Peggy-Sax 2 March 2, 2012: (Peggy)

Through email, I recently connected two study group members – Piper Clyborne and Jo Viljoen- working on different sides of the world, yet with some similar experiences.  They have given me permission to open this emerging conversation to the study group. (I have a dream that maybe this conversation might also be a good way to share Piper with you, and bring her into the study group. Up until now, Piper has been a silent study group member – with tons to offer us.).

Peggy: I am connecting the two of you – something I’ve been meaning to do for some time. You have tons in common, despite the fact that Piper lives in Burlington Vermont and Jo is in South Africa. First of all, I met you both through David Epston. Also you are now doing this incredibly difficult work in addiction and substance misuse. Would you be willing for me to overhear your conversation? I get real joy in connecting the two of you.

Piper-Clyborn 2Piper:

Peggy told me about you when I spoke with her a few weeks ago regarding my work in the drug and alcohol field. For most of my career I have just worked strictly with mental health and not substance use. I was telling Peggy that it is an entirely new world to me with a lot of traditional discourses and assumptions regarding people and their relationships with addiction and what is considered treatment. I find it quite the struggle to introduce social constructionist viewpoints in this world. Peggy said that you have been working on some really interesting projects around “addiction” and narrative work and maybe have some of these struggles of your own? Would you be willing to converse with me occasionally about this? Thank you for considering. I look forward to hearing from you.

Jo-Viljoen 2Jo:

What a joy to receive this message,thank you!  i would love to talk with you about our victories and struggles with addiction.
Like you i spent most of my life in mental health field; this is definitely the toughest challenge of my life ; and as i write this i realise getting free from substances is probably the toughest challenge of every clients life….We discharged a sixty year old man yesterday; he was free from alcohol for five years doing well, let down his guard over the Christmas festivities and indulged in some traditional Christmas cake ( traditionally laced with brandy ).  from cake to sips to five litres of wine resulting in encephalopathy by the beginning of feb . . . At least he is physically improved now.
I’m sure you can tell a million similar stories; don’t want to bore you.Maybe we can encourage one another with stories of hope?

Peggy-Sax 2Peggy:

I am so glad you are talking!  Hearing those stories of hope – as well as getting solidarity around those stories of discouragement – is something I cherish.   What do you think of the idea of moving this conversation to the study group site? I just know others would love to witness and maybe even join in. Maybe we can lean into a bit of collective support this way too?

Jo-Viljoen 2Jo:

I’m easy wherever you would like to chat? Its up to Piper and I will go with your decision, Piper.

Piper: I would love to move the conversation to the on-line forum. how would we go about doing this Peggy? That is fine with you Jo? Jo, you are right, there are so many stories to share about the triumphs and tribulations of the addiction world. The story you wrote about speaks to the insidious nature of this beast. It makes me realize more and more that the journey of “sobriety” twists and turns….

In the following, there are a few themes that I thought might be interesting to explore and chat back and forth about. Any sound good to you? Any other themes you would want to talk about? I will add your fantastic idea of sharing stories of hope..

1. Sharing stories of hope
2. How we work in a narrative way in the addiction world
3. Working with lying, stealing, and criminal behavior as it relates to addiction
4.How we position ourselves as practitioners with people that we meet
5. Stories of creative approaches
6. Is it necessary for a person to separate themselves from the problem before resistance can happen?
7. Can people still use without it moving to misuse?
8. Working with groups….how to run a narrative group
9. Traditionally, I am finding that practitioners call “bullshit” on those with addictions a lot. This is considered a helpful approach…more of a tough love approach. Is this necessary in order to be effective?

I am sure I will add on to this list…this is just all I can think of in this  moment…
Thank you for engaging in this conversation with me!

Peggy-Sax 2(It’s me, Peggy, again).

I’m delighted to bring this conversation to the study group, and to welcome anyone else who might like to join. Any suggestions in setting up this conversation?  Some of us will contribute directly while others might reflect more from an outsider witness position. Or should we just let it flow…Looking forward to hearing your thoughts.

