Venturing Upstream, Downstream, And The Interventions That Are Bringing Change
by Marca McCallie
For several years, I served as a therapist for a residential treatment center helping patients battle substance abuse. Every morning I led a therapy group of 16 men and women who I worked with for about 30 days at a time. By the end of the month their faces were like family to me and their stories were seared into my experience.
Finding The Child Within
Every session started with an introduction question to help us get to know each other better. One of my favorite questions was:
“When you were a kid, what did you dream of being when you grew up?”
I loved this question for two very specific reasons.
Every client I ever worked with dreamed as a child, we all did. Remembering those parts of us that dream can be powerful and mobilizing. I heard all of the classic answers and some not so classic answers. But no matter the answer, they were all directed towards a future of living an engaged, meaningful, and connected life.
I never once had a client that dreamed about growing up to become an addict, child abuser, addicted parent, criminal, or a person who was homeless. Never.
Working with group members month after month and consistently seeing the same answers, highlighted to me that people who struggle with addiction do not intend to go down that road. They don’t value criminal behavior and disconnection. Something interrupts their dreams. For whatever reason, they are pulled away from their child-like self that embodied their potential and promise. When we think about people struggling with addiction this is a helpful place to start.
The Depth of Suffering
People who are addicted are often far away from their true, value-guided self. A common understanding in therapy is that “the further the distance between who we want to be and who we are, the greater the suffering,” from The Reality Slap by Russ Harris.
Many people with addictions have been suffering for a long time. To quote my favorite addiction author and psychiatrist, Gabor Mate from In The Realm of Hungry Ghosts, “the question is not why the addiction but why the pain?” What were they seeking relief from? What happened to them that they longed so desperately for soothing from a substance instead of a human face? These are the better, more accurate questions to ask when seeking to understand addiction.
At What Point Does Compassion Turn to Blame?
It’s easy to look at a grown adult with an addiction problem and put the burden of responsibility solely on their shoulders. But remember, each adult was once a kid, and each kid was once a baby who grew up in a family and a system that either promoted health or stifled it.
At what point does compassion turn to blame?
- When they age out of the foster care system?
- When they turn 18?
- When they become juvenile offenders?
- When they become parents themselves?
- What were these addicted adults like as children?
Maybe they were the baby detoxing from meth, placed with multiple foster families and never landing in a forever home. Maybe they were the kids that came from generations of child removals or kids that lived everyday with historical trauma that was unnamed, overlooked, and minimized. Maybe they were the kids that were bullied relentlessly in school or the kids that were the bullies because they lacked a connection to their own authentic power within. Maybe they were the kids living in systems of structural violence like poverty, colonization, white supremacy, institutionalized racism, patriarchy, sexism, xenophobia, homophobia, etc.
Sometimes it’s easy to feel sorry for and want to help the child while simultaneously judging the adult, but they are one and the same. To help the adult is to help the child. In many ways addiction is not the problem at all, it’s the solution to the problem.
It attempts to solve pain by offering a momentary soothing balm, but in their attempt to avoid pain, double pain is created. People struggling with addiction are living with pain upon pain and many of the phrases used to describe themselves contain the words stuck, empty, hopeless, shameful, desperate, vacant, shut down, regretful, and lonely to name only a few.
Creating Change
For society addiction can be a symptom of a bigger systemic problem that requires more intentional, thought out interventions. So how do we intervene in a way that would have the greatest effect and impact the most people? A clue to how we might intervene can be found in the famous parable by Saul Alinsky, often told by people doing work of justice and activism. The parable goes like this…
The Parable of The River
One summer in a small village, the people in the town gathered for a picnic. As they leisurely shared food and conversation, someone noticed a baby in the river, struggling and crying. The baby was going to drown!
Someone rushed to save the baby. Then, they noticed another screaming baby in the river, and they pulled that baby out. Soon, more babies were seen drowning in the river, and the townspeople were pulling them out as fast as they could. It took great effort, and they began to organize their activities in order to save the babies as they came down the river. As everyone else was busy in the rescue efforts to save the babies, two of the townspeople started to run away along the shore of the river.
"Where are you going?" shouted one of the rescuers.
"We need you here to help us save these babies!"
"We are going upstream to stop whoever is throwing them in!"
I love that this parable uses the imagery of a river because in a river, three time points are important to pay attention to:
What is happening now?
What is going on upstream?
What are they varying downstream effects?
These three time points in a river are useful in framing effective interventions for people struggling with substance abuse, particularly with pregnant and parenting women which is the focus of Sage Home.
In the next few blog posts, we will begin the deep dive into what interventions are currently being utilized, what happens when we venture upstream, and what the downstream effects are when our interventions are effective versus when they are ineffective. My hope is this is a conversation starter that can lead to more just and equitable treatment options for pregnant and parenting women battling addiction as well as their children who are impacted by their use.
Please join us in our mission to better understand and serve this specialized population.
We believe that families should be able to safely stay together while on their addiction healing journey.
You can help us keep families together so that no child has to be separated from their family, and no mother separated from their child.
Are you with us?