Freedom and resistance: the phenomenal will in addiction by mary tod gray. Scene 1: 'help me! Help me!' she cried. 'What the hell do you think you are doing? Get away from me! I'll kill you!'
Freedom and resistance: the phenomenal will in addiction by mary tod gray. Scene 1: 'help me! Help me!' she cried. 'What the hell do you think you are doing? Get away from me! I'll kill you!'
Freedom and resistance: the phenomenal will in addiction by mary tod gray. Scene 1: 'help me! Help me!' she cried. 'What the hell do you think you are doing? Get away from me! I'll kill you!'
a r t i c l e Blackwell Publishing LtdOxford, UKNUPNursing Philosophy1466-7681Blackwell Publishing Ltd 2006
200681315
Original article
Freedom and Resistance
Mary Tod Gray
Correspondence: Mary Tod Gray, Associate Professor, East Stroudsburg University, 200 Prospect Street, East Stroudsburg, PA 18301, USA. Tel.:
+
1 570 422 3475 (ofce); fax:
+
1 570 422 3848; e-mail: mtgray@po-box.esu.edu
Original article
Freedom and resistance: the phenomenal will in addiction
Mary Tod Gray
PhD RN
East Stroudsburg University, East Stroudsburg, PA, USA
Prologue
The Feeling
A World of Stone
There once was an addict named will Whose patience amounted to nil He snorted and sniffed And often got miffed When his will was soundly ignored. So what is this will that exes and ghts And drives us to drink from within Its freedom enthroned And courage alight Wrapped tight in a world of stone. To move is to grow-to reach for it all When thwarted the rage is bright orange Will fantasy ight Match motion felt free Or dive to the depths like a stone. Join the group! Nurse will does entreat Connection demands it of all But will squirms and dgets Its strength feels diminished Wrapped tight in a world of stone. For resistance is keen, its contrast demands That choice supersede the control How will will feel free To feel real as me When the world is wrapped up as one. (Author)
The View
Scene 1
She stumbled into the hospitals emergency room, the fumes of alcohol both announcing and trailing her entrance. Help me! Help me! she cried. The triage nurse and security guard, calmly steer her in the direction of an unoccupied cubicle. What the hell do you think you are doing? Get away from me! Ill kill you! Arms ailing, legs kicking, she resists all efforts to direct and restrict her movements. Other team members arrive and collectively restrain her aggressive movements. She resists, struggling to break free, fear and panic intensifying her efforts. Abruptly, she vomits, and her struggle ceases; she blacks out. The nurse turns her on her side and clears her airway. Is this the third or fourth time weve seen her this month? one of the staff questions.
Scene 2
A toddler, sitting on his mothers lap in the waiting area of the airport, struggles to get down, and investigate the novel opportunities available. The mothers grip is rm as she restrains the struggling child, intent on his safety. The child resists; he is equally intent on freedom to move, to explore. His will, the desire to move towards the environment, encounters the mothers will to ensure safety. If the mother holds rm, the child might continue to strug- gle or eventually desist, becoming tired or distracted by another interest. His will momentarily succumbs to the strength and security of the mothers embrace.
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The Theme
Freedom, a cardinal value of individuation and our society, is also a feeling, a sensory experience, expressing the will. Threats to freedom are met with resistance as evident in the above scenarios. Nowhere is freedom more threatened than in addiction to drugs, in which the power to reason is relinquished to the effects of the drug. The individuals relationship to the drug and its effects, to the rituals of procuring and responding to the drugs, supersede individuation yet conversely, or even perversely, express the phe- nomenal will.
Introduction
Addiction to psychoactive drugs begins with a choice, a choice that changes subjective experience. The choice to change feelings, perceptions, or thoughts of subjective experience invokes the will: the will as action in the initiation of addiction, and its apparent loss when the addictive ritual becomes rmly entrenched as the central mode of activity.
1
The will, then, emerges as a salient concept to understand the larger phenomenonology of psychoactive drug addic- tion discussed elsewhere (Gray, 2003a, 2003b, 2004, 2005). How the will feels subjectively, and what meaning is conferred on that feeling, are elemental to the wills signicance in human agency. Human agency, in part, describes an internal renewable force or energy source (Lawson, 2001). The subjective will symbolizes the feeling of this vital force. Scholars have linked the will to movement or action (James, 1890/1981), faith or belief (Saint Augustine, 395/1964; James, 1897/1979), reason (Kant, 1934/1960), and power (Nietzsche, 1909/1964). These diverse perspectives suggest a symbolic mean- ing to the will beyond a biological capacity for action and choice. They suggest both a feeling component and a reective capacity which have consequences for the individuals sense of freedom: freedom to choose among the options arrayed before him or her,
and
to believe in his or her right to make those choices. Threats to this sense of freedom, inextricably tied to choice, arouse feelings of resistance. When clinicians work with individuals addicted to psychoactive drugs, they often sense the individuals resistance and label it non-compliance with treatment or denial of the drug problem (Wing, 1995; Wheeler & Lord, 1999). I propose that a deeper examination of the will, experienced subjectively as feelings of freedom and resistance, illuminates the values that are most important to the individual. These values are at the heart of the moral actions generated within the individual. They are based in feelings and provide the energy or capability for action that direct the individ- uals future. In this paper, I will discuss how the dynamic between the two feelings, freedom and resistance, are evident in the will in general, and how they become magnied in the experience of the will in some sub- jective narratives of drug addiction. My assumption is that an examination of how the will is subjectively experienced in these feelings will uncover the human- ity hidden within the layers of addiction; will provide insight into the struggles which recovery from addic- tion entails; and will further a humanitarian per- spective against which theories of addiction and therapeutic strategies can be measured.