Peggy

Jo-Viljoen 2Jo:

There is so much to talk about on the subject of addiction and substance misuse, that Im delighted in your suggestions, Piper.
I could kick off with lying stealing and criminal behaviour encountered in this field. We had a situation today involving lying and stealing, had to get the cops in, ag my goodness the ganse megilah and I still feel that the young man involved should have been arrested as he has a history of shoplifting, spent the weekend in jail prior to admission for shoplifting and was caught redhanded in the clinic. He looked me right in my eyes and promised me it was not him, i believed him, until kitchen and admin staff came forward and made statements to the policenow, I believe people can change otherwise I could not do thid work, but Im unsure how to proceed with him. He is young and a goodloking man, charming but something tells me he is extremely dangerous, not just to himself but also poses a danger to staff annd other clients.
Any ideas will help!

Sarah-Hughes 2Sarah Hughes (March 6, 2012)

Sarah here!  Hi Piper – so good to “hear” your voice.
I am very happy to be witnessing this conversation and might jump in at points but do not want to interupt your flow.
I also work with substance use and find many many challenges in both the work and the discourse.  Now I am struggling with my son who is struggling with using, lying….. and I am falling into “tough love” and not feeling good about myself as a mother but so not sure how to be in this role.  Yikes it is tough.  I could use your stories of HOPE.
thanks,
Sarah

Jo-Viljoen 2Jo: March 9, 2012

Hi Sarah,

Im so sorry about your son’s entrapment in the web of using, lying, stealing, etc. I remember how much self-belief dissipated after my late husbands suicide. .. How could he do such a terrible thing? What about me? What do I tell my colleagues?  etc.  All trivialities really…  there was  maybe a reason, I didn’t know, and he was successful.  Not quite a drug related problem but tough even so.its so hard when the lightning strikes so close to home. Just keep on loving him no matter what, love him from the bottom of the well. . …
Jo

Jo-Viljoen 2Jo: March 15, 2012

Hi Piper

I would love to share the experience of a group we had yesterday, where Maria (we know her as Rietjie) van Blerk played the part of the therapist and i played the part of Being Irresponsible.  I invited some of the clients to sit near me as advisers should I run out of answers, while Rietjie managed the rest of the group as a reflecting team.

Before I knew it, Being Irresponsible became “BI” for short, and from there progressed to try and convince the group that its true nature is free, wild and authentic, making it OK to be irresponsible.  My advisers were quick to jump in and to share the consequences of Being Irresponsible in their lives and how it fooled them into thinking  that using drugs made them free wild and authentic.

Oops gotta go groups about to start.

Rietjie, maybe you feel like filling them in on any of the other details. Jo

Jo-Viljoen 2Hi Piper and others interested in stories of hope

An update on the young man who was so used to lying and stealing that I had to call the police for assistance! He is doing very well, is participating in the program m, has remembered his manners, has not lied or stolen since the incident and during a family session which included his father, mother and girlfriend, myself and Rietjie, he apologised in detail, naming items he had stolen and occasions when he broke into his Prent’s home to feed his habit.

It might sound too good to be true, but, you know what I think k?  If we can co laborate with loved ones, clients and family and form a  team against heron, lying and stealing,  by being  honest and CONSISTENT,  respectful and practice what we preach, provide a structure that encourages choice and its consequences, we can celebrate moments like these.

I am not naive enough to think we are home and dry, but a different young man started showing up for group, without the hoody, wit
hout the frown, without the scaly look in his eyes.  This young man smiles easily, contributes to conversations, shows respect, is fun to be around and has earned the respect and love of the group.  One of the staff members has nicknamed him Cheeseboy, a mommys boy, and he responds very positively to positive feedback. Its almost as if Heroin is losing its grip on him  while he is at the clinic.  We are all aware of the dangers awaiting him when he goes home.

Since middle February Naltrexone has been approved for use in South Africa for opioid addiction in the form of an implant.  Anyone with more information on this, by the way? Well, our young man asked for and had his implant and is looking and feeling better every day.

He is due for discharge soon, so we are all holding our collective breaths.  He is returning to the same neighborhood, pity we cant rearrange society and cleanse it while our clients are in rehab!
So there is a story of hope in the making, I think…
Jo

Maria van Blerk: March 18, 2012

To introduce myself: I recently started working with Jo at the Clinic. I got interested in Narrative Therapy in 2005 and have been working mostly with individuals. Group work is new to me and I am really excited about this new part of my life journey!!

