Working with drug users

The other day I was talking with someone about psychotherapy matters especially in relation to working with people who use drugs or perhaps teenagers who may engage in antisocial and risky acts. I then got up and drew this picture on the board.



This is how I would rate myself as a therapist on that continuum. Clearly up the permissive end especially when dealing with the clientele I just described. With that clientele it is quite easy to use ego states like Controlling Parent or Critical Parent and using Adult facts to support the Parental statements.

The person I was talking with was working in drug rehab. I made the statement that I never tell drug using clients not to use and this was of some surprise to him. Obviously he does make such statements to his clients. This I think makes me quite a permissive therapist at least with clients like this. I would rarely use Parent ego state statements with such clients. This however creates a dilemma.

The reason why I would never tell a drug user not to use or make statements about why drug use is bad is because you quickly loose the client. They will quickly slip into the Child ego state and either stop coming, attend sessions but don’t tell you what they have been taking or take more drugs because they have moved into a rebellious position against you.



On the other hand I am tacitly giving them permission to use drugs and thus supporting their drug use in that way. Through the transference the client will introject me to varying degrees into their Parent ego state. If I am not saying, “Don’t do drugs” then they are not introjecting that so their Parental tape of me is in one way supporting their drug use.

So it seems we have the good and the bad. Obviously I see it as more important not to ‘loose’ the client as I described before, versus providing a Parent tape that is clearly against drug use being introjected into their Parent ego state.



On a side note:

As I looked at the diagram I drew I realised that if I was to rate my parents in this way on how they dealt with me in childhood and adolescence I would put them in almost the exact same position.

Graffiti