Towards a New Way of Doing Drug Treatment
“I may not get there with you, but I want you to know
That we as a people will get to the promised land.”
—Martin Luther King
What’s The Big Idea?
In a nutshell, this is the big idea:
- We don’t know how to help drug users in this country.
- The reason we don’t know how to help drug users is that we stigmatize them, and the stigma gets in the way of the treatment.
- The reason we stigmatize people like drug users is that our whole culture is traumatized and lost, and traumatized cultures are especially prone to projecting their bad stuff onto outcast groups.
- A new kind of drug treatment, or drug healing, can be one part of repairing the entire culture, so we can all feel better.
- One feature of that drug healing is that it will recognize this is a trauma-organized culture, and it will start from the place that compulsive drug use is a trauma-organized behavior, not a disease.
- You fix compulsive drug use by healing the trauma, not by banging it into people’s heads that they shouldn’t do drugs any more, or by putting them in jail.
This essay is broken into two parts. Part A – Trauma and Drug Use, looks at the personal level. What is the fight or flight response? How does it operate in the brain? How is it connected to trauma? How does that connect to compulsive drug use? Part B – Connecting the Dots: Towards a New Kind of Drug Treatment, goes to the cultural level. Why does our culture stigmatize? What makes it a trauma-organized culture? How does this affect current drug treatment? What would a more humane model look like?
“I’ve been ten thousand miles in the mouth of a graveyard.”
Begin with the Brain
Trauma, reactions to trauma, emotional overload, it all goes on in the brain, so let’s begin there. The brain evolved to make us better survivors. Everything it does, from sending out fight/flight alarm signals to communication and social signals, is there to help us do better as a species. But it didn’t all evolve as one organized unit. It grew in response to different conditions in vastly different eras across different species, and rather like a ramshackle old house, where the old dairy is now an extra bedroom and today’s kitchen used to be a parlour, it’s made of parts built on top of each other, in a haphazard way that happens to work, though not perfectly. You can think of the brain as made of three parts, starting with the oldest:
- The Reptilian Brain: takes care of the automatic functioning of the body and primitive reflexes.
- The Old Mammal Brain (paleomammalian brain, or limbic system): involved with learning, memory, and emotions, is wrapped around the reptilian brain. Responds immediately to fight/flight situations.
- The New Mammal Brain (neomammalian brain): mainly the cerebral cortex, this is the part of us that does conscious thought and holds our sense of self-awareness. It’s the “me” I generally know as myself.
- The two older parts of the brain process danger signals far more swiftly and powerfully than the new mammal brain, but they don’t accurately depict what is actually out there. If a friend comes up behind you and shouts “Boo!” your Old Mammal Brain takes it as a credible attack and responds accordingly. It’s only after you have jumped, squealed, flailed your arms and doubled your blood pressure that your New Mammal Brain has time to come in and express more sophisticated things like feeling embarrassed and getting mad at your friend for playing tricks.
Another important division is between left brain and right brain.
- The left hemisphere of the brain mainly takes care of thinking, assessing, language, and the construction of a social self.
- The right brain is more involved with feelings and with our physical movement in space, and is responsible for what we call intuition.
- A vast amount of processing happens in the right brain, beyond left brain awareness. The left brain often fabricates narratives to justify decisions or reactions that the right brain has already made. The right brain/Old Mammal Brain system can be called the seat of the unconscious, and the left brain/New Mammal Brain system is the seat of the conscious mind. Trauma gets stored in the right brain.
The final piece to know is about memory. Trauma memory gets stored in the area of the brain called the amygdala, which is linked to the Old Mammal Brain, and stores what is known as implicit memory. Implicit memory:
- Is the memory system we had as infants, before conscious memory came into play.
- Is immediate, sensory and non-sequential.
- Recalls the past as a series of vivid, non-sequential moments. They are triggered by association (“looks like something dangerous”, “smells like something scary”) rather than by logic or intention. A war veteran hears a car backfire and throws him/herself to the ground, because implicit memory associates danger viscerally, with the loud bang, not with the circumstances. We call these flashbacks.
Explicit memory gets stored in the hippocampus and is linked to the New Mammal Brain, or conscious mind. Explicit memory:
- Is the memory system we are familiar with as grown people with mature, adult brains.
- Registers as an accessible, sequential and coherent narrative.
Trauma work can be seen as releasing memory from implicit memory, where it is stored as a series of intrusive flashbacks, and moving it over to explicit memory, where it gets linked with left brain/New Mammal Brain systems of conscious thought and language-based understanding. This gives us the ability to be able to say, “that event was then, but this is now”.
Fight or Flight
Fight or flight is the defense system that evolved in the Old Mammal Brain and the Reptilian Brain. First we startle or freeze, and then we fight or run. When danger is gone, an animal literally shakes off the stress and goes about its business again. The response evolved over millions of generations of animals devising strategies to avoid being eaten by other animals. It is a swift, full-body survival reaction.
