Young people, drugs ... and others
Personality and drug dependence
Drugs and suicide among young people
Even children ...
The deficiency of imagination
The values invested
Drugs or something else
Author: J. BERGERET
Pages: 1 to 14
Creation Date: 1981/01/01
Director of the National Drug AddictionDocumentation Centre, Lyon, France
This paper reviews the emotional and relational difficulties associated with the crisis of adolescence, drug dependence being only one of the possible disorders. The use of drugs, perceived as a temporary self-defence measure in the struggle against a relatively serious state of depression possibly leading to suicide, is often also a form of aggression against the self. In addition, the creation, for example, by television or the supermarkets of artificial neo-needs encourages young people to expect magic, external solutions to their problems. The deficiency of imagination found among young people reflects the inadequacy of the ideals of early childhood (which are totally out of tune with reality). By setting themselves inordinately high goals in compensation, young people exaggerate the exterior ideal demands only to reject them later on because they are unattainable. The author argues against the setting up of primary prevention agencies specializing in the problems of adolescence and argues the case for positive primary preventive action in the field of health.
In 1978, a French television station broadcast a good film, produced with the help of Dr. C. Olievenstein, on the "drugs problem", which showed children asking adults very relevant questions. 1
The questions they asked were not primarily to do with "drugs". Those who are concerned with young people and their real problems are not surprised by this attitude which, in itself, is quite logical.
What really interests the younger generation, more than some particular accident which might happen to some of them in one form or another, is first and foremost the place that they themselves will be able to take in the world of tomorrow, the role that they will be able to assume, not only in terms of the space that adults will reserve for them, but also, and above all, of the way in which adults will have allowed them to prepare for playing their roles in qualitative terms.
1. "La vraie parole: les enfants en question", ORTF, 1978.
In the film referred to here, children were shown asking adults to have the courage to serve as valid models with whom they could identify to build their own sufficiently strong personalities. We know that this is indeed the way that personality is built, as much through the integration of part of the models proposed as through opposition to other aspects of those models.
Young people are profoundly disenchanted and are more and more threatened by depression - an increasingly widespread phenomenon - as a result of seeing around them models for identification that are too pliable, drifting with external conditions, and too inconsistent in the face of the crises which have to be weathered (and even more specifically, individuals who dare not even assert their sexual identity).
The adolescent in the throes of an identity crisis is of course easy prey to the radical assertions or simplistic black-and-white views of leaders, usually seeking to dominate, with their murky, exploitative schemes. However, what today's youngsters fear most of all is the void in image and feeling which they may find in their natural surroundings, the absence of people who not only would take an interest in them, but whom they could also perceive as valid touchstones, with whom they could establish an entire system of positive and negative elaboration and integration. This two-way identificatory process is absolutely necessary for the development of a personality capable of resolving and moving beyond most at least of the inevitable ambivalences which, for quite some time, block the crisis of adolescence and prevent it from coming to an end and giving way to more positive relational attitudes.
Many adults, and in particular those who want to take an interest in the young and drug addiction, would do well to bear in mind this lesson which the children themselves sometimes give us by not making drugs the focus of the main concerns of the moment, but rather stressing the emotional difficulties and relationship problems which are liable to lead to drug dependence or other disorders.
Children (contrary to what a good number of adults would tend, defensively, to think) do not ask for "authoritarian" parents as much as parents who are able to embody "authority", that is, to represent a valid reference point in their children's search for identity.
When one is known to be concerned with drug addicts, one is often asked to make an "identikit portrait of the drug addict", to which teachers, educators, heads of institutions and even the police could refer in their endeavour to detect "quite early on" young persons who are either already dependent on drugs or only in danger of becoming so.
Such a request may seem very dubious, not only from the point of view of professional ethics, but also from that simply of effective prevention. For a number of reasons, this singling out of individuals on the basis of appearances
Young people, drugs ... and others 3 alone would not be likely to help us find the actual or potential drug addicts more often or help them more easily.
