Beyond “Dry Drunkenness”: Facilitating Second Stage Recovery Using Wilber's “Spectrum of Consciousness” Developmental Model

ABSTRACT

The usefulness of Wilber's “Spectrum of Consciousness” developmental model in the treatment of substance abuse is demonstrated by a case study that illustrates how underlying emotional pain and intimacy issues can be worked through in the counselling process with a client during the second stage of recovery from addiction. Wilber's model allows for narcissistic, critical self, social, identity, intimacy, existential, and psycho-spiritual issues to be integrated into the counselling process for long-term recovery. This model provides social workers and addictions counselors with a useful map in embracing client recovery.     

Pathogenic and Protective Relations in Alcoholic Families (I): Development of the Ritual Invasion Scale

ABSTRACT

Family of origin daily routines and celebratory rituals may serve to protect offspring from the harmful effects of parental drinking. However, parental alcoholism may disrupt these positive rituals, and this “invasion” has been proposed as a mechanism for transmitting risk to offspring. This paper describes the development of a “Ritual Invasion Scale” which may facilitate research and treatment applications with these families.     

Addiction Treatment with Deaf and Hard of Hearing People: An Application of the CENAPS Model

ABSTRACT

Alcohol and drug addiction is a significant problem among deaf and hard of hearing people. Looking through a Deaf culture lens, treatment for alcohol and drug addiction is key for providing care for deaf and hard of hearing clients. Using the CENAPS model, an applied cognitive-behavioral therapy program is recommended for addiction treatment. The CENAPS model provides clinicians with tools for stabilizing deaf and hard of hearing clients, supporting their transition to early recovery. Educating the client about the stages of relapse and the stages of recovery, clinicians using this model can better treat and prepare deaf and hard of hearing clients for long-term recovery.     

Incorporating Spirituality and the Strengths Perspective into Social Work Practice with Addicted Individuals

Abstract

In the last two decades, the social work profession began to confront the professional avoidance of alcoholics and other drug addicts, and discussions of spirituality. While acknowledging the importance of 12-Step Programs of Alcoholics/Narcotics Anonymous, we also acknowledge that spirituality is a major aspect of addiction and recovery from an addiction. The authors present the Strengths Perspective and apply key concepts to Steps 1-3 of the 12-Steps to increase our understanding of addiction and recovery from alcoholism and other drug addiction. The article concludes that social workers must continue to increase their understanding of the recovery and spiritual issues of alcoholics and other drug addicts.     

Pharmaceutical Intimacy: Sex,Death, and Methamphetamine

ABSTRACT

In this article, I draw from ethnographic work conducted among residents of an “in-house” drug and alcohol treatment center in Baltimore, Maryland, to discuss the relationships born of pharmaceutical (ab)use. By looking in close detail at the autobiographical accounts of one man in treatment for addiction to methamphetamine, I attempt to chart the way life and death are at times brought into close proximity, and at others wedged firmly apart, by such things as love and avoidance. My concern is with the ethics of care that emerge through the so-called “small events” in everyday relations; that so often define a life or a relationship as falling under the category “normal” or “pathological.” I ask how such things as the known demands placed on the body by the need to maintain or avoid relations, whether pharmaceutically mediated or not, come to bear on the decision to “let die” or the resurgence of moral worlds. I end by discussing the different aspects of relatedness revealed by the dependencies and alliances formed by the kinship between pharmaceuticals and humans.

In compliance with current ethical research standards, the names of all informants have been changed to assure their anonymity.     