In the fight/flight mode:
- The body releases adrenaline, raises blood pressure and heart rate, and pumps blood to muscles in the arms and legs so they can get moving fast.
- The body neglects ongoing projects like performing digestion, producing growth hormones, producing sex hormones, and a host of other functions.
- The mind becomes alert and super-vigilant. Access to logic and speech centers in the brain gets turned down. Fear and/or anger get switched on. The fight or flight response is not designed to help us talk our way out of it.
Unfortunately for us, the Old Mammal Brain is hard-wired to go into fear states. This is because running like hell at the slightest provocation is more adaptive than sticking around to see if that rustle in the bushes really is a predator. When you think of the expressions we use to describe our fear states, they are describing that fight/flight response:
- Scared stiff
- Scared witless
- Speechless with fear
- Pissing my pants
- Scared shitless
- Shit scared
- Totally unnerved
- Paralyzed with fear
- “Looking like you’ve seen a ghost,” as in having a pale face, because the blood has run to the core of your body.
For our New Mammal Brains and selves, this system can backfire. We are social creatures, and irrational, uncontrollable fears get in the way of our normal living, especially these days when we are more likely to be exposed to chronic worries and emotional threats than occasional, sudden threats to our lives. What’s adaptive and protective for the animal part of our being becomes a liability for our social selves, and, over time, for our bodies too.
Fight/Flight on Overload
The fight/flight mechanism works extremely well for zebras being chased by lions or rabbits being chased by foxes, but three types of bad experiences can overwhelm this system, so that instead of returning to baseline, part of you stays permanently in panic mode. They are:
- When the trauma is especially extreme and horrifying
- When the trauma is repeated or ongoing, as in war, torture, domestic violence, living in prison, etc.
- When the trauma happens in childhood, a time where we are sensitive and have few defenses. Our entire systems can then organize around the experience, and this is known as Developmental Trauma.
PTSD, Post Traumatic Stress Disorder, is the name we currently give for the reactions that come as a result of Fight/Flight overload. The “intrusive” symptoms of PTSD come when the panic mode gets stuck in the “on” position. They are:
- Extreme emotional reactivity and mood swings
- Exaggerated startle reflex
When we try to block out the intrusive symptoms of PTSD, we create the avoidance symptoms, which are:
- Emotional shut-down and numbing
- Avoidance of people and situations that might remind us of the trauma.
Dissociation is a short-term safety valve against the intense emotions of the fight/flight state. It’s like an internal cast the brain puts around “broken” emotions. Like a leg in a cast, the bound-up emotions are unavailable for normal use, which is fine if all we need to do is survive under minimal conditions. But as we evolved, our higher functions became important to social survival and quality of life. A repeatedly traumatized person may have trouble even establishing a coherent sense of self.
People cannot “get over” intrusive symptoms, because they come from beyond our conscious reach. We either suffer the emotional roller coaster of unpredictable moods, or we shut down from emotions altogether. Or, we endure an uncomfortable state where high emotionality and self-numbing follow each other in bewildering succession.
“I heard ten thousand whispering and nobody listening”
The official diagnosis of PTSD says that you need to have witnessed or been part of a life-threatening and horrifying event, and afterwards, you need to experience those intrusive or avoidance symptoms listed above. The Bible of diagnoses, the Diagnostic and Statistical Manual of Mental Health (DSM) also allows childhood sexual abuse and hearing about the death of a loved one, not just witnessing it, as causes of PTSD. Beyond that, if you feel traumatized, you’ll just have to look for a different diagnosis.
But there are many who believe that developmental trauma is just as damaging as “official” trauma. It doesn’t need to be caused by life-threatening events, and it doesn’t need to have the exact symptoms listed above. But if negative experiences happen during childhood, our take on subsequent experiences tends to settle around the meaning we have ascribed to the traumatic ones, such as, “life is dangerous,” or “I’m a piece of shit.” These kinds of negative experiences include things like:
- Parents getting divorced
- Parental discord and depression, a chaotic household, or no household at all
- Being the black sheep of the family, or an outcast among your social group
- Being the victim of bullying
- Having to hide your sexual orientation
- Ongoing stigma about your race, language or class
- The fallout and fears that come from poverty: losing your home, insecurity around the basics of life, the stigma around the family not having enough money, having parents who are distracted, angry, and worried . . . and so on.
- Attachment and bonding deficits.
About the attachment and bonding deficits: think of a child as a young plant in the ground. Put poison (a trauma) in the soil and the plant will start to shrivel. But what if the problem is not so much poison in the soil as a lack of nutrients? The plant will wilt just the same. For humans that lack of nutrients includes:
- Depression of a parent or care-giver
- Inauthentic and limited communication in the family
- Unwillingness to help the child thrive and develop a sense of self
Just like a trauma, these experiences lead to damaging self-beliefs, such as:
- I am a fatally flawed person.
- I am unloveable.
- It’s impossible for me to fix myself.
- Since I’m a complete shit, the only way to make myself feel better is through some external agency – like drugs.