I have 2 daughters. The older one had a problem with crack and heroin addiction and has taken her life back from this horrible problem of addiction. She is now 4+ years free!! If it wasn’t for Narrative Therapy I would have fallen in the same trap as so many other parents. I would not have been able to seperate her from the problem. I cannot count the many times I told her: “I love you and you will always be welcome in my home, but I cannot love heroin and crack and I cannot welcome them in my home” Now 4 years later, although she has moved to another part of the country to get away of all heroin and crack’s buddies, we have a wonderfull relationship and she knew I never stopped loving her and I was always on her side!! Both daughters and all relationships are doing well!!

Rietjie

Hi Everybody!

We had a great week with the groups this week! Some alternative stories that emerged during equine therapy were “New Discoveries” and “Harmony”

Interviewing “Irresponsible” or “IB” who disguises himself as “Free and Wild” was one of the highlights! What the group realized was that “IB” used promises like “Excitement” and “Adrenaline Rush” to intoduce himself, not showing his true colours at first. Only when it was too late and the negative effects of “IB” was felt, came the realization that his promises were all lies!!

In the next group we asked the clients to find metaphors in the garden for “Life of Addiction” and “Life of Recovery” (I don’t like the word “recovery”, because there it still implicates addiction) They were all given two round steppings stones. One for ‘Life of Addition” and one for “Life of Recovery”. Remarks from the group were: “To see it like that – the dry, rotten life on the one side and the green leaves and seeds with the promise of the new life on the other side” This remark made me realize how powerfull this was as an externalizing excercise. The themes of “New Dicoveries” and “Harmony” on the one side and false promises and lies on the other side, all came together in this excercise.

Rietjie

Piper-Clyborn 2Piper: March 18, 2012

Hi Everyone…

(I think I accidently started a new post! oops! Peggy can you erase that?)

This is such an exciting start to the conversation! I have appreciated reading everyone’s responses so far and am gaining so many ideas from them! Thank you. My hope is growing.

Sarah….my heart warmed to see your face and name on the screen. You are working in the field of addiction? Its validating to hear you have a hard time with the discourse and the field as well. What do find most difficult right now? There is so much I find that I am learning. But I seem to have this struggle inside myself that I am constantly trying to make sense of.  It has to do with this pull to tough love and not wanting to go there at the same time. I want to engage in a collaborative relationship with people and honor whatever they are telling me as truth, but then when working with lying and addiction, I don’t know what to believe sometimes and then I wonder, am I just participating in the growth of the problem by honoring what people tell me and not calling “bullshit” on them like so many of my colleagues do? I know there is another way to work….that there is a way to keep people accountable, but also work from a collaborative and respectful place, but I haven’t  found what that looks like yet. Any ideas?
I have been looking into this traditional idea in Alonon around “detachment with love.” Have you heard of it? I’m leading a family group of those affected by addiction and a lot of the parents have found it really helpful. Maybe you would like it?  At the same time, all the traditional information around this stuff completely puts the problem and the person together…and bothers me!

Jo……I appreciate that story of externalizing “irresponsibility.” May I borrow this? I think the greatest thing I connected with after reading your story and when Marie so graciously wrote about externalizing heroin and crack from her relationship with her daughters, was that I remembered how so very important separating the person from the problem is! I have really tried to externalize with people I consult and be playful with the conversation, but I find people don’t really want to go there.. When I ask them, what would you like to name this problem, I usually get very blank stares and it never seems to get taken up! I do use relational language making (Johnella’s work) and people often will take this up without even really knowing it, but if the conversation ever takes on an imaginary element I find there are not very many takers.
I have two ideas about this. My first idea is that similar to eating problems, addiction too intertwines itself so much with the identity of a person that just separating oneself from the problem can be the largest mountain to climb? That there may be resistance to externalization because the problem has sunk its claws so well in the person? My other thought is that when people are still actively using, the ability for one to  engage in a lot of abstract thinking might be limited? What do other think of this? Do others ever run into problems with externalizing?