Measuring the Influence of Social Context Referents in Substance Abuse Treatment: An Instrument Validation Study

ABSTRACT

This paper introduces a newly developed assessment tool, the Ecological Assessment of Substance abuse Experiences (EASE) that has been designed to measure the influence of social context referents (i.e., family, peers, and community) on clients' attitudes and outcome beliefs related to substance abuse and recovery. An initial exploratory factor analysis was conducted with a small sample of adult treatment-seekers (N =103) to identify its underlying factors and to examine the instrument's item-factor fit. Items clustered onto four orthogonal factors: “belonging-recovery,” “belonging-drugs/alcohol,” “disconnect-recovery,” and “attitudinal congruence-recovery.” Preliminary findings suggest that socio-emotional outcome beliefs and attitudes about drug use and recovery behaviors, as related to family, peers, and community contexts, may be significant areas to address during routine assessment practices that may lead to more comprehensive and contextually appropriate treatment plans.     

Neurobiological Causes of Addiction

Abstract

Neurobiology and molecular genetics are contributing heavily to a new understanding of the causes of chemical dependence (“addiction”). Willful chemical abuse is a problem that continues to produce significant societal costs including accidents, medical expenses, and family suffering. Pathological chemical dependence, on the other hand, is being recognized as a true medical disease that is also devastating, but in different ways. There is strong evidence in animals and humans that chemical dependence involves a dysregulation of the pleasure pathway (the “medial forebrain bundle”), located in the mesolimbic portion of the brain. Dopamine is one of the medial forebrain bundle's major neurotransmitters. In this paper, we provide a research-based model for the causes of chemical dependence and its treatment, and integrate this information with classic Twelve Step treatment programs.     

The Importance of “Empty Gestures” in Recovery: Being Human Together

What do clients/patients want or value from their encounters with healthcare providers? Based on ethnographic research conducted with individuals suffering from drug addiction and mental health issues, this article argues that clients/patients treasure “everyday” or “human” interaction with medical staff. Everydayness is accomplished through three generic social processes: **co‐silence, inclusion in back‐stage activity, and physical dramatizations of authenticity. These processes and other ordinary interactional strategies for “being human together” should be seen as vital tools for recovery.     

In college and in recovery: Reasons for joining a Collegiate Recovery Program

ABSTRACT

Objective: Collegiate Recovery Programs (CRPs), a campus-based peer support model for students recovering from substance abuse problems, grew exponentially in the past decade, yet remain unexplored. Methods: This mixed-methods study examines students' reasons for CRP enrollment to guide academic institutions and referral sources. Students (N = 486) from the 29 CRPs nationwide operating in 2012 completed an online survey in 2013. Results: Students were somewhat older than traditional age (mean age = 26). Now sober for 3 years (mean), they had experienced severe dependence on multiple substances. One third reported they would not be in college were it not for a CRP, and 20% would not be at their current institution. Top reasons for joining a CRP were the need for same-age peer recovery support and wanting to “do college sober,” recognizing that college life challenges sobriety. Conclusions: CRPs appear to meet their mission of allowing recovering students to pursue educational goals in “an abstinence hostile environment.” Findings emphasize the need for more institutions to address the support needs of students in recovery.     

Nature,culture, and sexual inequality: A look at causal logic

The nature‐culture issue in recent exemplary cross‐cultural works is examined from a causal modeling viewpoint. The causal models in most current explanations do not depart radically from those of the 1950s. The recent models mostly continue to emphasize the interaction of biological and sociocultural factors in producing sexual inequality. In all of the theories examined, economic production is singled out as important in the sociocultural realm. Some researchers sidestep the nature‐culture issue by dealing solely with variation, or by translating conceivably biological factors into social causes. Biosocial writers have produced the most novel causal model—one which incorporates the effect of culture on biology. These findings suggest that we need to pay attention to the causal networks of theories, rather than dichotomizing them into “biological” and “sociological” explanations.     

Aging male symptomatology and eating behavior

Objective: The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men.

Method: We distributed anonymous questionnaires to men aged 40–75?years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males’ Symptoms scale (AMS), and classified respondents as “high-AMS” (AMS score ≥37; N?=?82) or “low-AMS” (AMS score <37; N?=?386).

Results: High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men.

Discussion: We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported “purging” via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.     

