The field of drug addiction is a dynamic field that establishes its priorities based on the prevailing social needs regarding this problem. In therapeutic communities, people live with each other 24 hours a day for an established minimum period and, therefore, this research aims to demonstrate the existence of benefits of the use of Alternative Therapies as a complement to psychopharmacological intervention in a therapeutic community Kambo. To this end, and together with the bibliographic review, a triangulated investigation has been carried out combining questionnaires with professionals and interviews with users of a therapeutic community.
INTRODUCTION: Benefits of alternative therapies, addiction treatments
What benefits does the application of alternative therapies have as a complement to psychotherapy and pharmacological intervention within a Therapeutic Community?
According to the World Health Organization (WHO), Alternative Therapies are the set of diverse health practices, approaches, knowledge and beliefs that incorporate medicines based on plants, animals and/or minerals, spiritual therapies, manual techniques and exercises applied in an individually or in combination to maintain well-being, in addition to treating, diagnosing and preventing diseases.
Alternative Therapies, from the perspective of social intervention, encompass a wide variety of practices aimed at improving balance in the biopsychosocial state of users, of which the following have been chosen to carry out said research: music therapy, laughter therapy and meditation or mindfulness.
Music therapy, laughter therapy and mindfulness (meditation)
In this sense, music therapy is understood as the discipline that uses one’s own body, voice, movement, sound objects and edited music as intervention tools, whose objective is to contribute to the promotion of health and, in the case of illness, facilitate the rehabilitation or treatment of the physical, psychological, social and emotional state of the affected person (Guevara, 2009).
On the other hand, laughter therapy is understood as a complementary treatment to maintain and promote the biopsychosocial well-being of people, since laughter is a mechanism that enhances and stimulates many physiological systems that help reduce stress, provide a feeling of control and enhance relaxation (Villamil, M, Quintero, Henao, & Cardona, 2013).
Finally, mindfulness is understood as a practice coming from the insight techniques proposed by Buddhism, which is aimed at intentionally paying attention to the present moment and controlling the direction of thoughts and their level of affect (Bolaños & Gómez, 2013 ). This technique is experiencing the opening to new fields of application such as hospital, educational, therapeutic, military and personal, understanding the human being in a holistic way, that is, as a whole capable of understanding and identifying emotions and deeper perceptions in a way that stimulates balance between body and mind.
For all this, the present research aims to demonstrate that the use and benefits of Alternative Therapies in addiction treatment as a complement to psychological and pharmacological intervention within a Therapeutic Community presents a series of benefits related to emotional expression and management, interpersonal relationship and the perception of the stay there, stress management and relaxation.
Staying in a Therapeutic Community is usually a satisfactory but complex experience for people who decide to carry out a detoxification and weaning process in this type of resource. As pointed out (Menéndez & Yubero, 2008), the basic actions regarding users in a TC are the following:
Promote linkage and integration in the CT
Reinforce healthy and socially responsible lifestyle habits
Become aware and take responsibility for your behavior
Promote emotional management
Encourage experimentation and internalization of values
Promote academic and work training
Strengthen the resocialization process
Integrate the family in the process of the person in treatment
Team and person involvement
To achieve these goals, great involvement is necessary on the part of the multidisciplinary team and, if possible, of the person in treatment. But, it should be noted that the person in treatment has to face great difficulties in their dishabituation process in a CT. These difficulties can be classified into three groups:
Physiological difficulties. Related to the detoxification process, withdrawal syndrome and stabilization of medication regimens.
Psychological and emotional difficulties. Related to the cognitive consequences of consumption, cognitive restructuring, assumption of responsibilities and awareness of the problem and lifestyle change.
Social difficulties. Related to family and social isolation for a certain period of time and to coexistence within the CT
For all this and to facilitate the emotional and psychological stability of these people, as well as the achievement of the goals described by (Menéndez & Yubero, 2008), it is advisable to include alternative activities such as Laughter Therapy, Music Therapy and Mindfulness as a complement or support. to treatment in CT, since they are offered experiential activities and emotional expression that facilitate the suppression of the difficulties described above, which is an important condition that facilitates personal growth and, therefore, the abandonment of substance use.
As previously mentioned, those known as alternative therapies have their origin in oriental and traditional medicine, referring to all those techniques that, far from the scientific method, aim to cure the person.
These techniques, therefore, have had great relevance in the field of medicine, with Dr. Eisenberg being the great pioneer of their inclusion in current medicine based on his study on the characteristics of the application of non-conventional procedures in the population of USA, which classified alternative therapies into the following groups:
Genuine: Highly genuine therapies, that is, with some scientific and safe evidence
Questionable: Highly questionable therapies, that is, not satisfactorily proven from a scientific point of view.
