Path of Drug Addiction

Michael, 43, was involuntarily admitted to the hospital for treatment of polysubstance abuse. He was frail looking, his body depleted and sickly-appearing due to years of drug abuse. Michael reported an extensive history of drug treatment for heroin addiction , which to date had achieved little success. Michael outwardly admitted that he was ambivalent about discontinuing his drug habits.

Once given the instruction to draw a road, Michael engaged the image-making process without hesitation. He employed the paper in a horizontal format, suggesting that his drawing is a story that reads from left to right. Michael employed crayons, a controlled and predictable art medium, attesting to his necessity for control. This seemed in marked contrast to his apparent lack of control over his heroin addiction.

Michael's road drawing revealed much about his submerged unconscious processes, experiences to date and grave premonitions regarding his future. The road originates in the west portion of the paper, travels north, and leads to a "T" intersection in the east portion of the paper. Impeded by hazard signs reading "DEAD END", the road reverts back to its origins only to be opposed by another "DEAD END" sign. After completing its circular course, the road narrows to a single line suggesting "burnout" or that Michael's life force is dwindling away. There is a sense of hopelessness and futility as Michael's alternative paths and return journey end at signs declaring "DEAD END". Several yellow hazard signs are an apparent attempt to warn himself of the impending danger should he choose to continue with the same course and action. The "T" intersection implies ambivalence toward an alternative or decision. Presumably, it is his hesitance toward relinquishing his drug addiction. Michael believes his options are limited, as both his alternative routes are blocked and his journey brings him in full circle.

I held the paper at a distance and rotated the image to adjacent sides while encouraging Michael to discover any resemblance of an image or form. Michael was astonished to recognize his road as a large "heart-shaped syringe". He laughed as he boasted, "Drugs are my true love! Unlike women, I can always count on it to be there for me". The heart is pink with a yellowish center, possibly attesting to his intense neediness and "love" for heroin. Malchiodi (1990) related heart-shaped imagery to an intense necessity for nurturance. Therefore, Michael's "heart-shaped syringe" and spontaneous associations allude to his attempts to substitute heroin for his lack of nurturing. His inability to soothe himself has led him to use drugs as a synthetic pacifier. Michael's use of color may also indicate he feels "in the pink" when experiencing the mind-altering effects of heroin. Michael's black road with yellow center lines resembles arteries or veins that transport the heroin throughout his body.

Michael uses red oil based pastel to write the words "ONE WAY IN - ONE WAY OUT", suggesting that his dichotomous thinking does not recognize a middle ground, but insists on an "all or nothing" attitude. Such polarized thinking is also visible in his depiction of a sunny blue sky in the west, which is juxtaposed by the dark brown mountain in the north and the pale yellow-green grass in the south. Michael's choice of colors may reveal his struggle between his nourished and healthy self (brown) and his weak, fading self (pale yellow-green) (Furth, 1988).

Michael's use of red to write the words "ONE WAY IN - ONE WAY OUT" alerts the viewer and denotes the impression of importance, danger and possibly illness (Furth, 1988). Often, words appearing in graphic material may be the client's attempt to draw the therapist's attention to something he/she wishes to address (Case & Dalley, 1992). Asked to elaborate on his written phrase, Michael stated, "I've always used drugs and I'll go out on drugs." His statement conveys a reluctance to change his self-destructive practices. Michael's drawing includes several images that suggest impending death: the sun departing in the west (Bertoia, 1993); the tapering and fading road; the "DEAD END" signs; and the fatalistic implications of the phrase "ONE WAY IN - ONE WAY OUT". In addition, Michael's road reverts back to its origins, possible representing the cycle of life.

While hospitalized, Michael's road drawing was instrumental in helping him to recognized the self-destructive effects of his addictions. His drawing revealed feelings of helplessness, futility, and his dwindling life force. Michael's road drawing was visible proof of his love for heroin. His road drawing also revealed his dichotomous thinking, which does not recognize a middle ground but insists on an "all or nothing" attitude.

Michael's road drawing portrayed his experiences to date and his intent for the future, which predicted self-destruction and relapse should he continue on his same path and course. Michael seemed overwhelmed by the drawing's sense of hopelessness and pessimism. I reminded him of the road's reparative potential and his capability to construct new paths. Michael smiled and nodded his head in agreement. Unfortunately, Michael was unable to resolve his indecisiveness and his intense need for heroin, hence he returned to his addictive practice shortly after being discharged from the hospital.