Psychotherapy of drug-addicts

Psychotherapy plays an important role in the treatment of non-alcoholic drug-addicts. During the first stage, when the efforts of the medical staff are directed towards the intoxication and the abstinent events, the purpose of the psychotherapy is mainly to show the sick person that the doctor is there to help him/her.

There are two types of psychotherapy – an individual one and a group one. In some Western countries, the group therapy is much more valued than the individual one, although without any good reason for it. It is very hard to agree with this trend because the main purpose of the treatment of drug-addicts is the build-up of a new system of true values, which should assure their proper social functioning without the usage of drugs. The accomplishment of this is possible with the help of individual as well as group forms of psychotherapy.

Contemporary psychotherapy, which is successfully applied in the treatment of some psychic and somatic diseases, is conducted by a doctor, psychiatrist, pedagogue or another well-qualified staff with methods and means, which influence directly or indirectly the ill person. It is accepted that not only the words of a doctor influence positively the state of the patient, but also the overall organization of the whole environment of the medical facility and so on. Most often such influence is achieved using plain old words, but it becomes more powerful, when the whole environment acts simultaneously with it – a speech from the mouth of a famous doctor, in an environment, imposing the needed trust, is also very powerful.

Experience shows that good curative results can occur not only during contact between the doctor and the patients but also during a guided psychotherapeutic communication between the patients themselves. The active participation of the ill person, for the achievement of the marked therapeutic aim, is also of great importance. When psychotherapy is held by a doctor, he or she has to, first of all, gain the trust of the patient and to create an atmosphere, where the balance between intimacy and distance, should be perfect. This is a basic principle in the psychotherapeutic communication between a doctor and the man he is trying to help.

That’s why, at the very beginning of the psychotherapeutic communication between the psychiatrist and the drug-addict, it is necessary a certain adjustment to be made for enabling the mutual communication, built up on the idea of conformation with each other. When this adjustment for communication already exists, the “healer” can pass on to the next, the most important stage – the phase of the so-called “mutual information”. The main rule in this stage is the therapist to receive more data on the life and the type of dependency of the drug-addict and to offer him only the most necessary facts about the doctor’s experience with the treatment of similar cases. Later the medical man also tries to offer additional information to the sick man, which should help him get rid of the narcotic from his ideology and establish new attitude concerning labor, family and friends’ circle. Having in mind that the drug-addict is emotionally immature, the psychotherapist should try to rebuild the whole personality of the patient all over again. This is a very hard process and takes a lot of patience and persistence.

Drug addicts are also influenced very well during individual rational psychotherapy. The most important thing about it is that the patient should be treated by means of logical conviction. Very often after the patients had already started and individual psychotherapy they move to the group one. When a group psychotherapy is conducted it is important that the traditional forms of therapeutic relation between a doctor and a patient, be remodeled and to move from an individual to a group type of therapeutic influence over the sick people.

The basic principles of the group psychotherapy are:

1. the psychotherapist has to influence not so directly each patient through his/her speech
2. the object of the treatment is not only the curing of a particular person but the simultaneous influence over several people
3. the group itself is not only the object of the treatment but a medical factor as well

In the so-made “therapeutic society” the patient turns into a therapist, that is the responsibility for the treatment is mainly in the hands of the patient himself. This is realized by different means: catharsis, self-recognition, self-understanding, altruism, optimism, etc. Under the influence of these and some other factors, during the group psychotherapy takes place, the self-confidence of the patients is lifted up.

After the group psychotherapy has ended the sick person feels much more mature and socially acceptable.

Although there is enough data, which show the advantages of the group psychotherapy, we should mention that sometimes there may be emotional tension in the group and conflicts, which totally oppose the expected relations between the members of the group. This has a negative effect on the execution of the medical program.

The in-directive psychotherapy strives to ease the sick person in his desire to find his true thoughts and feelings, which are really his own, and together with that to decrease and to eliminate the contradictions between the already created negative image of the personality and the imaginary-wanted one. This is how the patient can achieve self-realization, broaden his social communication, and at the end to approbate the feeling of freedom and independence. The therapist has to mainly be able to listen and to look at things the way the patient sees them, so that he can fully understand the feelings, which the ill person tries to express. The therapist shouldn’t manipulate the thoughts, the feelings and the plans of the drug-addict, but to encourage his/her independence. The stronger the feeling of freedom in the therapeutic situation is, the better the ill person can understand their previous experiences. The in-directive psychotherapy is applied mainly in groups of about 10 people.

During the last 30 years more often people use also the so-called “family psychotherapy”. This is a process, directed at the changes of the relations between members of the family and its purpose is the overcoming of emotional conflicts. The object of the therapy is not the “sick family”, but the sick person in it.

The researches show that in the treatment of drug-addicts the so-called “directive psychotherapy” may also be used. It consists of several lectures (not more than 12), to which the group of the doctor or the psychotherapist listens. These lectures concern mainly medical and law frequently asked questions – about the very sense of the dependency, the somatic and psychic disorders of the drug-addicts, etc. Most of those who attend this group are interested in the lectures, in which the different possibilities of compulsory treatment and the drug-addicts’ own responsibility before the law, in case of crimes committed in order to find money for the narcotic, are described.

The end purpose of all the types of psychotherapeutic activity is the accomplishment of good remission. Say may be achieved only with the help of the active participation of the patient himself during the medical program is conducted. This medical program should consist of treatment with medicines, psychotherapy and social therapy. In all events it is absolutely necessary for the patient, even after he/she has already been discharged from the hospital, to continue with his/her treatment in the non-medical environment.