The will
At its most elementary level, the will is feeling in motion; it is the feeling of movement: the perceived movement of the bodys internal processes or the feel of motion directed towards the external world. It is a feeling often perceived in contrasts: the feeling of action contrasted to the feeling of inertia; the feeling of choice contrasted with constraint, resistance, or oppression. Feelings of motion are embodied sensa- tions. Awareness, intensity, and tempo mark subjec- tive response to the wills movements, and to the consequences of choices made. The wills action, evi- dent in choices made, generate ideas of self and feel- ings about that self, feelings such as self-esteem and self-efcacy (James, 1890/1981). These actions and their consequences arouse moral sentiments, feelings
1
Fingarette (1988) took issue with alcoholism as a disease, and discussed heavy drinking as the central activity of the heavy drinkers life.
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of right and wrong, which coordinate with or diverge from individual ideals and social mores. William James (1890/1981), American philosopher and psychologist at the turn of the 20th century, iden- tied individual interest as the primary force direct- ing the wills movement towards a particular aspect of experience. I choose to direct my attention to a particular aspect of experience, whether I focus on internal feelings and thoughts or external objects and goals. In Jamess model of the will, biological capacity for choice or volition is shaped by previous experi- ence of various movements, which establish neuro- physiological pathways; the memory of involuntary movement sets the stage for the variety of movements and directions from which one might choose. Choice in this biological sense indicates that the proximity of feeling and the wills action is immediate because the patterns have been established. Immediate action, however, is frequently deterred by obstacles, arising both from encounters with the world, and from those which are self-created. These obstacles to the free ow of movement James symbolized as logjams in the stream of consciousness. Logjams create eddies in which the feeling is of a owing . . . in the direction of greatest resistance (p. 427). The feeling of effort accompanying these obstacles invites, even demands, deliberation: to choose among possible movements that will circumvent or overcome the obstacle. A vignette illustrates this biological progression in the wills development: my infant son learned to crawl in a small apartment in Manhattans Greenwich Vil- lage. To remain visible yet protect my son while cook- ing in the kitchen, I placed a chair on its side across the open doorway between the kitchen and living area. Visible but safe, my son crawled to the open door where he could see, but not get to me, the object of his intention. The movement, my sons action, towards the world, had encountered resistance (the chair). Movement, in the form of the infants crawl, already supplanted the involuntary practice move- ments of the newborns ailing limbs. My sons encounter with the chair halted the natural tendency of forward movement towards a goal. The obstacle interrupted the ow of movement and demanded fur- ther action in the form of choices, what James called deliberation. What are the choices for movement at this point?: cry, certainly a potent intentional action directed towards the world, and eventually receiving a desired response (the mother); turn towards the open (unob- structed) space under the table in the living area, and continue the forward movement; or cease movement and focus attention on a rainbow of dust particles illuminated in the suns rays ltering through the legs of the chair. The latter two choices divert movement from the intended goal, the mother, yet offer alterna- tive, perhaps more interesting diversionary experi- ences. The response of the child to obstructed movement is, of course, based on a myriad of factors. The point here is that the will embodied in the move- ment towards the world encounters obstacles, which might invite alternative actions or choices. When obstacles prevent choices, however, the thwarted movement might instead create internal feelings of tension, until motion is again realized. The subjective feel of freedom in this vignette is the feel of unim- peded motion; a feeling of resistance arises when obstacles to goal-directed movement occur.
The feel of freedom
In Jamess (1890/1981) model, the will is free if the focus of attention can be sustained over a desired period of time. Freedom in the wills motion implies not an obstacle-free path, but one in which the focus remains disciplined towards specic goals. James illustrated this focus when he differentiated between the healthy and unhealthy will. In the healthy will, an assessment of the eld of choices is entertained, and a selection made. The subsequent action follows the visions lead. The vision must be realistic within the individuals habits and societys norms. Maintaining the idea or vision in the focus of attention, until the action can follow the visions lead, invokes a feeling of effort in the act of will. The feeling of effort energy expended at a level of sensory awareness and the ability to stay goal-focused not only play a role in strengthening the internal sense of the wills capabilities, both also express consent to the reality of what is attended to (p. 1172). Focused attention and consent are two essential components of the healthy wills expression.
