Discussion

Thiele (1990) contends that for Nietzsche, "the multiple soul with its endless internal strive is the defining characteristic of man" (p. 58). Substance misusers, in recovery or otherwise, vividly demonstrate internal strife, a "two-ness" in which a "sober" or "straight" person wrestles with another, an "addict" who wishes to use drugs. Arguably, this theme of duality, of contradictory aims and selves, is at the heart of addictive suffering (Weegmann, 2005b). In the vignette, Jeremy is in turmoil, having re-tasted his drug of choice. The group responds to his struggle around "giving in", resonating to themes of temptation and fear of relapse, and to just how insidiously it happens. I was mindful of the lapse processes and how "psychological relapse" precedes actual use, even if the sequence between the two is not inevitable. Jeremy could pull back. The tiger metaphor is an attempt to encapsulate the struggle about using or not using, with its seductive beliefs about control ("I can handle this ..."). Metaphor can constitute a transpersonal aphorism, positing important general questions about human desire and limitation; it can promote understanding and soften self-blame. Elliot's reference to the "scorpion" tale added further wisdom, illustrating the power of self-seduction and forgetting ("denial").

I suggest that the group, in all its medley of communication, can be thought of in terms of shifting intensities of affect, and "the struggle of competing perspectives and their coalitions" (Thiele, 1990, p. 53). The intensities include temptation and indulgence, danger and excitement (e.g., Jeremy at the start), fear and arousal, (Jeremy, Elliot, Sarah), grandiosity (Robert), nostalgia, and "getting high without the drug" (Sarah and the group as a whole). There is a struggle for supremacy between an internal "drug user" and a person seeking to be abstinent; this occurs within given individuals, such as Jeremy or Sarah, and at the level of the group, as when the group orchestrates a nostalgic "high". In another instance, a usually level-headed and cautious person (Robert) is unsettled by feelings that might eventuate in grandiose fantasy or acting out, with or without picking up drugs. Finally, is there a turning to the group as object of assistance and inner resource?

The battlefield and coalition analogy is apposite, as the members bring to the group those very aspects that might threaten its safety and containing role. There is a bidding for the ruling passion, for example, between the excitement and relief of using drugs to the enjoyment and achievements of ordinary, sober living. Will "drug talk" and fantasy dominate the group or be corrected by "sober dialogue" (Weegmann, 2006b)? The memory (e.g., "It wasn't that bad ...") and desire (e.g., to give in to drugs, or to consolidate recovery) of people in recovery can change dramatically, depending, to use Nietzsche's (1967a) marketplace analogy, on which "drive" is uppermost: "Every drive is a kind of lust to rule; each one has its perspective that it would like to compel all the other drives to accept as norm" (p. 481). Continuing the political analogy, one could talk in terms of "regime changes" (Thiele, 1990, p. 63), such as from "I'm going to use and stuff your group" to "I'm here and determined to stay clean". Does the group and the therapist represent a position to be opposed, or is the group and therapist seen as a vital ally? Indeed, sometimes the group and therapist represents a helpful adversary. In dealing with fast moving shifts and transitions, the therapist's role could be likened to that of a diplomat, "attempting to acknowledge different parties within the personality and offering dialogue with both sides" (Weegmann, 2005b, p. 289). Partly this relates to "stages" of recovery: "Whilst in the earliest stage of recovery, there is usually an immediate struggle with addiction (rawness, cravings, conflicts about still wanting to use), this may give way in time to more of a struggle away from addiction (more confidence, rebuilding, a better sense of not having to use)" (Weegmann, 2006b, p. 62). Hatab (1999) uses the Nietzschean image of an "agonistic force field", underlining, rather than seeking to eliminate, the importance of opponents and the play of opposing forces. Indeed, it could be said that it is only out of the mix of such struggle, that a person, hopefully, constructs a viable trajectory of recovery.

The therapist is occupied (rather than, hopefully, preoccupied) by a perspective. In this case, I am hardly neutral but represent a position which was/is sought by the membership as part of their joining, a position broadly of "living life without drugs or alcohol". How this position is "carried" can be very varied indeed, but in this case, as an abstinence-based psychotherapy group, my approach operated within clear boundaries and careful administration (time, expectations, rules around non-using, sharing information about lapses promptly, and honestly, etc.), encouraging active reflection and due permissiveness with respect to possibilities of dialogue. In the scenario, furthermore, perhaps there was a kind of "safe using", but one bordering on actual use, at least for one group member. At the end, we glimpse a perspectival shift, from one of dangerous or complacent excitement over drug use, past and present, to reflection upon anticipated absences. A new feeling sweeps the group, of how to cope and contain needs when the group is not physically available?

Group analysis: a multi-lateral reality

Group analysis typifies an unremitting relational stance, continually moving in and out of the perspectival worlds, those variously organised subjectivities, of the participants. The skilled conductor, as due contextualist, holds lightly not only theory, but any particular view of meaning in the patient's experience. Foulkes' notion of the horizontal viewpoint encourages historicist, locational understanding, dispensing with any final, absolute view which could charactersie the group once and for all. This involves pragmatic inquiry and constant openness, and a willingness to develop warranted, imaginative formulations. The heat of exchange and perspectival shifts are all too apparent in groups, where, to adapt an idea from Nietzsche (1882), we stumble into a "world of evaluations, colours, accents, perspectives, affirmations, negations not found in nature, but based on the values that humans bestow" (p. 241). Foulkes did not cite Nietzsche (although, according to Elizabeth Foulkes, he had read him; personal communication), but I like to think that the following (Foulkes, 1975a, p. 131) is a vague nod in his direction: "Different interpretations are not contradictory but correspond to particular perspectives . the language of interactions is not confined to words, but extends to inflexions of voice; manner of speaking, looking, expressions, gestures; actions . emotional reactions of all sorts—sympathy, condemnation or contempt, attraction or disgust, love, hatred and indifference".

 
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