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Encounter with the human face of drug addiction

10 octobre 2005, 20:00

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I want to tell you about a few hours in Joe’s day as it was lived, and as I experienced it at Jardin de la Compagnie. Joe is a drug addict. For the past three weeks, I’ve been coming to the Jardin to research into the lived experiences of the sex workers – and they are young girls, some of them mothers, and they work sex to feed their drug addiction. I met Joe through his girlfriend Julie, a sex worker and drug addict. Joe and Julie are in love. When I see them fer gate I’m always moved – as they are like any other young couple in love.

I sit in the Jardin under the banyans and watch as the working girls float about. They don’t seem to have legs to stand on. They are like the shades of the underworld: souls locked into their distress and not inhabiting the houses of their lived bodies. According to the literature, traumatic experiences often occurring with male relatives usually lead women into in criminal activities – including sex work to feed their addictions. Some if not all women have usually experienced sexual abuse in childhood, or violence in their adult relationships. They are in post-traumatic shock and can’t stand to be with their experiences and difficult feelings. Drugs help them to forget their emotional pain. Drugs keep them outside the lived body where they don’t feel or want to be at home. Recovery is also more than just about recovery from drugs – it is recovery from years of physical and emotional abuse and neglect.

I wonder how I’m going to research the lives of people who have such damaged selves and who are only focused on getting what they need for their next fix. If I manage to get funding for my research I will compensate the girls for their time with me because it is time that eats into their working day of having to ‘trace’. Joe and Julie have had experiences with detoxification. Julie has been in and out of a treatment center four times. They desperately want to ‘recover’ and get back to ‘normal’ life they tell me. Is it that the treatment process fails them – or that they fail the treatment available? I will listen to their narratives and try to gain an understanding of the working girls’ lived experiences, as I feel a sensitive understanding of what leads to the addiction should be viewed as a vital component of policy and design of recovery programs.

On this particular day I arrive at the Jardin and none of the workers are around. I see a couple who usually lives under a tree and the man greets me with a broad smile. It’s an invitation for me to approach the couple. The woman is sleeping on the ground curled upon a thin sheet, and with another covering her. I notice flies swarming upon her exposed feet – as though she’s dead carcass and my impulse, which I resist, is to swoosh them away and to cover her feet. Her misye tells me that she’s not in forme. She’s been ill for several days. I think of the constant rain of the past few days and wonder how they have managed to keep dry…

‘Friends not around today… they should be coming soon’, he suggests.

As we’re talking I notice Joe coming towards me. As soon as he greets me he starts to describe that he’s had a blow up with Julie and he’s behaved towards a woman in a way he’d promised he’d never behave.

“You hit her,” I say. “Is she okay?”

‘I don’t know. I left her to go to work … She doesn’t listen…’

“To what doesn’t she listen?”

“Stuff – we’re trying to make a life together and I tell her things for her own good and she doesn’t listen.”

“As a woman – I don’t think it’s okay to respond by hitting her.”

Joe too thinks it’s not okay and he’s feeling ashamed.

“Focus on what you need to do to get the poison out of your body and allow Julie to do the same. You both need space to do that – maybe then you can be a couple.”

Joe nods but his heart is not in the agreement.

We sit on a bench and he describes to me what happened when he was fifteen. According to Julie, what happened to Joe when he was fifteen was pivotal to his downward spiral into drugs. This was my third encounter with Joe in the Jardin; and it was Julie who had urged him to speak with me to begin with.

<B>When Joe confides this to me, I realise we have a heart connection and he trusts me as a therapist. This is what I’m here for - practising a listening love - trying to attune to the feeling states of the person in addiction and matching my responses accordingly. It can be a hit or miss situation; and I take mental notes of what resonates and what doesn’t.</B>

“I’ve told one other person this – Julie. You’re the second person.”

