon, I'd like to comment briefly on the theory that only former abusers are qualified to relate to or "identify" with abusers. It seems to me that all too often this theory, whether it's mouthed by former abusers or professionals, serves as an excuse not to deal with the abuser as a human being like ourselves. It protects us from dealing with our own fears about our own loneliness and

72 JOURNAL OF CONTEMPORARY PSYCHOTHERAPY

inability to relate. In this process of segregating the abuser we end up dehumanizing him further and, moreover, dehumanizitlg ourselves. For, if we cannot relate to the abuser as a human being with fears and dependencies much the same as our own, how can we relate to ourselves as human beings? How can we learn to accept our own devastating fear of loneliness--and, moreover, how can we also learn t o accept the potential ibr growth that.i s inherent not only in our clients but within ourselves9

Finally_,, it seems to me that Guntrip in Schizoid Phenomenon; Object Relationsand the SelJ~ has stated the central purpose of the counseling relationship, whether it be with the substance abuser, the physically handicapped, the mental hospital patient, or anyone else. He writes: "A successfuipsyehotherapeutietreatment should end by contributing something permanent and intrinsically good in human relationship to t he patient's life."

We can all afford to remember this Criterion if we hope to change our luck.