Drugs, Adolescence, and the Family

Basil Jackson

   At this particular point in human history, the nuclear family is undergoing a more devastating and severe attack than ever before. It is in great danger of disintegrating from both internal and external forces.

   Radio, television, and much of what passes for current popular music is part and parcel of family life today. From the psychological point of view, these productions of the media fulfill exactly the same functions as relatively strong tranquilizers. Tranquilizers are medical compounds which affect certain areas of the brain and blot out pain, anxiety, and the pressure of having to think. This is very similar to the effect of much that appears currently in the world of music and entertainment. The nuclear family, as a cohesive unit, does not appear instantly but requires "overcoming." The production of a stable family unit requires the expenditure of energy — requires work. Such work is most usually the result of the perceived presence of anxiety, and it is a method used to overcome that anxiety. Without such work, family and personal cohesion is gradually eroded.

   Much of what appears as advertising in the news media today

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also has a similar disintegrating effect on the nuclear family. By far, the majority of television advertising is geared to the pleasure principle rather than the reality principle. People are being conditioned and educated to expect instant solutions for all problems. The pleasure principle is a method of attaining a goal without having to deal with the intermittent steps which may be painful and even anxiety-producing.

   The plethora of drugs which has appeared in our society within the last decade is another manifestation of this same disintegrative force. Drugs are not new in our society, but drugs — both legal and illegal, street or prescribed — tend to remove the anxiety which so often is the prerequisite for the work required to produce the cohesion without which no nuclear family can exist.

   The fact that we have more and more older people in our society has become an additional problem for the struggling family. At the present time, because of the increased ability of medical care to help the aging survive, the average nuclear family must anticipate taking care of and including more and more people for an increasing period of time. This becomes all the more difficult and disintegrating in terms of the nuclear family because as the family grows so does the proportion of nonproductive people within it.

   Automation is another specter in our society which not only depersonalizes the family but depersonalizes the individual. Today, we have become, not just members of a family, but digits and numbers. Our essential personhood and existential value as individuals are becoming less and less important. As the individual becomes less important, so will the family because individuals can only exist within the matrix of interpersonal relationships such as that provided by the family.

   Another example of this external disintegrating force is the effect of spectator sports. Today, the plethora of spectator sports leaves us inarticulate and inactive and, in a sense, reduces us to automata. The day of active participation, both physical and psychological, within the realm of family contacts seems to be decreasing, and, for this, a price will be paid.

   Numerous external forces are at work in our society which are detrimental and which either overtly or covertly seek to destroy the nuclear family. For example, the very relevance of the family

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and its usefulness at our particular stage of development of civilization is often questioned. This has been a long and overtly stated goal of Marxism. Psychiatrists and psychologists, unfortunately, also carry much of the blame for this disintegrating force on the family. As a result of new-fangled theories, which often had political bases rather than foundations built on objective data. We have produced a society of ultrapermissiveness and methods of childrearing that not only are anti-scriptural but are not supported by proven facts from the behavioral sciences. Within the past decade, the "in" method of childrearing has been to let the child do his or her own thing" and to practice permissiveness so as not to "stunt" the innate creativity of the child. Children brought up according to these principles are another example of the biblical admonition regarding the danger of permitting every individual to "do that which is right in his own eyes." Such living according to the immediacy of the moment is, of course, an example of pure pleasure-principle activity. Children raised according to this principle will eventually reject both their families and their parents, according to the same principle, because no one can continue to supply the ever-growing needs and wants which must be satisfied instantly.

   The so-called sexual revolution is another example of the increasing practice of the pleasure principle which results in serious negative effects on the nuclear family. When parents live according to a different set of values than those to which they expect their children to adhere, then automatically their children grow up incorporating the negative values of the double standard. They will suffer from an identity confusion in adolescence related to these double standards foisted upon them by parental authorities.

   As the result of disintegrating forces such as those just described, David Cooper, in his vitriolic attack on the family in The Death of the Family, says that the bourgeois nuclear family unit, rather than being the matrix for interpersonal contact and communication, has become the ultimate place of nonmeeting. This is, of course, the exact opposite of the divine institution and God's plan.

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THE FAMILY AND THE FACADE

   The family and the home can often be the greatest showpiece on earth in a negative sense. In the home situation, innumerable psychological traumata are committed against the supposed-to-be loved ones. Thus, it is no surprise that, today, in some places, there are almost as many divorces as marriages. In many families who stay together (for whatever reason — economic, social, ego-saving, or theologic), dissension, jealousy, suspicion, hatred, and sexual incompatibility are often the order of the day. Only God knows how many homes are, in reality, houses and not integrated families, and how often the only reason for not seeking divorce is reluctance to obtain such a decree "for the sake of the children," economic support, or avoidance of scandal. When a home is a convenience rather than a family, all types of problems will almost certainly eventually appear, and most of these will be related to poorly developed value systems.