I am taking so much hope from these stories and I feel more confident putting myself out on a limb and trying to externalize with people, even if the risk is people may not connect with it for some time.  Because maybe if I can really separate the person from the problem as well, I can be tough with the problem but have love for the person? Piper

Peggy-Sax 2Peggy: March 18, 2012

Maria! What a joy to find your words here, and to know that you are joining us. I am very touched by your story of narrative practices’ contribution to your daughter’s 4+ years in the Life of Recovery. Imagining you and Jo working together makes me smile. I can only begin to imagine the new discoveries, harmony, good work and mischief that you are uncovering together. I’m looking forward to hearing more. Your stories are riveting!

Piper! While I was writing this note to Maria, your post popped up. We are synchronistic! What a double joy to find you here as well! To think we are both taking time from this incredible springlike weather to write to each other. WELCOME!
Peggy

Jo-Viljoen 2Jo: March 19, 2012

Great to be chatting to you all.  Welcome Rietjie, and thanks for jumping in boots and all into this thread!

Piper, its a real joy to be connected to you.  I have found that I can only successfully externalize a problem when I believe that the person and the problem are not the same thing.  I once did a powerpoint show as part of training health professionals, I,re its on my website as Practical Narrative Therapy.

This morning we had a group discussion about Anger and its effects on people.  The group said Anger is like a predator, a vulture, a hyena, a snake, a tiger. … Making it possible for us to explore the various predators’ ways of getting its talons, claws, teeth into  a persons life, relationships, thinking and behaviour.

They said they found it very useful, as Anger shapeshifts and cons them into its prescribed ways of being and before they know it, they have either given in or given up.

Cate-Ryan 2Cate Ryan: March 27, 2012
Hi everyone,
though i don’t directly work in the area of addiction, I wanted to jump in and say how much I appreciate really this conversation and hearing about the group work elements that people are experiencing as they explore the grips of the rather encompassing problems that have been effecting their lives.

Jo, has there been any news about the young man ‘Cheeseboy’ and his return home? It would be so interesting to hear what could be sustaining for him the different ways of being that were free from the grip of heroin when he has returned to his family and neighbourhood. I’m not sure if you have ways of finding out this part of the journey though I to want to hold on to hope with the young man.

As I was reading this conversation it also stood out to me that some of the questions and themes that were coming up here seem to resonate with the practices I heard Rob Hall talk about in his (and Alan Jenkins) work when responding to violence. Mainly about finding ways to explore and understand how people have be ‘recruited or captured’ into the dominant/problem ways of being and acknowledging that these exploitative ways of being are not created by this person who’s come to consult us, rather is a set of ideas that are constructed by a history of discourse. He also talks about finding resistance to these dominant/problem ways and putting the spotlight on complicity so that people get the chance to see and respond to ‘dangerous thoughts’ that could lead to re-capture into the problem. The invitational practices also use practices of finding ethical ways of ‘being’ that are that person’s ethics, rather than a se
t of morals that society tells the person they have to be. When i think of this in the light of reading your stories here I wonder if the call of “IB” might be strengthened or inspired by previous moralistic positions that others have ‘expected’ from them and that the ideas of ‘free, wild and authentic’ could be attractive and important against someone else’s controls and values?

Jo, when you spoke of ‘co laborating with loved ones…’ and the experience of the young man apologising for the wrongs his actions under the influence of the addiction had caused others, it also linked to the restorative justice ideas that are a large part of Rob and Alan’s work. What I’ve really held onto in my own practice are the principles of ‘facing up’ and ‘accountability’. I’m not sure if you’ve looked at this stuff so I’ll just say a little… I imagine that the ‘facing up’ stuff could be what does it mean to be a rehab and what does this say about where you want to be with your journey as well as lead into the who needs to know about the discoveries along the way (positive and owning up). Accountability was a huge opening for me in the restorative work because it was ensuring the process of ‘apology’ was not confessional in the sense that this is what the person who’s actions had caused the hurt needed to do to feel better about what they had done, rather this was about the person who’s actions had caused the hurt found out the impact of their actions to the others and gains some sense of accountability to that person’s experience so not to act in that way again. it really takes into account discourse of power that problems cause and also opens space to look at possible injustices the person has experienced and look at where they want to continue repeating these to themselves and others that they care about.

So does any of this resonate or is it too much of a different context? Thank you for taking the time to share your work in this way as I find it sustaining to see how creatively and narratively you are working on this social issue.

