Both addiction and recovering from addiction are by essence relational processes. Addiction’s development, sustainability, and finally its ending are embedded in family community and broader societal context. In order to recover an addict needs to establish new bonds based on trust, respect, and love. And together with others build unique pathways to a sense of belonging.
Season 5 is a Collaboration with the Taos Institute
This season of the Positivity Strategist podcast is a collaboration with the Taos Institute. We’re focusing on the topic of Constructionist Practices as Social Innovation. My guests in this season are Taos Institute associates who’ve contributed to The Sage Handbook of Social Constructionist Practice. [Links are below.]
Author Bio and Chapter Title
Pavel Nepustil, Ph.D. works as a freelance psychologist, consultant, and supervisor, with a specific interest in drug use, addiction, and mental health. Between 2003 and 2013, he worked as a social worker and therapist with drug users and their families in NGO Podané ruce, Brno, Czech Republic, where he also launched two innovative services based on case management and multidisciplinary work. In 2013, he published Recovered without Treatment about natural recovery from methamphetamine addiction. He has a long-term interest in relational processes such as collaborative and dialogic approaches within the helping professions.
As a Fulbright scholar, he studied at the Houston Galveston Institute (Texas, USA) in 2008 under the supervision of Harlene Anderson Ph.D. and translated into Czech one of her books, Conversation, Language and Possibilities.
In the Czech Republic, he co-established Narativ Association, where his main responsibilities are two year-long intensive programs: Possibilities of Dialogue and Foundational Training in Open Dialogue. He worked as a consultant for the Ministry of Social Affairs and put together publications on community work, multidisciplinary teams, ethics, and human rights. Currently, he supervises 15 social service teams in the Czech Republic and he is a participant of a Trainer’s Training in Open Dialogue (Helsinki, Finland) headed by Prof. Jaakko Seikkula. He also co-established a mutual help group, Recovery Brno, and is a leading trainer of the first Czech training program for recovery coaches.
Chapter Title: Recovering from Addiction by Mobilizing Relational Processes
Addiction and Isolation
Pavel was interested in the topic of addiction early on in his life. While he studied social work, psychiatry, and psychology, it was the field of addiction that he felt most connected to. As a teenager, he hung out with his buddies and experimented with different substances – mainly alcohol. He considers himself fortunate that he was not drawn into the culture of addiction. Having a stable family provided an environment where he was able to keep growing and not get stuck into this culture so prevalent among teenagers. He was also a student committed to his studies.
What the research literature suggests, and according to his own experience and the experience of his close colleagues, isolation plays a strong role in sever addiction. The isolation doesn’t need to be very visible. Some people act sociably but their lives are restricted and narrowed to a particular pathway. His interviews with former addicts reveal a pattern: they talk about their relationship with drugs or gambling as fun in the beginning, but overtime the experience is less fun, even painful, leading to more and more isolation.
Bonds of love and trust
To help with recovery, one needs to establish new bonds based on trust, respect, and love. Being in relationship with others builds unique pathways to a new sense of belonging. There is also growing evidence that intimate partners play a major role in successful addiction recovery. By focusing on supporting couples the addiction is less likely to become a force that destroys them both but, on the contrary, becomes a joint challenge to overcome. Whether professionals or not, we can all seek to create such an environment where people do not get addicted in the first place and if they do, they are likely to recover.
Social Construction – an Orientation to Life
Pavel talks about his personal relationship with social construction that has transformed his life. He describes social construction as a “liberating approach.”
When you embrace social construction in an embodied way then you feel free to create your reality with others.
Social Construction has made a huge impact in Pavel’s life, opening up creative paths, discovering new possibilities and deepening his appreciation for relational processes.
Traditional discourse around addiction
As a social worker the dominant discourse around addiction did not sit well with Pavel, yet he didn’t have the language to question it. The dominant discourse approaches addiction in a very individualistic way – something an individual has in the brain. Even though there are changes happening in the brain in the addiction process, one cannot simply state that it is a pathological condition or a disease. It is important to see that addiction does not start out of the blue as an entity that invades the brain. There is always a background such as trauma or some specific interaction patterns, that develops addiction more rapidly.
It was the ideas and practices of social construction that offered new language that helped Pavel understand the idea that in the dominant discourse truth is a social construct. Therefore, studying addiction and its history with the orientation of social construction, he was able to understand the construction of addiction and develop new perspectives and appreciations. As an example, is “addiction” a useful word or is it stigmatizing?
When talking about addiction we are entering a much more complex world that captures all your identity, lifestyle, etc. The most important thing to take into account is context. Everything depends on the context. Then you need to examine: Who is saying that? And about whom? And with which purpose?
This work became foundational to the development of Pavel’s professional path in helping addicts recover through the lenses of social construction.
Relational View of Addiction
For Pavel, you can’t talk about addiction without talking about relational processes. There are two facets that result in different levels of addiction:
- the relational background of a person that makes him/her more vulnerable.
- the isolation that might cause addiction or marginalization.
Treatments offered by traditional health care services often result in people continuously coming back without changing their addictive situations. The question kept coming up: do these kinds of services really help people? In Pavel’s research, he learned of people who chose not to seek treatment from health services, and they were able to defeat the addiction habit. The question that became his Ph.D. research was:
How do people recover without professional help?
Throughout his doctoral research Pavel met wonderful, inspiring people and when looking at their process of recovery he could clearly see it happened along side a change in their cultural context. Relationships – with partners, friends, dogs, books, etc – were intrinsic to the recovery process. They were moving from a culture of addiction into a culture of recovery.
An important note is that each path is unique in the culture of recovery, but a common element is connection – feeling at home, a sense of belonging, a sense that the person participates in this world and their community. This contrasts with the elements that drew them into the culture of addiction.
Innovations In The Field
Pavel is enlivened when he talks of discoveries and innovations that are co-creating cultures of recovery and are positively impacting therapists, family and social networks. Among the collaborators in the relational recovery processes are former addicts, therapists, teachers, government officials, and policy makers. Funding is being made available for training of former addicts as recovery coaches in different cities to expand on these relational processes. Practices include:
- Use your own relevant life stories in developing your expertise
- Support former addicts to become helpers for others – recovery coaches
- Grow the collaborative networks across professionals and between therapists and the recovery coaches
- Find your inspirations – e.g. Seikkula’s Open Dialogue approach
- Invite others who might be involved in the situation to be part of the dialogue/therapy
Connect to Pavel
Books and Articles
- The Sage Handbook of Social Constructionist Practice
- Recovered without Treatment: The Process of Abandoning Crystal Meth Use without Professional Help
- Renouncing Methamphetamine: A Relational Perspective
- The Relational Essence of Natural Recovery: Natural Recovery as Relational Practice
- Conversation, Language and Possibilities.