"Nurse Jackie" & The Behavioral Approach To Addiction

By

"Nurse Jackie" & The Behavioral Approach To Addiction
"Nurse Jackie" shows the limitations of behavioral solutions to psychological problems.

Season Five of Showtime's darkly comic "Nurse Jackie" proves my contention that "if you deal with the behavior without confronting the underlying issues, you're just switching chairs on a sinking ship." I was referring to substance abuse in the quote, but it really holds true for the behavioral approach to all psychological problems. Yet another post about TV, you ask? As I learned in grad school, it's easier to see a book, movie, or TV character's issues and learn from them than to see our own.

Behavioral Approach To Chemical Dependency

In the TV show we watched ER nurse Jackie Peyton go through years (or at least seasons!) of prescription drug abuse and dependency, and spin a web of lies that even she couldn't maintain. She had an affair with her co-worker, the hospital pharmacist, primarily to get drugs from him. She never told him she was married and had kids. When the pharmacist followed her and saw her with her husband, the situation took a particularly dark, dramatic turn. Her marriage was irreparably damaged, and Jackie finally went to detox and rehab and began a recovery process that focused on staying away from drug use.

This is the conventional, behavioral approach to chemical dependency: detox, followed by rehab or outpatient chemical dependency treatment, and 12-step meetings. And it can be a great start for many, but not the whole story.

Viewers who don't understand psychology were probably cheering for Jackie and thinking everything would work out for her. But her recovery process didn't include ongoing therapy, and she blew off outpatient chemical dependency treatment and 12-step meetings for a long time; so while she managed to stay drug free, she continued to do things her way, avoiding her underlying issues.

The "chair" she's switched to is drama and lying to the men she's working with, dating, sleeping with three different guys as well as to her ex-husband. She lies to everyone in her life, including herself, but this has been her character for years.

Hey, but she's not using drugs, so it's a victory, right? Depends how you define victory. If you define it only in behavioral terms, restricted to drug use or abstinence from drug use, it's a victory. If you define victory as handling yourself well in daily life, living in a way you want your kids to emulate — in short, living with integrity — Jackie is far from victorious. And in the season finale, she pops a pill before going to her one-year anniversary celebration at her 12-step meeting, and doesn't tell anyone.

Problematic Life Equals Great TV

Jackie's character, which we'll define as how a person habitually deals with things, is coming back to "bite" her. Grace, her 14 year old daughter, is lying to her, sneaking around with an older boy, and experimenting with drugs. This is not going to end well, unless Jackie commits to getting lots of good therapy, rather than looking at her daughters' problems as separate from hers, and starts modeling a more reasonable orientation toward life for her daughters.

Of course, then we'd have a very boring show, because who wants to watch a show without drama? Jackie would turn the channel in a heartbeat!

Where do you stand on the drama in everyday life, versus the joy in everyday life? If the drama-to-joy ratio is high, good therapy can make a big difference. I'm happy to connect with you and help you have more joy in your life. Feel free to comment below.

More Advice from a Personal Development Coach on YourTango:

This article was originally published at Diane Spear. Reprinted with permission.
Article contributed by
Advanced Member

Diane Spear, LCSW-R

Counselor/Therapist

Diane Spear, LCSW-R, is a NYC-based psychotherapist who helps couples and individuals throughout the world find the joy in everyday life! She has been in practice since 1995, working with older adolescents up through older adults. Check out her website at www.dianespeartherapy.com to learn more about her therapy and counseling practice and couples and relationship therapy; and be sure to read her blog.

Connect with Diane through email here, or call 212-353-0296

 

Location: New York, NY
Credentials: LCSW-R
Specialties: Anxiety Issues, Couples/Marital Issues, Life Transitions
Other Articles/News by Diane Spear, LCSW-R:

How Wedding Fever Can Ruin Your Relationship

By

Melissa and Tom (whose names have been changed to protect their privacy) argued as they drove to meet their vocal coach. "Why do you want to sing The Wind Beneath My Wings?" she asked. "It's such a cliché, and I'll never hear the end of it from my dad." "You're not doing much better with that Shania Twain song," ... Read more

Communications Technology Vs. Relating

By

Communication is supposed to be helped by technology, right? We're available 24/7 now, through cell phones, texting, Facebook, Twitter, email, etc. We may be communicating, but are we relating? Is a Facebook friend really a friend? Is the first time you tell the person you're dating that you love them in a text? I know couples who have fights because ... Read more

"Enlightened" Returns! [EXPERTS]

By

Laura Dern, Mike White, Diane Ladd, and Luke Wilson are back for another season of HBO's "Enlightened"—and I'm thrilled to have one of my favorite casts of narcissistically-challenged characters return. So much material, so little time! In just the first three episodes of the season, Amy (Laura Dern's character) has already ... Read more

See More

Ask The Experts

Have a dating or relationship question?
Visit Ask YourTango and let our experts and community answer.

FROM AROUND THE WEB