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In the unhealthy will, or what James called the perverse will,
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action might either fail to follow the visions lead, creating a disconnection between vision and action, or the time lapse between vision and action is extreme. Either action occurs impulsively, what James called the precipitate will, before an ade- quate assessment of the eld of possibilities is assayed; or conversely, in the obstructed will, action fails to occur because energy to sustain the connec- tion between vision and action is insufcient or unavailable. The feel of the precipitate will is one of wild or uncontrolled action; the feel of the obstructed will is one of inertia or ineffectual action. Either feel- ing results when the wills movement or action is unable to follow the visions lead. This disconnection between vision and action has implications for a sense of a self which feels divided between the ideal, which is the vision, and the actual actions of living (James, 1902/1929). This division cre- ates in some an intense feeling of absence and a sub- sequent craving for more, however, ill dened that more might be. James frequently used the individual addicted to alcohol to illustrate both the unhealthy will and the sensible self which feels divided. Acting on a vision is important because it allows for a sense of meaning and purpose to emerge from that action; it permits a sense of coherence between feeling as sensation and action as movement; and it unies action and ideas of self. The importance of this coherence is evident in Jamess conception of belief. James (1890/1981) believed that the will and belief are simply two names for one PSYCHOLOGICAL phenomenon which indicates a certain relation between objects and the self (p. 948). Both the will and belief are goal- directed actions. Both embody a forceful feeling of motion and emotion.
3
When threats to the free move- ment of either one occurs, a feeling of strong resis- tance is apt to be experienced. Belief differs from the will because it is an action directed towards a future that has not yet materialized; it is an action that cre- ates a relationship between the sensible present and a future and thus hypothetical ideal. A beliefs action, like that of the will, is a feeling of movement towards an intended goal. However, the goal might be intan- gible, uncertain, or never fully attained in a material sense, and always just beyond reach. It is always beyond reach because the action denotes a temporal difference: present versus future; its intangibility thus derives from its imaginary status. Yet even imagina- tion carries a feeling tone, and this
striving towards
the ideal is the sensible experience of the beliefs action. It is value-laden in that it expresses what is most important for that individual to realize. Belief, in the sense of value enacted, is a powerful action, because of its potential to create the facts (James, 1897/1979), and, in doing so, generate feelings of empowerment and optimism, and sentiments of rightness. These moral sentiments inform the relationship between the wills action and beliefs commitment to an ideal or guiding principle. These sentiments are echoed in Saint Augustines (395/1964) discussion of the relation between the will and Gods divine law, and Kants approach to the relation between the will and moral law (Kant, 1934/1960) or practical reason (Zweig, 1970). A guiding principle, whether divine or moral, spiritual or secular, provides direction for the wills movement towards particular ideal goals. James (1897/1979) called it the will to believe. Benn (1988), more recently, describes this convergence between
2
James used the term perverse in the sense of turning away from what is generally deemed good or accepted behaviour. This jux- taposition of unhealthy and perverse to describe the impulsive will conveys the links between morality, social norms, and health in Jamess late 19th century context. Such links parallel the judgements about healthy lifestyles and behaviours pronounced with increasing moral authority by a current array of health professionals. See an interesting discussion by Luik (1999) on the emerging role of health professionals as health police.
3
James described emotion as the immediate feeling of bodily change in response to an exciting event (James, 1890/1981, p. 1065) and a seizure of excitement perceived as additive body sensations (James, 1894, p. 523).
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the wills action and belief commitments as autonomy. The autonomous decision maker is distinguished from the self-directing or self-determining decision maker because of these guiding principles. Self- determination denotes that one can freely act, but a free will establishes that one can choose the will one wants (Frankfurt, 1971, as cited in Glover, 1988, p. 184), or in Jamess parlance that your action will fol- low your visions lead. Jamess (1897/1979) will to believe proposed that the power of a belief directed towards an ideal helps to create the fact. An individ- ual, in other words, experiences creation of the future by relating his or her choice of action to his or her specic ideal. The feel of freedom is inextricably tied not just to the forceful thrust of unimpeded move- ment, which permits me to do as I please, but to the powerful pull of a meaningful future. I feel most free when I move in personally meaningful directions. In contrast, when those feelings of freedom feel threat- ened, I experience a powerful feeling of resistance.
