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Articles    H2'ed 4/4/11

Adolescent Addictions and Las Vegas

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This weekend I attended an adolescent addictions and mental health conference in Las Vegas, Nevada, which, of course, seems the perfect place to discuss addictions.   The conference was sponsored by U.S. Journal Trainings, a group with which I enjoy working.

My talk was about narrative psychotherapy.   I began by sharing some of what we learned in Australia -- that the world's indigenous peoples are the trunk of the tree of narrative practices, their traditions extended downward into ancient roots of ancestral wisdom from deep within the earth to connect upon which they live.   Their practices arise from the bones of all of our collective ancestors, as well as the bones of the animals and the plants.   Our contemporary work in narrative practices represents branches outward from that tree.   As is typical for many of my audiences, a handful of people had read one book on narrative psychotherapy and it had been Michael White.   As I mentioned in my blogs from Australia, Michael White certainly represents one branch on the narrative tree, but there are many others.   However, I did learn from my colleague at Union, Bill Lax, that Michael White did acknowledge the central role and contributions of Australia's aboriginal people to his thought and techniques.   I had not seen that in the one Michael White book that I read, and Bill is looking for the citations.   However, my point to the audience was that narrative practice is not synonymous with Michael White, who was one rather skillful narrative practitioner, but not the field's only theoretician.

Narrative practice began over 43,000 years ago, I said, when people were recognizably telling sophisticated stories for the purpose of changing each other's perspective.   This was the point at which long distance trade began and was linked to a series of volcanic eruptions that covered the earth in vog, blocking out sunlight, changing the climate, and forcing people to venture far from home.   In many respects, we discovered Others in an entirely more dramatic way during this time.   This is when story became even more important than it already was.

I dipped into neuroscience -- to Marcus Raichle's (Washington University, St. Louis) studies showing that making up story is the default mode of the brain and burns the least glucose, especially compared to more difficult activities like mindfulness meditation.   I reminded people of the obvious -- that when we don't direct our minds purposefully to a topic, we find ourselves "daydreaming" of social situations -- encounters with bosses, arguments with family members, upcoming situations in which we will find ourselves.   We run "what if" simulations" imagining ourselves behaving in a variety of ways, while we observe how our imaginary others will respond.   These social situation simulations form the basis for our plotting our social maneuvers to get what we want.   In folk psychology terms, we can talk about beliefs and desires.   We want to be held in high esteem by our boss, our spouse, our children, so we construct internal representations of these characters and run simulations to predict the best behaviors to achieve our goals.   We believe that we should have what we want and we believe that our representations of these characters from our outer world are sufficiently close as to allow us to predict their behavior.   We have "theory" of these other people's minds.   Theories are just stories that tell us what other people are likely to do in particular situations.   I have a collection of stories about what my boss has done in a variety of situations and I extract information and form future stories about what he is most likely to do in a hypothetical situation.   We need our big brains to do this, because running social simulations and keeping track of all this information on other people requires much computational time.   Brian Boyd, a professor at the University of Auckland, believes that our brains evolved exactly for this purpose -- social survival, since biological survival among our species is predicated upon social survival.

Then I told the audience about Schank and Abelson.   None of them knew these scientists from Yale University and Northwestern University.   I described how these two believe that no human knowledge exists that is not storied.   All facts, all information, all experience is stored in the form of a story about how to use those facts and when they were used and who used them and for what purpose.   We humans do not waste brain space on facts that have no obvious use (Rainman, of, course, being an exception).   I challenged people to imagine a fact that could be called into memory without a story about how it is useful and a time that it was used and for what reason should I continue to remember this fact.   One person in an audience of about 400 people claimed to be able to imagine such a fact.   The rest were with me.   Therefore, I said, anything uniquely human is part of a narrative structure.   Narrative structures incorporate a flow of time.   There is a sequencing that involves befores and afters.   They have characters who move about in a location.   They have plot.   The convey meaning and purpose.   They are colored by emotion.   They are plausible to an audience who find them engaging and entertaining -- worthy of paying attention.

Then we turned our attention to the stories surrounding adolescence -- to the negotiation of an identity.   During this socially constructed part of life that we call adolescence, the stories that saturate modern culture prescribe a crisis of identity in which the adolescent "finds" him- or her true self and discovers his or her unique talents -- what he or she is destined to do when grown up.   This story didn't exist in 1491, I said, in North America, because everyone knew what to do when grown up.   One's life was prescribed through stories about how people lived and what they did.   The number of choices was limited.   With the explosion of choice for how to live and what to do came stories about adolescent identity crises, mid-life crises, and the crisis of making meaning at the end of one's life.   These activities were not necessary in North America in 1491.   The same stories saturated everyone and dictated how to think and act.

Adolescents, I said, are trying out stories to see what they like the best, what works best for them to get what they want (which is not always certain), and what feels the most uniquely satisfying.   We know some of these characters that the can copy -- the gangbanger, the pothead, the jock, the cheerleader, the good student, the shop crowd, emu, and more.   The list continues for as many variations in identity as we can find.   Adolescents try on some of these stories the way they might try different clothes at the mall.   They watch the reactions of important others for feedback about their performance of these roles/stories.   Criticism by parents might reinforce the value of the role.   Criticism by peers might make one rethink the desirability of a role in exchange for trying another or modifying that one.

The story that saturates modern culture, I remarked, is the story of the magic potion.   It's everywhere we go in the form of the water from the Fountain of Youth, the holy water of Lourdes, the sacred dirt of Sactuario de Chimayo in New Mexico, ayahausco, and the pharmaceutical aids on television.   Our modern culture is in search of fast ways to get what we want.   We want drugs to keep us up all night.   We want drugs to put us to sleep after being up all night.   How can we not get seduced into believing in magic potions?   Here is our challenge -- to create alternatives to the magic potion story.   To find a way to make the slower approaches to growth and development sexy!   We do this in the Native American world through the sun dance, through the vision quest, through the sweat lodge, and through other ceremonies.   We try to captivate the youth with the drama of positive questing.   We need heroic stories that counteract the magic potion story.   That's our challenge in working with youth substance misuse -- to make it more exciting not to use, than to use!

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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and (more...)
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