There is certainly no specific personality model of the drug addict, whether a young person or an adult. Drug addiction can develop in any structural model of personality. It would therefore be vain, simply by relying on the character traits, by which a psychologist determines the structural substratum of a personality, to think oneself entitled, on the basis of the nature of this structure, to say who is bound, or not bound, to become dependent on drugs.
The only prediction it would be possible to make (and then with enormous caution and a great many qualifications) would not take into account so much personality types as the way the underlying structure of the individual's personality functions, or is functioning for the time being at least. This cannot be judged merely by hair length, personal hygiene or style of dress; it can only emerge from a deeper examination of the individuals' relationships with others and themselves, i.e. their interaction with the world and with their own structural elements.
Epidemiological surveys conducted by specialists in this area have shown that both actual and potential young drug addicts (whatever their structural personality model) demonstrate above all modes of functioning of their own individual structures (little matter what the structure may be) that can be classified as depressive.
Drug addiction can develop, in young people in particular, not only where the individual's mental structure has long been of the depressive type, but also in individuals with other specific personality traits who are going through an episode of depression, even when this depression is not at all deep-seated and in no way alters the pre-existing underlying structure of the personality.
The signs of a depressive state often remain difficult to recognize and interpret. Physical and mental apathy are not always manifested in a conspicuous way in the behaviour of individuals. They will often try to compensate for their inner inertia in externalized ways. Rather lengthy, repeated interviews are often necessary to elicit this deep-seated feeling of disappointment in the world and oneself, this loss of confidence in oneself and others, this lack of projects, this sense of being forsaken and isolated and the hopelessness of trying to attain ideals which are too lofty, all of which signify a depressive state which has reached an obviously morbid level.
It should also be pointed out that adults are all the less alert to such signs in young people given that they themselves are often immersed in a more or less distinct state of latent depression, which, however, is not of the same importance and gravity for them as for young people. One finds that older people often have, in the course of their lives, developed a number of more or less "perverse" defence mechanisms which enable them to avoid becoming depressed and becoming aware of their underlying depressive position. Few young people are capable of using such subtle and, in the final analysis, not very constructive protective devices at an early enough stage.
The studies on drug addiction conducted in France in recent years seek to avoid the strict distinction which, regrettably, is commonly drawn between drug-dependency behaviour and other difficulties encountered among young people today. It is in actual fact difficult to isolate the attitudes of dependence on a toxic substance with which public opinion is so preoccupied, from other, equally serious, problems such as alcoholism among the young, delinquency, violence and, above all, the gravest evil encountered among a whole age group: suicide.
It is difficult, for a number of easily grasped reasons, to draw too hard and fast a line between research into drug addiction and research into suicide.
For clinicians, every case of serious drug addiction conceals a suicidal problematic, since all drug abuse inevitably constitutes a game played with life and death very similar to the famous game of "Russian roulette", which comes back into fashion at certain times and under certain circumstances.
It should also be understood that in most cases the deaths attributed by families or by the press to "overdoses" are, in reality, nothing other than perfectly clear-cut cases of suicide, as is confirmed in the autopsy by the nature and multiplicity of substances used by the subject. It is no longer a question of mere error in the dosing of a substance habitually used to obtain pleasure. Society prefers the cause of death to be attributed to the substance rather than the individual. This poses fewer problems at all levels, as much in the context of practical considerations as in that of a desire not to stir the individual and collective imagination too much.
It should be understood that. paradoxically, the label "suicide" is attached to accidental deaths, the only real cause of which is the use of particular substances. An example would be the case of young persons who, under the influence of a dose of LSD (even a small one) suddenly fall prey to hallucinatory phenomena of such intensity that they feel, like a butterfly or bird, capable of flight; so, sure of themselves, they leap through a window ... with no desire to die, or any thought of death.
Finally we must recognize that by and large the clinicians who treat drug addicts claim to be convinced that many young people turn to drugs out of a clear need to ward off a serious state of depression which might lead them directly and swiftly to suicide. We know that this is simply a stop-gap attempt at self-defence, which does nothing more than put off the day of reckoning. We must, however, bear in mind the role temporarily played by drugs at this level and, while it is important not to leave the individual in a state of dependence on the substance, it is on the other hand essential to be able to replace this substance fairly quickly by a better and more promising emotional investment. There can be no question of failing to replace the drug by a more beneficial solution, of being satisfied with subjecting the individual to "detoxication" more or less under duress. In this case we would quickly find ourselves confronted even more directly by the problem of suicide.
