среда, 28. септембар 2011.

Modeliranje problema zavisnosti

Postoje pet modela problema zavisnosti, tj. pet pogleda na problem zavisnosti iz perspektive dijagnoze i terapije:

1.   Moralni model zavisnost posmatra kao bolest volje, i po njemu problem zavisnosti je u ličnosti. Ovo je najstariji model i bazira se na religioznom pogledu na svet, gde se drogiranje tumači ogrehovljenom i raslabljenom prirodom čoveka, a izbavljenje od bilo kog greha pa i drogiranja vidi u pribegavanju Bogu. Po ovom modelu čovek je svakako zavisno biće pre svega ograničeno vremenom i prostorom, a onda mnogim drugim faktorima, pa kada je to tako, izbavljenje od svih zavisnosti je moguće samo u interakciji sa Apsolutnim. Ovo je metod koji koriste mnogi uspešni metodi u svetu (AA&NA-step12, step4,5,8...), gde je osnova verovanje u Boga koji je jedini ontološki nesputan i slobodan, i kao takav jedini u mogućnosti da podari istinitu nezavisnost i slobodu.

2.   Farmakološki model zavisnost posmatra kao problem supstance, dakle kada ne bi bilo droge, ne bi bilo ni zavisnosti. Ovaj način posmatranja problema zavisnosti doveo je do prohibicije alkohola u Americi u prvoj polovini 20.-tog veka. Očigledno neuspešan.

3.  Model bolesti zavisnost posmatra kao poremećaj - genetički, hemijski, fizički. U ova dva modela rešenje problema se izmešta iz ličnosti koja koristi drogu ka doktoru, odnosno lekovima. Stoga ličnost nema ličnu motivaciju za promenom bilo čega u svom životu, već čeka od nekog drugog da mu reši problem. Ovo je model koji forsira Farmakološka industrija i njen najpoznatiji produkt je Metadon. Kao uspešan ovaj se model može posmatrati samo ako za cilj lečenja postavimo nedrogiranje to jest apstiniranje od ilegalnih droga. Ako, nasuprot tome, za cilj lečenja postavimo slobodnu ličnost, što je možda za neke zavisnike nedostižan cilj, onda ovo nije opcija tretmana.

4.   Psihološki model ili Model socijalnog učenja zavisnost tretira kao “naučenu”, a ljudi nisu loši, ludi ili bolesni već je zavisnost stvar interakcije između individue, socijalnog okruženja i droge. Ovaj model je osnova CBT - kognitivno bihevioralne terapije i pokazuje dobre rezultate.

5.  TA Psihodinamički model zavisnost tumači kao posledicu dinamike ličnosti, njenih disfunkcionalnih uverenja, zabrana, drajvera, igara i skripta. Težište rešenja problema zavisnosti je na klijentu i njegovom radu na otklanjanju ovih nabrojanih primarnih uzroka drogiranja. Teorijski najpotpuniji i uz moralni model najuspešniji.

Moralni i TA Psihodinamički pristup zastoju
Ako narkomaniju posmatramo kao svojevrstan zastoj ili posledicu zastoja, onda Moralni i TA Pshihodinamički pristup imaju sledeću strukturu:

Moralni i TA Psihodinamički pristup

Oba ova pristupa razrešavaju zastoj uspešno, i oba u nekoj meri deluju na sva tri ego stanja. Međutim, osnovna razlika između njih je u tome što se moralni prevashodno fokusira na reviziju sadržaja Deteta, dok je TA Psihodinamički prevashodno orijentisan na reviziju sadržaja Roditelja. Kako su ovo dva najuspešnija metoda za lečenje zavisnosti, bilo bi korisno osmisliti terapeutski model koji bi bio kombinacija ova dva.

понедељак, 19. септембар 2011.

