Substance Use, Perception versus Deception
Whilst talking about the use of substances, interventions seem to be based on the client’s perception.
Let us explore perception and deception. The definition of perception is, “the way in which something is regarded, understood, or interpreted.” (Oxford University Press, 2018)
The definition of deception is, “the action of deceiving someone.” (Oxford University Press, 2018)
Could it be possible that at times, the worker can feed into the client’s interpretation of perception, and from there deliver an intervention in response to this?
A client may state that they use substances in order to manage the external world. This is not an unusual statement, but does it make sense? If they are using drugs in a problematic way, how can the drug use help them manage the external world? It is usually the case that at this stage of their use, they do the opposite and retreat from the external world. Evidence from working with drug users suggests that it is very difficult to have a problematic relationship with substances and engage in the external world on its terms. If this is the case, is this a perception or a deception?
A client says, “I don’t get anything out of using anymore, it just makes me feel normal.” That is a very interesting statement. When somebody consumes a substance, they do so to feel different than the norm. After many years of using they may feel abnormal when they have no substances in their system, but once they take the substance, they feel normal. If that’s the case, it contradicts that they get nothing out of consuming the substance. More than that, it is informing them that they do get something out of it, as the substance is changing the way they think, feel and behave. Is their perception true or is it a deception?
Another frequently heard statement is, “I hate using substances as it is ruining my life”. The evidence is, that it is ruining their life, so why do they keep returning to the same activity? They may stop for a year and then return again. Surely, they must be getting something out of it, especially if they are investing that amount of energy and time? On the occasions in which you see somebody under the influence, you can see the change in their personality. They may feel they have confidence. It may take the edge of bereavement or make their perception of the world seem more bearable.
At times, is it possible for the client to mistake a perception for their deception? That would allow them to go to a place of cognitive dissonance. While they are in this place, it creates a space to make way for a justification. This then removes the guilt from any type of pleasure or enjoyment they are going to receive. This may be different from ‘denial’ as it is calculated, and they are informed time and time again when their deception comes to light.
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