2.1 A Disease of Perception
2.2.2 The Duality of Treatment
In the Journal of Neuroscience 21, 2001 a study on the improvements in the make-up and functioning of the brain after prolonged abstinence from drugs proves that as with all chronic diseases like diabetes, it can be managed by choosing treatment every day. Similar to other chronic diseases, relapse is normal and not a sign of failure but more accurately illustrative of the suggested need to treat the disease both medicinally and behaviourally (NIH, 2010).
Figure 1:Recovery of Brain Function (Source: www. www.attcnetwork.org)
18 | P a g e Medicated Treatment
The NIH suggests, that the use of certain medications used in the detoxification process that forms the initial period of treatment accommodates the recovery process, helping patients to a.) stop using, b.) stay in recovery and c.) not relapse. Withdrawal is common when a person first stops using a substance or behaving in a compulsive way (in the case of behavioural addiction) and is characterized by the experience of anxiety and depression, restlessness and sleeplessness. Some medications are prescribed to help the brain through the transition from the abused substance. These normally help the body to become less reliant on the substance, allowing for more attention to be paid to the behavioural therapies used in conjunction with the medicinal treatment. Association with 'peoples, places and things' as described by AA, acts as a trigger for the stress experienced as a precursor to substance abuse, to cope. In order to rewire ones perception of these triggers to not suffer the negative compulsion they would normally evoke, behavioural therapies are imperative to the sustained recovery of the addicted person (NIH. 2010).
2.2.2.2 Psychological Recovery
Behavioural treatment for addiction is advocated for the successful and sustained recovery of addicted people with many groups such as Narcanon International (NI), discouraging any form of medicinal treatment including, during the detoxification period. NI believe a drug- free detoxification is possible and have done a multitude of studies and research to this effect, suggesting that physical exercise and a healthy diet is as effective without the potential for a swop of addiction from one substance to another as is often the case with medicinal detoxifications (NI, 2013) .
"Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select--doctor, lawyer, artist, merchant- chief, and, yes, even beggarman and thief, regardless of his talents, penchants,
tendencies, abilities, vocations, and race of his ancestors."
(Watson, J. B., 1930) Behavioural therapy comprises many different types of psychotherapeutic methods of which the most well-known is cognitive behavioural therapy based on the theory of behaviourism
19 | P a g e and the psychological school of behavioural psychology developed by psychologist J.B.
Watson. The therapeutic approach is based on shifting perceptions by gaining empirical knowledge of oneself through the sensory experience of the built environment. Echoing the philosophy of Edmund Husserl, that all knowledge is gained this way - behavioural therapy aims at correcting primarily, the perception of self and how that perception effects and is effected by the built environment (Nesbitt, 1996).
The 12 Steps
The 12-step programme was developed from the teachings of the Oxford Group, a 'non- denominational movement' popular in Europe and the United States in the early 1900's, who in accordance with the 'Four Absolutes' of honesty, purity, unselfishness and love, advocated self-reflection, making amends and using prayer and meditation to maintain a balanced and healthy life. The first Alcoholics Anonymous group - with the help of suggestions from Swiss psychoanalyst, Carl Jung on the need for a 'spiritual awakening' to maintain abstinence from alcohol - developed the Oxford Group's philosophies into 12 practical steps to recover from an unmanageable life. The 12-Step Programme was developed by Bill Wilson and prominent Akron surgeon Dr Robert Sieberling. The two have come to be affectionately known amongst recovering addicts as 'Bill and Bob'. June 10 1935 is commonly accepted as the day of Dr Bob's last drink and the official beginning of Alcoholics Anonymous. Together with Dr.
William D. Silkworth, Bill and Bob wrote ' the Big Book' or basic text of AA (AA,2001).
The 12-step programme of recovery from addiction - translated into the popular therapy model, known as the Minnesota Model - offers the community as therapist, in a non- judgmental, non-discriminatory ethos of cooperation, mutual benefit and sharing. The atmosphere of freedom from discrimination that exists in the rooms is one of the principles of healthy communities and results from feelings of emotional and physical security (Butterworth, 2000), as an extension of personal identity and orientation in the built environment (Norberg-Schulz, 1985). The programme's core principle is the non- denominational spiritual element of one's 'Higher Power'. In this way the programme, as developed by AA and adopted by Narcotics Anonymous amongst others, provides a community based on empathy, honesty and love with a willingness to recover being the only requirement for joining. The sense of community and subsequent feeling of belonging and acceptance as advocated by the 12-steps thus becomes another powerful tool for sustained
20 | P a g e recovery and emotional support (AA, 2001). This may be expressed in the built environment through the creation of community spaces that provide a sense of love and belonging to a place, thereby encouraging interconnectedness amongst its people.
2.2.3 WholeHearted Living