The Drugs/Trauma Connection
“Take me disappearing
Through the smoke rings of my mind
Past the foggy ruins of time
Out to the windy beach
Far from the twisted reach
Of crazy sorrow”
Whether the trauma comes with the official definition or not, the emotional state it leaves us in – living with our panic button permanently set at “on” – is a supreme trial. No one lives long in that painful universe without doing something to calm it all down. What we do to cope may not always make rational sense, but then these internal experiences are coming out of our non-rational Old Mammal Brain. The coping mechanisms include things like:
- Overeating or not eating enough
- High-risk sex, in fact high-risk anything
- Going a little nuts, whether that means hearing voices or showing bipolar symptoms
- Lots more compulsive actions, from picking at our skin or pulling out our hair, to all night internet sessions or gambling our money away
- Last but not least, doing drugs
Being mood-altering and consciousness-altering agents, drugs are a natural for this list because:
- Downers calm the mood swings and anxiety, and distance us from bad memories. That’s why Big Pharma invented benzos.
- The elated mood that comes with uppers can jolt a person out of a down, withdrawn mood, or just toss the whole jig-saw puzzle of our life up in the air, so we can get out of our own skin for a while.
Either way, upper or downer, the drug offers a distancing and a disconnect
between us and our experience. Drug users will say that it “turns
off my brain”, or “gets me out of my head”. See how many
of our phrases for getting high suggest that the purpose is not so much
to alter consciousness, but to obliterate consciousness altogether, like
- Fucked up
Dandelions and Orchids
“Yes, to dance beneath the diamond sky with one hand waving free”
Have you have ever tried to get rid of dandelions growing in a lawn? It’s a huge drag, because whatever you do, beyond poison the whole lawn, those plain yellow flowers just keep coming back. You’ll never watch a child blowing a pretty globe of dandelions seeds in the same way ever again. Orchids on the other hand, will sometimes wilt and die right in front of our noses. But the orchids make all that hothouse TLC worth it by producing startlingly beautiful and delicate flowers that we treasure.
The difference between the hardy dandelions and tender orchids has been applied as a metaphor for people with different genetic traits. Research has shown that some people are more vulnerable to trauma (more likely to have PTSD symptoms) than others, and that those same people are more likely to wind up with serious alcohol and drug problems. So the researchers concluded, not illogically, that these people carried a genetic weakness that made them vulnerable in these areas.
It turns out that the researchers were looking at only half the picture. They were so eager to find deficits that they didn’t look for any of the strengths in the people who had the so-called “bad” gene. A closer look at the data showed that:
- The people with the so-called “bad” gene (known as the Orchid Children) are indeed more likely to develop PTSD after a trauma, and are more likely to engage in high-risk behaviors like doing drugs. But these people are especially sensitive to their environment, whether good or bad. While they do poorly in negative environments (become the drug users and PTSD victims), they excel when they are in positive and encouraging environments. In that setting, they become the social leaders, the artists and the innovative thinkers.
- The Dandelion Children, though they are genetically better equipped to deal with a negative environment, make less use of a positive one. They are the ones more likely to get a “Pass” in the class of Life, rather than an “A”.
- This doesn’t mean that everyone who gets traumatized is an Orchid Child. It does means that a disproportionate number of people with PTSD are Orchid Children, and that a disproportionate number of people doing drugs compulsively are Orchid Children.
- Traditional drug treatment, which has produced emotionally hostile and fearful environments is exactly the wrong way to treat the Orchid Children. What they are looking for is safety and encouragement. “Recovery”, for an Orchid Child, will best take place in a positive, nurturing and safe environment. It probably wouldn’t do the Dandelion Children any harm either.
Beyond the Dandelions of Life
“Most men lead lives of quiet desperation.”
Let’s take the ideas of developmental trauma one step further. For all people, but especially for the Orchid Children:
- The natural state of a person is to experience joy and ecstasy just by the act of being alive
After enough joyful and ecstatic experiences comes spiritual growth. This
- Enhanced sensitivity and a greater level of intuitive understanding towards other humans
- Communication with what gets called the spirit world, or what Jung called the “collective unconscious”
- A living feeling of connection with plants, animals, minerals, the whole natural world
- An understanding that we have a duty towards this living world, and a sense of joy in carrying out this duty
- The use of art and music as a tool for connecting with the spirit world and with one’s own inner world
- The idea that life is good!
The limiting conditions which prevent Orchid Children from opening naturally include:
- Regular old trauma and abuse
- Not enough authentic and loving communications
- An environment where everyone is uptight
- Experiencing the world as a drab, unyielding, or hostile place
- Schools that bore and scare off our inner spirit
- Jobs that do the same damn thing
- A general unspoken social agreement that life is limited and scary
- Being surrounded exclusively by people who respond to this situation with a very quiet and desperate despair
- A consensus that the main solace for a human being is a “higher standard of living”, meaning acquiring more of the fruits of power and toys of materialism than those around us
- An environment where not enough true spiritual experiences are happening to get everyone excited
This could be called the trauma of spiritual closure and it can lead to compulsive drug use, or addiction when:
- The closed-down spirit blindly reaches for the ecstatic state it craves but cannot reach.
