‘O brave new world, that has such creatures in it!’

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‘O brave new world, that has such creatures in it!’

Nick Mercer on the crucial importance of the first encounter in a treatment setting

In the light of June’s EU referendum my thoughts turned to the importance of cooperation, connection and engagement, especially in that crucial first encounter with a prospective client.

How do we create conditions propitious to a successful experience for someone asking for help, perhaps for the first time, for whom any kind of connection or joining – intimacy, in short – is a perilous endeavor fraught with anxiety?

Simply, we have to kindle a spark of hope in those whose predominant mood is often resignation or despair. We have to give them a glimpse of a world that is better than the one they currently inhabit… and we have to convince them of their eligibility for inclusion in that world. You can only do that successfully if you can produce a microcosm of that world in the treatment environment. Therefore, the initial aim of treatment is to produce a safe and healing environment that makes concrete the concept of recovery as a passage to freedom and a richer life, accessible to all who have exhausted the validity of self-medication as a meaningful life choice. It is a place where the inhabitants can begin to taste the fruits of recovery for themselves.

Most addiction counsellors would agree that ‘the therapeutic value of one addict helping another’ is the single most powerful component of primary treatment. It is the immersion in an active peer group imbued with ideas of service and selfless action (the antidote to the narcissism of addiction) – that holds the client in the crucial first day of treatment. This is especially important in a day programme where the onus is on the client to return. It is the ultimate manifestation of service user involvement. I often refer to this initial immersion as the swamp effect. It is an essential part of the orientation process.

For a mirror of the above we need look no further than the organic world of 12-step fellowships where total abstinence from drugs, alcohol or a damaging addictive behaviour like gambling is simply an aspiration or desire (rather than the essential requirement it has to be in formal 12-step treatment) and ‘the desire to stop using or drinking’ is the only requirement for inclusion. Successful meetings demonstrate this swamp effect very well from the greeters at the door to the newcomer’s representative to time set aside for the newcomer to share. All these factors and more create a hospitable atmosphere that allays anxiety and encourages participation and makes real the principle of ‘attraction rather than promotion’.

I would suggest that if we can successfully replicate the spirit of this philosophy in treatment centres, be they residential or day programmes, then we will be more likely to hold people on that tenuous perilous first step of their journey when they are at their most vulnerable. And if we are mindful of those same principles in our individual work then we create the same sense of safety and welcome that pervades in those communities above. Such practice can have a profound impact for the good on the society in which we live.

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