When Joe confides this to me, I realize we have a heart connection and he trusts me as a therapist. This is what I’m here for – practicing a listening love – trying to attune to the feeling states of the person in addiction and matching my responses accordingly. It can be a hit or miss situation; and I take mental notes of what resonates and what doesn’t. I feel that during my first encounter with Joe I struck a deep chord inside when I realized his ambivalence towards life. He took drugs in order not to feel emotional pain, but then he cut himself physically [there were numerous healed scars upon his wrists] in order to feel he was still human. There was his despair that with drugs he’d been dehumanized and there was no turning back.

Joe likes to describe himself as a lizard.

“But Joe you cut yourself in order to feel human.”

Sometimes I’ve had the felt sense that he holds a lot of anger inside. I notice that his brows draw together and he closes his eyes, as though there’s pressure behind. At first I was wary that he might hit me if there were mismatches in my responses.

“You’re holding a lot of anger.” I suggest.

“Not anger. It’s my nerves – they’re sick.”

When Joe was fifteen his mother lay dying in his arms as she’d taken an overdose of pills. He’d been powerless to help.

“I was sleeping, and by the time my sister woke me, it was too late to do anything.”

All he could do was hold her as she lay dying in his arms.

“You’re not responsible for her death Joe. You were only a kid.”

“She had left instructions to be cremated according to religious system and as the eldest son I had to light the flames all around her and watch as they burned.”

“It was like watching her die a second time.”

“I couldn’t watch…I had to turn and leave.”

Although he’s twenty-three, to me Joe’s just a boy – stunted in his emotional and psychological growth at fifteen. When he watched his mother die in his arms, something died inside of Joe.

“Your heart was broken in two,” I suggest.

“A thousand pieces!” he corrects me.

“Your heart was broken into a thousand pieces – that’s mighty broken Joe.’

“And it can never be mended.”

“What are your hopes? Do you have any?”

“Once it was to have a family and home.”

“You can still have those things Joe.”

“Can I? Can I get back to normal life?”

He describes his own botched attempts at suicide, with the second attempt being a drug overdose.

“I thought I was waking up in hell and it was the hospital.” He laughs.

“You need to think of what can keep you in life.”

“Julie – she keeps me in life. If I ever lost her there’d be no reason to live… I’ve lost everyone I’ve ever loved. If I lost Julie I’d make sure I end it this time.”

At a crucial point in the conversation we’re interrupted by a sex worker who comes up to us and asks Joe for a cigarette. She has a go at me for being there. But it’s like this – there’s not the intimate space of working from an office. [Joe has asked me several times when I will open an office.]

“What is it with you coming the same day each week – to chat. You think we’ve got time to chat. We’re busy working.” Then she starts to whine that she’s hungry and asks whether I can give her some money to buy food.

“I’ve said I won’t give money but love.”

She scoffs at my suggestion of ‘love’ and walks away. It may be cliched but the offer of a listening love is genuine on my part and it will resonate with some and not others. All I can do is wait – for connections to occur with the girls and try not to feel rejected when they don’t occur and they float pass me like shades…

After an hour and half of conversation with Joe I tell him I’m leaving for an appointment with an acquaintance but that I’ll be back in the afternoon. Mwa osi pe trace! I’m working voluntarily for a couple of NGOs that tell me they have no money to pay me and I need to get some paid work. Joe intended to wait around for Julie to show but he wanted to walk me part of the way towards Victoria Station. As we walk through the Jardin he meets a mate of his and starts talking. I interrupt to say I’m heading off and will see him later. Before I’ve gone a few hundred paces Joe bails me up and pleads with me to promise him something.

“What can I promise Joe?”

I notice tears in his eyes and feel my own eyes begin to moisten.

“That you’ll promise to take care of Julie if anything happens to me. You’ll take her to a center and put her on the road towards recovery.”

“What are you planning to do Joe?”

“Promise me.”

“Yes I promise I’ll do what I can – but I don’t like the way you’re talking.”

“This might be my last day.”

“What do you mean your last day.”

I take his hands in mine and look deeply into his eyes. I forget that we’re in the middle of the street and it seems the world stops. We’re out of time with what is happening around – wrapped in a relational cocoon of urgency and intimacy. I’m surprised that this intimacy can happen in a public place.