- We finally concede that if we cannot find ecstasy, we will at least make do with pleasure.
- We just want to medicate our misery, even when we’re not certain what’s making us miserable.
What larger vision is trauma and trauma healing nested in? How could the horrors of the world ever take place? I believe they take place after the spiritual closure has happened, that’s when we lose all perspective and do terrible things. Yes, replacing drug “treatment” with drug healing would be a wonderful thing, but it wouldn’t solve our real issue. The puzzle we have to solve is our own selves.
Healing the Trauma Fixes the Drug Problem
“I look at you all and see the love there that’s sleeping”
When we get hurt, we often medicate that hurt with some kind of compulsive activity, and the compulsion is not going to go away until the hurt part of us gets healed. Unfortunately, all creatures shy away from their wounds, and trauma memories are stored in that strangely inaccessible but strangely intrusive implicit memory. The fight or flight response, which turns us into one huge on/off switch, and which is so basic to the survival of the whole animal kingdom, backfires against traumatized humans. The only solution is to heal the pain from the original trauma.
Trauma healing comes when you process the chaotic, vivid trauma memory out of implicit memory into explicit memory, where it can become a sequential narrative devoid of its toxic charge. What is that healing going to look like? In psychotherapy it will need several components:
- The relationship between the client and the therapist will be connected and personal, not clinical.
- Emotional trauma is registered in the body as well as the mind, so the healing has to have some sort of engagement with the body.
- Implicit memory exists on the imaginal level, in much the same way as dreams and visions. The healing has to reach the imaginal level in order to revive the parts of the person that have been shut down by fear and terror.
Here are three modalities that do these things. Some other psychotherapy modalities also do this, and so do some interventions outside of psychotherapy. I’m just listing three that I know:
- IFS (Internal Family Systems Therapy): A person is seen as a system of internal parts. Some parts carry pain and trauma, while other parts function primarily as protectors. By “going inside” on the imaginal level and negotiating with the internal system, the protectors are persuaded to “step back” so that the hurt parts can be reached, befriended, and convinced to give up their burden of pain. This is done by helping the person access his “self energy”, the untraumatized heart of our being that is always compassionate, calm and wise. It’s nice to know we have that.
- EMDR (Eye Movement Desensitization and Reprocessing): This method calls up trauma memories, summoning the emotional, physical and cognitive setting. The reprocessing is done by stimulating the left side of the body, then the right side, by tapping, by sound, or – as it was originally – by eye movements from left to right. The idea here is that by alternate stimulation of the two sides of the brain, the trauma memory is reprocessed and its toxic charge alleviated.
- EFT (Emotional Freedom Technique): A different kind of tapping. Based on the energy meridians of acupuncture, it’s believed that by tapping on key acupuncture points, the energy system of the body is balanced and harmonized, and the trauma is relieved. In addition, the person develops a “set-up phrase” and “reminder words” which help him maintain contact with the emotions of the trauma state while it processes. A typical set-up phrase might be, “Even though I was hurt and terrified, I still deeply accept who I am.” The reminder word in this case would be “cravings”, said out loud at each of the twelve points that are tapped.
“I saw a highway of diamonds with nobody on it.”
In Part A, we say that the trauma model of compulsive drug use gives a coherent reason about why drug use should happen, and clear methods to fix it for good. In Part B we look more closely at the community aspect, how the larger community, or culture, can be instrumental in creating the trauma and condemning the drug user, and how a different kind of community can be part of the healing. Part B is will connect the dots that lead directly from the trauma model of compulsive drug use to new and innovative forms of drug treatment, or drug healing. There are six dots in all:
DOT ONE: Drug Treatment Doesn’t Work
The drug treatment we have in this country now doesn’t really heal people, and when it does help them, it’s more because of the respite it gives from life, or the intimate contact with one or two good providers, than it is from the treatment. That’s because:
- Historically, drug treatment in this country has been extremely punitive. People have been forced to clean toilet bowls with tooth brushes, they’ve endured marathon sessions, faced group punishments for individual infractions, and so on.
- Humiliating people and infuriating them doesn’t seem to heal them.
- These practices occur less often now, but demeaning language, demeaning treatment, and demeaning body language are still commonplace among providers – unless someone is well off. Then his drug treatment will have more of a spa atmosphere. Why can’t we all have a spa atmosphere?
- The links between drug use treatment and mental health treatment are very shaky. Drug users often get told by mental health providers they have to be “clean” for at least six months to be eligible for therapy. Drug programs often don’t have psychotherapy, and users get huge dollops of anti-drug propaganda and precious little healing for the pain they are in.
- Long-term residential programs have the bad habit of keeping people out of trouble for as long they are in a controlled environment, without teaching them the life skills they need to be successful once they are back in the outside world.
