Narcotic Anonymous and experience of a transitional object

Winnicott argues that the capacity to enter in the world of illusion for creativity is first experienced in optimal environment between mother and child. The good-enough- mother is attuned with the needs of the infant and also responsive to demands for satisfaction (Meissner, 1992). The infant comes to believe in illusion in that it is responsible for libidinal satisfaction; however, Winnicott does not equate the infant’s illusion with hallucination. The infant’s experience is both subjective and objective at the same time, in what is termed a transitional space. Transitional space and transitional object are very important concepts in understanding how an infant can transition from omnipotence to object relations. Although, transitional space and object may evolve overtime, these concepts are inherently enduring and play equally important roles in adulthood. Most of human creativity is found in the medium of transitional space.

Illusory experience in the form of play in childhood may turn into creative cultural experience of the adult (Meissner, 1992). The use of symbols emerge within the transitional space, thus includes all forms of cultural, religious and even scientific creativity. When the infant starts to use a teddy bear as transitional object and a substitute for the mother, for example, then the infant is said to have developed the capacity to enter into a symbolic realm. With symbolism, the child develops the ability to make distinction between fantasy, illusion and fact and between internal and external objects.

Transitional space is the gateway for experiencing reality using the creativity of imagination. Consequently, adaptation is itself a creative process of continuing and constant interaction by which one adapts autoplatically to the demands of reality as well as allopalstically in modifying reality to suit one’s needs and wishes (Meissner, 1992). Transitional object create transitional forms of experience necessary for adapting to reality (Meissner, 1992). Therefore, if the child is not able to generate transitional forms of experience, then adaptation to reality would inevitably become frustrating (Meissner, 1992).Freud’s approach to illusion was in stark contrast to that of Winnicott; whereas Winnicott found illusion - for instance in religion, as a way of adapting to reality, Freud saw illusion as something that one needs to overcome. In 1923 Freud wrote to a friend where he stated his wish to destroy his won illusion and that of humankind (Meissner, 1992). Freud held a negative view of illusion even though he understood the distinction between illusion and delusion.

Addiction and spirituality

For the past year I have been attending Narcotic Anonymous and a Substance Abuse ministry at the Morning Star Baptist church to study the effect spirituality and religion has on sobriety. I had to abandon observation of Substance Abuse ministry due to a very small size, inconsistent participation and high drop-out rate. I was hoping to make a comparative study of Narcotic Anonymous and faith-based recovery model. Now, I am concentrating on studying Narcotic Anonymous and how NA/AA model may help the process of recovery from addiction. I feel that I may have identified one component crucial to the recovery effort at least in relation to the minority clients at Narcotic Anonymous.

The core issue identified is that of shame. Although addicts rarely use the term shame, it is nonetheless spoken of in disguised form. There is a shame talking about shame, thus, other terms are used to express shame. The overwhelming majority of the addicts at the AA/NA meeting are men. The overwhelming majority at the observation site are also African-Americans and Hispanics.

The majority of the addicts appear to come from inner-city neighborhood with problems ranging from high unemployment rate, unstable family structure and violence. I use attachment theory in order to understand attachment patterns of addicts. Attachment theory is often utilized to explain mother-infant relation or to some other significant figure to the infant. I am extending attachment theory application to family and social structure.

My main argument in explaining addiction is the following: affects and impulses are contained and discharged not only in the dyadic relationship between an infant and its care-taker but also by the family and social institutions. Family structure and social structure help to adequately contain anxiety. However, when all these layers, i.e. dyadic containment of impulse, family containment of impulse and social containment of impulse fail, an individual may become prone to use external means of containing anxiety. In our society drugs happen to be the most widely used method of containing anxiety. However, despite the prevalence of drug abuse, especially in some quarters, there is a great deal of stigma and ostracism of the addict.

Obtaining and using drugs becomes the focal point of the addict in terms of expenditure of energy. Often and especially in the inner-city, the addict may resort to all manner of socially disapproved ways to obtain drugs. I would argue that shame becomes especially clear when the addict’s social status is increasingly lowered. Low social status means decreased social capital both in terms of financial resources, attachment figures and a sense of one’s appraisal, perception or feelings about its social standing. Decreasing social status leads to narcissistic injury and further intensifying the cycle of shame. There is also a close relationship between shame and rage which I will elaborate in the future.

What mechanism(s) explain sobriety in AA/NA? AA/NA provides a safe space where emotion around shame is intensified and processed. The 12 stapes in AA/NA are a blueprint in the ritual processing of shame. Addicts’ testimonies are primarily around shameful acts of betrayal, deceit and hurt of loved ones. The 12-step is a practical spiritual tool of primarily shame metabolism. Shame metabolism is an arduous process involving the surrender of oneself to a spiritual practice by acknowledging that one is not only an addict but can not maintain recovery by sheer self-will.

Initially there is a resistance followed by ambivalence and culminating in sobriety. The theory I am proposing is that intense affect of shame is catharted in personal narrative. AA/NA encourages sharing as a way of constructing and reconstructing personal narrative as it relates to shame. Spirituality aids in interpreting personal narratives. Spirituality may also foster internal phantasy. I am still in the process of thinking about how a rich internal phantasy helps to stimulate the imagination and the expectancy of recovery.

But how do we measure emotional intensity in relation to shame metabolism which presumably leads to a recovery? There is no objective measure of subjective emotional intensity but my hypothesis is that personal narrative of an addict at different stages of the recovery process should be different in terms of its emotional valence. Therefore, on average sober individuals should have a narrative rich and colorful in how they construct and interpret spirituality in the context of their own life experiences compare to addicts who are still using drugs and alcohol? However, I feel that a valid comparison may be the narrative of one individual over time than comparing the narratives of different individuals since each individual may interpret differently what has been helpful in the recovery effort.

To summarize, addiction may be the result of an attempt to contain anxiety by external means of drugs/alcohol because of a lack of or inadequate containment in the addict’s family dynamic and social institutions. In the inner-city shame may be is a result of lowered social status often due to decreased social capital. AA/NA provides safe space as well as containment and a safe controlled, purposeful discharge of affects. Sobriety is the result of a successful metabolism of shame. Shame metabolism occurs as a result of intense emotion cathercted into personal narrative. Life experience of the addict is continually constructed and reconstructed in light of spiritual practice. Spirituality helps to foster internal phantasy and expectancy of recovery to the addict.

Participating in a group of people with similar social status and addiction help to increase emotional attunement and decrease resistance. The 12 step method helps to intensify emotion around shame. The ability to tolerate intense affect (shame) may improve overtime. The ability and willingness to tolerate shame affect is in effect the process of shame metabolism. AA/NA focuses in the here-and-now; while past pain is acknowledged, the focus is how to overcome current obstacles to a successful recovery.

Areas needing elaboration

· How internal phantasy is increased with spirituality.

· Language and solidarity; how do slangs, figure of speech and culture specific gestures promote or hinder solidarity affecting emotional attunement?

· Internal phantasy and outer image. How to overcome the enormous and powerful reminders of images related to drug use, i.e. neon lights, prostitution, clubs, nights, back alleys, basements and certain people who stand to continually and visually evoke craving.

· The relationship between shame and rage. Alcohol/drugs as a way of containing rage due to perceived humiliation.

· Is recovery primarily the construction and reconstruction of personal narratives in the form of a language or image or both?

· Image precedes verbal language and is preoedipal; is spirituality in AA/NA perceived by the addicts primarily in the form of an image? Is regression necessary to magical thinking in order to meet the addict at its developmental stage? Is the goal to help the addict transition from magical thinking to maybe mentalization?