Junk stoke economy

Mirko Mitrovic
Psihopolis, Belgrade,
April 2011

Junk stroke economy[1]

A stroke economy, as Claude Steiner defined it, is more or less rooted in all modern societies of today's civilization. Under the influence of certain dysfunctional beliefs people feel unable to meet their psychological hunger for strokes in a constructive manner, and it is only logical to turn to other ways of satisfying them. These other ways of satisfying stroke hunger are called junk strokes. From the various sources regarding these types of strokes, we have chosen probably the most characteristic type present today. Facebook.

Facebook features a variety of strokes in each corner of its colorful pages - like, pokng, sharing, messages, smiles, games, writing on the wall, again likes, a change in status, events, friends, groups, photos, video, tagging, sending kisses and feeding chickens, gathering recommendations, send flowers, send cakes, send sausage, flirt, like comment, like picture, likes, likes, likes ... Everything you do is recognized, respected, someone has remembered you, sent you a token of appreciation, nominated you for the best poker player, cook, friend, etc. - really a very pleasant, welcoming and comfortable environment.

Some features of Facebook strokes:

1. Quantity . Whatever we say about it we have to agree that Facebook is an inexhaustible source of strokes which the company provides to its consumers. Also, it cannot be said that the new user finds these waves of strokes unpleasant - quite the contrary. Further, communication with friends is becoming easier, simpler and more comfortable - no need to go over to someone, prepare dinner because someone is coming, or even go out for a drink with someone. It is enough to login and they are all there, ready and willing to socialize and share much needed strokes.

2. Quality . The huge amount of strokes and the way of stroking, undoubtedly lead to inflation, i.e. the decrease in value due to hyperproduction. This happens because strokes obtained that way are exchanged without much thinking and experiencing, so it might be best if we compare them with junk food. For example, you will receive the title best friend” from a Facebook friend who has never been to your house, you will become the best charmer or prettiest girlfriend from someone you "know" only from the Facebook album (of well-selected) photos, or you will be invited to confirm friendship with someone just because his "network" recommended that to him. Suddenly you find yourself with a bunch of so-called friends, which, in numbers, is  ten or a hundred times more than the number of your friends in real life. Certainly, a  look in the eye from a friend and a hand shake have a lot more meaning to you than Facebook pokes, but nevertheless, the simplicity and convenience will refer you to continue insisting on the junk strokes.

3. Hunger - . If the hunger for strokes is satisfied by junk strokes i.e. the inadequate way and in large amounts, tolerance for strokes rises, which can be considered as the first symptom of dependence – with time, the person needs more strokes to get calm, "to experience the same feeling of satisfaction, fulfillment” (or whatever) as before, therefore making it logical that the time spent near the source of junk strokes increases - which brings us back to point 1 on this list where the loop closes and where the circle begins again. Furthermore, sticking to junk strokes the person receives less strokes in the real world, which only reinforces the hunger, as illustrated in Fig 1.

Figure1. Raising tolerance circle

Technically, this scheme, where all elements actually support each other is called Positive Feedback. The main characteristic of this process is instability. In nature, these processes are rare and usually destructive.

The abovementioned mechanism is valid for all types of junk strokes - shopping, internet, TV, food abuse, nail biting, luxury, sex, legal (e.g. tobacco, alcohol) and illegal drugs and the other drugs the individual is obsessively tied to. It is unfortunate that some of these dependencies are socially acceptable and therefore unrecognizable as such. An additional misfortune is that the Consumer society supports socially acceptable dependencies to a large degree – because it is based on them.

Viktor Frankl said that man is not driven by urge or instinct, but by meaning or sense[3]. On the other hand, Frankl argues that the will for meaning is also an urge. In any case, it is undisputed that this sense and drive exist and operate in parallel inside each of us, and that each of them has a constructive function.

The main difference between urge and meaning can be seen from the perspective of freedom: while drive threatens the quality of freedom, since humans are driven to certain actions, thoughts, life, etc., meaning meets the fullness of freedom with the realization of conscious decisions. Nietzsche wrote that man is a rope stretched between the animal and the superhuman[4], therefore causality and freedom, drive and sense.

