Oral stage of development

The oral stage fixation is often associated with the highly dependent person. That person who may have dependent relationships on others or develop a strong dependnecy on a drug of some kind.

These are some of the features of people who have an oral stage fixation.



The oral stage of development is broken into two parts. Initially there is the oral sucking stage which is followed by the oral biting stage, which breast feeding mothers can tell you about!



In the second digram the top two rows relate to the oral sucking stage and the bottom two rows relate to the oral biting stage



Oral sucking stage fixation



Pro-ana. Oral biting stage fixation

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Kahless script currency analysis

Results



One and only ++

Reverse status ++

Drugs ++

Booze ++



Analysis





Booze and drugs



Games: alcoholic, cops & robbers

Psychosexual stage: Oral

Lifestyle/occupation: Gourmet, wine taster, narc, temperance league, junkie

Illnesses: Gastrointestinal, oral problems

Therapist: Addiction counselling

Personality: Antisocial, schizoid, narcissistic

Issues: Can be more severe in terms of life threatening, despair rather than depression









Tends to result from pre-verbal quite early problems with the primary attachment figure. Primary attachment figures may be emotionally absent in some way.



May have a tendency to move to a position of non life if not obviously self destructive. Stroke deprivation can result when the individual enters periods of incapacitation (non life) which may last many months.



Possibility of openly self destructive behaviour with the use of alcohol and drugs but also by other means as well. Possible suicidal urges.





The sophistication of smoking Peter Styvestant thins.





Quite amenable to psychotherapy but needs to find a good attachment figure in a therapist. If achieved then considerable psychological gains can result but it takes time.



Needs to structure life such that social isolation does not result even though there maybe a constant pull to that position.



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Kronic and social engineering

Having been involved in drug counselling for over 20 years it is interesting to see current developments in the drug known in Australia as Kronic. This is a synthetic cannabis or synthetic marijuana. This marijuana is not grown on trees but produced in laboratories.

As of June 17th, 2011 the government of Western Australia has made this synthetic marijuana illegal. The first state in Australia to do so. It will be interesting to see what impact this new legislation has on marijuana production and use in this state. Those in the organised crime industry may be now rubbing their hands together in glee and dollar signs showing up in their eyeballs.



As of June 17th the production of synthetic marijuana moves from legitimate businesses into organised crime in Western Australia. How much organised crime take it on remains to be seen. If one counsels drug users in rehab one inevitably also counsels some drug dealers and producers. One hears all sorts of things about the business of drug production and distribution.

For those producing marijuana naturally by growing it, the big problem they have is that it takes a fair bit of space for the plants to grow but more so it takes a long time for the plant to become productive. Often 6 to 12 months for a fully mature marijuana plant. Synthetically produced marijuana takes one day to produce and can be made in a small kitchen of a house.



One would assume that this will make it very appealing for those involved in the organised production of illegal synthetic marijuana. It will be interesting to see in the next 5 to 10 years how much synthetic marijuana replaces naturally grown marijuana in Western Australia. One would hope that our law makers are not just handing a new multi million dollar drug to organised crime. We will have to wait and see the implications of this new legislation.

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Functional drug use

I have written before about the footballer Ben Cousins in the post, Drug use and prohibition. He has done a biographical documentary type of thing which gives some good insight into a particular type of drug use and the psychological dynamics behind it. He refers to himself as a functional drug addict.

The term drug addict is an nebulous term that is used in a wide variety of ways. Functional drug addict, usually refers to a person who can use recreational drugs regularly, in significant quantities and still maintain their life style, in particular their work life, in a functional way. The drugs do not debilitate the person in the place of work in any significant way.

This is a bit of a contradiction in terms because the term addict often means a person whom is consumed by their drug use. The person who wakes up in the morning and the first thing they think of is how are going to get their next hit. And if they manage to find some drugs then they take it. That means they will take it before going to work or even in the work place. This will effect their performance in the work place and thus they cannot remain functional in this way as sooner or later this will be noticed and they will be ‘sacked’ from the job or at least their performance on the job will be significantly reduced.




Ben Cousins functioned at a very high level in the workplace (the football field) over a long period of time. He was amongst the best of the best in that occupation. He states in his biopic that he never took drugs on game day or the day before game day. This must have been true most of the time because any drug use would quickly reduce his level of performance at such an elite sporting level.

