Healthy Obsessions

How can people in “the system” get a life?

As readers know, I take two days out of every week to volunteer in what’s called a “case management” position with a community service organization. That means I have regular clients with-whom I do regular check-ins, helping them with goal setting and otherwise helping them manage issues related to substance use and behavioral addiction.

Superficially, the structure of the work would appear to be a lot like that of a therapist. I sit in my own office. I have clients who make appointments, come in, sit in the waiting room, and then come into my office. I close the door, we talk for 45 minutes, they leave and make a new appointment at the front desk and I take notes for fifteen minutes for their file. Every single interaction about them goes into that file. I’m criminally liable for breaches of confidentiality on that file.

In their file are many of the notes about that client which have been written by other professionals. When deemed pertinent, we occasionally ask clients to provide written permission to other professionals to share confidential information about them with us. Once we have this permission, I can talk with their psychiatrist about their mental health and ask their doctor for their medical records. I can read their charge sheet, or speak with their lawyer about their case. I can talk to, or may in some circumstances even be obliged to speak with their parole officer or their social worker, etc. In short, I find myself a member of the private “inner circle” of professionals in the lives of people who are in “the system”.

My small domain in this larger system is, to remind you, the matter of helping these clients manage addiction.

On paper, my domain of work is helping clients with acknowledgment and acceptance of having a problem, conscious understanding of what triggers craving, strategies for managing cravings, reduction of harm or elimination of use, and prevention of relapse.

On paper. Now that I’m in the thick of it, I have to say that nobody can really talk about addiction as though it were some part of one’s life which can be dissociated from all the rest. People who speak and act as though they can abstract their use of a substance (or their unwanted compulsive behavior) as something separable from rest of their total-life situation are self-deluded.

Getting thrown into such a personal and intimate field has been a rough and exhilarating transition. It feels like I’ve been thrown into the deep end of the pool. But I’m beginning to get my bearings, and need to talk something through with you that I think I”ve discovered. Throughout the diversity of situations, one steady referent I’ve discovered has been the presence or absence of an ability to find and develop new healthy obsessions.

I’m too new at this to be able to speak too authoritatively. But my working model so far is that the overwhelming preponderance of “addiction” out there is largely because of everything else in one’s life being out of control. Clients are helpless to get the rest of their life in control—owing many different reasons from inability to fear to double-binds to total alienation—and so their addiction is really just the only routine that remains stable and comfortable.

There is a something I’ve recur across multiple clients—and even friends outside of work. People seems to experience it this way: We live in time, and we live awake, and we can’t sleep forever. Getting through the long duration of time that comprise our waking hours is a tough slog. Drugs and mindless surfing and other altered or sensuous states take the edge off—and they kill time before falling asleep again.

I believe that slapping a conceptual or ideological label onto this conundrum—and quite a few labels easily come to mind—is counterproductive. We may be able to label the situation, but escaping the situation requires a subtlety of perception that conceptualization deadens.

If our old self is the content of our new self, then labels are for expediently talking about the past, not for taking hold of the problems of our present. I’m not a therapist. Or a psychiatrist. Or a psychologist. I find that fortunate. I am not in a place where clients can demand I reach some diagnosis. I’m not allowed to label people in the way they want to be labelled, even if I wanted to! And I don’t. People who casually apply clinical labels seem mired in the generalities from which those labels derived. They’re playing statistical games instead of perceiving.

Now I run up to the larger issues. My clients are subject to the selection criteria of being the sort of people who walk into offices like mine and ask for help from professionals. People who have a file folder following them around; who have intimate details of their affairs being typed up, signed, scanned, and emailed between various strangers whose job it is to help them.

They are in the system. A system I, personally, never experienced deeply before finding myself to be part of it. But now I get to play social studies student! How are the lives and problems of our clients affected by the system? How can the system be examined, interrogated, deconstructed? How can the system help these people?

Incremental improvements aside, I don’t think the system can help people. Because, as I just said, what people need is a new, healthy obsession. I’ve had enough obsessions in my life to know how they’ve helped me pull out of very bad places. My vibe coding has been occupying most free waking hours every day for the past month and a half. It’s worse than it was last summer, when I was using my own tools. I can’t wait to get home and get back to it. When I was going psychotic, my video series Silicon & Charybdis was all I worked on all day, for months. The endless, methodical hours of finding footage—watching old ‘80s TV programs and Charlie Rose interviews and celluloid marketing films from defunct computer companies—was what kept me distracted from the raging war in my brain.

In a general sense, we don’t want the system to be shaping people into obsessives over something. That’s not scalable. It’s inherently political or corruptible.

So the question remains: how do we help people who experience the waking day as something to escape find the thing that will pull them into new activity? Pull them out of bed? Pull them into new relations to the world? And when I say we, I don’t mean we professionals. I mean, more broadly, we people who exist knowing other people who are like this? How do you help someone find the practical, achievable, healthy vision of some future thing or place, particular and resonant to them, so that they have a direction to direct their fight? The fight against what they want to get out of? The fight they ask the system to help them fight?

I’ll share some answers as they occur to me, but I welcome any suggestions!