In the face of the problems of identity and depression which we have just outlined, even children are no longer untouched by the "drug" phenomenon inasmuch as it reflects an attempt to react to depression, isolation and moodiness. The phenomenon has spread progressively from adults to the much younger age groups, who are far more emotionally vulnerable.
In France, this spread to the younger age groups began in the suburbs of large towns, and first of all the suburbs of Paris. The problem is spreading quite rapidly, in terms of both prevalence and gravity, and is quite rightly a source of anxiety to the public authorities.
It is of course out of the question for young schoolchildren to use conventional toxic substances, since it is difficult for them to obtain access to the market. These children have therefore devised an addiction to their own measure. They just buy or steal from shops, supermarkets or department stores bottles of solvents or certain glues from which the solvents can easily be extracted (by simple processes) and which produce an immediate state of intoxication, when inhaled, repeated every day before going to school or at the end of the school day. The physical consequences of such easily spread habits are often serious: the circulatory system, lungs, liver and kidneys can all be affected.
When they are no longer able to cast a blind eye on the problem their families claim to be surprised. Broadly speaking, those concerned are inhabitants of large complexes, where the parents work a long way from home, while the children are left to their own devices for much of the day, with only each other for company. They have no parent or grandparent to keep an affectionate eye on them, not even a neighbourhood shopkeeper and friend of the family or perhaps a building caretaker who, assuming an authoritarian air, would all the same show some interest in the child as an individual.
Furthermore, from their earliest years, children are extremely sensitive to the insistent and repeated messages with which they are consistently bombarded (whether in the supermarket or while watching television), urging them to consume more and yet more.
It begins, following the example set by adults themselves, with the inability to make do with a glass of water to quench one's thirst or a slice of bread when the meal is a little delayed. The right thing to do is to grab a fizzy drink or a tantalizingly packed, flashily advertised toothsome treat, whether or not one is thirsty or hungry. In this way veritable artificial neo-needs are created in people's relations with the external material world; thus a whole civilization is led into a permanent state of need, which quickly results in various forms of dependence.
Surveys prove that only in rare cases are young drug addicts the children of addicts; however, they have often witnessed at home how, when faced with some physical, moral or social problem, their parents, instead of looking for the cause in themselves, would deliberately seek a solution which was at once "magic" and "external", i.e. a solution of the drug-addiction pattern. These parents will often, for years, have been taking daily doses of sleeping tablets, tranquillizers or even medicines as seemingly harmless as cholagogues or laxatives. In the image that children form of their parents' behaviour, this attitude of dependence on a product counts much more than the nature of the substance used.
The emotional impoverishment resulting from the new way in which the older and younger generations relate to one another combines with the action of adults on young people to persuade them that an "external" and "magical" remedy can be found for every difficulty.
The absence of a sufficiently intense emotional inner life, then, joins forces with the false promises held out by a consumer civilization, to make young people less and less able to resist the "ready-made desires" proposed from outside according to standardized, painless, odourless and flavourless models, while at the same time making them less and less able to form their own models of desire and imaginary pleasure, ones specifically suited to their personalities and individual, original needs, which cannot be those of others or limited to purely material objects or reduced with impunity to a sort of collective lowest common denominator.
Everyone is the loser in such a restriction of the individuals' capacity for creating their own, warm and absolutely personal imaginary world of feeling, involving their original personality and the forces set free through realization of a specific desire directed towards an object which is itself specified. The individual is weakened and depressed by such a lack of imaginative ability and the community soon suffers from this stunting of its members' emotional and creative potential.
Disadvantages such as these seem quite evident to the careful observer, but we must look further and seek the causes; and here again we find that something went wrong between the parents and their children just when the children's imagination should have been both reinforced and stimulated by that of their parents. The child's own imagination needs parental stimulation to encourage its development, and at the same time parental serenity, so that fear will not hamper this development.
