La cuestión nodal a responder es si un programa asistencial que abarca una problemática que se irradia desde y hacia lo social, puede restringirse a una línea teórica específica.
Si la oferta terapéutica tiene en la articulación de redes uno de los pilares básicos, el marco teórico también se articula como una red de referentes configurados orgánicamente. Más allá de la estructura básica sobre la que se construye la red, cada nodo tiene en sí mismo sus propios referentes teóricos, lo cual genera un entramado multidisciplinario que requiere ser evaluado periódicamente.
Esta particularidad elude encasillamientos, pero genera un proceso dinámico que no se agota en sí mismo (si así fuera, debiera cuestionárselo), asentándose hacia el análisis organizacional y epistemológico.
En este sentido, el Proyecto “UOMO” conlleva en su espíritu y en su accionar los basamentos necesarios para el desarrollo de un programa abierto, dinámico y en proceso continuo. Hacia él confluyen diferentes vertientes que provienen de la psicología y la sociología. Pero lo que le da particularidad y consistencia es su formulación estructural que admite líneas teóricas diferentes, sin renunciar a su filosofía terapéutica-educativa.
En tanto modelo de intervención, tiene a su servicio una variada gama de instrumentos terapéuticos pero no admite concesiones en lo educativo, razón por la cual muchos pilares de la prevención primaria “conviven” con instancias del orden asistencial. No es casual que los dispositivos de reducción de recaídas y de seguimiento biopsicosocial funcionen a partir del alta institucional como soportes explícitamente preventivos.
Consideramos a la drogadependencia como síntoma de un malestar personal, en el que confluyen aspectos de la historia personal y social del individuo. Como toda adicción, tiene un soporte psicopatológico. Pero se “desprende” del lugar del síntoma para ser, en sí misma, una estructura con funcionamiento propio.
Los dos ejes del tratamiento son el terapéutico y el educativo. En el primero no solo hay una revisión de la vida íntima del sujeto, sino también una reformulación de su proyecto de vida. Sin renunciar al análisis de su estructura psicopatológica de base, ésta es elaborada en profundidad luego del alta institucional (en este sentido, el aporte del psicoanálisis es esencial). Esto no representa una posición a “priori” únicamente, es uno de los requisitos indispensables para el logro de la rehabilitación.
El aspecto educativo se caracteriza fundamentalmente en los grupos de convivencia y en toda situación institucional que ayuda a movilizar aspectos personales del individuo.
Como protagonista de la acción terapéutico / educativa, el drogodependiente es una persona que posee los recursos suficientes para cambiar su propia situación. A partir de esta concepción puede pensarse nuestro programa terapéutico como un gran grupo de autoayuda que posibilita un seguimiento personalizado a través de situaciones individuales.
Otra particularidad es que el marco teórico no excluye un profundo trabajo sobre los aspectos transferenciales y contratransferenciales, ya que en la relación terapéutica (que se instala a partir de la primera entrevista) no sólo se juegan situaciones vinculares personales, sino que desde la estricta posición educativa se desarrollan aspectos de “horizontalidad” que desmantelan vestigios autoritarios y omnipotentes.
Sin descalificar la “falla estructural en lo normativo” del drogodependiente, pensamos la tarea desde dos perspectivas complementarias:
• La normativa institucional que, a modo de aspectos superyoicos, convive durante el tratamiento
• Los pilares institucionales que representan aspectos del ideal del yo que se desarrollan a través del vínculo social con sus compañeros y operadores.
Es difícil pensar en una tarea “No directiva” ya que la “directividad” funciona como matriz reparadora de una falla estructural en el yo del individuo. El terapeuta se sitúa en el rol de acompañante y orientador del proceso de autoayuda, pero también es un modelo, abierto, perfectible. Por esta razón, la Asociación Civil El Palomar enfatiza la tarea desde una lectura de la transferencia y tiene como soporte básico y excluyente de la tarea a los espacios de supervisión institucional y clínica (en ese orden).
La concepción de la comunidad terapéutica, pensada como una instancia integradora y superadora de la subjetividad de sus integrantes plantea el simple desafío de “mirar y mirarse” a través del intenso proceso de crecimiento.
Es pertinente aclarar que la omnipotencia representada por la fidelidad a los textos en desmedro de la mirada hacía sí mismo y hacía el otro conlleva al riesgo de la fascinación de la subjetividad de la persona. No existen rehabilitados marca “El Palomar”. Se trata simplemente de personas que son lo que pueden ser, y que deben ser respetadas en la profunda dimensión de su libertad.
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