Identity change in a drug-free Therapeutic Community: a Lacanian interpretation of former residents’ perspectives on treatment process and outcome

Abstract

Purpose In drug-free Therapeutic Communities (TCs), people with addictions live together in order to achieve recovery in terms of a modified drug-free lifestyle. Central to the TC approach is the assumption that this shift is only achievable when “identity change” has taken place. However, this claim has rarely been addressed in TC research. Further insight into the nature and realization of such identity change might help to understand how this community approach contributes to long-term recovery. The paper aims to discuss these issues. Design/methodology/approach The present qualitative interview study explores the perspectives of ten former TC residents on their treatment and their process of change. To organize the interview data, Lacanian psychoanalytic theory on identity formation/change is used as a framework. Findings The common thread in the participants’ process of change is presented in three parts: their life before, in and after the TC. The substeps within these parts are illustrated with several quotes. Originality/value The findings highlight the value of innovative qualitative research designs to address the many challenges to addiction treatment research. A Lacanian reading of the data makes it possible to describe the subjective logic of the process of change in the TC, focusing on how substance (mis)use functions as an attempted solution in dealing with identity issues. By linking crucial TC ingredients such as the TC law and TC tools to the process of the identity change, a new reading of this long-term group approach is achieved.