An issue used to be made of the way in which parents behaved in relation to their children with regard to sexual fantasy. This problem seems quite outdated now, since the images which young people form of genital sexuality are so trite and transitory - a reflection of the adults' abdication from their educational role in this area.
A further modern phenomenon is that adults (either directly within families or indirectly through the mass media or live entertainment) are stirring violence in young people without giving them any protection. Only the "balance of power" counts. The end result is a diffuse anxiety directed towards the individual's very right to existence.
Young people are particularly sensitive to this deficiency of imagination and pressure of violence. Drugs will represent for them a "miracle" solution which they assume will resolve the crisis of depression which has them in its grip.
Experience proves, however, that there is no substance able to revivify an imagination which is in itself enfeebled; certain drugs are known to stimulate the imagination and to evoke certain fixed, odd and colourful images, but these are never imaginary scenes in which interpersonal relations are conceptualized.
Psychopathologists have often described the tendency to react to a deficiency of imagination by channelling one's frustrated mental energies towards dementalized behavioural attitudes. This is what is behind the increase in violent behavioural attitudes, without any Political conceptualization, which are acted out directly in the community. The same is true of the repetitive act found at the root of all alcoholism, all tobacco abuse and, of course, all serious drug addiction, the final result of which is a compulsive pattern of behaviour, merely acted out and in the end emptied of all creative and emotional content.
Despite the language they sometimes adopt, young drug addicts do not behave like genuine rebels. On closer inspection it becomes clear that they are quite quick to take refuge in attitudes of fruitless gloom. In general they show a tendency to abdicate in the face of life's difficulties, while on the other hand displaying an inclination to put their trust in anything which might promise a "magical" and "external" solution. They rely on illusions to make up for their lack of initiative and personal creative powers.
These tendencies are reflected in the attitude shown by most drug addicts to ideals and the law as they experience it.
Contrary to what one might suppose (and also to what public opinion feels led to believe) most young drug addicts continue to have a fairly childish conception of the ideals they should seek. Their so-called "lack of ideals" is no more than a defensive decoy, which public opinion is quick to accept at face value, since this enables them to justify the feelings of disapproval and contempt (themselves defensive) which they feel towards drug addicts.
It would be incorrect to say that young drug addicts have no ideals at all. It would be more accurate to regard them as maintaining ideals which are totally out of tune with the realities of their various situations. Like the ideals of early childhood, their later ideals remain far too grandiose and purely external.
These ideals appear too grandiose from an essentially anti-depressive point of view. Given the poor esteem in which they hold themselves, these individuals make a point of setting themselves inordinately high goals. There can be no doubt that these goals are unattainable (even for an individual who is both better equipped emotionally and capable of heroism). This inability to attain such ideals immediately triggers off a disappointment in themselves which further deepens the addicts' depression, which in turn leads them to set themselves new, over-demanding goals. We are dealing here with a real vicious circle which, furthermore, is founded in passivity: Why try to do anything, since every effort is doomed to failure from the outset? Individuals feel that they might as well not do anything, not attempt anything, since the result of their efforts will always prove disappointing. In the "normal" post-adolescent, one will always find (as in any adult) some unattainable ideals, but only some, and the failure to attain all one's ideals does not elicit guilt, shame, self-contempt or depression, but simply creates a sense of modesty which, far from paralysing action, stimulates it by encouraging flexibility in one's relationships with others and oneself.
We must also consider the fact that in the cases which concern us here the individuals' ideals have remained purely external to them. The ideals pursued by so many adolescents today are in no way original or personal; they have not at all been formulated on the basis of interiorized information. They clearly belong (or are simply experienced as belonging) to representative figures, in particular to the parents, and are ideals that the parents themselves failed to attain. In this regard, then, we observe considerable ambivalence, based on a dual attitude: exaggeration of external ideal demands and at the same time rejection of them because they are unattainable. Adolescents in difficulty manage neither to rebel against unjustified real external pressures, nor to accept responsibility for what might on an ideal level go hand-in-hand with happy relationships, for both themselves and those around them.
