Qualitative analysis: addiction to recovery

At 13, Erin Khar injected heroin. She continued drug abuse and other self-destructive behaviours for seventeen more years. In her thirty-first year, upon delivering her first child, Erin knew she was not going to use again. And she has not. The opponent-process theory (Domjan 2015, p. 54) predicts that drug addiction will continue with increased dosages, diminished highs, and deeper lows until malnutrition or death end that person’s life. In most cases of addictive behaviour this does not happen. That epistemic gap, between prediction and outcomes, provided the opening for a narrative analysis (NA) based on the research question: What was the agential experience of moving from addiction to recovery?

Qualitative research, of which NA is one type, makes a point of acknowledging a researcher’s position with respect to the data set and research question. My background includes growing up as a middle-class, white male in 1960s-1970s Canada. I was affected by family-based addiction and mental health issues from birth onward. Relatively late in life, I switched from a career in architecture to focusing on a philosophical approach to psychology. Part of what led to that switch was attendance at hundreds of open Narcotics Anonymous, Alcoholics Anonymous, and Al-Anon meetings. From there, and as part of my new educational endeavour, I trained as a volunteer facilitator of Self-Management And Recovery Training (SMART Recovery), meetings for addictive behaviours and for the family and friends of those with addictive behaviours (two separate weekly meetings). These are science-based recovery meetings welcoming crosstalk and cognitive behavioural theory-based education using prescribed psycho-social tools.

With that background, Erin’s memoir, Strung Out (Khar, 2020), was selected based on the veracity of Erin’s voice—she felt real, honest, and like one seeking greater understanding. Her story was harsh and at times hard to read. I had no difficulty envisioning just how excruciating it must have been to live the life that became that story. With Erin’s 296-page memoir as the data set, the means of analysis was filtered scrutiny of the text. Over 10,000 of Erin’s words were copied into a Word document for analysis. Once reviewed, the abstracted passages were examined with respect to the tools of Labov, Frye, and Holman. This approach to NA came from Murray (2003). His suggestion of using Labov’s (1972) linguistic approach, Fyre’s (1957) genre analysis, and literary analysis were adopted with the latter-most modified to consist of an analysis of the refrains most frequently used in Erin’s narrative.

Through Labov’s (and Frye’s) questioning of central struggles (agon), the theme of Erin’s narrative was identified as “the I-want-to-shine Erin versus the I-crave-unconsciousness Erin”. For 17 years, this struggle shredded Erin’s life into momentary fragments of light arising between almost relentless bouts of dark self-harm, depression, anxiety, promiscuity, and drug use. Much of this self-destruction appears to have revolved around untreated depression and childhood sexual trauma. What was learned?

Labov’s mode of analysis came first permitting me to look at condensed, thematized, and book-ended versions of Erin’s story. Frye’s mode of analysis tested the supposition that Erin was on a quest for deliverance from pain. Erin’s refrains, per Holman’s (1972) definition, provide concise examples of the tenor and direction of Erin’s struggle, below, Table 1.

Table 1

Most Prevalent Refrains, Strung Out (Khar, 2020)

The box cutters were a means of self-harm while the compulsion for self-annihilation exceeded mere death in its desired erasure of Erin’s footprints. By most objective standards, Erin was healing, lovely, sane, and highly intelligent—quite the opposite of the self-talk that prevailed for her 17 years of addictive behaviour.

Erin’s awareness of her privileged birth and upbringing—in socioeconomic terms—was another whip she used to keep herself low. As can be seen, comparing the page numbers on which the last two refrains appear, the “monster” was frequently appended to the aborted fetus with which Erin lacerated her already wounded soul.

On one level, Erin’s story is that of a woman addicted as a young teen, who used for nearly two decades, and walked into a successful and healthy life, based on her self-reports. On another level this is a story about what must be overcome to enter sobriety—the state of not using—and beginning recovery— “…an ongoing dynamic process of behaviour change characterized by relatively stable improvements in biopsychosocial function and purpose in life” (Witkiewitz, Montes, Schwebel, and Tucker, 2020).

Three issues arose from the discussion of the analysis of the data set with respect to the theory presented in the literature review. What Strung Out (Khar, 2020) revealed to this researcher is that 1) our understanding of the depth and impact of emotional pain may be underestimated; 2) a desire for ontological negation can have sufficient intensity to provoke cravings for unconsciousness and annihilation of any trace of one’s existence; and 3) that our understanding of ends-based human motivation may be oversimplified, particularly if conceived as merely antipodal.

As a final point, readings after the completion of this NA have begun to delve into human pain and direction. “Depression involves a continual focus on negative thoughts, experiences, memories, and feelings to the exclusion of all else—a kind of inverse learning. As a person narrows his or her attention, focusing on only the most negative stimuli, the mind slowly devours itself” (Kessler, 2016, p. 5). With that characterization of Erin Khar’s addicted consciousness in mind, imagine what it takes to reverse the cumulative momentum of that downward thrust.

References

Domjan, M. (2015). The principles of learning and behavior (7th ed.). Cengage Learning.

Frye, N. (1990). Anatomy of criticism: Four essays. Princeton University Press.

Holman, C.H. (1972). A handbook to literature: Based on the original by William Flint Thrall and Addison Hibbard (3rd ed.). The Odyssey Press.

Kessler, D.A. (2016). Capture: Unraveling the mystery of mental suffering. HarperCollins Publishers Ltd.

Khar, E. (2020). Strung out: One last hit and other lies that nearly killed me. Park Row Books.

Murray, M. (2003). Qualitative research in psychology Chapter 6. Narrative psychology and narrative analysis. (P.M. Camic, J.E. Rhodes, Eds.). APA Books.

SMART Recovery. (2016). SMART Recovery Distance Training Program. www.smartrecovery.orgopens in new window

Witkiewitz, K., Montes, K.S., Schwebel, F.J., and Tucker, J.A. (2020). What is recovery? Alcohol Research: Current Reviews, 40(3): 01.