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Health: Lessons in the good life for teenage addicts: Jerome Burne on a self-discovery programme for American teenagers who find drive-by shooting easier than dancing in front of their peers

Jerome Burne
Monday 30 August 1993 23:02 BST
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'THE TROUBLE with drug addicts and young offenders is that they don't know how to enjoy themselves. There is no point in banging on to kids about the dangers of drugs if you don't offer them something else that is just as pleasurable.'

This is the sort of approach to reforming tearaways that induces apoplexy in supporters of the recently revived lock-'em-up-in-army-camps school of thought, but in America it has just attracted a dollars 12m grant from the federal government for a two-year trial.

'These kids have been psychologised to death,' says Harvey Milkman, a psychology professor at Metropolitan State College of Denver, Colorado. 'They know all the talk about dysfunctional families and deprivation. The challenge is to show them how to get pleasurable feelings without the pitfalls of addiction. And the best route to that, we've found, is the arts.'

The result is Project Self-Discovery, an intense 10-week course that has treated almost 100 teenage drug abusers since it started in January. Many of the teenagers also have convictions for crimes such as car theft, burglary and assault. They start by trying out various arts - painting, music, dance and theatre - and then specialise under a tutor. 'Just getting up and dancing in front of their peers is taking a huge risk for these kids,' Professor Milkman says. 'Some of them would find it easier to do a drive-by shooting.'

The difference between his approach and familar 'art therapy' is that it is based on the role of brain chemicals in providing pleasure. Professor Milkman's theory, set out in Pathways To Pleasure (co-author Stanley Sunderwirth, published next month by Maxwell Macmillan International, pounds 14.95), stemmed from work with addicts. He found that people become addicted to gambling, crime, risk-taking, sex or drugs because they produce chemical changes in the brain.

'People become addicted to their own brain chemicals. The brain is like a pharmaceutical factory producing its own mind-altering chemicals. The challenge is to find ways of stimulating the chemical you are addicted to in a socially acceptable way. We make it clear to the kids that they won't get the same roar and crackle of neurons as when they take crack. The pleasures we are talking about are gentler and long-lasting, but the feelings can be the same type.'

The book describes different ways of stimulating these brain chemicals, which involve two brain centres: the reward centre and the arousal centre. The reward centre is triggered by a range of activities, from running to meditation, and stimulates the production of serotonin and endorphins, which are involved in making people 'feel good'. This is the brain pathway that gets hijacked by drugs such as morphine and heroin.

The arousal system gets the body ready for action; it can be either frightening (just before a car crash) or thrilling (hang-gliding or racing driving). A brain chemical called norepinephrine (or noradrenaline) is involved in this process - and drugs such as amphetamines and cocaine can increase its effect.

The youngsters answer questionnaires to work out which brain system they are engaging when they steal or take drugs. Then they seek alternative activities that trigger the same brain centres. 'Some find performing a play stimulates their arousal system and gives them as big a buzz as stealing a car; others get their relaxation 'reward' by becoming involved in music; others like to do climbing or running, which could involve both systems,' says Professor Milkman.

Towards the end of the course comes a rite of passage into the responsible, adult world. 'We take them into the wilderness and they go on a ropes course that is 40 feet in the air. They think they are going to die. Their tough front begins to crumble and we get to what they are really about.'

This vulnerable state is only the beginning of a long night. The young offenders meditate on their goals and do yoga or listen to music; then they take part in the 'fire talk'. For this they sit in a tepee, talk about what they want and write down their aims. Finally, at dawn, they go out to make pledges to themselves during the 'medicine walk'.

So does this combination of dance and drama, of frightening physical activity and pseudo-native Indian ritual, have the desired effect? It is too early for formal results.

British experts are sceptical. Dr Stephen Wolkind, of the Institute of Psychiatry, London, says the real test is long-term effect. 'There have been lots of imaginative schemes that start with huge enthusiasm and look as if they should work, but when you follow them up carefully you find most of the kids drifted back into their old ways.'

Dr Nicholas Emler, lecturer in social psychology at Oxford University, points out that delinquency is a group activity. 'No one is a delinquent on their own. Treatment programmes often assume that it is a result of some individual weakness, but that is to miss the point. It is a result of a particular social context and environment. If people from this project are going to end up in the same dreary slum they came from, with the same people, the same patterns are going to re-emerge.'

A different concern is expressed by Andrew Bates, currently senior psychologist at Grendon Prison but recently with the young offenders centre at Feltham. 'Outward- bound type courses that build self-esteem are fine as long as they are combined with psychotherapy that tries to deal with the problem behaviour. Otherwise you just end up with very confident burglars who are also good at rock-climbing.'

Professor Milkman counters that the course brings about psychological changes. 'You can produce exquisite art and still take drugs, so we teach the kids to deal with the stress using relaxation and meditation techniques.' The youngsters learn how to disconnect themselves from other people's unreasonable demands. 'We don't allow them to form groups until they have found their intrinsic talent - then we encourage them to bond with kids who share their intersts.'

His project may not be the final answer. At least it is positive thinking in a field that badly needs it.

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