As for the "law" as experienced (what is often termed "the father's law"), this itself, just like the ideals, remains purely external and is not interiorized. The ideals constitute a pole of attraction towards what would have to be done in order to be loved, while the "law" as experienced corresponds to the prohibition of what must above all not be done, under pain of punishment. These are two completely distinct, albeit complementary, emotional positions.
One of the logical results of resolving the crisis of adolescence is the ability to accept responsibility for a personalized and interiorized "law", which, without persecuting the individual in any way, will facilitate social relations. In the final analysis, the aim is genuine "situational ethics", whereby the individual is able to decide what practical solution to select in each concrete situation, rather than deciding in too general and systematic a way, while at the same time maintaining general positive guidelines.
To the extent that it is not sufficiently interiorizcd, the "law" as experienced by the young person who is going to become dependent on drugs (or be trapped in another social impasse) manifests itself as demanding and sadistic, imposed by others without any personal allegiance or assumption of inner responsibility. We therefore end up with a sort of "book morality" under which all the solutions are provided for in advance, and what is "good" and what is "bad" is determined in terms of black and white, without any account being taken of the actual circumstances or their diversity. This is an experience of the law which is looked upon as unacceptable by truly mature people in the 1970s and 1980s. To become adult means both rejecting this book morality and building oneself a different one.
These are the two attitudes between which young people who are going to venture on the solution of drug addiction waver, in their depression, without success. This moral isolation is hardly to be envied and only serves to reflect, in the individual's relationships, the basic personal emotional and imaginative poverty discussed above.
Public opinion claims to be deeply concerned at the present increase in the number of drug addicts of the most varied types. But people are far more distressed by the manifestations of violence recorded in almost every country throughout the world.
There would appear to be a tendency to fall back on laws and sanctions as a means of calming people's anxieties. But does this really indicate an understanding of the problem?
Those most alarmed at the open explosions of violence are not the most serenely peace-loving people, the ones who have had the good fortune to be able to integrate their own basic perfectly natural violence by channelling it towards more constructive goals. The most anxious people, and those who call for a violent counter-action are, on the contrary, the ones who feel unsure of having integrated their own deep-seated violence. They are afraid that, at any moment, they may no longer be able to control this deep archaic violence which is awakened by external events and liable to provoke them to terrible outbursts. They therefore appeal for repressive measures to be imposed from outside, measures which in themselves will yield no social benefit, but are designed to ease the personal anxiety born of the danger that their inner violence might erupt.
This was the way many adults reacted to the May 1968 student uprising in France.
In order to gain a better understanding of the matter, we must first distinguish between the concepts of violence and aggression: aggression, i.e. the need to strike out at adversaries for the sake of thereby gaining some precise advantage, implicates the individuality of these opponents (their bodies, their property etc.). Aggression differs considerably from the simple innate violence with which every child comes into the world and which is impressed on to the genetic equation of every human being (as of every animal).
The primitive, brutal experience which gives rise to violence is not at all hatred of the other person for complex reasons, but rather the elementary conviction that there would not be a place in the sun for both the "other person" and oneself. No account is taken of other persons at this stage; they are no more than mere imaginary rivals in the struggle for survival. The way a brother or a sister is experienced is often spoken of in these terms, but in the first moment of life the "other person" refers essentially to the parents (as painful as this might be to recognize) and this primitive violence immediately becomes mutual, even if, in the fortunate cases, it is quickly relegated to a secondary role in the context of reaction formations developed under the names of "filial love" or "parental love".
Fundamental violence is undifferentiated: it is not the object in itself nor does it carry any feeling of hate or of love. After the birth of the child, violence appears in an anguishing two-fold fantasy of infanticide on the one side and parricide on the other. As soon as love is able to emerge, it is the feeling of tenderness that gains the upper hand, and the violence is integrated within this new dynamic orientation, which is positive and reassuring for both parent and child. Thus, the way is cleared for other, entirely creative relational dynamisms.
