Monday, August 9, 2010

Drug use and suicide

In the previous post it was suggested that what has been called a gambling addiction may not an addiction. It certainly is different from what would be called a drug addiction. Whilst in the act of gambling the personality is not transformed like it is with taking drugs. With drugs the Parent and Adult ego states are rendered null and void which could be seen to constitute a major personality change. With gambling this does not happen.

Instead repetitive gambling could be seen as more as what is known as the defence mechanism of regression. The person responds to stress by engaging in behaviour where they end up in a child like position such that someone else has to take over for them to cope. Whilst this happens with some drug takers there are those where it does not happen for instance with many recreational users and what are known as functional alcoholics.
Ice cream truck

The point at hand here questions the definition of addiction. Those people who feel a compulsion to engage in a piece of behaviour that they find very hard to resist. With some discussion it becomes apparent that there are many differing reasons why that compulsion may exist. This would seem to be important to articulate because the way of treating such an addiction could vary considerably than if they are all assumed to be of a similar nature. As mentioned above if this thing that have been called a “gambling addiction” is actually more of a defence mechanism than an addiction how one deals with it will vary. Another example of this is described below.

There are a group of people who use drugs, some of them in a habitual and addictive way that are different and separate from the mainstream type of drug addict. Drug use in this group is more of a suicide attempt than drug use in the usual sense of the word.
Woman drinking wine

The suicidal person has made one of seven suicide decisions:

If you don’t change I will kill myself
If things get too bad I will kill myself
I will show you even if it kills me
I will get you to kill me
I will kill myself by accident
I will almost die (over and over) to get you to love me
I will kill myself to hurt you

To summarise, some people have the ability to be able to take their own life if things get too bad or to hit back at someone and so forth. These people can imagine killing self, they have it in their behavioural repertoire to do such a thing.

For example
If you don’t change I will kill myself
If things get too bad I will kill myself
I will kill myself to hurt you

Some people do not have that. They cannot conceptualise of planning a suicide attempt, obtaining the items necessary and going through by acting out the plan. It is simply something beyond their imagination. However these people may still have made the suicide decision and thus they need to achieve it some other way.

For example
I will get you to kill me

These suicidal people can get others to kill them such as ‘Death by cop’ where the person behaves in such a threatening way to the police that they shoot him dead. They can voluntarily enter into a war zone and behave in such a way that the enemy kills them, or they can behave in such a way in a country that has the death penalty where the state kills them. The suicidal act is carried out by someone else.

Execution

Or there is another decision:
I will kill myself by accident

This person engages repetitively and voluntarily in high risk behaviour. This is where the line between accident and suicide gets blurry.
Iworks test

Some behaviour is a bit of both, an accident and a suicide and you can’t clearly distinguish between the two. This can include dangerous sports, driving cars at high speed (Peter Brock), working with dangerous animals (Steve Irwin), working in high risk occupations and also dangerous drug taking.

The type of drug taken and the method of ingestion can vary enormously. Smoking marijuana is quite safe compared to injecting heroin which is much more dangerous. If the person has had a few over doses where they were getting closer to the point of death then one could begin to diagnose that the drug taking has a suicidal motive underlying it. Alternatively one can do a life script analysis and ascertain if such a suicide decision exists in the person’s psyche.

If this is the case then there are significant treatment implications. Why would one work with a drug user to identifying the triggers for use, do motivational interviewing or work on relapse prevention with some one who could easily die a month or two latter by and ‘accidental suicide’ in a car accident.

In these circumstances they are suicidal first and a drug taker second and ones treatment plan would need to reflect this.

Graffiti

4 comments:

  1. So an addiction is a cover for something else.

    ReplyDelete
  2. Hello Kahless,

    I suppose you could say what you have said.

    The drug use in itself is a problem but it is also the means to an and not the end in itself. If the drug use stops the basic problem of suicidal urges is still not solved.

    Been some time my blogging buddy

    Tony

    ReplyDelete
  3. 1. you still haven't answered my question... Why did you delete my comment - it wasn't a bad one?

    2. I was about to say that gambling is not the same as addictions in regression and such and that it was more of a game with the promise of a payoff type thing? But I see where it is similar to the regressive behaviour of the other addictions.

    Is there a way of clarifying the difference at all?

    ReplyDelete
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