“As an occupational therapist at the National Addictions Management Service (NAMS), I help people recovering from addictions to reintegrate into society by re-introducing them to the roles they would need to take up, be it as an employee or a member of their family and social circles.
The patient guides the process. First and foremost, they have to tell me what they want for themselves because it needs to be meaningful and real to them.
Some of them tell me that they want to stay clean; some of them tell me that they don’t want to spend the rest of their lives in prison. Whatever it is, changing is not easy and there will be failures along the way, and a part of my job is maintaining that motivation.
Breaking the bad habits and patterns of a person recovering from addiction requires a complete cultural change. It’s not as simple as saying, ‘Oh you’ve done wrong. This is how you should do it.’
It’s not even rehabilitation; remove the ‘re’ from that word because it’s actually habilitation. You’re teaching the person entirely new things – new coping skills, new ways of living. You have to understand that addiction in itself is a subculture, and people in recovery are used to a set of behaviours that are functional within this subculture. But when they try to reintegrate into mainstream society, the norms that they’re used to do not work.
It’s very easy for those observing from the side to say that these behaviours are bad and need to be changed – “if you’re feeling stressed, go for a run because ‘that’s what people do’.” But in the past 11 years that I’ve been in this line of work, I’ve learnt that people’s patterns and coping mechanisms are based on their upbringing and where they’ve been socialised.
I’ve heard stories of mothers who actually bring their children out to sell drugs. If you’ve been socialised in an environment where your uncle is using heroin, your father is serving time and your brother just came out of prison, how do you expect to do any differently?
It’s ingrained in you from childhood; that life is all you’ve known. When you’re stressed out, you would probably turn to that very thing that got you into prison in the first place.
It’s also no surprise that some people think it is just simpler being in prison. Outside the prison walls, to properly survive you have to find a job, pay your rent and your bills. As the years come by, a whole slew of technological products and digital devices have been introduced without you knowing any of these. When you have to deal with all of that, it can be pretty terrifying.
That’s why having a support group of recovering peers is most important, and it’s definitely part of my prescription as a therapist. The bonds they create remind them that there are people going through the same problems, and that in turn motivates them to get better.
Our relationship with ISCOS is also very important because many of our patients are ex-offenders and we had trouble placing them in jobs. Since three years ago, we started partnering with ISCOS because they help ex-offenders with employment and reintegration into society.
There are challenges of course when we refer them to ISCOS. The thing about many of the most ex-offenders I’ve worked with is that they have low self-esteem. You have to persuade and convince them of the benefits of going to ISCOS. You need to be ready to hold their hands and guide them there. But it’s a two-way thing – they also need to be willing to accept that support and be internally motivated.
It takes effort to keep going in this line of work. If you stop caring and become jaded, that becomes an issue – but so is blaming yourself for what happens to your patients and clients.
I actually started my career in general psychiatry, and during my first eight months at the job, one of my patients committed suicide. When that happened, I questioned myself repeatedly on what I could have done differently. As a young therapist then, there was this tendency of tying your feelings or self-worth to how well your patients do – in reality however, this depends not just on the solutions you can offer, but also on the person’s choice to take them up.
Eventually, I started to compartmentalise mentally. I’m not sure if it was something I did deliberately, but I learnt not to take my work back home with me. If I’m in an emotionally-compromised state, I’m useless to my patient. How can I be somebody’s anchor if I am unstable myself? I cannot take things personally.
We’re all trying in life. We’re all trying to be who we think we’re supposed to be, and in order for those recovering from addictions to reach that state of self-actualisation, people like you and I need to give them a fighting chance.” – Jayson, 39
Jayson Davamoni-Thomas is an Occupational Therapist at NAMS and a working partner of ISCOS.