“Just promise me…when I found out you’d been to court for Julie’s hearing I was touched. I told Julie you had feeling.”

“I can’t leave you when you’re feeling like this Joe.’’

“Leave me to die – things are finished for me – but promise you’ll help Julie. She can come through and find another man to love…”

“You know I give my word and try my best to keep it… You’ve just described your own mother’s suicide and how you felt watching her die and now you dump this on me and expect me leave you to die.”

“I’m not dumping it on you. I just wanted you to take care of Julie if anything happens to me.”

He plans to have something happen to him.

For the next hour I try and persuade him to come with me to a center for detoxification. On the corner of Lebrun Street, in my broken Kreol, absurdly – I tell him the love story of Aeneas and Dido and what happens to the soul that suicides because it can’t live with heart pain. As it happens when Aeneas goes into the underworld to meet with his dead father, he sees Dido’s shade still gripped by intense anguish. In her suffering Dido doesn’t recognize her lover and runs away from him.

“Death doesn’t bring the ease you think it will Joe.”

“It doesn’t? It’ll be suffering in another world and not this one. Look it’s no good – just leave me to die”.

“Like a rat in a sewer? Just come with me Joe – you make me plead... Everyone is watching.”

“Know why they’re watching? Because a zoli madam like you is talking to someone like me.”

“The lizard, the low life, you mean.” Inside I don’t feel zoli. I too have experienced feeling like one of those creatures scuttling across the floor of silent seas – in places where no one can reach me, in despair because no one can reach me.

Joe was crying out for help and he was reaching out to me.

‘Yes the lizard.’ He smiles through his pain. And he has a tendency of brushing things aside with a wry humor.

‘For me you count Joe. For me you’re a person.’

‘Am I?’

Still holding onto his hands because I’m afraid to let go – I describe that I try to live with the Christ force in me.

“Where was Christ working Joe? What people was he among? – The poor, the beggars, the homeless, the sick” –

“The prostitutes”.

“To him they counted.”

“That’s true… You’re going to leave me there. I don’t want you to leave me there. I don’t have any money for bus fare and I won’t be able to come back.”

“I won’t leave you. We’ll just check it out – see what’s involved with getting detoxified. Then the work with me can begin once you’ve gone through that.”

Together we’ll start to reconstruct Joe’s damaged sense of self.

But I do have half a mind to leave him somewhere I’ll know he’ll be safe. Joe describes what he’s experiencing as he goes deeper into withdrawal. He needs a ‘fill up’ and intends to use a prescription drug to ‘hold’ him until he can get his fix of heroin. The mate he met in the Jardin now sits in a pharmacy on the corner of Lebrun and Chausee Streets, while he waits to have a prescription filled. Joe has already given him some money for a couple of pills.

‘Ask for your money back.’

I accompany Joe inside the pharmacy so he can ask for his money back but it’s too late to retrieve the money. His mate thinks it’s a good idea that Joe is trying to kick the addiction and tells me that he’d like to talk to me sometime. He was a long time user and had been in and out of treatment. For over twenty years he’d been an addict.

‘When you’re serious about talking – I’ll be in the jardin this same day of the week.’

I follow Joe back into the jardin where he gives instructions to another mate that so and so will give him a couple of pills and to hold onto them for him.

‘You trust him to hold onto them?’

‘Where there’s drugs, there’s no trust,’ he tells me.

I hold Joe’s hand while we walk to Victoria Station.

‘I’m feeling weak.’

‘You can use my strength Joe.’

‘I’m going to be indebted to you for life.’

‘You don’t need to feel you owe me anything.’

When I have Joe sitting on a bus en route to a treatment center, he experiences one of his nervy fits. He draws his brows together, clenches his fists and jaw, and his cheeks puff out.

‘What’s happening Joe?’

He points to his head. ‘It’s like a cord twisting inside.’

I sit with my hand over his hand, which is locked into a fist. After a while his hand seems to relax.

‘I’ve blocked you from getting on with your day. Mauritians have been giving you a hard time since you came.’

‘Seems my fate to always have Mauritians giving me a hard time.’

