35 clinicians and harm reduction providers from around the world working in a wide variety of settings are gathering this weekend to explore what is effective harm reduction helping. The following are reflections from an opening session on “What is Harm Reduction?”
“A fluid process, what is the role of substances and healthier ways to use?, meeting the client where the client is, preventing further harm-”how can we reduce the harm in some way?”, person focus and process of self-discovery, No Box-allows person to see where they can be, embraces a person’s uniqueness and respects person’s goals, any positive change or realization about yourself, harm reduction is relationship, shift from drug to the person, honor the whole person, no judgment, collaboration, part of a larger social movement-marginalized group looking to grow their power-we are collaborators, not being that directive-it helps when they are in charge, pragmatic and realistic, social justice, acknowledging the spiritual role substances can have in people’s lives.”
Some or what the group explored: What is harm reduction?, the challenges of working with people with risky and addictive behavior in terms of clients, providers and the broader social context, the scientific revolution-paradigm shift-from crude disease model to psychobiosocial/multiple meanings model and its implications for positive change interventions-from “abstinence-only” to integrative harm reduction psychotherapy, if substance use and other potential risky behavior carried multiple meanings and functions and vital parts of the self-must we not invite people into helping contexts while they engage in these behaviors in order to be of help?, must we not start our helping relationships around what the person wants as the point of engagement, the starting point for the journey toward healing, growth and positive change? In order to begin where people are we must be radically committed to examining our own agendas and subjective experience as helpers in order to put them aside to create a space to invite the other to emerge and listen effectively, while at the same time attending to our subjective, “countertransference” experience as a potential source if information about the other and what is happening between us, our subjectivity is a guide to understanding what may not be expressed in words but lives dissociated in addictive experience; is the concept of addiction so loaded with problematic, stigmatizing presumptions that we must abandon it and find new language for describing these experiences?, can we escape our language?
It was an exciting, rich, collaborative process. More to follow!
Andrew Tatarsky, PhD