So he is not a drug addict in the usual sense of the word. Just go and meet a few such addicts and one quickly sees they are physically wrecked. The drugs quickly take their toll on the physique. There is no way a drug addict can function at an elite physical level. They can’t even function at a moderate physical level. They would struggle to run around a football field a couple of times let alone run a marathon every game of football they play.

The other thing about him which he states in his biopic and has been reported by others on many occasions is his work ethic. It was unparalleled. He would train longer and harder than all other footballers and thus his fitness was at the highest level amongst a group of very fit men. This is where the psychology behind his drug use starts to become apparent.



To train in such a way means he has a driven quality that others do not have. He can deprive his Child ego state more than most others. When others are exhausted and stop he keeps going. To do that he must have a very large internal critic inside his head. It pushes his Child ego state relentlessly and thus he has that driven quality about him such that he can keep training when others can’t.

The problem with such a psychological structure is it can’t continue on for too long without some symptom developing. The Child ego state is being deprived of pleasant feelings and comfort such that sooner or later some symptom will develop and thus we have the psychological basis of such drug use. He even says this, that the drugs were his reward after training so hard. The good feelings provided by the drugs were the relief for his Child ego state. After training so hard he allowed himself to party and thus he could continue on psychologically. The Child aspect of the personality felt looked after and thus the sense of deprivation subsided. In this way he would be described as a symptomatic drug user rather than a drug dependent user. The drugs solved the problem of physical and psychological deprivation.



If he had not found the drugs worked then some other symptom would have developed. This applies for any person who is highly driven in any kind of workplace. It cannot continue on for any length of time with out something happening. If the drugs or alcohol did not work for him he could have developed depression or had panic attacks which is the Child ego state stating that it can no longer handle the deprivation. It is the Child ego state putting up its hand and saying, “Hello!! I am still here, take notice of me” as indeed any child will do when it is being ignored. If it cannot get noticed for being good it will start doing bad behaviour to get noticed.

This type of drug user does not have the ability to self regulate. As shown in the diagram the Critical Parent ego state is so dominant in the personality the Child ego state is overwhelmed and its needs are lost under a tsunami of parental directives from the CP.

Thus the treatment strategy for this type of drug user is clear. Reduce the CP allowing the Child ego state to gets its needs met, then the desire for the drugs looses its importance, or the depression lifts or panic attacks subside. The person learns how to listen to their Child ego state thus allowing them to self regulate.

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Drug use and prohibition

At last Ben Cousins can take as many drugs as he likes. The David Beckham of Australian Rules Football has spent the last 5 years being the bad boy of football. The governing body, the AFL have been drug testing him almost every week for recreational drugs. Never tested positive but he has been banned from playing on a number of occasions for a variety of misdemeanours off the field in a highly publicised way.

However the AFL holds the sword of damocles above all players. If they take recreational drugs and test positive they risk loosing their income and right to play football in that league. Ben Cousins retires in two weeks and thus the sword of damocles disappears and he can take as many drugs as he likes. And you know what, he now has the chance to really deal with the drug issues he has. This raises the issue of the difference between externally driven prohibitions and internal choices in the want to use drugs.

The problem if you have an external force whether that be a spouse, a parent or the AFL, pressuring you to stop using then it does not allow you to make your own decisions. Or at least it makes it harder to make your own decisions as this diagram shows.



If an outside person or organisation gives the directive “Don’t use” (particularly if they are using some kind of punishment like loss of income) then the user is pressured to respond from an AC (Adapted Child ego state) position. They can adapt to the directive in two different ways. They can either conform and don’t use or rebel and the use simply goes under ground and they try and outsmart the detection system.

The problem with both of these responses is neither is about what the user wants. The external prohibitor makes it much harder for the user to find out what they actually want. That comes from the Free Child aspect of the personality and it is here that one gets the possibility of the user deciding that drugs are not for him or he uses recreationally or he is OK with his current drug use. The decision comes from inside the psyche of the drug user and not as a reaction to some outside pressure.

Now the AFL can no longer pressure Ben Cousins about his drug use, he is much more likely to be able to find out what he actually wants in relation to using drugs. And that is his decision.



As I mentioned before, with pressure from out side the person can continue using by rebelling against the pressure and the use simply goes under ground. This is why drug counsellors need to be careful not to present themselves as an outside pressure because the client will simply stop telling the truth about their drug use. Then the counselling starts to flounder.