- The biggest residential drug treatment in this country is prison, where people get raped, beaten, terrorized, humiliated, and forced into gangs – a service paid for by the American taxpayer. There is no mental health treatment in jail, and there are just as many drugs inside jail as outside – they’re just more expensive.
- Historically, drug treatment has been about total abstinence from all psychoactive drugs, even the ones that aren’t problematic for the person in question. Treatment adheres to Protestant ethics of giving over his will to God, making a moral inventory of the people he has wronged, and admitting he is helpless in the face of his addiction. Some people may like it, but many others don’t care to buy into this belief system.
In 1980 a study called Rat Park was published. It challenged the commonly-held disease theory of drug addiction, whose science was based largely on experiments with rats. Bruce Alexander and Simon Fraser said that these experiments were bogus, because the rats in question were held in such miserable and stressful conditions that they were bound to become drug addicts.
So Alexander and Frazer designed a Rat Heaven and a Rat Hell. Rat Heaven was made of large, airy cages with stimulating activities and plenty of opportunities to mate and raise litters. Rats who had been made to be chemically dependent were placed in there, and given a choice of bottles, one with plain water and one with laced with sugar and morphine. Said Alexander, “The rats gravitated more and more to plain water, thank you. Nothing we tried produced anything that looked like addiction in rats that were housed in a reasonably normal environment.”
However, chemically dependent rats in the crowded, bare cages of Rat Hell continued in their morphine addiction. The disease model would have predicted that any animal with a genetic predisposition would have stayed on the drug, and that circumstance would have been a minor variable. The Rat Park studies proved this wrong, and showed that the concept of “addiction” is more a cultural construct than a genetic predeterminate. The studies were replicated and published in journals, but were quietly ignored by the treatment community until the funding eventually drifted away, and Rat Heaven became a distant Shangri la for us all. (Thanks for that one, Carolina!)
DOT TWO: There’s A Reason We Do Treatment So Badly
“Tolling for the outcast, burning constantly at the stake”
We’re just not that stupid. We’re smart enough to split the nucleus of an atom to make electricity (or bombs), and invent arcane financial instruments that can bring the world economy to its knees. There must be a reason we are so obtuse about drug treatment.
There’s a saying, I’m not sure I agree with it entirely, that “hurt people hurt people.” What I do think is that “hurt cultures hurt people.” Because our culture has been “hurt” so often, it has become a trauma-organized society, and we have arranged ourselves around stark polarities like insider/outside and privileged/outcast. Here are some of our traumas:
- All the wars we have been in, from the Indian Wars, through the Civil War and the World Wars, to the war against the Current Bogeyman
- At least two genocides, one against Native American people and one against African people
- Slavery, Jim Crow, lynch mobs, and discrimination against all people whose skin was the wrong color
- Everyone who is an immigrant, or the child of an immigrant, has been through or inherited the traumas of leaving a homeland, dislocation, and resettling
- The only non-immigrants are Native American people, who are the most dislocated and traumatized of all
- Ongoing generational violence again women and children.
- Class discrimination
- Industrialization, for all its benefits, has its own attendant traumas of detachment from contact with the earth, overcrowding, mass poverty, and the further separation and malaise of living en masse in unnatural settings
- Western culture is the only culture to have inflicted upon itself the optional trauma of destroying its own shamanic tradition. We have chosen to sever ourselves from natural and fluid contact with the unconscious, or the spirit world. We did this by burning alive our own wisdom people, and ending our shamanic tradition in rampages like witch hunts. In the West, we now have special difficulties communicating with our own inner lives.
Think for a minute about who gets stigmatized; it’s a familiar list:
- The poor
- People with dark skins
- The mentally ill
- Children, especially children without parents
- People who don’t fuck according to the rules
- People who walk, act or talk funny
- People who take drugs, but especially those who take a lot of drugs, or take drugs and aren’t well-off and White.
Stigma allows us to assign all the qualities in ourselves that we don’t like (or that we fear) onto some person we perceive as flawed, or who is an outsider of some kind. We project our negative qualities onto our victim and punish him for being the way he is. If by any chance he finds a way to shrug off the assigned identity, we either work harder to put it back on him, or we just keep it moving and put it on the next scapegoat.
In a culture that started out with Puritanical settlers – intolerant, fearful, living behind compounds in a new and unknown continent – certain qualities were bound to be encouraged and others destroyed, or hidden. We are still living with their imprint to this day; just listen to the current political discourse. The qualities the Puritan fiercely abandoned were:
Don’t we all feel lazy, irresponsible, selfish, some of the time? To these impulses it’s important to say, “it ain’t me babe,” and shunt them on to someone else who looks less like us. And these days, who better to project all our feckless, lascivious, aimless, non-achieving, anti-work ethic, lazy-as-hell thoughts onto than the drunks and the junkies? They are the ultimate anti-capitalists, and they will never let us down.