The feel of resistance
Resistance is a feeling which arises when the unre- stricted ow of movement feels thwarted or delayed by unintended or unanticipated obstacles, or the per- ception of a superior force. Envision the latter in the toddler struggling to escape the adults restraining arms and explore a crowded restaurant. Submission to overwhelming force of the parents arms might temporarily vanquish the force of the will and the feel of free movement; the trade-off for submission lies in a feeling of safety and belonging. To extend this anal- ogy further, the will as movement, denotes a force in individuation, in this instance of the toddler; and its submission or relinquishment a price for connection and security. Resistance is the feel of the wills force when individuation feels threatened, when the joy in feeling an authentic me (Glasser, 1998) feels limited by superior powers or external circumstances. As such, resistance embodies a sensible response to the conning or conforming pressures of external sources; it also might embody a sensible pause in the wills forward movement perhaps a pause that invites reective choice. Choosing goodness as a guiding principle as Rus- sell discussed in
A Free Mans Worship
(Russell, 1917/ 1959) is one way to assert ones free choice in the face of the overwhelming external forces of determinism; similarly, in Jamess (1897/1979, 1909/1977) philoso- phy of pluralism, free choice and responsibility are compatible with determinism when the belief in a vision provides a guiding principle. It is the guiding principle, which the individual chooses for his or her sense of moral reality, which has consequences for the quality of future life experiences.
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Deliberately choosing a path that deviates from the established norm or common good can equally express the wills free movement. In this instance, the value of freedom in relation to the will might predominate over good or rational choices as perceived by others. In the con- text of drug addiction, the obvious good of abstain- ing from psychoactive drugs might, in this instance, be overshadowed by the affective value of choosing a path that feels freely chosen by me. The feel of the wills freedom, then, can be viewed either as unobstructed movement or movement that abides by a guiding principle or law, whether imposed by God or society, or self-created and self-imposed, such as described in belief systems (James, 1897/1979) or autonomy (Benn, 1988). The feel of resistance is experienced as obstructed movement, a sensory pause in movement, which necessitates deliberation and redirection towards a realizable goal. From a psy- chological perspective, the sensory response might arise from a perceived threat to individuation or authenticity. When a previously existing freedom feels threatened by others imposed choices and rules
4
To offset the pessimism of determinism, James (1897/1979) extolled the hopefulness of chance possibilities in indetermin- ism: the chance that in moral respects the future may be other and better than the past has been (p. 137). Chance, however, highlights uncertainty, that permanent presence of the sense of futurity, that can keep us from feeling at home in the present (p. 67). Jamess pragmatic and pluralistic philosophy allowed for multiple ways of knowing the data of experience, which included drug experiences.
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or even more powerful personalities,
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the individual feels an impenetrable, protective shield arise to resist such frontal assaults as coercion or persuasion. From a spiritual or philosophical perspective, feelings of resistance can conceal and protect a deeper feeling of loss: a loss of direction, vision, or guiding principle that give purpose to ones life, or that recognize and afrm ones worth and personal values. Both freedom and resistance can be deliberately abandoned in what is called the surrender or abey- ance of the will. Such a voluntary surrender feels like another kind of freedom: the feel of letting go of the brakes on a downhill bike ride, experiencing multiple sensations colliding all at once, until the rapidly pass- ing environment becomes one with the speeding internal sensations of exhilaration and fear. James (1902/1929) described this type of surrender in sub- jective experiences of mystical consciousness. These experiences, transitory and ineffable, result in a sense of extraordinary personal knowledge. The will, the feel of choice and control, and resistance to its loss, is voluntarily surrendered to the awesome sensory experience of the immediate moment. James com- pared the abeyance of will to the feelings of ease and optimism induced by alcohol (James, 1902/1929), or to the feelings of transcendent unity with something beyond the self and others experienced with nitrous oxide (James, 1882). He cautioned that when choice is too long abandoned to these sensations of ease or transcendent unity, individual action and goals becomes meaningless. In such an endless network of connection, the individuals creative unique force feels stied. These examples: the will subjectively experienced in the dynamic movement between feelings of free- dom and resistance to its loss, and the voluntary sur- render of choice to immediate sensory experience, suggests that these feelings are common to human experience. Authors, who narrate their subjective experiences of psychoactive drugs of addiction, illus- trate how these feelings of the will are expressed in action and surrender, and subsequently interpreted within a framework of meaning for that individual. Meaning arises from the feel of freedom as powerful unobstructed movement: to magnied sensations of internal processes, and to feelings of individuation or of connection to self and to the world. The drug in the narratives, in a sense, becomes a conduit for the wills movement towards a personal and meaningful goal.
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John Keats, the 19th century poet, described this force of oth- ers personalities on self-feelings upon entering a room full of people, the identity of everyone in the room begins so to press upon me that I am in a very little time annihilated (as cited in Glover, 1988, p. 148).