Each one of us has the will for meaning which essentially defines us. When the pursuit of meaning is thwarted, this causes a nonsensical neurosis – the spiritual or existential neurosis. People perceive their lives as empty, meaningless, pointless, and not-anchored and correspond to the experience by hurting themselves, others, society, or all three. A man without meaning tries to fill his existential vacuum with "things", which provide him with some satisfaction, hoping to give him the final satisfaction. He may try to meet life by eating more than he needed, going into promiscuous sex, living in high society, seeking power, especially through the power of instant gratification, or trying to fulfill his life with "business", conformity, conventionality or to fulfill the void with anger and hate and spend his life trying to destroy what he believes is the source of discomfort/suffering. But whatever he does, it is never enough. Why?

While the drive is tied solely to survival, meaning refers to the mental and/or spiritual enhancement. This may not be, as many tend to think, a term referring only to something religious, yet a much wider set of consciously chosen aspirations. Every man has his own conception of the universal good, which, if not contaminated, can be directed towards improving the world. Some will sense this through religion, and some through altruism or ecology.

However, beside sense and drive there is another guiding principle which is usually interpreted as a need. It is an acquired urge.

From an ontological perspective, a junk stroke is defined as a stroke that has no basis in urge nor in sense but in an acquired urge.

Even though consumer society tries to ensure the presence of junk strokes, contrary to them, constructive strokes surround us all, every day, yet pass unrecognized. They can vary: natural, anthropological, social, aesthetic, spiritual, and others.

It has already been mentioned that strokes are biological needs of children, and psychological needs of man, implying that their lack (the lower stroke limit) can cause death in children and pain or discomfort in adults. However, there is another limit - the upper stroke limit. We cannot absorb too many strokes. Too many positive strokes bring about some changes:

  1. 1.      If the excessive intake of strokes is temporary, it is easy to absorb the excess strokes as a Junk stroke or a Discount.
  2. 2.      If the excessive intake of strokes is constant, it leads to the changing of the stroke profile[5], which is in closest relation to the frame of reference.

Strokes can be classified in several ways, and here we shall give the following classification: Plato's tripartite structure of personality:

Figure2. Body, soul and spiritual strokes

Body strokes are, for example: food, bodily sensation, a caress. Soul strokes are the praise of a friend, enjoying a Beethoven concert or watching a quiet starry night. Spirit strokes are the spiritual, metaphysical, transcendental experiences. Strokes are food for a certain part of the person’s personality: if we feed a part with strokes, it grows and gets stronger. Given junk strokes, the personality deforms. Long-term abstinence from each type of stroke induces atrophy of the given part of the personality structure.

A stroke limit refers to total stroking of the whole personality, which means that if we overstroke one part, later stroking of another part is not experienced properly. Vice versa, if we reduce stroking one part, other parts become more open and susceptible to stroke and the received stroke is seen as one of higher intensity. This is exactly what led to the appearance of abstinence and fasting in many religions, where it reduces stroking of the body in order to enhance the experience of stroking of other two parts. In the stricter religions, there is a decrease of soul stroking (and eliminating mental pleasures such as listening to music) in order to emphasize only the stroking of the spiritual part of the personality. This conscious directing of the stroking mainstream to one or more parts of the personality is called a stroke optimization[6].

Conclusion: Junk strokes can be part of an addiction problem, neurosis even ADHD[7]. If the person succeeds in establishing a constructive stroke order, as the counterpart to the stroke economy, then the real constructive strokes will recognized and exchanged adequately, and such will be sufficient for normal and affirmative functioning. Junk strokes may be present only within pastimes. Under no circumstances, nor under any belief should junk strokes be recognized as a need – as is the case with people who exhibit dependency tendencies.

[1] Proposal of new TA concept by Mirko Mitrovic
[3] Man searching for meaning, Victor Frankl 1946
[4] Also spoke Zarathustra, Friedrich Nietzsche, 1891
[5] Jim McKenna, 1974
[6] Stroke optimization and constructive stroke order are part of Junk stroke economy concept
[7] There is many indicators for this theory but need more investigation