Addiction in dialogue

(Art: Markéta Profeldová @marketa_profeld_tattoo)

Since I recently turned forty-five, I realized that I have been working in the helping professions for more than half of my life. I started at the age of 22 as a social worker, then switched between positions of psychologist, case manager, individual psychotherapist, family therapist, and currently I combine all these roles as an Open Dialogue facilitator.

And for all that time, I have been constantly occupied by two almost unsolvable puzzles: addiction and dialogue.

Why puzzles? And why unsolvable?

The puzzle of dialogue stems from its inevitability. If we understand dialogue, following Russian scientist Mikhail Bakhtin, as a life force, and if we understand life, following Czech-British psychologist Ivana Marková, as essentially dialogic, any attempt to escape dialogue is similar to an attempt to escape life.

However, life is damn hard, at least sometimes, and so dialogue is not easy either. Attempts to reduce dialogue in one's life are therefore very understandable. There are many ways how one can try (concsiously or unconsciously) to decrease the number or the intensity of outer and inner voices and make his or her life more monological.

Addiction can be understood as such an attempt.

Two words needed

The puzzle of addiction starts with the word "addiction" itself. Let me quote my favorite addiction expert, Canadian professor Bruce Alexander (from Globalization of Addiction):

„Addiction is not a promising conversational topic. When an everyday conversation goes there, it is time to anticipate misunderstanding and hard feelings, partly because people use the word „addiction“ in such different ways. (…) I have learned by hard experience that there can be no productive interchange about addiction unless people can agree on exactly what the central word in the discussion means.“

I cannot agree more, especially given the fact that in Czech language, we have only one word ("závislost") for both addiction and dependence. When I told this to Bruce while he was visting us in Brno and we walked through Lužánky park, he suddenly stopped, stared at me and pretended fainting. "How could you live with only one word?" he asked amazed.

While both words are sometimes used interchangeably also in English, it wouldn't sound right to say that we are addicted to the air. We are dependent on air, on water, on soil, we are also dependent on each other, on plants, some people are dependent on different kind of chemical substances. But it does not say that they are addicted to them. Meaning of addiction is different. If we would be addicted to the air, we would either passionately live only for air, or we would feel enslaved by the air. 

To put it simply, dependency makes our life possible, while addiction makes our life narrow. 

Green powder

We could problematize the word addiction even more and maybe we would need more words than two, but the important message is that we never know what others mean when they talk about addiction. It's also why at every networking meeting when the word is mentioned I always interrupt the conversation and ask "when you say 'addiction' what exactly do you mean?"

Like, for example, at a meeting with the parents of 14-year-old Luboš. His mother first called me and said they found kratom in Luboš's room, which scared them, and then they also found a conversation on Luboš's phone where he was texting about using kratom with his friend. And she added that she was referred to me because I specialize on addictions.

Kratom is a psychoactive substance derived from a tree that is predominantly cultivated in Southeast Asia. It is legally available in our country (although not as a food) and in recent years there has been a lot of discussion in the media about how to regulate it. There were number of media warnings that kratom is highly addictive. And of course journalists don't bother to explain what exactly they mean by addictive.

I proposed to organize a networking meeting where there would be the three of them, me, and my colleague Sylva, who is both a social worker and a recovery coach. And so we met. Luboš sat the whole time with a motionless face, hands in his pockets and eyes fixed on the wall clock. One of the few pieces of information he was willing to give us was that his parents had ordered him to come with them. Sylva and I assured him that he didn't have to say anything and thanked him for coming.

We also learned that Luboš had not told his parents anything about using kratom before this meeting. "It would be useless," he muttered. He later noted that he used it before, but he is not using anymore. The parents said it was positive news for them. "But how do we know it's true?" mother asked with anxiety in her voice, father sighed and shrugged.

Although we started the meeting by talking about kratom use, we didn't stay with it much. We were more interested in the fact that Luboš refuses to talk to his parents. What are his concerns? Does he have any bad experiences? Why is it difficult for him? These were the questions Sylva and I shared with each other in our mutual reflective interview. We didn't demand any answers from anyone, we just wanted to share where our curiosity leads us.

Luboš did not arrive at the next meeting. This time he didn't get any order. But his parents came. The main topic they wanted to discuss was how to communicate with Luboš when he refuses to talk to them. And also how to hold him accountable for being part of the family. How to make sure he goes to school, does his homeworks, helps around the house. Parents came up with an idea of ​​creating a list of ground rules. And we all agreed that we could go over this list at the next meeting.

At the third meeting, again without Luboš, the parents brought a draft list of rules, while Sylva and I suggested that it would be useful to talk about the consequences, that is, what will happen if Luboš does not follow the rules. During this conversation, it surprisingly became clear that there is no longer a consensus here. On the contrary, it seemed that it even increased the tension between the parents, which Sylva and I also commented on.

Another meeting has not yet taken place.

Addiction without essence

You might think that the message of this story is that the parents got it all wrong and there was no addiction in the family. But I don't see it that way. On the contrary, in this family, addiction had a serious impact and has caused considerable worries on the part of the parents. The addiction came to them through the media, the education system, family stories, it was intertwined with the green powder found in Luboš's room, his conversation on Messenger, it was supported by Luboš's silence, and it was somehow related to the partnership of the parents.

There is no essence of addiction. To emphasize its elusive nature, some scientists offer the term assemblage, which I like very much. It originally comes from art. London Tate gallery describes assemblage as "art that is made by assembling disparate elements – often everyday objects – scavenged by the artist or bought specially."

French philosopher Gilles Deleuze, together with psychoanalyst Felix Guatarri, used the concept of assemblage in the book A Thousand Plateaus to emphasize multiplicity versus unity and a network of events versus essence. What if we stopped trying to discover the true self, the essence of life, the true nature of the world, and paid more attention to all the diverse elements that make up life, the world, us, and the relationships between them?

The concept of assemblage has been used by some researchers (such as Suzanne Fraser, David Moore, and Helene Keane, authors of Habits: Remaking Addictions) in recent years for their addiction studies, and for me it is currently the most comprehensible way to approach this difficult topic. The mere fact that the concept of assemblage refuses the question "What is..." is particularly comforting. I have attended so many lectures and discussions on the subject of "What is addiction?" that I have become somewhat allergic to the question because, to quote Bruce again, it has only produced "misunderstanding and discomfort" and never any consensus.

Solvable puzzle

If we stop asking "what is...", more space opens up for other questions, such as "where", "who", "how", "with whom", "with what", etc. In the case of addiction, these questions are particularly interesting, because many elements of the assemblage seem quite rigid, similar to how Markéta depicted it in the image above. As if a certain place in an otherwise fluid assemblage was suddenly more fixed, couldn't move around. A pot that may create an impression that there is no escape. But it's just an impression...

Through our curiosity about the assemblage including these rigid and somehow impenetrable spots, including relationships between the elements, including their stories, a very interesting and rich dialogue can develop. Such a dialogue becomes living water, which gently and slowly flows between all the parts of the assemblage, embraces them, sets them in motion, turns them to one another, including those that have been motionless for a long time.

When these parts are awaken under the touch of others, new things can begin to happen, that are unexpected and unpredictable. The rigid part of the assemblage will once again enter the vortex of life.

Addiction may be a way how to reduce dialogue. But there is no way out of addiction without dialogue. Yes, another puzzle. This time, however, it is a solvable puzzle, and Open Dialogue network meetings are very good platform for solving it.