Consciousness of the Substance abuse
PSYCHOACTIVE DRUGS alter perceptions, feelings, and thoughts of the individual consumer [Mangini 1998, Weil 1996, Weil and Rosen 1983 and Zinberg 1976. N.E. Zinberg, Observations on the phenomenology of consciousness change. Journal of Psychedelic Drugs 8 1 (1976), pp. 59–76. View Record in Scopus | Cited By in Scopus (6)Zinberg 1976]. Individuals who compulsively abuse psychoactive drugs experience these alterations in consciousness. [James 1890/1981] concept of the fringe of consciousness sheds light on how these changes in consciousness feel and what meaning emerges for the individual in that feeling. The emphasis on feelings in James’s concept of the fringe offers a deeper understanding of the immediate experience of addictive drugs; this emphasis on feelings also has import for the relationship between client and nurse.
William James, a philosopher and psychologist at the turn of the 20th century, developed a model of consciousness that theorized how changes in consciousness occur, and how these changes modify ordinary manifestations of consciousness. [James 1912/1976] conceived consciousness not as an entity but as a function. That function was knowing. The active nature of the verb symbolizes the ongoing process of the activity. It symbolizes a particular relationship between the individual and the world. How this knowing occurs has implications for the changes in consciousness that nurses observe and clients experience under the influence of psychoactive drugs. The paramount significance of this kind of knowing is its relationship to feelings and their intense counterparts, emotions.
Feelings and thought
Feelings are a biological expression of the body: the afferent impulses of the nervous system. Feelings are also a manifestation of the response of the whole person to life’s experiences. In James’s model of consciousness [James 1912/1976], whether one examines feelings as biological sensations or psychosocial-spiritual responses depends on the individual’s interest and the immediate context. Interest in this sense is what captures the individual’s attention. Biology, habit, culture, and the unique processes by which the individual synthesizes those components and acts on them shape this interest. Consciousness in this sense of action is selective [Taylor 1981].
[James 1890/1981] described feelings as the germ (as in a germinating seed), and the thought that emerges from and surrounds that feeling as the developed tree. This metaphor describes the relationship between feeling and knowing. It also describes two types of knowing: that of direct experience and that arrived at by thought and analysis. “Through feelings we become acquainted with things, but only by our thoughts do we know about them. Feelings are the germ and starting point of cognition, thoughts the developed tree.” (p. 218). This metaphor of germ and tree is particularly important when describing states of consciousness altered by psychoactive drugs: when selective awareness deviates from the ordinary waking consciousness of most people’s everyday experience.
The substrate of feelings is critical to all states of consciousness and helps to differentiate among them ([James 1884 and James 1890/1981]). This is true for the subjective experience of the client as well as the feeling response of the observer or nurse. But these feelings, because they are feelings, are not mature, developed, and orderly thoughts. They are therefore difficult to describe, conceptualize, and articulate. Our perception of feelings is an awareness of a change at the organic level of the body ( [James 1890/1981 and James 1894]). Whether we conceptualize those feelings as physical processes or psychological needs reflects a selected point of view; how the individual experiences those feelings at the time of the changes, however, might be difficult to articulate, particularly when the feelings are intense. The intense feelings ascribed to addiction [Khantzian 1985 and Khantzian 1997] might in the subjective experience of the individual preclude conceptualization. James noted that in emotional experiences, the undifferentiated organic response persists longer before distinction between feeling and thought or self and not self occurs ( [James 1912/1976], p. 73). Yet that subjective experience reflects the unique response of that individual. This dynamic nature of feelings is what brings them to the focus of the individual’s attention.