Relationship and
Addiction
Gary Broderick
SAOL Project
Relationship
 “The way in which two or more people or things are connected, or the
state of being connected”
 SAOL
 Addiction
 Trauma
 Responding as an addiction worker
SAOL
 S: Stability
 A: Ability
 O: Work (from the Gaelic word Obhair)
 L: Learning
 SAOL is the Gaelic word for Life
SAOL
 Is an integrated programme of education, rehabilitation,
advocacy and childcare, for women, children and community
members of the North Inner City.
 SAOL has worked over the last 19 years to promote the needs of
female drug users and their children.
 We have tried to highlight the many extra difficulties that face
women who use drugs including the impact of broken
relationships with self and others, the stigma attached to being a
mother who uses drugs, fears about the impact drug use might
be having on their children but also fears about losing children
because of their drug use.
 Women who use drugs have different needs to men who use
drugs – physically, emotionally and socially. SAOL is dedicated to
improving the services for female drug users in general and
particularly for those in the North Inner City of Dublin
The gender paradox
Although females seem less likely to develop an
addiction than males, when they do develop an
addiction, they present with greater and more
complex needs than males.
In SAOL, “There’s just something lovely about her!”
Different for Women?
 Addiction is different for Women:
 Getting addicted
 Staying addicted
 Detox
 Recovery
 Aftercare
Central to this is
RELATIONSHIP
Addiction
 Disease – medical approach
 Dis-ease – spiritual unease
 Disturbance with self:
 Self-esteem or relationship with self
 Self-efficacy
 Self-image (particularly here in relation to social roles)
 Bio-psycho-social model of health/addiction
Trauma
 Vast majority of people who have serious addiction issues have
experienced trauma (roughly four times the normal rate)
 Seventy-five percent (75%) of women and men in treatment for substance abuse
report trauma histories (SAMSHA/CSAT, 2000)
 “Individuals with a trauma history rarely experience only a single traumatic event,
but rather are likely to have experienced several episodes of traumatic
exposure.” Cloitre et al., 2009
Trauma includes personal/private
experiences as well as public experiences
Examples of personal and private events:
 Sexual assault
 Sexual abuse
 Domestic violence/interpersonal violence
 Witnessing domestic violence
Examples of public trauma/traumatic events:
 Natural disasters
 War
 Community violence
(Hopper, 2009)
Impact of trauma
 “Prolonged exposure to repetitive or severe events such as child abuse, is
likely to cause the most severe and lasting effects.”
 “Traumatization can also occur from neglect, which is the absence of
essential physical or emotional care, soothing and restorative experiences
from significant others, particularly in children.”
(International Society for the Study of Trauma and Dissociation, 2009)
Impact of Trauma
Activation of survival responses:
 Fight
 Flight
 Freeze
 Submit
 Shutting down of non-essential tasks.
 Rational thought is less possible at this time.
(Hopper, 2009)
Trauma and Addiction
 Addiction is an effective way of responding to trauma. It eventually kills
you; but it does what it has to do when it has to do it.
 It numbs; gives false confidence; makes you part of something; it alienates
you; it is irrational; it takes over and allows you to submit.
 It is a ‘brilliant’ response to trauma
Trauma Informed Care (TIC)
Three phase model of treatment:
 Safety and stabilisation: Our main work in SAOL
 Attention to basic needs including:
 connection to resources
 self-care
 identification of support system
 Focus on the regulation of emotion and develop capacity to self-soothe.
 Education on trauma and treatment process.
 Processing of traumatic material: acknowledge, experience and normalise the trauma
and its emotions at a pace right for you
 Reconnection and reintegration: Development of a new sense of self through
 Friendships
 Intimacy
 Spirituality
(Second level work of SAOL)
You can’t ‘do’ TIC without relationship
 So you have to build the relationship so you can do the work.
 My own journey…
A Man in a Traumatised Woman’s
World
 I was an intruder!
 I was every dominant male they had ever met.
 But I was also every positive male they had ever met.
 I was an intruder to the staff too – so everything that was being done with
the women in mind was also being done for the staff!
I had to develop relationships with the women in SAOL; ones that allowed
recovery to happen and not ones that suited the ‘text books’.
I had to be ethical but also creative and generous and put my trust in the
people who say ‘Meet the client where they are at’.
I just didn’t realise that that also meant that I had to be different too.
Doing Men’s Things
 I wanted to show that I could assist in making things better so I did what
makes me feel better and I started to spring clean!
 Changing the environment – tidying up; buying furniture; painting – sourced
new carpets
 Changed smoking area
 Reclaimed classroom with the women
Relationship with boundary
 The women had easy access to me but I met nobody on my own
 Harm reduction background – I could be generous; sometimes I had to
challenge the bossiness of the staff
 The children of participants were welcome and I knew all their kids and
they knew me.
 My own kids visited and became ‘involved’
Expect to be changed...
 More political – angry, vocal
 Increased self awareness
 Bringing your work home
 Happier
 Greater sense of my/our self efficacy
 Sense of belonging
 Less tolerant of bureaucracy
Education as relationship building
 We take as our guide Paulo Freire’s ‘Pedagogy of the Oppressed’
 Become aware of our incompleteness and strive to be more fully human
 Shared learning
 Shared ideas to lead to ‘revolution’
 Reduce the Use 2 – on drug use
 RecoverMe – on emotions
 (Free to download at www.saolproject.ie)
 Solas sa SAOL (contact admin@saolproject.ie for a copy) – on domestic violence
Art, drama, song, poetry
 Finding new expressions of self, with others, in a spirit of ‘yes we can’.
 Telling their story as a journey of success
 acknowledging what has worked so far and where they want to go.
 Drama – ‘Scéals and Anthems of Outstanding Lives’ – Performances
 SAOL Sisters
Development of peer relationships and
peer leadership
 ‘I’ll have what she’s having’
“So when the respondents talk of value they talk of seeing other people
getting clean and wanting that for themselves; when they talk of benefits,
they talk of feeling normal again because they usually feel like the
‘other’; when they name how important SAOL is, they talk of feeling
stronger, having increased confidence and independence; and they
remembered, reflecting over 18 years of experience of SAOL recording
the important moments that changed how they see the world… And the
researchers, all women in recovery, did not question these answers, but
understood them and agreed. Hence, the inspiration for the title of this
research, “I’ll have what she’s having.”
It is central to good community education and development that
participants feel ownership of the projects where they work. This research
suggests that this is the case for many of the participants of SAOL; this is a
hugely important finding for all involved with the project”.
Community Development Practice as
relationship building
Community development is based on certain principles:
 It enables people to work together to influence, change and exert control over the issues
that affect their lives.
 It is about a collective focus rather than a response to individual crisis.
 It challenges inequitable power relationships within society and promotes the redistribution
of wealth and resources in a more just and equitable fashion.
 It is based on participative processes and structures, which include and empower
marginalised and excluded groups within society.
 It is based on solidarity with the interests of those experiencing social exclusion.
 It presents alternative ways of working, seeks to be flexible, dynamic, innovative and
creative in approach.
 It challenges the nature of the relationship between the users and providers of services.
 It is a wholly positive endeavour which challenges the prejudice and discrimination faced
by its community without being discriminatory to any other community.
Lewis, 2006
Relationship and Addiction
 In the end, addiction destroys relationship – with self, with others and with
community.
 Recovery has to involve relationship building – otherwise it dooms those in
recovery to being, at best ‘dry drunks’.
 Such relationship building requires the ‘professional’ to take a risk and be in
relationship with the other – to meet the risk that we ask of the person in need.
 Both lives become enriched in the process and post-trauma lives become
possibilities.