Love and creativity should logically integrate the primitive violence which, in return, bestows on them its powerful underlying energy. Conversely, violence seeks to recover a part of what should have been love, and this gives rise to aggression in the true sense of the word, the most refined forms of which are sadism and masochism.
The behavioural patterns of drug addicts are among the possible results of inadequate integration of violence, but this, of course, is not the only eventuality in the current world of relationships, particularly among young people.
Every day the psychologists, sociologists and ethnologists bring us ever more compelling information on the profound nature of violence and its uncertainties. They help us to understand why, in itself, fundamental violence is neither good nor bad. What matters most is the direction, the vectorization, that individuals will be able to give to this violence and the extent to which they will be able to integrate it.
It is therefore understandable why any proposal to combat violence seems illusory and ill-fated from the outset. In any rationally conceived primary prevention action, it is necessary above all to provide young people with the best conditions for integrating their natural violence. One cannot pretend to solve the problem by repressing innate violence when this is a force with a positive potential which there is an advantage in putting to use. Any purely repressive attitude can only give rise to more or less well-controlled and more or less unexpected resurgences of the same violence in the form of a far more serious type of aggression.
Aggression, strictly speaking, may be directed against others, as in the case of delinquency in general. It may also be turned back against oneself, and drug addiction is one of the ways in which this happens, since at the outset all serious drug addiction takes on a suicidal aspect, constituting not only a challenge to others, but also a game of life and death with one's own body.
One should not, as has occasionally been said a little too frivolously, believe that all young people today are either actual or potential drug addicts.
A number of epidemiological studies have shown that there are a great many young people who are totally incapable of turning to drug dependence to satisfy their needs and desires, and that they look to quite a different system of relationships for such satisfaction.
It should also be remembered that the genuine drug addict should not be confused with the person who merely takes drugs occasionally, particularly when the substances involved are not serious (even if one remains opposed to the too artificial distinction between "hard" and "soft" drugs).
But neither should one focus too selectively on the "drugs problem", isolating this problem too strictly from other dangers encountered in today's world and avoiding the task of examining the hazards, which are no less serious (even if not always apparent), threatening a considerable number of adolescents and post-adolescents who are in difficulties regarding emotional relations, identity or depression.
Earlier we discussed the risk of suicide. We took note of the trend among young people in many countries towards the consumption of alarming quantities of medicaments, tobacco and now, once again, alcohol.
Certain forms of juvenile delinquency are also showing an upward trend.
It would be unfortunate to compartmentalize all these patterns of behaviour too arbitrarily; one should rather try to gain better insight into their common emotional bases and then to turn one's thoughts to ways of reducing the number of individuals threatened.
It is probably good to train either individuals or bodies to specialize in attending to the various kinds of physical, emotional or social problems already found in many young people, but it does not seem well-advised to scatter and diversify too soon the efforts, funds, people or organizations intended, through early action, to protect young people as a whole from the various risks just enumerated.
It would be useful to have here a centre specializing in receiving young drug addicts, there a service able to receive chronic alcoholics, somewhere else an intermediary institution open to predelinquents, and so forth. But how are we to make headway in our study of the emotional causes common to all these problems and of the best way of preventing them by organizing here a "committee" to combat drug addiction, there a "committee" to prevent alcoholism and somewhere else an information "centre" on the dangers of smoking etc.?
As regards action to prevent drug addiction, is the most important thing really to focus on "drugs", thus endowing them with a specific importance in anticipation which will magnify the "drugs phenomenon" in the eyes of both the public and young people, just as the fuss about terrorism helps to aggravate this evil?
It does not seem wise to create primary prevention agencies specializing in the "drugs problem", nor yet to encourage individual or collective action involving "talks on drugs" (even in the guise of warnings) for young people for whom the problem has never hitherto arisen in such a specific way.
Primary preventive action in the field of health, particularly among young schoolchildren, calls for a number of precautions of which a great many countries have not yet become fully aware.
None the less, it is precisely through educational action of all types that primary preventive health action must pass.
For this purpose, therefore, it is first of all necessary to consider these problems in great depth, and then to take extremely clear-cut general measures, dictated not by anxieties or pressures that are too specific, but by an awareness of the real levels at which the general and basic problems arise.