Others respond to the outside pressure by conforming and do stop using. But this is fragile because the use depends on the other remaining present. In this sense the person becomes addicted to the outside force which at times can be something like a religion. If the person drifts away from the ‘force’ then the risk of using significantly increases and thus we have the new “addiction”.



Having said this sometimes this approach can work in the longer term with AA being an example. In the initial stages the person becomes addicted to AA, the sponsors and uses them to stop drinking by responding from a conforming position to the ‘pressure’. If the conforming non use can persist for a long time then the person can construct quite a solid non drinking type of life style. Such a person is less likely to fall off the wagon because their whole life style and family are structured to ‘pressure’ them not to drink. And some remain sober for the rest of their lives. A good result indeed.

However in my view, by and large it is better for the user to be given the opportunity to take a look at self with no outside pressure. Then they can begin to decide what they want out of life and one is more likely to get longer term change in their drug using patterns. Again it is their decision.

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Human attachment and addiction

This is a follow on from the post before on human attachment.

Sometimes however children do not go through the attachment build up followed by the attachment breakdown. Consider the experiments done by John Bowlby with attachment many years ago.

A mother and young child would go into a room that had a chair in the middle. In the room there would be toys and other interesting things for a child to look at and play with. The mother sits in the chair by herself or just talks with another adult. The researchers then simply observed what the child did and there were three patterns that came up.

1. Some children would stay next to mother but slowly and surely move away from her to investigate the room. They would move away and then come back and then move away again further and further each time. Checking on mother from time to time. This they called a secure attachment

2. Some children just moved away from mother did not look back at her or seek her out again and amused themselves with the toys. This is called an isolated attachment as the child did not use mother as a secure home base. Typical in later life of the schizoid personality

3. Some children never left mother’s side . They may look around the room at the interesting stuff but never left mother’s side in any significant way. This is called an insecure attachment. This is the psychological basis of the addictive personality. They never adequately learnt the process of the attachment breakdown.

The vast majority of children learn how to form an attachment. Those who don’t end up showing autistic like symptoms. Children will develop an attachment to a parent who treats them well and also to the parent who treats them badly. The need to form an attachment is that essential for the psychological well being of the child. The stockholm syndrome is an example of those who developed an attachment to their abuser as do young children.

However the process of breaking down the attachment is not learnt by all, those who don’t can develop the insecure attachment and continually seek mother’s side. As we know the essential feature of an attachment is the desire to maintain proximity with the attachment figure. Thus the child’s reluctance to leave mother’s proximity.

The dependent personality is the same and this explains the ‘drug addict’ type of drug user. These are the ones who find it really, really, really hard to stop using. People use drugs for many reasons and these are the ones often portrayed in the movies, usually live wretched lives and use up most of the health, legal and counselling resources in the community. In number they are quite small but they use up most of the resources allocated to drug users in the community because drugs ruin their lives, families and often they are outside the law and require health resources as a result of their drug taking. Listening to these people talk about the drug one finds an uncanny similarity to talking about a relationship with a husband or wife. The drug becomes their partner.

As they grow through life into adulthood they discover something that feels good for them. That can be anything with the most common ones being cigarettes, alcohol, drugs, food, sex, gambling, religion, another person and they in essence form an attachment to it. As they never developed the ability to break the attachment down they then form an insecure attachment with the ‘thing’. Thus they have a continual heightened desire to maintain proximity with it and thus one ends up with the addiction. It is an attachment problem.

In the histories of drug addicts one finds they have gotten off the drugs on many occasions. Their problem is not to get off the drug but to stay off the drug. When they remove self from the attachment figure (drug) they find it so difficult to maintain the distance that they they sooner or later again seek the proximity of the attachment figure and thus start using again.

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The drug addict

I was asked a question in supervision yesterday about the drug addict and I gave an answer that I want to record and thus it is going in as a blog post to join my tome.

As I have mentioned before there are different types of drug users. One that gets a lot of notice is the drug addict type of user. This is the person who finds it really, really, really hard to stop using. Or more correctly they do not find it that hard to get off drugs but they find it really hard to stay off drugs. In their histories they have often given up on many occasions but they always start using again.

This type of drug user represents only a small number of the overall drug using population. By far the largest group is the recreational drug user who uses drugs intermittently in their life and it never causes them any real problems. Whereas the drug addict type of user ends up with numerous familial, legal. financial and health problems as a result of the drug use. Whilst they are a small group in number they are the ones who use up most of the resources - health, police, courts and so forth.

