Tony White

There are many colloquialisms used in the counselling field. For instance there is a thing called ‘Door knob therapy’. That client who has the habit of bringing up very important information just as the therapist is about to turn the door knob on the door to let the client leave at the end of the session. Typically a form of resistance as the client knows that the session will end and thus they don’t have to deal with what they just brought up. Ambivalence - they want to deal with it and they don’t want to deal with it at the same time.

 

 

 

I want to deal with it but it scares me.

 

Then there is another axiom where the client is said to have tried ‘Geographical therapy’. The person relocates geographically so as to get away from a person (most often mother or father) or a situation, or a job, or they may relocate geographically so as to get near some person or circumstance.

 

The magical thinking behind doing such a thing is, “If I can just geographically move away from her then my emotional issues will go away and I will feel less disquiet and more emotionally secure”. Although it can work it is rare. The key factor in geographical therapy is timing. If geographically therapy did generally work then there would be very few therapists and an awful lot of travel agents. Of course most people take their emotional angst and pathologies with them when they move.

 

 

 

Geographical therapy is particularly prominent in the area of drug abuse therapy. I worked for 5 years at a drug rehabilitation centre. This organisation had another treatment facility that was called the ‘Farm’. This “Farm”, was a farm and was located about 50 Kms out of the city and drug users could go there to live for months at a time. They would work on the farm which was a drug free environment and thus they were not consistently being tempted to use like they would be if they were in their usual domain. Thus the treatment method of geographical therapy was being applied.

 

I have my doubts about its effectiveness. Often removal to the farm was a last resort measure done out of desperation. “Nothing else is helping so we might as well try the farm”, was often the thinking behind going there. This also allowed the parents, partners and friends of the user to feel secure for a little while as they knew where the user was and that he was not using. Whilst that is good for them it may not have been so good for the user. Whilst being drug free, and it by and large was, the drug user is being placed in an environment with 20 other drug users who were trying to get off the gear.

 

 

Putting a drug user with other drug users is like getting two swines with the flu to kiss each other.

 

Now we in the counselling field are often banging on about the importance of relationships in the cure of emotional malaise. It is the relationship between the client and some significant other (usually a therapist) that has the most curative powers of all. At the farm the user was placed in a situation where he would establish a whole new set of relationship with others who were also drug addicted. There is something not quite right about that!

 

However geographical therapy in the treatment of drug abuse does on occasion work. I have a very dear friend of 20 years. A lovely woman and we have met regularly for all this time. She has a son who some years ago became quite a heavy amphetamine user and she would often talk to me about what was happening and really seek my counsel on it a bit. At one point it was decided that he would move from the west coast of Australia, where we were, to the east coast and live with his uncle and aunt. Now for those of you who don’t know Australia the east coast and west coast of Australia are a very long way apart.

 

Geographical therapy was being employed as this would remove him from the drug scene and his drug using comrades and he would be forced to establish new relationships. So the move was made and it worked a charm! He established himself over there with a job, found himself a girl and is now married with a child. He never sought out the drug scene over on the east coast.

 

 

 

So geographical therapy with drug users can be effective if the timing is right. It is very difficult for drug users to establish a non drug using peer group and geographical therapy can greatly assist with that as long as the user is ready for it. Geographically relocating a user to an environment with a group of drug users who are currently in remission I do not think is a wise move to make. The geographical relocation needs to be to an environment with very few ex users.

 

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