of why
Existentialism is a philosophy that is concerned
with finding self and the meaning of life through free
will, choice, and personal accountability. Its basic
premise is that there is no inherent purpose in life and
that each individual is responsible for finding their
own meaning, making autonomous choices and
aspiring towards freedom and authenticity. The topics
that it focuses on are directly relevant to the
symptomatology of addiction, and because of its
emphasis on understanding people as free agents who
are fully accountable for their lives, it can offer a fresh
angle that complements biopsychosocial theories and
treatment of substance use.
Clients with substance use problems often present
under the illusion that they are working against their
will when they are using drugs. The existential
perspective suggests otherwise. It argues that drug
use is not random but serves a specific purpose;
underlying drug use is a particular need and people
are acting in accordance with their will, which aims for
this need to be met. As a part of effective addiction
treatment, this need has to be identified, fully
explored and addressed in an alternative way.
However, that is not enough. We shouldn't just
focus on why the drugs, we must also inquire into
why anything else. What motivates a person at a
specific time to change their behaviour? What could
carry more significance than drugs? What can
provide solid ground and a sense of direction? What
has the potential to offer some value to life?
Drug use is essentially a needs-driven behaviour,
and underlying every addiction there is a certain lack,
an emptiness, a gap that needs to be filled. This gap
might have been, to varying degrees of success, replete
when the person was using drugs. However, when
drug use stops and once the initial post-detox
honeymoon phase comes to an end, the person is
faced with the original void that played a material role
in setting off compulsive drug use in the first place.
J
ean Cocteau once wrote down reflections
on his opium using days and treatment,
and I have encountered the same message,
expressed with different words, on
multiple occasions during my work with
people with substance use problems: ‘After
the cure. The worst moment, the worst danger. Health
with this void and immense sadness. The doctors
honestly hand you over to suicide.’
Every person is unique, and people use drugs for
a variety of different reasons, but among those who
progress from recreational to dependent drug use,
certain patterns keep emerging. There is a recurring
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motif of disconnection from the world; an acute
sense of feeling out of place. Reality is experienced
as unsafe and unreliable to lean on, relationships are
perceived as overwhelming and bewildering, and self
is interpreted as overly sensitive and ill-equipped to
navigate through life on its own resources.
Among other things, drugs bring relief, freedom,
joy, relaxation, company, safety, focus, comfort and
solace. Because they serve to compensate for the
deficits in other areas in life, the relationship with
them develops the structure and dynamic of a volatile
love story, and practitioners need to be aware of the
meaning clients attribute to drugs and the amount of
hope they invest into this relationship. Meaning and
hope, in combination with extreme attachment to the
drug, is what makes the transition away from
compulsive drug use a complicated process.
Change can, of course, be initiated by applying
pressure or removing an obstacle, and recovery often
‘If we have our
own why in life,
we shall get
along with
almost any how.’
Friedrich Nietzsche
begins in the context of a crisis of sufficient magnitude
that it temporarily overwhelms the person’s deep-
rooted aversion to stopping using drugs. However,
what triggers the commencement of recovery is not
necessarily sufficient for its maintenance. To keep drugs
out of the equation on a consistent and long-term
basis, something else will need to start to matter more
than them because a satisfying life can simply not be
built around emptiness.
But just as there is no one-size-fits-all in
addiction treatment, the new meaning is not
universal. Every person needs to find what gives
their life a direction, fulfilment and purpose, and the
practitioner’s role is to support this journey of
discovery, not endorse a particular model of living.
Clients primarily need to be encouraged to consider
their life experience in light of their implications,
purpose and consequences, and leading the way in
the process of reflection and change must be the
client’s own narrative, not the practitioner’s
theoretical model or personal biases.
A
ddiction tends to be accompanied by
a dissatisfied world view and thrives
in an atmosphere of unhappiness,
mistrust and isolation. It is also
closely associated with a general
feeling of disorientation and
discomfort with existing in the world. However,
while it is overall a rather unsatisfying condition, it
does come hand in hand with the longing for
something more, with an itch to live a different life –
a life that matters.
This is a natural human condition that addiction
doesn’t eradicate. It might temporarily mask it, but it
doesn’t put an end to it because people have an
intrinsic orientation towards a
personally meaningful life. After all,
human beings are just meaning-
making animals. This inclination
towards purpose is important to be
acknowledged and utilised as a
solid foundation for the process of
change, self-discovery and
development of a value-driven life.
Once people feel safe within
their own psychological resources,
once they have a better
understanding of their authentic
self, and once they discover things
that are of personal significance to
them, they will find it substantially
easier to move on from drugs and
invest their time and energy in activities and
relationships that are purposeful, fulfilling and
sustainable on a long-term basis. And while an
important part of recovery consists of learning new
skills and adopting alternative patterns of thinking,
feeling and relating to the world, people also need a
rationale for making these changes, direction as to
where they want to go, and the belief that a drug-free
life is worth the effort.
Essentially, when the going gets tough, people
need a reason not to give up. Or to put it in words of
Friedrich Nietzsche, a philosopher whose work has
been fundamental to the existentialist movement: ‘If
we have our own why in life, we shall get along with
almost any how.’
Lana Durjava has a background in forensic
psychology and works in the probation service
May 2019 | drinkanddrugsnews | 7