Aspects of drug use ambivalence

Since the release of my book Working with Drug and Alcohol Users a number of people have raised an interesting theoretical question with me. It relates to this diagram of drug use ambivalence.

Some have asked why is it the Free Child that does not want to use drugs and the Adapted Child aspect of the personality that does want to use drugs?  This is a good question and has highlighted a need for more clarification.

My response is that the diagram shown above is for those who have problematic drug use. Those people who are using drugs in such a way that it advances some negative aspect of their life script. Those people who are using drug so that they suffer psychologically.

However as I mention in my book there is quite a sizable group who use drugs and alcohol in a non problematic way. They use drugs and alcohol such that their life script is not advanced and they and their relationships are not damaged in any significant way. The best example of this would be the recreational drug user who I discuss at length in the book. For this type of drug and alcohol user the following ego state diagram would probably be a better representation of the theory behind the recreational drug user.

As the drugs are not being used in a destructive fashion it would not be seen as a function of the Adapted Child ego state. Therefore one could put it as a Free Child activity. Also with this type of user there is little or no ambivalence as the drug use is not a problem and thus the person has little motivation to stop it.

Other ambivalence

With further consideration one can also formulate another kind of ambivalence where two ego states are in conflict with each other. Some people and indeed certain groups think that drugs (and at times alcohol) are wrong. It is wrong or immoral to use drugs regardless of whether they harmful to the individual or not. 

These views it could be said to reside in the Parent ego state thus making the following form of drug use ambivalence. Thus the person would experience some kind of internal conflict. Two different aspects of the personality both want opposing things. In this case to use drugs and to not use drugs. This view can be found in some religious groups or temperance leagues in particular.

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Drug counselling approaches

In my book - Working with alcohol and drug users - I make the point that there is no such thing as drug counselling instead there is a group of drug counselling approaches. People use drugs for a variety of reasons and the drug counselling approach varies for each differing reason. I discuss this in chapter 4 when I list the 6 main reasons or types of drug use. These being:

Experimental drug use and counselling. 

Rebellious drug use and counselling. 

Recreational drug use and counselling. 

Situational drug use and counselling. 

Symptomatic drug use and counselling. 

Dependent drug use and counselling.

If one is working with a recreational drug user, what one does is quite different compared to working with a dependent drug user. Indeed we have a somewhat odd situation when it comes to counselling drug users. By far the largest group in number are the recreational users but one rarely sees them in drug counselling. They rarely seek drug counselling because they do not see they have a drug problem and indeed the drug use does result in very little disturbance in their life. One only tends to see them in counselling when they come for some other reason and the drug use gets mentioned as a sideline to the counselling for other difficulties.

A much smaller group is the dependent drug user who is the ‘addict’ type of user. One sees them much more often in counselling even though over all they represent only a small group of drug users. In counselling these people, in my book, I focus on the relationship the person has with their drug of choice. 

In this sense the drug counsellor becomes like a couples counsellor but working in reverse. Instead of counselling the ‘couple’ to repair their relationship the drug counsellor is working with the drug user to end his relationship with the drug. Working with how to break the attachment to the drug, just like one can have an attachment to another person. I highlight three main ways this can be done.

This approach does provide some insight for the average person on what the life of the dependent drug user is like. Think of a time when you were in a relationship that was not good for you but you stayed in it despite that. Recall how difficult it was for you to leave and how hard it was to break the attachment to the other person and all the pain and grief you experienced when it ended. Recall how you went back to the relationship knowing that it was the wrong thing to do. If you have had this experience then you are given some insight into what the dependent drug user feels and what they experience as they endeavor to give up the drug.

It is very easy to sit on the sideline an have the view that the drug addict is simply a weak willed individual who is a loser and just a drain on society. Have you ever stayed in a relationship which you knew was not good for you and may have even been quite destructive for you and the other party? If you have then you know that is not just a matter of being weak willed. Leaving a relationship where there is a significant attachment is not an easy thing to do and that is the dilemma for the dependent drug user.

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