Social Movement Scenes: Place‐Based Politics and Everyday Resistance

Sociologists Darcy Leach and Sebastian Haunss coined the term “social movement scene” to refer to people “who share a common identity and a common set of subcultural or countercultural beliefs, values, norms” and the network of physical places they frequent. Leach and Haunss explain the numerous ways in which scenes can benefit social movements (e.g. as pools of mobilization or as places for cultural experimentation) and that scenes are places where resistance happens. I propose that thinking of a scene as a process is more useful than thinking of it as a stable context where political activity happens. Scenes are the products of urban protests, such as squatting; rituals, such as protest and music; and the activities of everyday life. Drawing on research from sociologists, geographers, historians, and cultural studies scholars, I discuss social movement scenes on both the political left and right in terms of their spatial, symbolic, and relational dimensions.     

Social Smoking: An Untenable Position

Abstract

Social smokers manage the conflicting aspects of their liminal identities by negotiating complex roles of performance and exchange. Using a combination of methods, including both participant observation of cultural performances and informal interviews, to elicit lay theories and accounts of self-conscious practices, this project examines social actors, self-defined as nonsmokers (or reformed smokers), who engage in recreational tobacco use. Through in-depth interviews and observations of self-identified female social smokers, we document general characteristics of this subpopulation, sampled from a large Midwest capital and its surrounding areas. Social smokers occupy an untenable social space; as neither smokers nor nonsmokers, they use both practices and discourses about those practices to stake their claim to an untenable social position. We conclude with a theoretical discussion that compares our findings with other discourses on smoking, especially the discourse of addiction narratives. In an age of increasing awareness of the health consequences, smoking has become a culturally unavailable category producing “disconfirming realities” in which social smokers constantly renegotiate their status.     

Ideological Primary Groups in Contemporary Cultural Movements

Abstract

This paper argues that “post-modern” societies generate movements for cultural change in models “of” and “for” identity and consciousness, rather than traditional kinds of social movements aiming at structural changes in institutional arrangements. The distinctive and crucial unit in comtemporary cultural movements is what we have termed the “ideological group.” These groups are similar to the “ideological informal groups” which recruited members of traditional social movements on the basis of personal contacts and confidence, and which rested on shared “inner convictions.” Like other, earlier, ideological groups, they focus on the construction and legitimation of a shared symbolic interpretation, and ideology of a dissatisfying reality as well as their own personal and collective identity in relation to it. However, contemporary movement groups have been influenced considerably by the sensitivity training-encounter-group dynamics techniques associated with the intensive group movement. The result is a new interest in artificial primary relations among sociologically homogeneous peers for joining socio-cultural analyses with psychological interpretations of common personal experiences. The processes generated in these ideological primary groups lead to the collective construction of new or modified ideological interpretations of reality which contain different, more satisfying, models “of” and “for” personal and group identity, and “consciousness.”     

Cultural Orientation of Hmong Young Adults

Summary

Most studies of Hmong Americans focus on the cultural adjustment of refugees who arrived in the United States immediately after the Vietnam War. Few studies have examined the cultural adjustment of the children of these refugees, who have been raised primarily in the United States. This study explored whether American-born [ABH] and overseas-born [OBH] Hmong young adults differed in levels, models, and meanings of cultural orientation. Fourteen ABH and 32 OBH college students were asked what “being Hmong” and “being American” meant to them and complete were asked to the General Ethnicity Questionnaire (American and Hmong versions). Both groups reported being more oriented to American culture than Hmong culture. Despite similarities in mean levels of orientation to Hmong and American cultures and in the meanings of “being Hmong” and “being American,” ABH and OBH differed in their underlying models of cultural orientation. For ABH, “being Hmong” and “being Americank” were unrelated constructs, whereas for OBH, they were negatively correlated constructs.     