Piper-Clyborn 2Piper: April 2, 2012

Jo—I really appreciate that you said, “I have found that I can only successfully externalize a problem when I believe that the person and the problem are not the same thing.” I have been working with narrative ideas for so long now, that I didn’t even think of this as being something I was struggling with.  But when you wrote this statement, something struck me. I realize that I have been working with a very internalized type of problem that is new to me, in a traditional context  and hearing my colleagues talk in ways that position people as the problem as well as working with people who truly believe the problem is them.  I think all of these influences have at times, coerced me into the dominant theme that the problem is the person. I  didn’t even realize this was something I was being pulled into. I realize its takes a certain kind of courage everyday to show up for work in a traditional context and with a problem that likes to be a daily nuisance    and to engage with people in a  narrative way. What have you found helps you boost your courage?

I also was thinking about your group on anger and how creative it was.
It seemed that people were very  much drawn into seeing the effects that anger had. What have you found are some of the most useful questions/statements at the beginning of your work with folks that position them as separate from the problem?

Cate, I also want to say that what you wrote  helped me so much. While you said you do not work closely with addiction, I think everything you shared absolutely overlaps and is very useful. I have often looked at my Alan Jenkins book, “Invitations to Responsibility” on my shelf and thought, I should take that down again! And now I will!  I have not read Rob Halls work, but would like to. And Allen Jenkins, I know, has some amazing examples of questions that invite a person to take accountability and develop a personal ethic. So I’m going to go back and revisit some of that work. I think it is especially useful because I work with mandated clients. Iin my work right now, I am seen as an extension of the criminal justice system; a system that takes a moralistic position on behavior and what is considered right and wrong. Its been difficult to help clients develop their own ethical way of being when I work for a program that expects clients to comply with societies morals in order to succeed. Have you worked with mandated clients as a narrative practitioner and found useful/hopeful ways of navigating this role?

Bonnie-Miller 2Bonnie Miller: April 2, 2012

Hi Piper…

I just had the privilege of a five day intensive with Alan Jenkins and got to interview him as well… I recommend that you get his latest book- ‘Becoming Ethical’- its amazing, and really speaks to some of the systemic issues that you mention.

Bonnie


Cate-Ryan 2Cate Ryan: April 3, 2012
No, I haven’t worked with mandated clients as a narrative practitioner. I do feel as you have mentioned though, that if I was working in this context, there would be much more personal agency that could come out of these invitational practices for the ‘client’ rather then a ‘correcting’ that might come from the moralistic approach. I just feel there is so much more room to move when inviting ways to continue taking responsibility and being accountable when it come from a personal meaning of ‘how to be ethical’ then me trying to convert or change anyone. I too second Bonnie’s comment a
bout Alan’s latest book…it’s good and from what i’ve heard a little easier to read.
Bonnie – a 5 day intensive would have been amazing. I’m jealous! Cheers, Cate

Jo-Viljoen 2Jo: April 3, 2012

Hi Peggy, Piper, Cate, Rietjie, Bonnie and other friends who may have read this thread and not responded

Is it only me, or does time seem to slip away for you as well?  Before I knew it i found myself well into the first week of April.

I have found your posts very interesting and thought provoking and practical in terms of the work I’m involved with.  Thank you for taking time to read and respond despite the busyness of all our lives.

Piper you wrote this:
Jo……I appreciate that story of externalizing “irresponsibility.” May I borrow this? I think the greatest thing I connected with after reading your story and when Marie so graciously wrote about externalizing heroin and crack from her relationship with her daughters, was that I remembered how so very important separating the person from the problem is! I have really tried to externalize with people I consult and be playful with the conversation, but I find people don’t really want to go there.. When I ask them, what would you like to name this problem, I usually get very blank stares and it never seems to get taken up! I do use relational language making (Johnella’s work) and people often will take this up without even really knowing it, but if the conversation ever takes on an imaginary element I find there are not very many takers.
I have two ideas about this. My first idea is that similar to eating problems, addiction too intertwines itself so much with the identity of a person that just separating oneself from the problem can be the largest mountain to climb? That there may be resistance to externalization because the problem has sunk its claws so well in the person? My other thought is that when people are still actively using, the ability for one to  engage in a lot of abstract thinking might be limited? What do other think of this? Do others ever run into problems with externalizing?