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In the later stages of addiction, the drug itself seems to become the goal, yet it is the sensible awareness of movement, that
striving towards
, that describes both the feeling of absence felt as craving and the feeling of more that fuels an optimism in the future missing in ordinary reality. Such optimism sensi- bly connects the present with the feeling of a meaningful future. In The
varieties of religious experience
, James (1902/ 1929) described the self divided, in perpetual conict, when the reality of the actual self will not sensibly connect to the yearning for something more imagined in that ideal self. He illustrated this sense of optimism, the pragmatic effect of such human yearning, in a comparison of drunkenness and mystical consciousness: The sway of alcohol over mankind is unquestionably due to its power to stimulate the mystical faculties of human nature, usu- ally crushed to earth by the cold facts and dry criticism of the sober hour. Sobriety diminishes, discriminates, and says no; drunkenness expands, unites, and says yes. It is in fact the great exciter of the
Yes
function in man. It brings its votary from the chill periphery of things to the radiant core. It makes him for the moment one with the truth. Not through mere perversity do men run after it . . . The drunken consciousness is one bit of the mystic consciousness, and our total opinion of it must nd its place in our opinion of that larger whole. (p. 387) For James, studying drug consciousness, such as alcohol, was another way of understanding the plural ways of knowing reality, of revealing something more of the human condition.
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Subjective narratives of addiction
In some narratives related by individuals addicted to psychoactive drugs, the drug effects magnify percep- tion. Davy (1839/1972) in repetitive use of nitrous oxide noted that objects become dazzling and appar- ently magnied (p. 289). Actions intensify in quality and power: toward the last inspirations, the [highly pleasurable] thrilling [in the chest and extremities] increased, the sense of muscular power became greater, and at last an irresistible propensity to action was indulged in . . . I know that my motions were var- ious and violent (p. 272). Sometimes the actions involved stamping or laughing . . . [or] dancing around the room and vociferating (p. 274). As repeated inhalations of the drug continued, actions took the form of designing new ideas: vivid visual images were connected with words in such a manner as to produce perceptions perfectly novel. I existed in a world of newly connected and newly modied ideas. I theorized I made discoveries (p. 289). For Davy, a scientist, new discoveries are a highly desirable goal. The drug experience, as described, reveals the sensible quality of the authors desired actions (thrilling, pow- erful, irresistible) and implicit goals (discoveries). Jamess (1882) aforementioned personal experi- ence with nitrous oxide described feelings of unity, when sensible connections are created between the self and the world, The centre and the periphery of things seem to come together . . . The
meum
and the
tuum
are one (p. 206). No longer does the individual experience feelings of isolation but a merging between me (
meum
) and you (
tuum
), mine and yours. James used his personal experiences with psychoac- tive drugs like nitrous oxide for philosophical pur- poses. He rejected the enervating effects of such an absolute unity, whether created with drugs or from a philosophical perspective of absolute monism. For James such absolute connection, left no room for the unique efforts of the individual in shaping his own future; personal choice becomes meaningless. James (1912/1976) believed that in some ways individuals are connected, but, and this, I believe, is particularly signicant to feelings of resistance in addiction, in some way each individual is uniquely separate, and prizes that separateness. Other addicted authors cite creative and soothing actions in the drugs effects. De Quincey (1821/1956) noted that opium created a chronic pleasure, a steady, equable glow, experienced as an order, legislation, and harmony to mental faculties, and most importantly the benign impulses of the heart (pp. 389390). For De Quincey, opium restored the feelings of serenity which are the natural state, disguised by sobriety: opium compose[s] what has been agitated, . . . what has been distracted . . . The diviner part of his nature is paramount; [and] the moral affections are in a state of cloudless serenity; overall is the great light of majestic intellect (pp. 309391). The natural state, extolled by 19th century romantics (Untermeyer, 1955), nds its parallel in 20th century concepts of the authentic self (Bishop & Scudder, 1996). The authentic self, sensibly experienced in the drug experience, demonstrates desirable personal actions, which sensibly feel right, indicating they are most important and meaningful to the individual, and, as such, t within the personal belief system. This per- sonal law framing belief commitments and action proclaims an autonomous self (James, 1897/1979; Benn, 1988) which feels real and authentic. Similar to Jamess and Davys nitrous oxide expe- riences, Cocteaus (1957) experience with opium cre- ated connections between the self and the world, connections which were not felt in ordinary circum- stances. Movements tempo, experienced as subjec- tive time, is slowed so that connections are sensed and reection permitted: Everything one does in life, even, love, occurs in an express train racing toward death. To smoke opium is to get out of the train while it is still moving (p. 36). Opium accentuated internal processes at a sensory level of awareness, the minds processes feel expanded beyond usual connes: Opium lightens the mind. It never makes one witty. It spreads the mind out. It does not gather it to a point (p. 100). Like nitrous oxide, however, the choices incurred in the actions of these drugs, which initially led to harmony, familiarity, and slowed tempo, eventually become no choice at all when the harmony transmuted into feelings of impotence and enervation. The wills choice, exemplied in repetitive drug rit- uals, results in self-destruction, and transforms reality