THE BIBLICAL BASIS FOR THE FAMILY

   The Biblical basis for the family is found in the opening chapters of Genesis as exemplified in the interpersonal relationships which existed among Adam, Eve, and their offspring. This divine institution was not formulated as a result of sin, but, as ordained by God, it preceded the entrance of sin into the world.

Then God said, "Let us make man in our image, in our likeness, and let them rule over the fish of the sea and the birds of the air, over the livestock, over all the earth, and over all the creatures that move along the ground. So God created man in his own image, in the image of God he created him; male and female he created them. God blessed them and said to them, Be fruitful and increase in number; fill the earth and subdue it." (Gen. 1:26-28). And the Lord God said, "It is not good that the man should be alone; I will make him an help meet for him" . . . And Adam said, "This is now bone of my bones, and flesh of my flesh" (Gen. 2:18, 23).

   No man can live or develop spiritually or psychologically in an interpersonal vacuum. Man has been made a relational creature,

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and the family has been designed as the matrix within which these relationships — whether horizontal or vertical — may develop and mature.

   In Pauline theology, we are again impressed with God's perception of the nuclear family and of its importance because it is used as a model to describe the relationship between Christ and his church. "Wives, submit yourselves unto your own husbands, . . . let the wives be to their own husbands in everything. Husbands, love your wives, even as Christ also loved the church, and gave himself for it; . . . So ought men to love their wives as their own bodies. He that loveth his wife loveth himself" (Eph. 5:22-28).

   Here, the relational aspect of marriage and the family is clearly demonstrated, and Paul is careful to remind us of the continued need for this type of exhortation as the last days approach. "That they may teach the young women to be sober, to love their husbands, to love their children, to be discreet, chaste, keepers at home, good, obedient to their own husbands" (Titus 2:4-5).

   Pauline eschatology is very much concerned with the disintegration of the family unit to the point that it would appear reasonable to view such disintegration as one of the predicted signs of the approaching second advent of Christ. "In the last days perilous times shall come. For men shall be lovers of their own selves, . . . disobedient to parents, . . . Without natural affection" (2 Tim. 3:1-3). It would be difficult to improve on this description of the breakdown in the relational functions of the nuclear family as we see them today.

PSYCHOLOGICAL FUNCTIONS OF THE FAMILY

   Intimately associated with the relational functions of the nuclear family is the fact that the family serves as the seedbed for conscience and the values which continue to influence thinking, behavior, goals, and morality for as long as a particular individual lives. In spite of its obvious importance, there has been a significant reluctance by behavioral scientists to examine the formation of value systems. The philosopher likes to think of a man's sense of values as being a question of emotion versus reason. The psychologist directs his or her attention to the relationship

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between the developing value system and the particular instinct characteristics of the human species. The historian elaborates the theme of the growth of conscience in Western civilization while the anthropologist, as the expert in family structure and functioning, traces its emergence from the group morality of the primitive tribe.

   On the whole, modern psychology, especially the academic in contrast to the clinical variety, appears quite reluctant to use the term value system or to discuss the concept. An examination of the leading works on psychology of the past century reveals that many more psychologists have failed to use the word conscience than have used it.

   The more modern psychological thinkers, particularly those of the psychoanalytic school, consider personality to have structural divisions or segments which perform separate and specific functions. These parts are not to be considered as concrete realities or self-acting entities but as groups of forces and functions which are dynamically interrelated. The particular area of personality — namely, the conscience — examined in this study is that proposed by Freud who postulated three separate segments within the human personality. However, many of the terms — namely, id, ego, and superego — used to describe these dynamic interrelationships refer to highly metaphorical concepts and only the latter — namely, the superego — will occupy our attention for the present purpose.

   The superego is the inhibiting, conscience-including, and repository-of-values component of the personality. It functions to sustain the internalized moral and social values learned from the parents' behavior. It is a conceptualized adviser, admonisher, and threatener, with both conscious and unconscious aspects.

   The basic process of organization of this particular function of the personality is advanced by the age of five, but it continues to develop through adolescence and probably through the early adult years. During the period of development, figures of authority capable of punishing or rewarding become incorporated into the personality to form a distinguishable repository of family values.