When you listen to these people talk about their relationship with the drug one finds an uncanny resemblance to the same qualities one finds in a relationship between a child and a parent. Of course a child is dependent on a parent and one finds the drug addict type of user with a similar type of dependence on the drug. So we end up with a symbiosis as such:

A young child is dependent on it’s mother and as it grows it is meant to become more psychologically separate from mother. As this happens then the dependency reduces and the original symbiosis is broken. If it does not happen then the dependency does not reduce and one develops what is called the dependent personality. This type of person can then become a drug dependent individual - the drug addict. See White for more on this. The recreational drug user does not have this personality trait and thus they do not become drug dependent in the same way.

So what is the solution? Can these people stop using drugs and if so how? My answer to that is yes they can, as some do, and there are a number of ways depending on their circumstances.

1. Switch the dependence. These people are psychologically dependent people as was described above. They can stop using by switching the dependence. Thus they still remain dependent but on something besides the drug. One sees this happen sometimes with religion. If the drug addict seeks a religious based treatment for their addiction some times they can become addicted to the religion and thus stay off the drugs.

An OK solution to my mind. For some AA can be the same. The addiction can be anything though from religion, to sport, to sex, to a person or whatever. It would seem to be much better to be addicted to religion than to heroin.

2. Grow out of it. One does not find many 40 year old heroin addicts. If they survive their twenties and thirties as most do they get tired of the highly charged lifestyle, mature a bit with age and start needing the drug less. If you are working with a 25 year old habitual heroin user the goal may be to help them get through the next decade and then they are more likely to start to tire of the lifestyle and then one has a real chance of them ceasing to use for long periods of time.

3. The psychological solution or cure. Whilst this solution is possible it does take a significant amount of time and money, thus one needs to be realistic and see that it may work for a minority but the majority are going to need to look for the other solutions.

The solution is via a transference cure where the process is as such:

In essence the client develops an attachment to the therapist and thus a symbiosis develops like shown above. The addict becomes dependent on the therapist in the same way. This growth of dependency happens in the positive transference stage. After a time that ceases and the client goes into a negative transference where they fight the therapist in many and varied ways. The separation stage begins.

This is the crucial part of the cure as this is what the person never completed in childhood. In the negative transference the client begins to psychologically separate from the therapist, thus they breakdown the symbiosis so their dependency on the therapist reduces until they basically outgrow them and don’t need them anymore. The dependent quality in their personality reduces and thus they become less dependent on the drug.

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Self harm as self punishment

One of the eight reasons why some people self harm is because of a self hatred or as a form of self punishment. As a result of childhood experiences some people end up with a self hatred or with a sense of self loathing. This may be because they were told precisely that. They were told they were useless, worthless, not wanted, hated and loathed by the parent figures.

In other circumstances the child may have been physically and sexually abused. When this happens sometimes the child has faulty thinking and believes the reason why they were abused is because there is something wrong with them. It was because of their inherent badness that the parents physically abused them. The child thinks that it is their fault and thus a sense of self loathing and hatred can evolve in their perception of self.

If a person has a basic sense of self hatred that does not mean they are going to be suicidal. A person will be suicidal if they have made the suicide decision and thus see suicide as a viable solution to their problems. There are plenty of people who have a basic self dislike who do not see suicide as such a solution.

Those who do have a very low self perception will self harm in some form but maybe not in the usual sense of the word. That is they will not self harm by cutting, burning or stabbing self but will self harm by the lifestyle they live. For instance a woman may prostitute herself at least partially because she hates herself. This could be seen as a type of self harm in terms of the life style she lives.

Any person who has a sense of self loathing will somehow live a life style where they treat self very badly either physically and/or psychologically. For instance the drug addict type of drug user can be taking drugs in such a way that it amounts to physical self harm. Such as with intravenous drug use where they share dirty needles with high risk others and so that their veins eventually become essentially mutilated.

Most drug addicts also hate themselves for being an addict. They know society views a junkie as being at the lowest level of society. They are seen at least by some as the useless crap at the bottom of the pile and often view themselves in a similar light. This can amount to psychological self harm. Thus the drug addict may hate self and that is expressed by self harming physically and psychologically.

Despite this there are a group of self harmers such as ‘cutters’ who harm self as an expression of their self hatred and self loathing. They cut self as an expression of these thoughts and feelings about self. Some self harmers will talk of bloodletting as a way to getting rid of some of their badness. As the blood flows out they see their inherent badness also flowing out.

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