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in ways that ultimately sever relations with others and intensify feeling of isolation. Intense self-feelings experienced by Crowley (1922) with cocaine created feelings of mastery and superiority: I was Feeling itself! I was all the possibilities of Feeling fullled to the utmost (p. 28); and one cannot feel ones body, yet one has the feeling that this passion is animal is completely transmuted and utterly etherealized (p. 47). For Hendriks (1992), addicted to cocaine, actions increased both feelings of speed and power: I can move so much faster up here [near the ceiling]. Im like a y buzzing around . . . I have all the strength in the world. I never seem to tire (p. 55). Actions feel etherealized, powerful, and unlimited. Crowley contrasted heroins action with that of cocaine; heroin induced inated self-feelings, charac- terized by a sense of superiority to others, and a transmutation of bodily feelings into spiritual equivalents:
We felt ourselves crowned with colossal calm. We were mas- ters; we had budded from nothingness into existence! . . . our happiness was so huge that we could not bear it; . . . ineffable mysteries must be expressed with sacramen- tal action . . . The sense of our superiority to mankind was constantly present. We were dignied beyond all words to express (p. 60). The sensation was of innite power which could afford innite deliberation. Will itself seemed to have been abolished (pp. 6162). Crowley summarizes: With cocaine, one is indeed master of everything; but everything matters intensely. With heroin, the feeling of mastery increases to such a point that nothing matters at all. (p. 62)
Feelings of universal benevolence translated into feelings of moral indifference to others. Just as the drug personies the desired actions and goals of the individual, when choice becomes a ritualized pat- tern, and action is experienced as compulsive, rather than chosen; the self and drug become one: You are no longer indulging in the speedball [cocaine and heroin], youre Living it . . . You are a prisoner now, and getting and absorbing the mix is your utmost priority, next to breathing and actually higher than eating, or for that matter anything else (Rem, 2000, non-paginated). Experiences with the hallucinogen Ketamine describe the freedom found when the will feels vol- untarily surrendered; when self-destruction is viewed from an optimistic perspective: One can discard all traces of ego awareness and individual volition [the will] and still be more than one was before. The loss of personality does not bring extinction . . . How else can it be possible to drop the body, emotions and mind and still exist as a self-aware entity in a realm of innite and animate potential (Moore, 1982, p. 281). Another narrative of ketamine experience revealed that through dimensions of time and space this little bit of existence expands into omniscient realms . . . I have nally seen that existence has direc- tion, a bias, a movement of a positive nature. Death itself is the illusion, that the impossibility of nothing- ness leaves us with innite possibility, never-ending realization. Pain and evil are simply reference points from which pleasure and beautycan [
sic
] be perpetu- ated (Legofeel, 2000, non-paginated). Movement that feels authentic, self-afrming, and optimistic also is evident in Knapps (1996) experi- ence with alcohol. She dubbed alcohol liquid self transformation which acted to diminish the fear of being without, being exposed without your armor . . . [It expressed a] yearning for
something
, something outside the self that will bring relief and solace and well being (p. 55). Knapp linked such transformation to dancing: the rhythm of the music . . . gave me a sense of connection to my own body, gave it permission to move, . . . There was a sense of surrender, a melting into the shape of his [her dancing partner] body and a sense of myself as pretty and giddy and free (p. 75). Drugs, such as alcohol, induce the feel of freedom, to move beyond the connes of the body, the self and everyday existence. Huxley (1954) wrote that such transformation, which he personally experienced with the hallucinogen peyote, revealed a human need. Most men and women lead lives at the worst so pain- ful, and at the best so monotonous, poor, and limited that the urge to escape, the longing to transcend themselves if only for a few minutes, is and has always been one of the principal appetites of the soul (p. 62). Hallucinogens like peyote by opening Huxleys doors of perception, somehow capture this same feeling of freedom, the free spirit whose movement feels like not just the real me, but the moral senti-
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ment of the best me, expressed in Jamess will to believe.
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The feelings of the will described in the drug narratives
The values revealed in these narratives of psychoac- tive drug experiences emphasize the importance of experiencing moral sentiments of the best me. These feelings arise from active participation in creating and transforming ones reality. Action and choice in the form of attention to internal processes and intricacies of the external environment demonstrate the feelings of movement or motion described in Jamess (1890/ 1981) concept of the will. Such feelings of movement expressed in these drug narratives include: sensations magnied in quality and power, and irresistible action, novel discoveries (Davy, 1839/1972), feelings of connection and slowed tempo of life (James, 1882; Cocteau, 1957), order, legislation and harmony (De Quincey, 1821/1956), feelings of mastery and superi- ority, innite power and innite deliberation (Crow- ley, 1922; Hendriks, 1992), dissolution of the will, optimism and meaning (Moore, 1982; Legofeel, 2000), optimism, authenticity, a yearning for some- thing beyond the self (Knapp, 1996). The meaning of those actions arises from how the individual inter- prets these experiences subjectively: how the individ- ual values the choices and the feelings experienced in those choices. Meaning is created rst at the sensory experiential level.
