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Developmental Trajectories in Adolescent Addiction
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In the last section, we discussed four levels of teenage addiction. These are use, misuse, abuse, and addiction. We have also discussed the characteristics, chemicals of choice, and consequences of use at each level.
In this section, we will discuss the four tasks of adolescence I have observed in my practice. These are, to determine a vocation, to establish personal values, to explore personal sexuality, and to establish personal authority.
As you know, teenage addicts tend to be more out of touch with reality than adult addicts. Because they have not yet answered the question "who am I?" adolescents are confused and uncertain. They are in the middle of the "stage of identity", transitioning from childhood to adulthood.
As you are aware, many "primitive" cultures have formal rites of passage to mark this transition. Prior to 1900, our culture had a similar process. Children worked side-by-side with parents and other adults, who modeled life and job skills for them, and the transition into adulthood did not take very long.
As you are well aware, adolescence today is more of a ‘waiting period’. Ally, 14, complained to me, "My Mom expects me to act like an adult, but she treats me like a kid!" I have found that many teenagers, confused by sexual changes and pressures to use alcohol and other drugs, get little guidance from their parents and other adults in their life.
These teenagers usually end up turning to their peers, who are just as confused, for help. In addition, I find a sense of invulnerability and immortality in many teens, that leads them to behave in reckless ways. Ally stated, "Sure I drink a lot. But I’ll never get hooked. It just won’t happen." Confusion and feelings of invulnerability both add to the disconnection with reality that fuels addiction.
Four Basic Tasks pf Adolescence
♦ Task #1
- Determine a Vocation
I find that there are four basic tasks of adolescence, and that understanding these helps me to understand the role of alcohol and other drugs in my clients’ lives. In my experience, the first task is to determine a vocation. In a broader sense, this task is expressing the need to be somebody. In this task, the teen makes choices to determine their life’s work, and what training they will need to achieve it.
As you are aware, this self-esteem need to be somebody is best met by doing things that lead to success. I find that some teens may do less schoolwork, school activities, or drop out entirely to work, in order to fulfill this need. When the need to be somebody is not met, the teen experiences feelings of being inferior, a failure, confused, frustrated, and stupid.
♦ Task #2 - Establish Personal Values
In my experience, the second task is to establish personal values. The goals of this task are to give life direction and to develop integrity. Throughout childhood, we learn values from people significant to us. Teenagers trying to establish a personal set of values must sort out what to keep from what they have learned, and what to reject. Questions involving spirituality and worship are frequently involved in this task. I find that it is very common to have conflict with parents over this task.
Chandra, 17, addicted to heroin, was raised Roman Catholic. Chandra stated, "I just don’t feel anything at church anymore. Why do I have to go through all that stuff to be a good person? Every Sunday, I say I’m not going anymore and my Dad and I have huge fights. It sucks." When this task is not accomplished successfully, I find the teen experiences feelings of being depressed, hopeless, guilty, remorseful, and lost.
♦ Task #3 - Explore Personal Sexuality
The third task is to explore personal sexuality. As you know, the goal of this task is to establish a community, a sense of belonging, and to experience intimacy. This task includes examining the teen’s heritage, as well as their sexual orientation and gender. In my experience, teenagers exploring personal sexuality are learning to develop the capacity to love and win the acceptance of their peers.
As you are aware, this can easily lead a teenager to experiment with drugs and alcohol. This task also involves the choice of when to begin dating, and when to become sexually active. As you are aware, these important decisions often lead to conflicts with parents. In my experience, when the need to belong is not met, the teen feels isolated, rejected, ugly, lonely, hurt, and unlovable.
♦ Task #4 - Establish Personal Authority
In addition to determining a vocation, establishing personal values, and exploring personal sexuality, the fourth task is to establish personal authority. As you know, the goal of this task is to develop individuality, and to move from being externally supported by parents to being internally supported. In my experience, to accomplish this task, a teen must have an internal support system, and believe that they are special.
As you know, many teens working through this task experiment with personal appearance and hobbies that their parents might find objectionable. I also find that this need to individuality leads to teens choosing more frequently not to participate in family activities. When the need for individuality is not met, I find that teens experience feelings of insecurity, embarrassment, vulnerability, awkwardness, inadequacy, and shame.
♦ "I Am Worth It" Technique
As you are aware, low self-esteem is normal in many teenagers working through these tasks. But some teens turn to alcohol and other drugs to escape from the negative feelings. I encouraged Chandra to try the "I Am Worth It" technique as an alternate method of processing her negative feelings, and to help her decide whether an action she was planning to take would be a good decision.
I explained to Chandra that the I Am Worth It technique has four steps:
(1) The first is deciding whether the matter is important. As you know, sometimes teaching oneself to be aware when something is not worth getting upset about makes a large difference in the pervasiveness of negative emotions.
(2) I told Chandra that the second part of the I Am Worth It exercise is deciding if her feelings were appropriate given the facts. This can be the most difficult step in this technique to master. I explained to Chandra that something she could do to help herself with this step were to try to consider only the exact, objective circumstances to gauge if her feelings were appropriate.
(3) The third step is to consider of the situation is modifiable. As you know, some situations are more easily acted upon than others. An upsetting television program can be turned off, but dealing with a person who is upsetting is much more difficult.
(4) The final step in the I Am Worth It exercise is to decide if it is worth it to take action. I told Chandra that the key to this step is learning to balance between her needs and the needs of others, and that we would work on communication skills to make this step easier.
In this section, we have discussed the four tasks of adolescence I have observed in my practice. These are, to determine a vocation, to establish personal values, to explore personal sexuality, and to establish personal authority.
In the next section, we will discuss the four kinds of power plays used by chemically addicted teenagers: the avoider, blamer, controller, and protector power plays. We will also discuss the 5 Steps to Anger Deflection exercise.
Peer-Reviewed Journal Article References:
Crawford, A. M., Pentz, M. A., Chou, C.-P., Li, C., & Dwyer, J. H. (2003). Parallel developmental trajectories of sensation seeking and regular substance use in adolescents. Psychology of Addictive Behaviors, 17(3), 179–192.
Ellickson, P. L., Martino, S. C., & Collins, R. L. (2004). Marijuana Use From Adolescence to Young Adulthood: Multiple Developmental Trajectories and Their Associated Outcomes. Health Psychology, 23(3), 299–307.
Jackson, K. M., Sher, K. J., & Schulenberg, J. E. (2005). Conjoint Developmental Trajectories of Young Adult Alcohol and Tobacco Use. Journal of Abnormal Psychology, 114(4), 612–626.
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