Emerging Adulthood and Recovery Work at Passages to Recovery

Bryan Thomas, MAI

Within the age range of twelve to eighteen, the developmental theorist Erik Erikson identified the psychosocial crisis of ego identity versus role confusion. Dr. Erikson defined ego identity as knowing who you are and how you fit in, molding what you have learned into an integrated self-image. In order to avoid role confusion at this stage, it is important to recognize the significance of the transition taking place from childhood into adulthood. One means to foster this recognition is a rite of passage. At Passages To Recovery, we use rites of passage to assist our clients to find their own adult answer to the question, “Who am I.”

In adolescence, one is looking toward role models and the significant relationships are peer relations. The dynamic function of this stage is to be one’s self and share one’s self. Erickson believed that in adolescence a psychosocial moratorium occurs, where time is taken to explore new social roles without taking on adult commitments.

Jeffery Arnett insists the duration of this period, this moratorium, is lengthening significantly. “During the past half-century, the transition to adulthood has become increasingly prolonged in virtually every post industrial society” (Arnett, 1998). Young people are unable to achieve economic freedom from their parents and they stay in school much longer. They postpone the adult life events of marrying and having children. This postindustrial transition into adulthood can last until the mid-twenties, constituting a new developmental period, called “emerging adulthood,” the time between adolescence and adulthood, from 18 to 25 years of age (Arnett, 1998).

“In the theory of emerging adulthood proposed by Arnett, identity issues have a prominent role (Schwartz, S., Cote, J., and Arnett, J., 2005).” If one is going to undertake the task of choosing a career path and making life commitments, one must form a stable and strong sense of identity that can guide and sustain these commitments. Some individuals find this prolonged period of identity formation difficult to navigate without guidance. Symptoms of addiction may emerge in the lives of those who struggle with their identity as they begin to leave home, go to college, and step into their personhood outside the parental umbrella.

Schwartz, Cote, and Arnett argue that individuals may capitalize on this extended time to explore identity issues later into life, with more choices to consider. “The unstructured nature of emerging adulthood, the vast array of potential identity choices, and the lack of external guidance has made identity development a personal project for many emerging adults and may require the exercise of agency, a sense of responsibility for one’s life course, the belief that one is in control of one’s decisions and is responsible for their outcomes, and the confidence that one will be able to overcome obstacles that impede one’s progress along one’s chosen life course,” (Schwartz, S., Cote, J., and Arnett, J.,2005).

Life events structured in post industrial society, such as marriage, gender roles, and religious beliefs, are left up to the individual to decide. Without cultural or religious pre-determination, individuals must take personal responsibility for the formation of their identity and the undertaking of their interpersonal and societal roles, and make sense of the consequences of their actions and decisions. Failure to do so leaves the individual vulnerable to social and economic forces which may become overwhelming. This coupled with unresolved developmental tasks result in poor choice making and maladaptive coping strategies.

At Passages To Recovery, we see how easily this failure translates in substance abuse and chemical dependency. The neurobiological response to the ingestion of many substances is a heightened sense of capability, well-being and euphoria. Seeking this state of being through substance abuse rather than the resolution of developmental tasks leaves an emerging adult’s innate resources depleted, including their natural health and vitality.

Passages To Recovery’s program, which weaves rites of passage work and addiction recovery, can benefit those who struggle with addiction, and with the greater freedoms of identity choice. We help emerging adults utilize this extended period of time to mature and to choose a life path deliberately. “Emerging adults who address these issues in a proactive and agentic manner may be most likely to form a coherent sense of identity that can then be used to guide their life paths and negotiate for social resources and positions” (Schwartz, S., Cote, J., and Arnett, J.,2005).

The Passages To Recovery program is designed to provide the external structure necessary to foster a proactive agentic approach, assisting young adults in bringing themselves into conscious adulthood with a willingness to take responsibility for themselves and the quality of their lives.

References

Arnett, J. (1998). “Learning To Stand Alone: The Contemporary American Transition to Adulthood in Cultural and Historical Context” Human Development. Vol.41. pp 295-315.

Arnett, J. (2003). “Conceptions of the Transition to Adulthood Among Emerging Adults in American Ethnic Groups” New directions for child and adolescent development. pp.100, 63-75.

Schwartz, S., Cote, J., and Arnett, J. (2005). ”Identity and Agency in Emerging Adulthood: Two Developmental Routes in the Individualization Process” Youth and society. Vol. 37 No.2 pp. 201-229.

Addiction is a Brain Disease that can be Successfully Treated in Young Adults

Aaron Lopez, LSAC

In recent years there have been great breakthroughs regarding the neuroscience of addiction. These findings indicate there are changes in the reward center of the brain. These changes are initiated by the person feeling an excessive amount of stress. The addicted person then begins to rely on the chemical to relieve stress. As the disease of addiction develops the midbrain begins to "depend on the substance for survival." The successful treatment of the chemically dependent person requires abstinence (Hoffman, 2003). This period of abstinence will allow the brain to begin adjusting to functioning without the foreign chemicals. The chemically dependent person will also need to develop skills to cope with common stressors. In young adults, it will be also be necessary to address their developmental needs (Gillispie, 2006). Let's first take look at the emotional state of the chemically dependent person without the substance: restless, irritable, and discontented.