   The superego is derived within the family matrix, primarily

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from identification with parents and their substitutes, and herein lies one of the most important psychological functions of the family. Prohibitions and obligations are internalized and incorporated into the unconscious psychological structure of the child. Later, the injunctions and prohibitions of other authorities and of cultural influences are also absorbed into the superego. Still later, the aesthetic and moral demands of one's social group become incorporated, and if stable values have not been internalized earlier from within one's family, trouble becomes inevitable. The superego, as the repository of the value system, may threaten and punish and thereby seek to maintain its authority. It does this by creating anxiety and by producing guilt and remorse. If the superego and the internalized value system which it contains are severe and inflexible, the resulting fear will lead to a rigid, inhibited, anxious, and often neurotic personality.

VALUES AND THE ADOLESCENT IN THE FAMILY

   All psychologists agree that adolescence is one of the most difficult periods in life in terms of coping with changes, developing personal identities, and steeping out from the family fold to put to the test the values which have been learned, and hopefully internalized, within the family. All adolescents have two major tasks to accomplish as a prerequisite to further development, and how these tasks are accomplished will, in a large measure, be related to the value systems they have acquired within the nuclear family unit.

   The first major task of adolescence is to separate from the family and parents, a prerequisite to being one's own person and to developing a personal identity. Retention of the old family and personal ties becomes more and more uncomfortable as adolescence progresses, and a process of separation must be initiated. Normally, this process takes place gradually, but if the parent, for example, overreacts and does not permit the separation, a relatively abrupt and violent reaction may occur which has the secondary effect of leaving the youngster with an intense, passionate desire for substitute relationships. This explains the "deep and eternal love of today in which tomorrow is forgotten" syndrome. If the separation has not been easy, the new

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relationships will tend to be characterized by everything which would tend to be distasteful to the original parents and their values. Love may suddenly appear to be transmuted into hate, dependence into open rebellion, respect into contempt and derision. Drugs and other currently available antiestablishment practices suddenly become doubly attractive.

   Another characteristic method of hastening the separation process is to become increasingly preoccupied with self. The adolescent suddenly develops inflated ideas of his or her own strength and beauty. At this stage the comb and the mirror are never far away. Unfortunately, with the inflated sense of one's personal strength and ability, aggravated by peer pressures, there often comes the idea of "I can handle drugs; I will be the exception." If value systems developed within the family have not demonstrated that some things are more important than peer-group acceptance and popularity, then resort to drugs may be accepted as the price of initiation. Preoccupation with the body is also often manifested by phobias over acne, blemishes, body odors, and various other body sensations which can be tranquilized by a wide variety of street drugs.

   Another method of dealing with the pain and reluctance of separating from the parental figure is to regress psychologically to an earlier stage of development. In effect, the adolescent becomes preadolescent in his psychological functioning. He tends to become more dependent on his parents, and in many cases, unconsciously, parents encourage this type of regression. There will be a tendency to use an excessive amount of identification as a means of molding their personality to that of the parents as a means of staying with parents rather than separating from them. Adolescents using these particular techniques constantly seem to be asking who they are, where they are, and what they are going to do because, in effect, they are making no progress in stabilizing a separate identity of their own. Their goals tend to be fluid, and they shift from one pseudoidentity to another. When more severe regression occurs, overt psychiatric problems almost always appear. There is disturbance in reality testing, and the individual may end up in a state of confusion to such a degree that he is unable to distinguish between himself and the external

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world. Again, in my practice, one of the tragedies of this particular problem is that so often, to ease his internal pain and confusion, the adolescent reaches for a variety of street drugs as a method of self-therapy, and these only aggravate the situation.

   The second problem the adolescent has to face in his development is coming to grips with his own physical and psychological maturation. In particular, he has to deal with an increasing sense of himself as a sexual object and as having sexual abilities. A common method of dealing with this is to apply excessive repression so that sexual ideas, thoughts, and fantasies are rarely, if ever, permitted on the conscious level. The result is an inhibited, shy, introverted adolescent who, as a means of protecting himself from his own sexuality, will tend to become overly dependent upon his parents, like a child. Again, drugs offer a special attraction to this kind of individual. The psychological effect of most drugs is to act as a social lubricant, and, in effect, they ease the discomfort and pain that many adolescents experience in the peer group situation.

   Occasionally, this repression becomes so great that the adolescent develops, not just a dislike for the basic sexual impulses which he is beginning to experience, but a definite antagonism toward them. At this point, he tends to practice the religious asceticism that, at times, resembles elements of Gnosticism. Very often there will be a mistrust of any kind of enjoyment in general, and anything that might even remotely savor of satisfaction of a sexual nature must be completely and absolutely renounced. This manifests a blind fear of all instinctual activities, but the extreme ascetic behavior often manifests sudden swings so that one one day the adolescent practices extreme asceticism while the next day he attempts a process of psychological restitution and becomes completely hedonistic. At this stage, he often will be preoccupied with mystical religions, Eastern religions. This kind of preoccupation on an abstract level increases his inability to look at what is going on within him. However, when the sudden vacillation occurs the next day, he may be just as attracted to the pleasures of dope as a means of regaining some of these psychological effects.