8
This meaning assumes importance because of its t within a broader belief system of that individual and his or her sense of personal standards and autonomy. Autonomy, described here as the convergence between feelings of freedom and resistance to its loss, and a set of clearly dened beliefs or principles, indi-
7
In
The will to believe
, James (1897/1979) articulated a philos- ophy which anticipated Huxleys conclusions; he acknowl- edged the power of those subjective yearnings for something more, those feelings of something missing in ordinary life, which he called the craving of the heart to in fact create the facts. He argued that faith, this sensible optimism in the future, and in the individuals ability to participate in creating that future, counterbalanced what he saw as a general pessi- mism, which resulted from an overemphasis on intellectualism in philosophy and on authoritarianism and materialism in science. The nightmare view of life has plenty of organic sources; but its great reective source has at all times been the contradiction between the phenomena of nature and the craving of the heart to believe that behind nature there is a spirit whose expression nature is. (pp. 4041) The individual addicted to drugs cannot sustain a healing pro- cess on the advances from todays neuroscience of the brain and increasing precision in measures of physiological and behaviour changes induced by drugs. As wonderful as these scientic advances are in clarifying pharmacological conse- quences, they can only provide partial answers to the addic- tion puzzle. The individual is sustained by feelings and actions that provide meaning for that individual. Opportunities to experience and progress towards satisfying these cravings of the heart, I believe, are central to nurses commitment to the client.
8
James (1912/1976) claried in his later philosophy of radical empiricism that immediate experience is pure, sensation undif- ferentiated into subject or object. It is the wills movement, by sorting sensations into object or subject, that creates meaning of experiences for the individual: Pure experience is the name which I gave to the immediate ux of life which furnishes the material to our later reection with its conceptual categories. Only new-born babes, or men in semi- coma from sleep,
drugs
[italics added], illnesses, or blows, may be assumed to have an experience pure in the literal sense of a
that
which is not yet any denite
what
, the ready to be all sorts of whats; full both of oneness and of manyness, but in respects that dont appear; changing throughout, yet so confusedly that its phases interpenetrate and no points, either of distinction or of identity, can be caught. Pure experience in this state is but another name for feeling or sensation . . . Its purity is only a relative term, meaning the proportional amount of unverbalized sensation which it still embodies. (James, 1912/1976, p. 46) Drugs which facilitate this pure experience free the potential to experience the different, the novel, the authentic or the ideal, unrealized in usual reality.
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cates a sensory awareness of connections between ones existence and the external environment, of con- nections between the present self and some energy source both within and beyond the self at a universal level. This open, indeterminate future symbolizes the possibility for positive change.
9
Autonomy equally, and almost paradoxically, demands that choice follows paths of individuation that might diverge from accepted norms and cultural language. Both the choice to use drugs and the result- ing loss of will demonstrate a motivation to be a full participant in choice and its accompanying feel of freedom, and a resistance to choices imposed by oth- ers. If the individual can be guided to identify both valued feelings of freedom and feelings of resistance, he or she can begin to focus on the meaning of those values, and their importance to the clients goals. These values, of course, represent an important part of the individuals belief system; as such, values are the personal standards by which goals and goal attain- ments are judged by their harshest critic: the individ- ual. These values, because they are personal, carry a signicant feeling component. Feelings of resistance, when examined within the therapeutic setting, signal energy available for goal-directed action.