Addiction is a brain disease; more specifically it is stress-induced deregualtion of the brain's hedonic system- its 'pleasure sense' (McCauley & Reich, 2007). This means that the chemically dependent person cannot derive pleasure from daily activities because they are probably feeling overwhelmed. Furthermore, the addicted person has compromised coping skills that hamper their ability to deal with common stressors. The natural state of the alcoholic (addict), as stated in the text Alcoholics Anonymous, is restless, irritable and discontented (Alcoholics Anonymous, 2001). It is amazing that the text Alcoholics Anonymous, written in 1939, described the alcoholic so well. And much of the wisdom found in Alcoholics Anonymous and other 12 step groups is relevant to the recovery of young adults. If we look at the term "restless," it is actually listed as a symptom of hyperactivity in Attention Deficit Hyperactivity Disorder (ADHD). We now have the clinical term Depression which was then described as discontented. We often see individuals with chemical dependency problems also have "authority problems" or "anger problems" which could also be depicted as "irritable."

When an addicted person says they are self-medicating, many of them are right on target. It has been estimated that over 50 % of chemically dependent individuals also suffer from at least one mental illness (Storie, 2006). In essence the neurotransmitters in the midbrain, particularly the dopamine system, are not working correctly (McCauley & Reich, 2007). Well-meaning loved ones often try to treat a specific symptom that the addict displays as opposed to the symptom and the chemical dependency. They try to treat only the "restless", "irritable" or "discontented" symptoms. There has been significant progress in treating these symptoms with psychotropic medications. However, if the individual continues to drink or use other drugs the benefit of such medication is nullified. The addicted person may modify the prescribed amount or frequency of their medication in conjunction with their drug use, or not take it at all. This is because the medication does not provide instant relief that the midbrain craves. This may leave the addicted person and their family confused and worse yet feeling hopeless that the addicted person is not improving despite treatment.

That is why it is crucial that chemically dependent persons get appropriate treatment that will allow them to maintain abstinence. Then it becomes the old question of, "Which came first the chicken and the egg?" Ideally the addicted person should abstain from the substances so that a more accurate picture of the underlying issues can be formulated (Buelow & Buelow, 1998). This can be accomplished with thorough psychological testing. This will help rule out if their behaviors are a result of their addiction or whether there is an underlying diagnosis that would benefit from psychotropic medications. Again the addicted person should remain abstinent for a period of time to determine if medication is indicated to treat any underlying diagnoses.

Thus it seems to the outside observer and often to the addicted person that abstinence would alleviate the unwanted behaviors of their drug use. This is true to an extent. The alcoholic is no longer being arrested for drunken driving and the heroin addict is no longer putting themselves at risk by injecting the drug. This will relieve a great deal of stress in their lives. However, as mentioned earlier, the true nature of the disease is an inability to handle stress. That is why a person may report feeling worse after they have gotten sober.

It is imperative that the clinical professional help the addicted person develop skills to cope with daily stressors and to provide them with assistance in building in sober support network (Gillispie, 2006). For young adults, the 12-Step model of recovery has values that correlate with their developmental needs. Young adults may resist including 12-Step support groups as an adjunct to therapy. However, 12-Step support groups often reinforce cognitive behavioral techniques that therapists use with chemically dependent clients to learn new behavior and thinking patterns (Duffy, 2006). For example, the common AA Phrase, "This too shall pass", moves the person thinking away from catastrophically. It is very common for chemically dependent persons to have rigid thinking patterns. As the amount of time the person remains abstinent increase, the reward center of the brain begins to recalibrate. The dopamine, serotonin and other neurotransmitter systems will return to the homeostatic level that existed before the person began using substance. With enough time, and if needed, medication, the person's midbrain will begin derive pleasure from every day activities. Deriving pleasure from daily accomplishments and the ability to cope with stress will help the addicted person maintain abstinence from detrimental psychoactive substances.

References:

Alcoholics Anonymous, (2001) Alcoholics Anonymous, New York, NY: Alcoholics Anonymous World Services, Inc.

Buelow, George D. & Buelow, Sidne A. (1998) Psychotherapy in Chemical Dependence Treatment: A Practical and Integrative Approach. Pacific Grove, CA: Brooks/Cole Publishing Company.

Duffy, B. (2006, May/June). AA and CBT: One in the Same?. Addiction Professional, [4(3)], 33-34.

Gillispie, C. (2006, March/April). Reaching the Demographic. Addiction Professional, [4(2)], 33-36.

Hoffman, N. G. (2003, March). Distinguishing 'Dependence' from 'Abuse': The Data Make a Clear Separation. Addiction Professional, 19-21.

McCauley, K. & Reich, C. (2007) Addiction, New Understanding, Fresh Hope, Real Healing. Salt Lake City, UT: The Institute for Addiction Study.

Storie, M. (2005) Basics of Addiction Counsleing: Desk Refernece and Study Guide. Alexandria, VA: NAADAC.