But if these people are our elected scapegoats, the “blank screens” of our projections, how deeply invested can we really be in getting them to be more like us? Isn’t it easier to jail them, tell them they are diseased, punish them by taking their kids away, put them in crack-den shelters and SROs, infantilize them with a welfare check, than it is to say, “Oh my God, you’re just like me, you just ran into some personal (or global) misfortune, you got messed up, but you could be fixed!” A benzo addict I was talking to recently said, “As a kid I was born behind the eight ball. I thought I could get away from it, but I never quite did. My big mistake was being a nice guy. They never let me get away with that.”
DOT THREE: Want Real Change? Make A New Start
“Tolling for the aching, whose wounds cannot be nursed
For the countless confused, accused, misused, strung-out ones and worse”
If you look at our record since we started a drug treatment industry and a drug incarceration industry you’ll see that:
- Drug use rates remain essentially stable. They’ll sometimes go up slightly, and if they dip down slightly, there is great fanfare. But nobody is taking a huge bite out of this pie.
- Most of the people in drug treatment have a history of untreated trauma.
- On any given day, there’s that half a million people in jail for just using a drug.
- The drug cartels grow larger and stronger, taking over whole cities and countries.
- The poppy and the coca bush remain among the world’s top cash crops.
If we start being kind to drug users, we will be forced to reevaluate:
- Who we stigmatize
- Who we forgive
- Who we are
So, if we want to start drug treatment that is not quietly invested in keeping people where they are, we have to work from new principles, such as:
- Compulsive drug use is a trauma-related behavior, not a disease.
- The trauma can be healed.
- After someone is healed, he can go back to living his life, and he doesn’t have to wear the Scarlet Letter of “addict” forever.
- Successful models for doing drug treatment are not going to come out of mainstream culture. We need to look further afield than that, to other times and other places, and other ways that people found to heal. We also need to look for other paradigms and parallels for inspiration, whether it’s how to build a fire from scratch, or from chaos theory. The only likely places for solutions are the unlikely places.
DOT FOUR: Far Away Places
“How many seas must a white dove sail before she sleeps in the sand?”
You can only heal what’s been injured. People who do drugs for fun, amusement, to fit in with the people who actually are having the fun, or because they are mildly bored, these folks do not have a drug problem and do not need drug healing. The ones who need healing usually know they do, and were hurting before the drugs ever came along. Unfortunately, that’s a lot of us.
I’ve come across three models of healing that could show the way towards a new paradigm of drug healing. There’s probably 916 more, I’m just describing what I’ve come across.
1 The Sanctuary Movement
The sanctuary model of mental health treatment was created by the Quakers in York, England, in 1796, after Hannah Mills, one of their members, was killed by the abuses of the mental health care system of the time. The sanctuary movement spread through Europe and America, and had its heyday in the early nineteenth century, until it was destroyed by overcrowding, rising costs, and an outraged medical profession. It gave rise to the word “asylum,” which originally was an untainted term, meaning a nice place to find refuge – not a Willowbrook-style horror show. It’s central features were:
- Attractive buildings with beautiful gardens and places to walk
- Nutritious meals
Invitations to patients to keep active throughout the day with:
- Games, like chess
- Working in the garden
- Tea parties, where everyone dressed up and showed their manners
- Warm and soothing baths
- Readings and performances by visiting artists, intellectuals, and theatre groups
The basic tenets of treatment were to:
- Create an environment of cleanliness, order and comfort.
- Be kind and respectful. (“Soft speech is to distemper’d wrath, medicinal.”)
- Model and expect “normal” behavior. The prevailing conventional model was that mad people were akin to wild beasts and needed to be treated accordingly.
- Give an unusual degree of freedom and self-governance. Patients were allowed to leave the grounds and go into town.
- Make no attempt to reason or bully patients out of their delusions, just change the subject.
- Make no medical or psychiatric interventions, in fact the Quakers abhorred them. They did “little more than assist nature.”
If the majority of the mentally ill are Orchid Children, then this safe, kind, nurturing environment would have been just what they needed to recover and flourish. At its height, the movement reported between 59% and 80% success rates. “I think it is not too much to assume that insanity is more curable than any other disease of equal severity; more likely to be cured than intermittent fever, pneumonia or rheumatism.” said Samuel Woodward, Superintendant of the Worcester Asylum, 1843.
Confidence and success rates like this create lots of enemies. Those enemies, combined with the fact that the people running the sanctuaries were not medical doctors, made the death of the sanctuary movement inevitable. Swamped by patients, underfunded, and deeply criticized by the medical establishment, the asylums, or retreats, lapsed back into the medical model, to the disastrous result of anyone who wanted to get well (or be well-treated).
A new sanctuary movement, modeled on the original one, exists now, founded by Sandra Bloom. It is run by psychiatrists committed to humane treatment of patients, and struggles with funding issues, overcrowding, and health insurance issues, but continues to this day within the conventional system.