Piper, in agree with you, much like Anorexia/Bulimia, addiction intertwines itself completely with a persons identity; it usurps the persons identity and replaces it with “drunk”, “junkie”,”alcy”, “druggie” or even “recovering junkie” as one young woman called herself today.  I find myself constantly reminding my clients to watch their “grammar”, by stopping them when they refer to themselves in such internalizing and pathologising ways, and inviting them to choose different names for themselves.  To me its like learning a new language, I know the language a little bit, and feel I need to encourage them to learn to speak about themselves in different ways.  Many clients have been in recovery for a while, some have been previously admitted to residential facilities where the emphasis is either on pathology or religion.  In addition to being seen as an addict, many people in this country are also regarded as sinners, and urged to confess their sins and espouse religion as their saviour from addiction.  To my mind this only deepens their feelings of self loathing (you are all welcome to disagree with me on this one) but I have found that this kind of confessional approach is not helpful in the long term.  So I often find myself stopping and re-thinking the words they use to describe themselves with, encouraging them to call themselves by different names.  this then sets the stage to call the problem a name of its own.

A sixty year old woman offered the following in a group yesterday:

“Struggling with Alcohol is like having a thirsty snake inside myself, I have to satisfy it all the time.  It is never satisfied.  I have to start thinking about myself and making choices for myself without the snakes influence.”

This might not be a volcanic eruption for you or me, but for her it was HUGE.  She went on to explain how the snake entered her life, how it slithered into her relationships, how it poisoned her health and how she has had enough of it now.  How she has asked God to help her fight the snake and how she is planning on using her ability to make different choices against the snake.  The rest of the group were enthusiastic about her contribution and other group members related their own experiences with the snake.
Identifying the snake enabled her to see alcohol through a different lens, to invite her peers in the group to share that lens, and to separate herself from it and its effects. Notonly did her thinking change, she is also looking completely different, a week into her treatment.

When this woman was admitted I remember her appearance; her back was bent, she looked thirty years older than her sixty years, she wore no make up, her hair was a mess and her personal hygiene non existent.  Her husband phoned me seventeen times in one day to say if we give her any medication he is going to drop her off at the local mental hospital where she can “rot with the other crazies”.  Today she is well groomed, she eats all her meals, she interacts well with the group and individuals and expresses feelings of self worth.  A week ago she was trapped in an identity of alcoholism and failed personhood, sin and self loathing, crying all the time.

That’s the stuff that boosts my courage and determination to do this work.

Cate, your post just said it all so sweetly: you are so clever with words!  You contextualised my story snippets perfectly in words that belong in a narrative text book.

You asked about Cheeseboy?  Rietjie is following him up and can probably give more details, but I’m afraid not all stories have a happy ending.  Our Cheeseboy is not doing so well.  He has missed one followup0 appointment and we have heard from his girlfriend that he is using again.  The Dragon does not want to let go; and this is such a big problem in South Africa.  If you could write him a letter, what would you say to him?  Perhaps you could help me think of ways of putting a letter together for him?

Ive dusted off my Invitations to Responsibility and will definitely be reading it again.  Thanks for reminding me of that wonderful book.  I read it extensively when I worked on my masters thesis in the South African police service.  I know reading it again will inspire me in this context as well.  and Bonnie, I will definitely order Jenkins new book.  You guys really help me to stay connected to this field of narrative work.  Its so easy to get stuck in the rut of ones own thinking.  That’s why this study group is my lifeline.

Got to run!  Take care all!
Jo

Cate-Ryan 2Cate: April 3, 2012

HI all,

Jo – i’ll put some time aside in the next few days and over the long weekend to reflect more about some question I might ask Cheese Boy and get back to you. I could only imagine that returning home would be one of the toughest journeys in this work and could have potential to invite many learnings.

I can only imagine how powerful the discovery and naming of ‘the thirsty snake’ must have been – such powerful imagery. Jo, I’m so curious about possible ways to engage her husband in a position of understanding about these discoveries and I wonder if he has an insider knowledges of life that isn’t controlled by the snake that they can strengthen together? It’s just a thought that rose for me after reading the intensity of his initial actions and comments about the intervention for his partner. I wonder what hopes are fuelling this for him?

chat soon
Cate