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SUBSTITUTES, VALUES, AND THE ADOLESCENT

   People resort to drugs for a number of reasons, and it is not surprising that the greatest attraction of these agents is to young people in the midst of adolescence with all its turmoil. It would be wrong to say that there is one single answer to the question of why adolescents are attracted to drugs, but some reasons stand out more than others. Basically, the abuse of any kind of drug, whether it is legal or illegal, is an admission of failure to cope with one's internal anxiety and with the world as it is. Some of the commonest reasons for drug abuse that I have seen in my clinical practice with adolescents are as follows.

   Experimentation. Many young people experiment with drugs as a response to peer pressure. Fortunately, many of them never repeat the process. Those who become chronic users of a drug tend to have more than the usual degree of adolescent problems, and they seem to be desperately trying to establish some form of psychological homeostasis.

   Identification. The process of identification may be one of two sorts. It may be an identification with peers and with the peer group as a means of separating from the parents, or it may be a negative identification in which the adolescent becomes as unlike the parents and their values as possible. If the family beliefs and the family value systems have been very much against drugs, the adolescent may choose drugs as a means of demonstrating individuality, difference, and his or her own identification. Similarly, it may not be so much an antiparental maneuver as part of an initiation fee one pays to be fully accepted in the peer group.

   Alleviation from anxiety of any cause. Adolescence is one of the most anxiety-ridden periods in life, and a very common reason for taking drugs at this stage is to treat the anxiety by self-medication. Since anxiety is the outstanding characteristic of this age, it should not surprise us that adolescents are especially afflicted with this malady. Nor should it surprise us that the adolescent should use a variety of pills or alcohol to treat this anxiety when, in effect, although perhaps legally, his or her parents may be doing exactly the same thing.

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   Mystical preoccupation. It would be very wrong to imagine that the present generation of young people has turned away completely from inner spiritual experience. I believe that, indeed, just the opposite is the case and that adolescents today appear to be searching for authentic religious experience more than at any other time in history. In adolescence the religious and spiritual needs of a person are perhaps more acutely felt because one has not yet gained the calloused quality that so often goes with maturity in the world today. A common story in the American family today is that as our standards of living have gone up our standards of loving have gone down, and no adequate value system will be formulated outside of a milieu of love in the family. When parents try to supply the needs of the growing adolescent with dollars rather than love and compassion, that value will very rapidly be found to be self-destructive.

   Spiritual vacuum. By far the most important cause of drug abuse seen in my clinical practice is the existence of a spiritual, religious, and existential vacuum. It seems that young people today, lacking foundational value systems from stable family units, are constantly looking for meaningful models of identification in other places in society. When they fail to find them, they are left to struggle on their own with an increasing sense of frustration, lack of purpose, and meaninglessness. As materialism has become a god, there has been a simultaneous humanization of God. Experience has shown that when such an "adamification" of God occurs there always is a corresponding deification of man. Such a human production of God, however, will always fail to fill a sense of emptiness and to infuse any sense of value, hope, or meaning in the existence of the young person. Thus, again, adolescents become likely prospects for the psychochemical experience, fascination with the occult, and have all the prerequisites for the development of antiestablishment delinquent activities.

RECONSTRUCTION OF THE VALUE SYSTEM

   Value systems in our society today are at a low ebb, and this is a direct reflection of the disintegration which has occurred within the family unit. A vacuum exists, not only in the family,

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but in the adolescent and, indeed, in man everywhere. If this vacuum is not filled by one means, then it will be filled by another. Herein lies the tragedy of the church of the twentieth century. The church possesses a message in the person of Jesus Christ which can give meaning, purpose, hope, and reason for existence and, in the process of making new creatures, will incorporate within man the person of Jesus Christ and all the values he represents.

   This is the message of regeneration which we have at our fingertips, and this is the message that we can communicate, not only to individuals, but to families. We can be assured that if we give our all to carrying out this commission not only adolescents but the family, as a unit, will gain new vitality and increased impetus in providing those models of identification and values which are the prerequisite to both individual and national survival.

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Basil Jackson, M.D., is presently chairman of the Department of Psychiatry, Lutheran Hospital of Milwaukee, Milwaukee, Wisconsin, and associate professor to the Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin. In addition he has served as visiting professor at Trinity Evangelical Divinity School in Deerfield, Illinois.

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