Relationship and Addiction Gary Broderick SAOL Project Relationship

Relationship and Addiction Gary Broderick SAOL Project

Relationship “The way in which two or more people or things are connected, or the state of being connected” SAOL Addiction Trauma Responding as an addiction worker

SAOL S: Stability A: Ability O: Work (from the Gaelic word Obhair) L: Learning SAOL is the Gaelic word for Life

SAOL Is an integrated programme of education, rehabilitation, advocacy and childcare, for women, children and community members of the North Inner City. SAOL has worked over the last 19 years to promote the needs of female drug users and their children. We have tried to highlight the many extra difficulties that face women who use drugs including the impact of broken relationships with self and others, the stigma attached to being a mother who uses drugs, fears about the impact drug use might be having on their children but also fears about losing children because of their drug use. Women who use drugs have different needs to men who use drugs – physically, emotionally and socially. SAOL is dedicated to improving the services for female drug users in general and particularly for those in the North Inner City of Dublin

SAOL

Busy Insurance Broker Homeless Services Lithuanian Shop Vacant building SAOL Ex-Community Development Service TDs Office

The gender paradox Although females seem less likely to develop an addiction than males, when they do develop an addiction, they present with greater and more complex needs than males. In SAOL, “There’s just something lovely about her!”

Different for Women? Addiction is different for Women: Getting addicted Staying addicted Detox Recovery Aftercare Central to this is RELATIONSHIP

Addiction Disease – medical approach Dis-ease – spiritual unease Disturbance with self: Self-esteem or relationship with self Self-efficacy Self-image (particularly here in relation to social roles) Bio-psycho-social model of health/addiction

Trauma Vast majority of people who have serious addiction issues have experienced trauma (roughly four times the normal rate) Seventy-five percent (75%) of women and men in treatment for substance abuse report trauma histories (SAMSHA/CSAT, 2000) “Individuals with a trauma history rarely experience only a single traumatic event, but rather are likely to have experienced several episodes of traumatic exposure. ” Cloitre et al. , 2009

Trauma includes personal/private experiences as well as public experiences Examples of personal and private events: Sexual assault Sexual abuse Domestic violence/interpersonal violence Witnessing domestic violence Examples of public trauma/traumatic events: Natural disasters War Community violence (Hopper, 2009)

Impact of trauma “Prolonged exposure to repetitive or severe events such as child abuse, is likely to cause the most severe and lasting effects. ” “Traumatization can also occur from neglect, which is the absence of essential physical or emotional care, soothing and restorative experiences from significant others, particularly in children. ” (International Society for the Study of Trauma and Dissociation, 2009)

Impact of Trauma Activation of survival responses: Fight Flight Freeze Submit Shutting down of non-essential tasks. Rational thought is less possible at this time. (Hopper, 2009)

Trauma and Addiction is an effective way of responding to trauma. It eventually kills you; but it does what it has to do when it has to do it. It numbs; gives false confidence; makes you part of something; it alienates you; it is irrational; it takes over and allows you to submit. It is a ‘brilliant’ response to trauma

Trauma Informed Care (TIC) Three phase model of treatment: Safety and stabilisation: Our main work in SAOL Attention to basic needs including: connection to resources self-care identification of support system Focus on the regulation of emotion and develop capacity to self-soothe. Education on trauma and treatment process. Processing of traumatic material: acknowledge, experience and normalise the trauma and its emotions at a pace right for you Reconnection and reintegration: Development of a new sense of self through Friendships Intimacy Spirituality (Second level work of SAOL)

You can’t ‘do’ TIC without relationship So you have to build the relationship so you can do the work. My own journey…

A Man in a Traumatised Woman’s World I was an intruder! I was every dominant male they had ever met. But I was also every positive male they had ever met. I was an intruder to the staff too – so everything that was being done with the women in mind was also being done for the staff! I had to develop relationships with the women in SAOL; ones that allowed recovery to happen and not ones that suited the ‘text books’. I had to be ethical but also creative and generous and put my trust in the people who say ‘Meet the client where they are at’. I just didn’t realise that also meant that I had to be different too.

Doing Men’s Things I wanted to show that I could assist in making things better so I did what makes me feel better and I started to spring clean! Changing the environment – tidying up; buying furniture; painting – sourced new carpets Changed smoking area Reclaimed classroom with the women

Relationship with boundary The women had easy access to me but I met nobody on my own Harm reduction background – I could be generous; sometimes I had to challenge the bossiness of the staff The children of participants were welcome and I knew all their kids and they knew me. My own kids visited and became ‘involved’

Expect to be changed. . . More political – angry, vocal Increased self awareness Bringing your work home Happier Greater sense of my/our self efficacy Sense of belonging Less tolerant of bureaucracy

Education as relationship building We take as our guide Paulo Freire’s ‘Pedagogy of the Oppressed’ Become aware of our incompleteness and strive to be more fully human Shared learning Shared ideas to lead to ‘revolution’ Reduce the Use 2 – on drug use Recover. Me – on emotions (Free to download at www. saolproject. ie) Solas sa SAOL (contact admin@saolproject. ie for a copy) – on domestic violence

Art, drama, song, poetry Finding new expressions of self, with others, in a spirit of ‘yes we can’. Telling their story as a journey of success acknowledging what has worked so far and where they want to go. Drama – ‘Scéals and Anthems of Outstanding Lives’ – Performances SAOL Sisters

Development of peer relationships and peer leadership ‘I’ll have what she’s having’ “So when the respondents talk of value they talk of seeing other people getting clean and wanting that for themselves; when they talk of benefits, they talk of feeling normal again because they usually feel like the ‘other’; when they name how important SAOL is, they talk of feeling stronger, having increased confidence and independence; and they remembered, reflecting over 18 years of experience of SAOL recording the important moments that changed how they see the world… And the researchers, all women in recovery, did not question these answers, but understood them and agreed. Hence, the inspiration for the title of this research, “I’ll have what she’s having. ” It is central to good community education and development that participants feel ownership of the projects where they work. This research suggests that this is the case for many of the participants of SAOL; this is a hugely important finding for all involved with the project”.

Community Development Practice as relationship building Community development is based on certain principles: It enables people to work together to influence, change and exert control over the issues that affect their lives. It is about a collective focus rather than a response to individual crisis. It challenges inequitable power relationships within society and promotes the redistribution of wealth and resources in a more just and equitable fashion. It is based on participative processes and structures, which include and empower marginalised and excluded groups within society. It is based on solidarity with the interests of those experiencing social exclusion. It presents alternative ways of working, seeks to be flexible, dynamic, innovative and creative in approach. It challenges the nature of the relationship between the users and providers of services. It is a wholly positive endeavour which challenges the prejudice and discrimination faced by its community without being discriminatory to any other community. Lewis, 2006

Relationship and Addiction In the end, addiction destroys relationship – with self, with others and with community. Recovery has to involve relationship building – otherwise it dooms those in recovery to being, at best ‘dry drunks’. Such relationship building requires the ‘professional’ to take a risk and be in relationship with the other – to meet the risk that we ask of the person in need. Both lives become enriched in the process and post-trauma lives become possibilities.