Shamanism is not a discrete belief system, but a practice spanning almost all cultures through all human time. You’d expect differences, but surprisingly, across shamanism a great deal of commonality exists. Here are some of those features:
- All share a foundational belief that the physical world is nested in infinitely larger spiritual realms.
- All believe the earth and the sky are wiser than us, and emanate openness and peace. When we are at our smartest, we make ourselves ready to receive these elements; we don’t do anything with them.
- The shaman is called to the work by spirit beings. The initiation may involve fainting, madness, or life-threatening illness. It may even involve, on the imaginal level, the death, dismemberment, and revival of the initiate. There is no degree program and no multiple choice quiz.
- Spirit beings, working as helpers, teachers, adversaries, and sometimes a combination of all three, give teachings and songs to healers, who then help heal other people.
- Shamans take journeys into the spirit realm where they encounter spirits and do things like retrieve the soul of the initiate from hidden and difficult places.
- They also conduct initiations, as people move from one stage of life to another, or from one stage of awareness and interaction with the spirit world to another.
The shaman practices his or her craft through rituals involving:
- Singing, chanting, drumming and prayer
- Sacred baths, sweat lodges, shaking, and sweating
- Ceremonies and/or psychedelic drugs.
The understanding I have of shamanic ritual is:
- The shaman is not focused purely on alleviating symptoms, but is focused on our life- long journey towards spiritual experiences, spiritual growth and spiritual understanding. I want the shaman to get rid of my symptoms, but the shaman wants to present me to the Great Lord for the dance that takes place in front of him.
- The ailment or problem is seen as something that highlights an area where need for spiritual growth exists. If the ailment had not been a thorn in the person’s side, that portal for growth and change might not have been noticed.
- Drug use issues are one of the problems that can bring us to the threshold of initiation.
- Our maladies only make sense in the larger context of our individual spiritual journey and the spiritual journey of our community.
The Aborigine people of Australia have one of the oldest shamanic traditions on the planet, going back 40,000 years. They walked the Song Lines, lines of spiritual power which criss- cross the continent for thousands of miles. Each Song Line has its places of power and, along the way, sacred stories and songs that are associated with these landmarks. To walk a Song Line is to undergo a spiritual initiation. It’s feared that no one knows enough of the tradition to be able to walk a whole Song Line today.
So, a culture which lies somewhere below zero on the poverty scale has – had, rather – such spiritual richness that it sustained itself and flourished for an unimaginable length of time. It collapsed into drunkenness, petrol-sniffing, and despair shortly after the European invasion, and has not yet found a way to recover. The “Rat Park” of the Australian Outback was in Heaven mode for the Aborigines when they were spiritually connected, and Hell mode when traumatized and spiritually disconnected. Physically though, it was of course the exact same Australia.
If you look at the shelters, SROs, and ghettos of our culture, you’ll find the people who live there are immeasurably wealthier than the pre-conquest Aborigines could ever have imagined. But the place most of our poor folk live in is an unspeakable Rat Hell of violence and degradation. A lot of rich people also live in their own Rat Hells, because Rat Hell for humans is not just a place of physical discomfort, it’s one where connection with community and connection to spirit have been shattered.
The shamanic way says that we are not on this planet to reach a higher standard of living. We are here to live to a higher standard. We are all here to learn, and we can all learn from each other.
3 Reconnecting with the Ancients: Asclepius
Asclepius was the son of Coronis, a mortal woman, and Apollo. Being one of the guy gods, Apollo killed Coronis in a fit of jealous sexual rage, and then immediately regretted what he had done. He plucked the infant from Coronis’ womb just as she was being consigned to the funeral pyre, and named him Aslepius, which means “to cut open.” Apollo had him raised by the centaur, Chiron, from whom Asclepius learned the healing arts so well that he eventually graduated to god of healing.
The temples, or Asclepieia, flourished from about 300 B.C. well into the Christian period. Their main features were:
- They were built on sites of considerable physical beauty.
- They were built near a spring, preferably a hot spring.
- Great care was given to the grandeur and proportion of the temple and its buildings.
- The temples were decorated with paintings and sculptures done by great artists of the day.
- Patients drank the water, had ritual baths in it, and got to enjoy it aesthetically as sacred fountains. They had a sauna-like set up where people plunged from extremely hot water into quick frigid baths.
- People exercised in gymnasia.
- People were entertained by dramas and/or rituals in amphitheaters that even today have perfect acoustics.
- In the temple on the island of Cos, supplicants changed from their regular clothes to white robes before ferrying over to the island temple.
- Supplicants would sleep in the abaton, or incubation chamber. There, among swarms of non-poisonous snakes associated with the god, they would have healing dreams, to be interpreted by priests and doctors the following morning.
- People were healed of physical and emotional ailments.
DOT FIVE: Not Drug Treatment, But Drug Healing
One way to begin devising a new form of working with drug users on a communal scale is to take elements from the sanctuary movement, shamanism, and the Asclepieia, and see if a coherent pattern can be created from them. But what do we call the work that will be done? I don’t like to call it drug treatment because in drug treatment:
- I am the expert and you are the patient.