Many young people today have great difficulty in bringing to a constructive end the crisis which traditionally characterizes the period of adolescence.
The consequences of prolonging this crisis, sometimes under dramatic conditions, may be many and various. Drug addiction is one of the possible unfavourable developments, neither the least nor the only one.
When a person has become addicted to drugs it is, of course, necessary to look for specific solutions, but without in the meantime losing sight of the more general, emotional and relational problems which gave rise to the addiction. It is never wise to turn dependence on a substance into something entirely set apart.
It is all the more important, then, not to focus attention on the toxic substances and their potential effects when it is still only a question of warning youngsters with emotional problems (who have not yet shown any interest in toxic substances) as much against the risks of drug dependence as against other risks to which we know them to be equally exposed.
Moreover, fear and prohibitions have never proved sufficient deterrents: mountaineers cannot be protected by fear or prohibitions alone; nor can all mountains be equipped with safety-nets. It would seem more effective to give future mountaineers a proper training for all that awaits them.
Accordingly, the Council of Europe Select Committee of Experts on Prevention of Drug Dependence, which met at Strasbourg in 1980 and 1981, concluded that it was vital in every country to develop a health-oriented education, of the type that would not only protect young people from the dangers of drug dependence, but also prepare them to cope with all that threatens their physical, moral and social development as individuals.
The adolescent must be allowed to work through his crisis by integrating his own needs and values, without being forced to submit only to the demands of what appears to be external or magical, or being limited to a mere static, systematic and paralyzing opposition to the input of the external world, part of which at least must appear as capable of being integrated and adapted in the formation of an individual personality.
Genuine education for health is the only reliable form of primary prevention in all the areas we have mentioned above.
This type of education is an overall teaching operation, involving all who are in a position to play a role in this work, whether at the level of the school or the family, or other social agencies concerned, either directly or indirectly, with the fate of children and adolescents. There is no question of this being a matter for "specialists" (whatever their field), and above all not for drug specialists.
In tackling the problems which lead a considerable number of young people into the by-ways of drug dependence, there are no grounds for concentrating on the pharmacological aspects of the question.
However, having said that, there remains the problem of striking a balance between study of the personal and social factors which could be regarded as crucial both with respect to difficulties encountered in general in resolving a crisis of adolescence and with respect to the more particular reasons behind the individual's specific choice of drug dependence out of a number of possible attempted solutions.
It seems neither correct nor effective to deny any personal responsibility on the part of the individual for creating and maintaining a state of dependence on a toxic substance. However, there should be a recognition and denunciation at another level of the share of responsibility which rests with the environment: the family environment with its crises and current evasions; the socio-cultural environment with the increase in anonymity, conformism and despondency (whatever the justification given); the economic environment which is hardly beneficent to young people, not to forget, with respect to civilization itself, the extent of the demands and pressures on the individual to seek happiness in the passive consumption of "magical" products.
In the midst of these many environmental deficiencies, adolescents are hardly helped or spared. It can be seen why they are not easily satisfied with the customary models proposed to them.
But are adults themselves any happier? Have they found truly individual and positive solutions? In a great number of cases, certainly not. However, previous generations more or less succeeded in "patching together" some adjustments which, while they may not have made them truly happy, were at least of a nature to gloss over their most important deficiencies and sharpest pangs of anguish.
The young person who neither can nor cares to rely on such niceties without a future, calls for other solutions and has so far drawn a blank.
In their protests against their elders, they throw up to them a caricature of the innermost deficiencies which they are seeking to camouflage. Adolescents in crisis, then, and drug addicts in particular, are looked upon as unbearable in their environments, in their families and in the community.
They are, however, our fellows; they even awaken in us part of our unconscious personality, at once unhappy, unacceptable and the bearer of desires.
The difficulties peculiar to the younger generations are already serious enough that we should refrain from adding our own difficulties to them by projection or, having done so, from shrugging off the whole problem by trying to create in our own imagination a "world apart" which is too different and too remote from ours.
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