Competencies at the Intersection of Difference,Tolerance, and Prevention of Hate Crimes

Summary

This article develops competencies for social workers to enable them to counter harassment and hate crimes by examining the intersection of “self” and “other” when the “other” is either a gay man or a lesbian or when the “other” is the perpetrator of hate crimes. The authors contend that there is a cultural foundation to hate crimes and that it involves oppression like that experienced by other minority groups, that this oppression is supported by the dominant culture, and that oppressive behaviors can be changed. A typology of five competency areas is presented to develop culturally relevant knowledge, attitudes, and skills that strengthen understanding and tolerance for gay men and lesbians and to work with those who oppress them.     

An Interplay of Individual Motivations and Sociocultural Factors Predisposing Men to Acts of Rape in Kenya

ABSTRACT

There is a general public perception in Kenya that rapists are “sick” people who deserve to be put far away from the society. Consequently, rape perpetrators are left to be dealt with by the criminal justice system while most of the research has focused on the rape survivors without taking into consideration the need to explore and understand the motivations and sociocultural factors that could predispose men to rape. This paper examines this form of “deviant” sexuality characteristic of some men. The paper is based on findings of a study conducted in three main prisons in Kenya between January and March 2008. The study sample was drawn from the Kamiti, Naivasha, and Nyeri main prisons. Respondents were convicted rapists serving their jail terms. The findings suggest that a number of factors may predispose a man to rape. These factors could be either individual motivational factors, sociocultural factors, or a combination of both. The individual motivational factors identified included drug consumption, marital problems as an excuse for rape, inability to negotiate for consensual sex due to being shy or afraid of women, rape as a form of sexual access, psychological factors like pornographic influence and rape hallucinations, impersonal sex and power, and use of rape as a “tool” for punishment. On the other hand, the sociocultural factors identified included the view of rape as a sexual act rather than an act of violence, social attitude that the woman “invited” the rape, early childhood environment, cultural practices, peer influence, and a lack of parental advice on sexual activities.     

Tobacco use in the treatment trenches

As reported here (see “Dirty Words: Smoker, Vaper, Harm Reductionist?” ADAW, Oct. 14, 2019; https://onlinelibrary.wiley.com/doi/10.1002/adaw.32509 ), recently I have focused much of my time on raising alarms about the very high rates of smoking among addiction treatment and recovery populations. In addition to archival research, I have conducted a series of key informant interviews to better understand the roots of our field's ongoing reluctance to address this issue. These interviews with national leaders in the alcohol and drug field confirmed that when presented with statistics about the very high rates of cigarette smoking among treatment and recovery populations, there is widespread consternation about the resulting tobacco‐related mortality and morbidity. Paradoxically, however, this concern has not translated into strong remedial action.     

The Phenomenon Of The Public Wife: An Exercise In Goffman's Impression Management*

Approaching the topic of American leader-image from the perspective of politics-as-theater (political communication as exchange of symbols), this paper examines a taken-for-granted visual symbol which a national political leader is invariably expected to present: a wife. Her contributions to her husband's “impression management” techniques (Goffman, 1959) are studied in Goffman's “defensive” categories of dramaturgical loyalty, dramaturgical discipline, and dramaturgical circumspection. This analysis suggests that the visible presence of a wife in public leadership rituals offers the public voter or viewer important reassurances or symbolic guarantees about her husband's “morality”—and, therefore, his appropriateness for public trust. She has become a necessary partof his public performance because of our everyday need for “cultural absolutes” (Furay, 1977) in the image of our leadership figures.     

On Race and Culture: Beyond Afrocentrism,Eurocentrism to Cultural Democracy

Abstract

The author contends that the struggle for cultural democracy in American education will be critical in determining the quality and the future of education and of America itself. Cultural democracy recognizes the human right of each ethnic / cultural group in a culturally diverse society to have equal access to life chances and sources of social power. Power means to have a “voice,” that is, to have the capacity to define oneself as an active participant in the world rather than a passive victim. Thus, the “voice” as expressed in the theoretical underpinnings or major premises of Afrocentrism, Eurocentrism, and cultural democracy is examined with emphasis on their current contributions and future possibilities for shaping higher education and charting the directions in intergroup relations in American society in the twenty-first century.