Limitations of the phenomenal will in addiction
Several limitations emerge from this examination of the phenomenal will in addiction. The rst is one that was lodged at Jamess philosophy in general: an excessive reliance on subjectivity and introspection to the neglect of objective social dimensions (Taylor & Wozniak, 1996). Public outcries from families, social institutions, and health professionals, whose function and values are jeopardized by the destructive conse- quences of drug addiction, lend weight to this criti- cism and to their demand for immediate solutions to the addiction problem. Neurobiological studies add objective support to the destructive effect of psycho- active drugs on our most human capacity, the cogni- tive centres in the neocortex and orbitofrontal cortex which regulate the will (Gjelsvik, 1999; Lyvers, 2000; Volkrow & Fowler, 2000). Yet illness transpires within the individual, and it is within the individual that meaning from the experi- ence is gleaned, and healing initiated. James, edu- cated as a scientist and physician, whose brother died of alcoholism, was well aware of the outcomes of addiction and its social context. Yet in his philosophy, he asserted that a greater emphasis on subjective experience was needed to counter the prevailing reductionist traditions in science and philosophy. The phenomenal will, as experienced in feelings of free- dom and resistance discussed in this paper, is one piece in the larger picture of addiction necessary to help the individual explore that interior experience to nd meaning in his or her recovery; the nurse who understands the phenomenal will is better prepared to assist in the clients journey. The second limitation is linked to the rst by its focus on the human condition. Such a focus requires that the healthcare professional be able to intertwine the individuals drug experiences with a larger under- standing of the wills role in addiction and the inten- sity of those feelings of movement which express freedom and resistance to its loss. Such an examina- tion of the subjective will provides no immediate rec- ipe, no expeditious or cost-effective solution. Instead, it demands reective time in which to expand under- standing of individual experience. It demands a con- centration on individual values to struggle with the moral overtones which have historically accompanied drug addiction (Lenson, 1995; Walton, 2001; Acker, 2002). These moral overtones centre on the concept of choice that express the phenomenal will. To strug- gle with human values afrms the meaning which arises from subjective experience. Yet with increasing numbers of addicted individuals, decreased health- care manpower and resources devoted to addiction treatment, and the historical distance which health- care professionals established between their practice and addicts in the 20th century (Acker, 2002), the call for reective time in client therapy seems unrealistic.
9
Such openness to the future creates unlimited opportunities for individual human agency (Watkins, 1999), yet also entails considerable anxiety as rituals and traditions which guide an individual through lifes experiences in familiar sequence are diminished or discarded (Wilshire, 1998).
Freedom and Resistance
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The fast pace of life in general, and a healthcare sys- tem inadequate to meet growing needs demand a quick albeit transitory x to the addicts problem; such a x is inconsistent with a focus on where addic- tion ts with being human, and, similar to addiction itself, fosters a compulsive ritual of fragmented care. A third limitation arises from the drug narratives illustrating the phenomenal will in this paper. The narratives writers, whether professional or amateur, chose to capture their subjective drug experiences in often lyrical prose to communicate their impressions and the meaning gleaned from those experiences. The question might be posed as to the relevance of these experiences to ordinary addicted individuals seen in a public clinics or hustling for drugs on the street. Writers do attempt to capture something universal in the human condition to which their intended audi- ence can relate. My feeling is that the feelings of freedom and resistance expressed in these narratives will resonate with individuals addicted to drugs, and perhaps articulate for them what the intensity of their feelings or the paucity of their language or concepts precludes. An examination of the relevance of these ideas for ordinary individuals living a drug problem would be an interesting area for future research.
10
Conclusion
Feelings of the will are embodied human experiences. In the subjective narratives of addiction, drugs are the conduit by which individuals experience the wills feelings of freedom: the sensible actions of unlimited movement, of power, and of optimism, or the voluntary surrender of choice and control to immedi- ate sensations because of the often positive, self- afrming and connecting nature of those sensations by which the best self is judged. The drug experiences thus highlight both the wills power in individuation and in connection. These subjective experiences indicate the importance of both, but not the pre- eminence of one to the exclusion of other. As James noted in his nal philosophy, in some ways we are unique and separate; in some ways we are intercon- nected (James, 1912/1976). Both must be equally acknowledged and respected. Feelings of resistance arise when the wills movement towards individua- tion feels blunted or constrained by social norms or healthcare doctrines that weight compliance over individual values. The phenomenal will, evinced in the drug experi- ence: its surge of individual power or voluntary sur- render of that power provides substantive content for a therapeutic dialogue which emanates from the per- sonal values and goals of the individual client rather than those of the healthcare provider or current healthcare doctrine. The nurse because of his or her professional choices often embodies consensual norms of the healthcare system and society which vary from the addicted clients. The interior view of the clients subjective will helps the nurse to reect on how embodied feelings are valued, a reection endorsed by James (1890/ 1981, 1897/1979) and several current philosophers (Elster, 1999; Solomon, 1999). Such evaluations ener- gize movement towards personally meaningful goals. Concepts generally lack the richness of perceptual experience, possibly one of drugs allures that cannot be replicated in ordinary reality. Nurses who are aware of the values embodied in the wills sensory experiences can help the client to create the subjec- tively realized links between vision and the action, principles and movement that both honour and afrm the individual. Nurses facilitate the opportunities and permission for the individual to resume the power of his or her development, so often experienced as lost in the world of stone cited in the initial poem. Per- sonally meaningful standards support sustainable individual growth. Growth is sustainable when the individual develops what feel like safe connections between personal values and those standards estab- lished in the surrounding culture.
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Thank you to Dr Joan Liaschenko for suggesting this limitation in review of this manuscript.
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