Poverty, Addiction, and Criminality

| Photo by Taylor Williams on Unsplash

For several years, I have been doing consulting and personnel training at different treatment and rehabilitation centers under the Philippine Department of Health (DOH). Many of these facilities are better staffed, with more modern infrastructure than before. Highly trained personnel in the clinical arts and science of psychosocial rehabilitation are severely lacking to serve its overwhelmingly poor and marginally educated, criminally involved clientele.

This treatment population is challenging to work with because of the feeling of social isolation and the inability to relate to mainstream society with its laws and values. They have a disdain for authority that stems from early problems with authority figures, such as parents, teachers, or local authorities, and a lifelong brush with the law for illegal activities. Court orders often facilitate their tenure in the treatment center for drugs and criminal offenses, complicating further their already negative attitude towards authority.

Somehow, my social background provides a window into which I could peer into the soul of these people. I could relate to their pains and sufferings, which are often expressed in their antisocial lifestyle of drugs and criminality. I could communicate with them and get them to do my bidding better than most staff.

The key is understanding their needs and my ability to connect with them deeply. They respond to harsh language and approaches, a common strategy employed in prison, with their familiar façade of toughness. And yet, they show the ability to develop rapport with counselors and respond positively to emphatic and respectful approaches. The challenge to the treatment personnel is balancing social control and security strategy and maintaining therapeutic relationships. Sometimes, this feels like walking on a tightrope.

Poverty spawns a myriad of problems at home and in the community where they grew up. Their lack of normal socialization results from inadequate parenting from parents who often have to spend many hours making a living. Many grew up in homes characterized by family dysfunctions, such as domestic violence, alcoholism and substance abuse, absentee parents, physical, emotional, or sexual abuse, parental neglect, and abandonment. The lack of adequate parental guidance results in school dropout and teen pregnancy or fathering children at a young age. Siring children who lack adequate parenting skills might perpetuate the cycle of addiction and criminality.

The key to their hearts and minds is establishing a positive therapeutic relationship that fosters mutual respect, therapeutic boundaries, and emotional connection. Though their capacity to establish and sustain reciprocal relationships is impaired, they respond well to warm and caring relationships because they seldom feel deep emotional connections with other people.

Fractured attachment with caregivers early in life and adverse life experiences characterized their history. Drug use and social deviance were their means of coping with negative emotions and suffering. When they enter treatment, their level of emotional maturity is that of children with low frustration tolerance and a propensity for acting on their impulses because of their inability to curtail the need for immediate gratification. Their self-regulatory deficits are the outcome of chronic stressful life brought on by poverty, poor home life, and exposure to a life of crime.

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ABOUT THE AUTHOR   Dr. Fernando B. Perfas is an addiction specialist who has written several books and articles on the subject. He currently provides training and consulting services to various government and non-government drug treatment agencies regarding drug treatment and prevention approaches. He can be reached at fbperfas@gmail.com.