I’m not sure what I’m doing. All I know is that in the here and now moment I need to get Joe to a treatment center and perhaps they can take him in – or give him some medication to ease the physical pain he’s experiencing.

When we get to the center I sit beside Joe while we speak to a counsellor (at least I assume he’s a counsellor). He sits with his clipboard and form in front of him. Joe has picked at a pimple near his mouth and it’s bleeding. I rummage into my bag and find him a tissue. I notice the counsellor looking at my gesture and he twists his mouth lightly and quickly on one side – but it’s not really a smile. I find it hard to read his emotions – and perhaps he’s trying not to have any – whereas I use heart-centered connections.

Joe dabs at this small sore on his face while we talk. The sore on the inside is also bleeding – it’s been festering for seven years.

At first the counsellor asks Joe to describe what is going on inside. Is he looking for connection – ways of accessing Joe’s experience and being with and for Joe? Sometimes I don’t understand the drug jargon in Kreol but I have confidence in the counsellor.

Then the counsellor tells us there’s no medication, and the doctor won’t be on site until the next day. In any case there’s a waiting list of fifteen to get into the program at this center. He can’t make an exception. He gives several referrals among them the mental hospital when I inform him that Joe is thinking of harming himself – and that he’s tried twice before.

“What does that tell you?” he asks Joe.

Joe’s not sure what it tells him. He keeps dabbing at his sore.

‘That death doesn’t want you!’

Joe describes he started treatment at one center but it was interrupted when he had to go to prison.

‘Why didn’t you take him there?’ the counsellor asks me.

I look at him and I feel my displeasure shows. I was under the impression that I was working with his director – and so my response was to bring him into the care of a center I was involved with – albeit marginally. The counsellor had recognized me when I had first entered. If Joe entered treatment here I could visit him from time to time and we could engage in some therapeutic process.

<B>At what point does my attitude and trust in the

counsellor turn? I’m not sure. When I realise I’ll have to drag Joe through another bus ride because he’s been referred elsewhere? He’s getting deeper into withdrawal and feeling sicker. The counsellor’s questions are interrupted when Joe goes into one of his nervy fits. I can hear his teeth grinding and his jaws are locked together.</B>

At what point does my attitude and trust in the counsellor turn? I’m not sure. When I realize I’ll have to drag Joe through another bus ride because he’s been referred elsewhere? He’s getting deeper into withdrawal and feeling sicker.

The counsellor’s questions are interrupted when Joe goes into one of his nervy fits.

I can hear his teeth grinding and his jaws are locked together. Both the counsellor and I try to massage Joe into relaxing into his body. I massage his hands and shoulders.

‘Breathe Joe.’ I suggest. “You need to breathe in order to live.”

“Take him to the mental hospital – at least there he’ll get medication for his nerves. He won’t have to say he’s an addict.’

“Won’t they be onto that immediately?” I ask the counsellor.

He shakes his head to indicate they won’t.

‘It will only be Valium and that will make me sleep,’ Joe says, ‘ I don’t want to sleep. I’ve used too much heroin for it to help anyway.’

‘There’s always a private doctor. There’s one in Beau-Bassin who’s not too expensive.’

‘He has no money and you probably know this. What are you trying to get him to do – steal the money? Or do you expect me to pay for his medication? I’m doing voluntary work – am I expected to pay for his medication too?’ Perhaps it’s my teeth that are beginning to grind.

The counsellor shakes his head. He didn’t imply that.

‘Come on Joe – he’s not going to help.’

I’ve tried to make Joe experience that he’s a person and he counts. What the counsellor reinforces to Joe is that he doesn’t count at all and needs to wait in line – they have a procedure and it is to refer elsewhere. There are no exceptions and he’s not going to make any. There’s nothing in the counsellor’s attitude or responses that expresses empathy or unconditional positive regard. I ask him what his ‘role’ at the center is; and he tells me he’s a social worker.

‘I’m a humanitarian like you,’ the counsellor tells me.

