From: lamontg@milton.u.washington.edu (Lamont Granquist)
Subject: Re: Partial Legalization
Organization: 'Operation: Mindcrime'
Distribution: usa
Date: Sun, 26 Jul 1992 01:40:33 GMT

pwh@bradley.bradley.edu (Pete Hartman) writes:
>In <lamontg.712069595@milton> lamontg@milton.u.washington.edu (Lamont Granquist) writes:
>>pwh@bradley.bradley.edu (Pete Hartman) writes:
>>>The point is, "outside assistance" that just reinforces the idea that
>>>they are slave to their genetics (or whathaveyou) is not much assistance
>>>at all.  Therapy to help them realize the power of the mind (both conscious
>>>and unconscious) to overcome whatever it is that "enslaves" them (be it
>>>addiction or anxiety attacks) is much more beneficial.
>>Well now, I have yet to see any evidence that the power of the mind can
>>overcome addiction/anxiety attacks/etc in all cases.  Also, the specter
>>of the all-powerful subconscious mind is continually being raised in
>>this discussion (even if its not directly stated).   THAT IS UTTER FUCKING
>>COMPLETE BULLSHIT!
>>In my most humble opinion of course.  *smile*.
>
>Two points:
>
>1) What exactly are Yogi's doing then?  Some things they can do seem awfully
>miraculous.

Yeah, so are the miracle cures that some cancer patients pull off.  This
is exactly my point, that people take one miraculous example of how the
mind can overcome the brain, and think that everyone is lucky enough and
talented enough to do it.  

>2) note "conscious and unconsious".  Dave (for one example) is working on
>controlling his anxiety attacks--this takes conscious effort, which is
>eventually internalized so that he doesn't have to think about it (kinda
>like riding a bike).
>
>I didn't mean BY ANY STRETCH that the power of the unconscious is
>omnipotent.
>
>And a third point (we have TWO main weapons: fear, surprise, and an almost
>fanatical...we have THREE main weapons...):

Right.  For Dave, psychotherapy is possibly more effective than 
pharmacotherapy ever would be.

>3) I also did not mean to imply that there was a completely mental
>solution to all these problems, right from the start.  Without
>psychological treatment of some sort to get the abuser/addict to
>recognize his/her own power over their addiction, all the 12-step
>blame-free plans in the world will only work so far.  The fact of
>the matter is that it is ultimately the individual who is responsible
>for his/her actions.  Period.

I am *NOT* advocating 12-step programs.  12-step programs teach you that
addiction is a "disease" which is not curable.  Essentially this is a
thinly disguised metaphorical relationship with some kind of "satan"
figure.  And IMHO the whole thing is just sunk into religion, and is
only useful for certain people.

What I am saying is that for *certain* people, they may be driven by
primarily biochemical vs. psychological disorders.  They have what is
primarily an organic disease for which psychotherapy is not going to
be effective.  Psychotherapy would probably just leave them with a
feeling that they were "weak willed" or "mentally weak".  Without
adequate pharmacotherapy and only *supportive* psychotherapy they
probably wouldn't get anywhere.  Impressing them with the idea that
they are the only ones that are ultimately reponsible for their
actions would (IMHO) just be a wonderful way to completely rip
them down, because you would be requiring them to come up with the
mental willpower to resist something that might be *extraordinarly*
hard to cure via psychological action alone, and quite hard to simply
tolerate. 

>>Personally, I don't think its of much assistance to someone who might
>>have a genetic disorder for which they will damn near need a miracle to
>>overcome it simply via using the subconscious mind.
>
>I think that your hyperbole of "damn near needing a miracle to overcome"
>is just as much F.B. as any implied (or not implied) concept of the "all
>powerful subconscious".
>
>In my not-so-humble opinion. :-)

Oh really, why?  I know someone who had an affective disorder which was
due to brain damage that he recieved from a beating as a child (Admittedly
we're not talking about addiction here, but I can see the parralel 
myself since both are mental diseases).  This person went through 20
years of psychotherapy, and IMHO would have needed a miracle to
pscyhologically overcome his problem -- phenelzine fixed him up in a couple
of weeks.  I *DONT* believe that this is the case with *everyone* with
*any* mental disorder, but to deny that there are *SOME* people who do damn
near need a miracle to psychologically overcome a mental disorder is
utterly ignorant (in my not-so-humble opinion). 

>>What these people need is adequate pharmacotherapy to fix the underlying
>>biochemical problem without all the psychological "you can do it yourself"
>>bullshit.
>
>I think you also might not be aware (Dave didn't explain it very well)
>that he was on medicines to help him gain the stability he needed
>while he transferred whatever mental cure he has achieved into
>reality.  He didn't have some magical enlightenment whereby he tapped
>the power of his subconscious and miraculously was cured--he had some
>drugs and some therapy to help him through the beginning stages of
>the problem, and has since been able to abandon most (or all?) of the
>drugs in favor of a more internalized long-term cure.
>
>(of course if I'm wrong about any of this, since it is after all my
>take on Dave's situation rather than Dave's own perception, I'm sure
>he will be glad to correct me).

That is *ONE* example.  And I will agree that in Dave's case, it may have
been more appropriate to have pharmacotherapy play a supportive role in
just facilitating the eventual effectiveness of psychotherapy.

However, on the other side of the coin, I can see other cases, where
pharmacotherapy would need to be used as the primary cure.  And
psychotherapy would be used in a supportive role -- to eliminate remaining
neuroses and personality problems and to assure that the person did not
become dependent upon the pharmacotherapy.  But with the pharmacotherapy
being the primary "cure" for the mental disorder.  In that case, "you
can do it yourself" messages really would be bullshit, since they'd
need pharmacological help.

My whole point is there is a spectrum.  And that psychotherapy is no more
important than pharmacotherapy and that blanket statements about addiction
that only address psychology are utterly ignorant without also addressing
the biochemical mind to an equal extent.  What really concerns me is that
most of our focus on rehabilitation is entirely psychological and I think
that they've entirely missed the boat...

Well, I'm leaving for San Francisco, so this is the last I'm going to be
writing on this subject...  Someone else will have to defend my viewpoint.
 
-- 
Lamont Granquist  lamontg@u.washington.edu  (anon: ap.2187@cupid.sai.com)
University of Washington, Seattle.    Disc: if UW ever finds out what I post... 
alt.drugs FTP site: ftp.u.washington.edu[128.95.136.1] dir:/public/alt.drugs
               For quotes and other useless info see my .plan
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