J08 – Narrative Approaches to Addictions Counseling with Native American Populations

Summary

Within addictionology, narrative approaches to the addictions exist though are less recognized than conventional counseling methods. Their advantage lies in their greater acceptance by indigenous and marginalized peoples. The narrative paradigm steps aside from shame and blame by asserting that addiction is a narrative template that people adopt, often because of hopeless life circumstances with no vision for change. In the positivist paradigm, there is one and only one explanation for addiction, which is usually genetic, given its relations to the reductionist paradigm. Narrative philosophy states that we see the world using the stories that we have absorbed or constructed to explain our perceptions. This is supported by neuroscience. Story production is the default mode of the brain, what it does on idle. Human brains are organized around story, its comprehension and production. The brain evolved to manage story, especially about our social relationships. Using substances is a story that people have adopted for managing the unrelenting pain and distress of their lives. It is connected to poverty and adverse childhood events. Narrative therapies aim to provide a different story for managing adverse life events and life stressors. Typically. these new stories involve the development of agency, the sense that one’s actions can make a difference in one’s life. They make meaning of the adverse life events that contributed to the addiction. Through meaning making, shame is reduced. We present the lessons learned and the results of our using this approach with a tribal population in Maine in conjunction with a medication assisted treatment initiative. We show that a narrative approach is readily accepted due to the storied nature of much of North American indigenous cultures and that counselors working on tribal settings can readily adapt narrative approaches to their populations. Some key concepts include (1) reframing the person’s self-story about being addicted within a threat-power-meaning network in which the story of reducing or eliminating substance abuse becomes a story of opposing threatening power relationships derived from colonization and working toward recovery and rebellion becomes an act of rebelling against colonization and restoring balance from the imbalance produced by historical trauma, (2) working with stories about the spirit of the addiction and the consequences of ingesting spirit-laden substances without knowing their songs and protocols and without showing the proper respect to that substance, (3) constructing future-self-narratives that explore right relationships and meaningful conduct in the context of recovery, (4) constructing stories about the intergenerational transmission of addictions and exploring the question of “whom will be the recipient of your addiction?” We come to understand that the client sets their goals and defines what recovery means for them, which is the heart of a harm reduction approach.