I’ve never considered myself as a ‘humanitarian’. I’ve felt and told many people including my teachers that practicing therapy makes me feel more as a person. I work with the ‘person’ and not the illness or the disability. It is person to person interaction and responding – holding the person with unconditional positive regard so that the person experiences a fullness of his own self – and not a lessening. I want the person to feel he or she can be anything they want in the world – and they can be loved. Following therapists such as Carl Rogers, I am practicing a listening love whose quality follows no abstract values but is concrete to the situation and the moment – where the decision for action or responding is gained. It creates an inner feeling of satisfaction when the match in response is good – or dissatisfaction when the match is bad.

‘Yes you’ve done your job and you’ll be able to sleep easy tonight,’ I tell the counsellor.

‘What I can see is that you’re angry because I’ve not been able to help in the way you expected. Joe understands the way it is here whereas you don’t.’

Damned right I’m angry and I become incoherent in Kreol and have to revert to English. What I expected was some unconditional positive regard and empathy coming Joe’s way – even if he could not be taken into the program. Show him he’s a person and you care. What does Joe understand? That he’s less than a person is – a ‘lizard’ in his own eyes – and someone who doesn’t count in most other people’s eyes. He accepts he’s a low life and I was trying to change that self-perception.

We stand on another street corner, trying to decide on the next step. I’ll trust Joe’s judgment I think to myself. He knows what he needs to deal with his physical pain – and I’ll pay for it. We take the bus back to Port Louis.

‘I’m sorry you had to experience that back there.’

Joe shrugs. ‘You really insulted him.’

‘Did I really insult him?’ I imagine the counsellor has a more resilient sense of self. Perhaps unconsciously I did want him to experience a little of what Joe was going through – feeling like a low life. At one point of the interview he had mentioned he wasn’t in Joe’s place – but he could have tried to understand the experience from Joe’s place.

‘If he’d laid a hand on you, it would have been like raising a hand on Kalima.’

‘What do you mean? I don’t understand.’

‘He would have had me to reckon with. Anyone who tries to hurt you will have me to deal with.’

‘I didn’t feel threatened Joe.’ It may well have been Joe who felt threatened by the counsellor’s attitude.

Joe has another fit and each time they seem to intensify. I massage his hands to calm him down.

‘I’m suffering,’ he tells me but he’s laughing. ‘I’m dying here.’

‘Think of the moments when you experienced joy in your life.’

‘You mean before my mother died? – Or more recently? With Julie…I feel joy with you too.’

Inside I’m warmed…in the moment no other person is more important to me than Joe.

‘I’ll have to keep in life at least until the end of the month so I can pay you back.’

‘At least that’s something – you in life until the end of the month! Is that a guarantee?’

‘Even if I don’t make it, Julie will get my paycheck. I’ll make up some story that it’s for a radio or something that you got for me. Don’t tell her you gave me money.’

‘But I want you in life – at least until the end of the month!’

Once in Port Louis, I give Joe the money for his medication.

‘I’m coming with you,’ I tell him.

‘Where I’m going you can’t come. I promise to meet you in the Jardin later.’

If I manage to keep Joe in life a while longer I’ve done my job – of providing the good self-object for Joe to internalize and feel good about him-self.

I realize much later that I’d given Joe enough money for a heroin fix, with a little bit left over for bus fare.

I haven’t encountered Joe since that day. I ask about him from others and hear that he’s still in life…for the moment… or possibly until the end of the month when he needs to pay me back for the money I’ve loaned him. The end of the month is only a few days away…

What do I do with the others like Joe, who trust me, to come with me? Do I lead them into futile bus rides to a treatment center that can’t take them in and must turn them away? It seemed to have been a grave error of judgement on my part and I have learned from the experience. And the counsellor was right – in that Joe knows more about what goes on here than I do – as he’s been in treatment before. I’ll have to listen more closely and trust that the addict’s experience of the system of treatment is more clued in than mine. Both Joe and Julie don’t seem to have much faith in it.

What makes you turn your face away from some of the most vulnerable people in society?

● All names have been changed to protect the identities of the persons involved. Some of the narrative is not verbatim and has been condensed for clarity and brevity in construction.

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