Red Sistémica · Addictions
“Those who take drugs are already outside themselves… and vice versa”. Psychotherapeutic intervention in a therapeutic community in the face of psychiatric comorbidity
Starting from the recent changes that have taken place in the systemic relational approach, from the point of view of epistemology, the author offers some reflections on an experience of working in a community setting with drug-dependent patients presenting psychiatric comorbidity. The emphasis is placed on the therapist’s responsibility in constructing evolving processes, without losing sight of the important role played by the subject himself.
“Why is it that, when we think of killing ourselves, we imagine ourselves dead not for ourselves, but for others?”
Luigi Pirandello, One, No One and One Hundred Thousand
Editor’s note
Red Sistémica republished this article as an excerpt: the epigraph, the abstract, the title of its first section and its bibliography. The full article was published in issue no. 82 of Perspectivas Sistémicas.
Abstract
Starting from the recent changes that have taken place in the systemic relational approach, from the point of view of epistemology, the author offers some reflections on an experience of working in a community setting with drug-dependent patients presenting psychiatric comorbidity. The emphasis is placed on the therapist’s responsibility in constructing evolving processes, without losing sight of the important role played by the subject himself.
Keywords: therapeutic community; psychiatric comorbidity; epistemology; psychotherapeutic process.
Key takeaway
Two threads run through the author’s argument: the therapist’s responsibility in constructing paths of evolution for patients who combine drug dependence and a psychiatric disorder, and the active role of the subject himself in this process. The title of the first section captures the tension: between therapeutic nihilism and furor therapeuticus, a false dilemma.
Therapeutic nihilism or furor therapeuticus: a false dilemma?
(The full article was published in issue no. 82 of Perspectivas Sistémicas.)
Who is José Aguayo
José Aguayo, former psychotherapist of the “Villa Cilla” SAMAN therapeutic community in Sant’Alberto (Ravenna). He is a psychologist and psychotherapist at the Family Therapy Centre of Treviso.
Author’s email: josagu@libero.it
References
AA.VV. (1993) L’approccio sistemico alle dipendenze (alcolismo, dipendenze alimentari, tossicodipendenze vere e proprie) (El enfoque sistémico de las dependencias; alcoholismo, dependencias alimentarias, toxicodependencias verdaderas), Il Vaso di Pandora, vol. 1, Genova.
Aguayo, J. (1990) Una proposta sistemica nella ricerca psico-sociale: esperienza comunitaria con un “club de madres” a Lima (Una propuesta sistémica en la investigación psico-social: una experiencia comunitaria con un “club de madres” en Lima), Il Bollettino, no. 22, Milano.
Boscolo, L. e Cecchin, G. (1988) Il problema della diagnosi dal punto di vista sistemico (El problema del diagnóstico desde el punto de vista sistémico), Psicobiettivo, vol. 3, Bologna.
Cancrini, L., Colacicco, F., Fiorini, L. (1997) Le comunità terapeutiche di SAMAN (Las comunidades terapéuticas de SAMAN), Attualità in Psicologia, anno XII, n. 2.
Cancrini, L. e Nocerino, S. (1999) Tossicodipendenti con problemi psichiatrici e Comunità terapeutica: un’esperienza di lavoro (Toxicodependientes con problemas psiquiátricos y Comunidad Terapéutica: una experiencia de trabajo), Attualità di Psicologia, anno XIV, n. 3, Roma.
Guidano, V. (1998) Psicoterapia: aspectos metodológicos, problemas clínicos y preguntas abiertas, VI Congreso Internacional de Constructivismo en Psicoterapia, Siena.
Haley, J. (1971) Possibili approcci alla terapia della famiglia (Enfoques posibles en la terapia familiar), Feltrinelli, Milano.
Malagoli Togliatti, M. e Telfener, U. (a cura di) (1994) Dall’individuo al sistema. Manuale di psicopatologia relazionale (Del individuo al sistema. Manual de psicopatología relacional), Bollati Boringhieri, Torino.
Marzari, M. (1991) La costruzione della differenza (La construcción de la diferencia), CLUEB, Bologna.
Quiñones Bergeret, Á. (1997) Significado social y viabilidad emocional narrativa, en “Constructivismo en perspectiva: implicancias teóricas y prácticas para la psicoterapia”, Ed. Artes Médicas, Brasil.
Ruiz, A. B. (1997) Las contribuciones de Humberto Maturana a las ciencias de la complejidad y a la psicología, Instituto de Terapia Cognitiva INTECO, Santiago de Chile.
Ruiz, A. B. (1998) La psicosis: perspectiva cognitiva postracionalista, VI Congreso Internacional de Constructivismo en Psicoterapia, Siena.
Tomm, K. (1993) Una revisione critica del DSM (Una revisión crítica del DSM), Connessioni, no. 4, Milano.
Von Foerster, H. (1987) Sistemi che osservano (Sistemas que observan), in M. Ceruti e U. Telfener (a cura di), Astrolabio, Roma.
This article is an English translation of “Esos que se drogan ya están fuera de sí y… viceversa. La intervención psicoterapéutica en una Comunidad Terapéutica para la rehabilitación de la toxicodependencia en comorbilidad psiquiátrica”, published by Red Sistémica (first published in Perspectivas Sistémicas, n° 82). Translated and republished with the journal’s permission.
Read the original articleHow to cite this article
Aguayo, J. (2022). “Those who take drugs are already outside themselves… and vice versa”. Psychotherapeutic intervention in a therapeutic community in the face of psychiatric comorbidity (Complexe Systémique, Trans.). Complexe Systémique. https://app.complexe-systemique.com/en_GB/articles/those-who-take-drugs-are-already-outside-themselves-and-vice-versa-psychotherapeutic-intervention-in-a-therape (Original work published in 2022 in Perspectivas Sistémicas, n° 82; republished in 2022 by Red Sistémica, https://redsistemica.ar/2022/07/19/esos-que-se-drogan-y-a-estan-fuera-de-si-y-viceversa-la-intervencion-psicoterapeutica-en-una-comunidad-terapeutica-para-la-rehabilitacion-de-la-toxicodependencia-en-comorbilidad-psiquiatrica/)
To go further
- A project for change in addictions. Interview with Gastón MazieresHow to think about change with people who are dependent, beyond withdrawal alone.
- Three decades in the drug field: context and differences. Interview with Ricardo W. GrimsonAn Argentine pioneer’s view of drug treatment services and how they have evolved.
- Conversations on systemic biology. Interview with Humberto MaturanaThe epistemology of the observer, cited in Aguayo’s bibliography, explained by Maturana himself.
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