Thursday, April 15, 2010

Psychodynamic perspectives on mourning

The role of mourning in Narcotic Anonymous

The mechanism by which sobriety is achieved in narcotic anonymous may rely on affective hermeneutics. The addict may not be able to reach the affective core to verbalize feelings in a way connecting both the conscious and unconscious apparatus. Rather, the narrative of the addict is first hampered by narcissistic defense as a result of past trauma which interferes with narrative imbued with affective charge. The addict may willingly engage in a seemingly revelatory exercise of narrative sharing purely on a cognitive level disconnected from unconscious processes. Such an addict functioning on a cognitive level is referred by Bucci operating on a symbolic level. The addict whose mode of communication is expressed somatically without the ability to articulate feeling states in a meaningful way is said to operate on a sub symbolic way. Some addicts use image as the best mode of communicating feelings on a symbolic level in distinction from those who verbalize affect. Thus, addicts do not have a uniform way by which they express affect and the mode of expression regarding affect reflect defenses surrounding painful experiences.

Multiple code theory states that all information including emotional information is represented in three major forms; the sub-symbolic nonverbal processing which includes somatic and sensory systems, the symbolic nonverbal system of imagery and the symbolic verbal system of language. These three systems are connected by the referential process which links all types of nonverbal representations to one another and to words. The capacity to express all manner of nonverbal experience, particularly emotional experience, in verbal form has been termed referential activity. In treatment the emotion schemas are important and the goal of treatment is to integrate these systems that have been dissociated.

In narcotic anonymous, any component that is activated has the potential to activate other elements, so that language and imagery may activate traces of sensory or visceral experience or action, or the converse may occur. The new participant in narcotic anonymous may just feel sensation without the ability to express subjective feelings into words. The sub-symbolic system dominated by somatic and sensory feelings is what may be initially activated. The addict may experience all manner of bodily sensations without the capacity for explaining them into words.

Activation is often a function of the interaction with other addicts in a group. The group is responsible in activating the symbolic or sub-symbolic system when sharing personal narratives that the new addict in the group start may identify reflecting one’s own experience. When a negative emotion schema is activated by any of its elements, the affective core and the behavioral response associated with the schema will be aroused. For the addict, the intensity of emotional activation relates to the extent he or she relates to the narrative being shared. What is often aroused in a setting like Narcotic Anonymous is painful emotion emerging from the mourning process. Often, the addict attempts to control or regulate the symbol related to the painful emotion by attacking the objects, images, sounds and words that are linked with the schema. The operation of dissociation or de-symbolization, in which the connection between the sub-symbolic and symbolic components is cut, works as the converse of the process of organizing the schema.

It appears that what occurs at a narcotic anonymous meeting is to activate affect using each person’s personal narrative of mourning as a way to linking the symbolic and sub-symbolic system. The theoretical assumptions is that affect needs to be activated first in order to label and interpret such an experience using spirituality as a referential activity The spiritually based interpretation in this case means an imaginative exercise of ordering one’s internal experience by finding a narrative that is useful for the individual. A successful narrative comprises both sub-symbolic and symbolic system harmonized by a spiritual narrative functioning as a referential activity.

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