Fraudulent: Highly fraudulent therapies, i.e. fake therapies and therapeutic scams
The first work of Music Therapy written in our country, “Critical-Medical Palestra” written in 1744, is due to the Cistercian monk Antonio José Rodríguez. From that moment and, specifically, during the second half of the 19th century, the use of music as a therapeutic treatment was coined by the doctor Rafael Rodríguez Méndez (Corbella & Doménech, 1987).
For his part, Francisco Vidal y Careta wrote, in 1882, the first musical thesis that combined music and medicine and was titled “Music in its relations with medicine.” From this thesis, the author draws the following conclusions (Palacios, 2014):
Music is an agent that produces rest and distracts man
It is a social element
Moralize the man
It is convenient to apply it in neurosis
It serves to combat states of excitement or nervousness
In these first studies, certain benefits of Music Therapy begin to be reflected as a tool that positively affects the state of biopsychosocial well-being of people, but it will not be until the middle of the 20th century when the true boost of this discipline occurs.
In relation to the topic at hand, that is, the relationship between the use of this tool and the field of addiction, Emile Jacques Dalcroze is the main percussor, who in 1950 created the first National Association of Music Therapy in the United States. , which served various groups including people with addiction problems. Dalcroze stated that the human organism is capable of being educated according to the impulse of music (Pascual, 2015).
Music Therapy allows us to evaluate the emotional well-being, physical health, social interaction, communication skills and cognitive capacity of users in the process of drug addiction rehabilitation. This evaluation is carried out through specific procedures, such as clinical musical improvisation, receptive musical imagery, clinical song creation and therapeutic vocal technique, among others.
Music therapy and emotional management
The use of Music Therapy in addictions is mainly aimed at emotional management. Normally, people with an addictive disorder present a distortion and alteration of emotions and music, in this sense, they try to read these bodily states as speeches, as a form of non-verbal expression, transforming it into a greater knowledge of oneself and others . own limits (Pascual, 2015).
In this sense, Jorge Cavia, music therapist and worker at the Hugo Pomar Foundation, states (Pascual, 2015): It is about expressing feelings and giving more importance to the emotional part than to the intellectual part. We know that feelings are hidden there and we know that the key is in them. Music is used to work on losses, sadness or feelings of guilt. Music Therapy should be another support in any therapeutic team.
It is from the 20th century when the use of this practice begins to spread in the therapeutic world, specifically, the North American doctor Path Addams promotes alternative means of healing for patients, being the inventor of Laughter Therapy for medical-therapeutic purposes and responsible for the inclusion of this in modern medicine (Collado & Cadenas, 2013).
As stated (Carbelo & Jáuregui, 2006), numerous benefits are attributed to laughter:
Psychological: sensations and states of joy, well-being and satisfaction, stress reduction and prevention of depression, among others.
Physical: increases pain tolerance, activates the immune system, improves the cardiovascular system and releases serotonin, among others.
Social: improves motivation, facilitates communication as well as order and social stability.
Mindfulness has its origins in Buddhism, being one of the eight components of the “noble eightfold path”, transmitted by Buddha to his disciples approximately 2500 years ago. Despite its connection with Buddhism, this technique has nothing inherently religious (Santachita & Vargas, 2015).
Its peak period can be established in 1979 at the University of Massachusetts, specifically in the program that Dr. Kabat-Zinn developed to treat patients with chronic diseases, creating a structured course of approximately eight weeks that included Mindfulness techniques, yoga and the application of meditative techniques in daily life, with the title “Mindfulness-Based Stress Reduction (MBSR)” (Bertolín, 2015).
Mindfulness as a facilitating process
From this moment on, Mindfulness begins to be used in different areas, being widely used as an adjuvant treatment in depressive disorders, anxiety disorders and pain.
This technique as a facilitating mechanism of the therapeutic process seeks, primarily, that emotional events and aspects and any other non-verbal processes are accepted and experienced in their own condition, without being avoided or trying to control them (Vallejo, 2006), that is, that the person let themselves be carried away by the sensations they perceive, without judging them and putting full awareness into practice.
To mention the Freiburg Mindfulness Inventory, studied in relation to tobacco and alcohol consumption and which provides very positive data regarding the abandonment of addictive behavior ((Buccheld, Grossman, & Walach, 2002).
Mindfulness steps as therapy
The author (González-Bueso, 2016) states that this tool can facilitate, as a complement to treatment, the abandonment of addictive behavior by following eight steps:
Accept that suffering is inherent to life
See that human beings create additional suffering that must be gotten rid of
Accept impermanence, that is, you can end suffering
Take the road to recovery and discover freedom
Transform words, actions and way of subsistence, reconciling peace with the wrong that has been done in the past
Place positive values at the center of life
Strive to stay on the road to recovery
Help others share the benefits that have been obtained from the change