Substance abuse clinicians working at the coal face with clients daily are confronted with client problems that are robust and tangible. The understanding of these problems is granted epistemological and ontological legitimacy by the psy-sciences. As a result, practice in the substance abuse treatment and addiction fields are rarely subject to the scrutiny provided by post-structural analysis. Moreover, the disciplines of addiction treatment and sociology rarely collaborate in any meaningful way for numerous reasons. For the AoD clinician caught betwixt and between biological psychological and sociological discourses, there has been a tendency to opt for the perceived problem solving capabilities of psychological discourses. However, in a post-aetiological hemisphere, attention is increasingly fixated on the fiscal imperative. Clinician/Client relationships have been reconfigured in neo-liberal society. In this study, materials used to train undergraduate students Motivational Interviewing skills in an Alcohol and Drug degree programme were subject to a textual analysis deploying the Foucaultian concept of governmentality. The familiar aetiological descriptor model used in the field was transposed into the Foucaultian term discourse. One article subject to analysis is presented here. The intention was to interrogate the effects of Motivational Interviewing on client and clinician and the resultant repositioning. It was found that Motivational Interviewing technologies reposition the client as an active self-governing autonomous subject while the clinician is professionally and spiritually imprecated in the manufacture of a neo liberal subjectivity within the client. It is argued that the client/clinician interaction constituted, owes less to clinical considerations than to contemporary neo liberal agendas. Proponents of the practice cite progressive and enlightened facets of Motivational Interviewing through an uncritical indebtedness to ascendant resilience and strength based discourses. Alternatively it can be understood as an individualising strategy that displaces clients from former robust communities of understanding, latterly positioned as primitive or deficit ridden. In the resulting motif cli-T. Carton 193 ent/clinician interaction is reconfigured so that the active rational, self-empowered client is produced by the newly embourgoised clinician. Clinical concerns are casually jettisoned. Thus Motivational Interviewing is at once a political/apolitical apparatus, which requires further interrogation.
This article problematizes the current western hubris around resilience and compulsory positivity that has ideologically insinuated itself into the addiction counselling treatment field. It argues that these discourses emanate less from clinical propositions but represent a virulent enactment of a neo-liberal agenda wherein language is implicated in the recreation of new subjectivities conducive to a declining social state. We also apprehend the ideological effect of verbal softeners, euphemisms and fabricated binaries and inversions routinely utilized by addiction clinicians enrolled as ground troops in this project. We also anticipate some likely challenges to this. The objective of this article is to reinstall the veracity of vulnerability and deficit appreciation, thus problematizing a prevailing Pollyanna version of resilience. It reviews the ineluctable alienating trajectory of lexicons used in the field over a few decades in various interventions, including Twelve Step Therapy, Client Centred Practice, Cognitive Behavioural Practice and Motivational Interviewing in order to show how clinicians now reproduce neo-liberal subjectivity through a language that constitutes subjectivity amenable to a declining social state. We apprehend grammatical structures that stigmatise sickness to reproduce hegemony of compulsory wellness. When self-esteem, or others' adulation, Would cunningly persuade us we are something, Above the common level of our kind, The grave gainsays the smooth complexioned-flattery, And with blunt truth acquaints us with what we are-The Grave by Robert Blair (Clymer, 1995) Of the argument with others we make rhetoric, Of the argument with ourselves we make poetry-W. B. Yeats (Bloom, 1970
The concepts burnout and alienation are routinely connected in a linear unproblematic trajectory (Tomei et al., 2011) perpetuating more of an ideological conflation than providing any insight into either concept. This is not due to the selection of shoddy analytic categories but to structural determinants of thinking, more systemically interesting than the entities themselves. The author attempts to problematize, politicise and polemicize the insipid commonsense understandings of these classifications endemic in the counselling/addictions field. An informal discourse analysis was conducted on an aggregate example based on observation over several years in teaching professional practice. He concludes that the reported trajectory from alienation to burnout is more a narrative around changing ideology diffusion than a robust appraisal of social science. Furthermore, the concept of burnout serves to perpetuate, worsen and naturalise the problems it claims to remedy by a facilitation of spiritualising acts of passivity. An appreciation of alienation on the other hand enables awareness of the unnaturalness of current neo-liberal social structures. The author concludes that the quazi-religious mantra of burnout invites the reader into a regime of self-care/self-blame contradictions and proves its effectiveness not by applicability but repetition. By continued use of the concept we reify the myth of burnout and grant it credence. The author also describes how clinicians enact their own informal and invisible means of resistance to power in the workplace where solidarity is enacted through humour and humanity.
This article illuminates how the transfiguration from the sociological concept of moral-panic to moral-regulation replicates wider socioeconomic conditions. The author urges that the Alcohol and Other Drug (named so in order that alcohol can also be categorised as a drug) clinicians reflect on the structural and reproductive impact of their work. The sociological concept, "moralpanic" has socio-clinical efficacy in the (AOD) treatment field. It has much affinity as history in the field is littered with the phenomenon. The author, a long time Alcohol and Drug clinician, now lecturer in the AOD field, considers the phenomenon in New Zealand around the use what is known locally as P (pure) or methamphetamine. Various texts on a War on P campaign were analysed. It was found that, through various literary devices familiar themes emerged, evoking local folk devils and heroes. This analysis was carried out against a backdrop of creeping neo-liberalism, a new right-wing government committed to market liberalisation, and thereby the increased availability of a more dangerous yet licit drug, known as ethyl alcohol (Saunders, 1989). However, the concept of moral-panic can be deployed as a means to critically analyse the impact of various licit and illicit drugs under the theme of proportionality. Moreover, a sociological understanding of the prevention paradox can create a pathway to understand the role of moral-regulation and its ramifications as outlined by a governmental analysis. An appreciation of Moral-panic theory and Moral-regulation is crucial in the AoD field, as alternatives to dominant medical and psychological individualising discourses, in order to empower clinician and client alike and to politicise a discipline that traditionally eschews politicisation. The author argues that reflecting on the trajectory from moral-panic to moral-regulation creates insights into the dismantling western social state. From an ethical standpoint, it is important that clinicians become aware of the politically reproductive nature of their profession and how they are required to codify themselves and clients into ideological positions.
The idea that clinicians who are in recovery from addiction or substance abuse working as addiction practitioners seems deeply counter-intuitive. Compounding this is the problem that many have incurred criminal records, so the idea seems, at best nonsensical. Yet the cold hard essentialisms of professionalization and medicine gives way at times to the sophistry and serendipity of empiricism. These former sufferers know what they are talking about. The result is that there is an extremely high success rate in securing employment at practitioner, supervisor and management level as well as popularity with clients, due to them having a high affinity with lay experiences. This is an exploratory sociological article intended to raise some issues that present with the employment and training of recovering people as addiction practitioners. The tentative conclusions are that counsellors in recovery have a sophisticated awareness of the idiosyncrasies of the addiction field. However, of much more impact is the issue that they face challenges, related to matters of professionalization, stigma and the associated ongoing gentrification of the addiction field. There is a need for further research and emerging themes given the changing and reconfiguring nature of the health field and the wider neo-liberal political arena. They also possess a resilient and strength based wisdom not located in the over accessible neo-liberal vocabulary around these precepts but have experiences of the encounter with the Gethsemane understanding of deficit and purgatory; thereby the right to take back the stolen neo-liberal appropriation of resilience. They also importantly have access to alternative proven yet marginalised discourses that have stood the test of time.
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