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Therap-e

By Kevin Durrheim and Kevin Burton

 

Western society has a dual consciousness around drugs. We produce and consume unprecedented quantities and types of drugs; at the same time we outlaw them, view their users as mentally ill, and jail drug offenders. All the while, capitalists and criminals make huge profits. This dual consciousness, consumption and repression, rests on a grand division between drugs which are licit and illicit, cures or poisons.

Like all forms of categorisation, the licit/illicit division produces an accentuation effect which minimises the differences between members within categories, and maximises the differences between categories. This thinking is especially marked for illicit drugs, which are often viewed as uniformly bad, whereas in fact each has a specific physical and psychological effect, and they differ too in their uses and dangers. Of course, the problematic language we use to talk about drugs is more than a problem of cognition; it is also about power over representation and jurisdiction.

Although chemical intervention in the human body is an everyday phenomenon - the body has a chemical make-up, which is affected by everything we eat, drink, breathe, etc (see e.g. www.foodnews.org/ on the effects of chemicals we consume daily in food) - advances in chemical technology have made available new classes of substances which give people the ability to programme their own nervous systems. Ecstasy is one such "designer drug" which has a profound psychological impact, and which is now being consumed regularly on a mass (and increasingly global) scale by people who are generally considered to be normal folk.

Like all technological advances, advances in chemistry raise practical and ethical dilemmas. We now have the ability to create designer drugs, which have the power to alter our psychology in highly specific and controllable ways, but is this a good thing for us as individuals and societies? Should we be using ecstasy? Do the benefits outweigh the costs? Although there are some clear cut cases - e.g., the sense of well-being, clarity and insight ecstasy gives to cancer patients on powerful chemo and radiation therapy - the problem is that we know very little about the drug. On the basis of clinical trials we know, for example, that ecstasy does affect the brain structurally. However, we don't know how permanent these changes are, what exactly causes the changes, or what psychological effects (good or bad) may be associated with these changes. We know that people have been taking ecstasy regularly for over 15 years, and that these people (unlike long terms users of alcohol - which also causes structural changes to the brain) do not appear to be presenting psychological and social problems (such as violence, unemployment, chronic illness). However, we don't know the long- or short- term costs or benefits of using ecstasy. An honest review of the literature is bound to confuse as much as enlighten.

Although the small body of research on ecstasy has grown exponentially over the past few years, the bulk is of questionable methodology, conducted in some cases by individuals whom it seems are trying to make careers out of sensation; or dopeheads, justifying their preferences. Why so little information about such a widely used and powerful drug? We suggest that our dual consciousness around drugs facilitates and underpins a repression of knowledge, which limits and structures our understanding of ecstasy.

This repression is manifest in two ways. First, the classification of ecstasy as a Schedule 1 drug has meant that it has been difficult to get approval for research, and (the) leading research programmes in the USA and Europe have been prematurely terminated due to the withdrawal of government approval. In effect, in the face of widespread illegal/recreational use of MDMA (the pharmacological acronym for e), governments are stopping scientific investigation.

Second, repression is evident within the scientific field itself. Most of the research that is being conducted is informed by the neuro-medical view of human nature, in what we could term a harmfulness paradigm. The focus of the research - it's all about possible damage and deficits - is peculiarly lopsided given the anecdotal/recreational and therapeutic accounts of its benefits. This dual repression of knowledge means there is a lack of research into both the harmful but especially the beneficial psychological effects of ecstasy and other psychedelic substances.

This dearth of reliable information poses not only a research agenda, but also an ethical dilemma for therapists, most of whom are committed to fostering human well being. Should therapists be using, for therapeutic purposes, some of the most powerful, controllable and specific psychoactive substances we have available? This is an ethical dilemma for therapists who understand that the dominant perspective on drugs is a construction, full of contradictions, which is linked to power and control in our society. Such therapists must reflect politically and ironically on their role which is limited to either prescribing drugs to contain pathology, or healing the pathology of drugs. Our dilemma is to decide just how far we will go in understanding and harnessing the power of psychoactive drugs to bring about positive change in individuals and our societies.

Further reading

Eisner, B. (1994). Ecstacy: The MDMA Story (2nd edition), Berkley, CA: Ronin.

Greer, G., & Tolbert, R. (1986). Subjective reports of the effects of MDMA in a clinical setting. Journal of Psychoactive Drugs, 18 (4).

www.maps.org/news-letters/v05n3/05303psy.html.

The authors

Kevin Durrheim is an associate professor at the School of Psychology, University of Natal, Pietermartizburg, South Africa. He can be contacted at kevindurrheim@hotmail.com.

Kevin Burton is a lecturer in the Department of Geography, University of Natal, Pietermaritzburg, South Africa. He can be reached at burtonk@geog.nu.ac.za.

 

 

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