The Drug-free Therapeutic Community: A Total(itarian?) approach for the Treatment of a Total Experience

In this article the authors, using psychoanalytic concepts, will discuss the treatment process in a drug-free Therapeutic Community (TC). A TC is a long-term group programme for people suffering from addiction that aims at an identity transformation and a drug-free lifestyle. Although the TC model exists for over 50 years and is applied worldwide, it has always been controversial because of its “totalitarian” approach. Subjects that are under the spell of a drug addiction do not tend to seek treatment for psychological problems. If help is sought, it is usually related to the debts, family problems, prison sentences and so on that are the consequences of addiction. Once the addict has decided to embark on a TC programme, they go through a process of detoxification and enter the drug-free TC peer group. By living together in an environment that is both holding and frustrating, the subject manages to reconnect with his own emotions and thoughts and the process of the becoming of the subject can continue. Affects such as anxiety and anger can be experienced and carried and the mirroring effects of peers provides the material for symbolization. Maintaining the TC values that guarantee a safe environment is essential to this process.