- I diagnose you according to my symbol system of diagnostic codes, and that tells you what is wrong with you, even if the previous expert gave you a different diagnosis.
- I then impose my treatment, or my intervention, and see whether you respond favorably or unfavorably.
- The process is entirely top-down.
Drug healing happens where we recognize that:
- You and I are both humans, and we are making a commitment together to help fix your problem.
- I can’t heal a compulsive behavior, but I can heal the pain that triggers it.
- In the end, I don’t run the healing, you don’t run the healing, it is supervised by our intuition/the spirits – whatever you want to name it – and by the ritual we have devised.
To do this healing we – ideally – need:
A healing environment
- A beautiful house in a beautiful setting because, as the Greeks noticed, beauty is a portal to the spiritual world, which is where the healing takes place.
- Buildings designed for the purpose of healing – a temple, a theatre, a sauna, a meeting area, therapy rooms that are actually sound-proof, etc.
- Lots of water around, in as many forms as possible. Bathing in water seems to denote self-change, and transitioning from one realm to another. Water comes from two places: the top of the sky and the depths of the earth.
- Lots of sun too – sun porches, outdoor facilities, large windows, and large views.
- A healing tradition going back a long time, which is associated with this particular location.
- The workers must be kind! They must make it obvious that they are on your side, and they must be ready to treat you with extreme care and respect, as someone about to undergo a major initiation.
The workers must:
- Show a sense of purpose
- Focus on change, healing, and new possibilities
- Create an atmosphere of calm, sympathy, and respect
- Help everyone walk in beauty
- A transformative experience, a ceremony or initiation people go through that is designed to move them towards change
- This ceremony can be shamanic ritual or something of our own devising
- Energy work, massage, tai chi, etc.
- Poetry, journal writing, art, dance, and music that are focused on the ritual, self-reflection and transformative change
Simple, “chop wood/carry water” type work that is done mindfully,
- Building and construction of the temple, etc.
- Cooking the food that came from the garden
- Exercise, to reinforce the mind/body healing
- Skills training, for those who will be returning to the Rat Hell of the ghetto system after the healing
A Final Thought
In ancient cultural time, in 1626, the Lenape Indians were foolish enough to sell the island of Manhattan for $24 worth of beads, buttons and a few other trinkets. But they were people who thought you could no more sell the land you live on than you could rent out the wind that blows over it. Though they paid dearly, what they kept was their own selves. We, on the other hand, have sold our soul’s heritage for an ongoing stream of baubles and trinkets, and contrive to feel enormously pleased with the quality of the electronic knick-knacks and glossy toys we have secured. Our culture is disconnected from Earth. As individuals, we have disconnected from our moment-to-moment joy in experience of self. We don’t quite know how to completely be here.
As I walk down the streets on the island that was bought and sold, I see how we carry the weight of all the harm that’s been done. The bad end of our cultural bargain is written all over us, in the expressions of weary boredom and guarded grief that we have held for so long they have sunk into us and become our own shape. We try to cover it with a sharp look or a sharp outfit, but the burden of the past clings to us heavily. We have not made peace with it, and it is slowly squeezing the life from us.
In this “lost world” that turns out to be our own world, no wonder many of us steal the illegal cookies of heroin, cocaine, speed, marijuana and so on. Drug treatment that is just about drugs keeps us in place; it supports the illusion that “consensus reality” is real, when it isn’t. Shamanism is about soul-retrieval; but today, in our times, it is we who must retrieve our own souls, and we need our shamans back, to help us do that. Most of all, we need to wander the lost and dusty passageways of our hearts to find the lonely, exiled parts of ourselves, sleeping somewhere on a bed of straw, ignored and forgotten.
Many of us have been through terrible traumas, sometimes in prisons or in torture camps, but our quiet rowhouses and sedate suburbs also hold their own dramas of soul-closure and unwatched despair. Years of inauthentic and stultified communication, a dreary life lived entirely in square boxes, being surrounded by people who don’t sing together – these will bring you to loss of soul just as certainly as abuse and trauma. A people that doesn’t have the heart yet to sing the kind songs of humanity or to hum among the spirits will not protect its vulnerable ones from shame and stigma, or find the road to its own truth.
Everybody needs to help everybody. We just need to accept ourselves, trust ourselves, and then the terrible things we have done to each other over and over again may be finally be put to rest, and the ghosts of our own action may be lifted from our shoulders. The healing can always begin.
Wherever the spirits are, we thank them for bringing us together and making us dance. We thank our problems for making manifest what might otherwise have passed as normal life. That state, the one called “normal” is what we need “recovery” from. Our hearts know better than us where we should be going. This is my prayer: that we begin our journey.
“We are going, Heaven knows where we are going,
We know within.
We will get there, Heaven knows how we will get there,
We know we will.
It will be hard I know
And the road will be muddy and rough
But we’ll get there, Heaven knows how we will get there
We know we will.”