Bridge over Troubled Water: Patients’ Opportunities for Collective Participation in Substance Use Institutions through Research Circles

This study explores patients’ opportunities for collective participation in an institution for people with substance use disorder. Patients and staff from the treatment institution cooperated with researchers to make changes in the treatment practice, using a research circle as a model for the project. In the article, we discuss the following research questions: How and in what areas did patients have the opportunity to participate collectively in the treatment institution? How did the patients experience participation in the research circle? Data consist of minutes from meetings, seminars, and focus-group interviews. The participants analysed the material together, and the authors carried out a thematic analysis after the project. The participants chose to explore how milieu therapy could build a bridge from treatment in the institution to life after treatment, a “Bridge over troubled waters”, to quote Simon and Garfunkel. Findings show that activities in the research circle led to changes at the institution, e.g., regular Sunday afternoon meetings, a weekly quiz, and less controlling procedures of substance use, and that the institutional culture in general became based more on participation and equality. Patients, staff, and researchers participated in a partnership; mutual recognition promoted cooperation and fellowship in the research circle. We conclude that the project provided the participants with opportunities for collective participation in the institution. In addition, the patients experienced partnership and empowerment in the research circle. Our attempts to change institutional practices yielded some improvements but also met with structural and cultural barriers. Thus, the project experienced challenges and obstacles mostly related to limitations in the institutional system and culture.

Afterword

I was first ‘introduced’ to Stevan Pavlowitch thanks to Hurst sometime in 1993. A freshly arrived refugee from the former-Yugoslavia, unsure what to do with life and yet to begin my university studies in history, I was wandering the streets of Covent Garden when the Africa Centre bookshop on King Street caught my attention. Among the various books on African topics stood a biography of Tito, written by someone obviously of Yugoslav origin, but the spelling of whose surname suggested he had lived outside Yugoslavia for considerably longer than me. It was a Sunday afternoon, the only time I was off work (as a busboy and a barman in London clubs and pubs), and the bookshop was closed, to my disappointment. I stared at the book display for what seemed like a long time, excited and emotional, probably wondering who was Stevan K. Pavlowitch, what did he write about Tito, my (our?) former president, and why would an African cultural centre sell a biography of Yugoslavia’s late leader....

Obliquities

This chapter explores how obliquity functions as both a narrative mode and a literary style in the fiction of Elizabeth Bowen. It contends that, for Bowen, confrontations with history and modernity are best handled indirectly and tactfully, to the point that obliquity becomes a signature of her short story style. The early part of the chapter outlines Bowen’s poetics of the short story. Her thinking on the short story is compared with that of her compatriots, Seán O’Faolain and Frank O’Connor, whose stories informed her discussion of ‘national imprint’ in a class on short fiction that she taught at Vassar College in 1960. The latter part of the chapter analyses how Bowen develops an aesthetics of oblique representation of Irish history in her own fiction, with particular reference to ‘Sunday Afternoon’ and ‘A Love Story 1939’, two stories set during the Second World War.

Seurat, Georges-Pierre (1859–1891)

Born in Paris in 1859 to a bourgeois family, painter and draughtsman Georges-Pierre Seurat enjoyed a brief but mature career as the leading French Neo-Impressionist. His invention of Divisionism (or "chromo-luminarism"), a painting technique grounded in science and the study of optics, challenged the spontaneity and fluidity of Impressionism, which by the 1880s had been largely subsumed by a capitalist gallery system. In 1886, at the eighth and final Impressionist exhibition, Seurat debuted his monumental Sunday Afternoon on the Island of La Grande-Jatte (1884–1886), a "patient tapestry" of line and color that led the art critic and activist Félix Fénéon to coin the term néo-impressionisme. Equally shaped by the Renaissance frescoes of Piero della Francesca and the Baudelairean praise of the ephemerality of modern life, La Grande-Jatte symbolically closed a chapter in French painting. Seurat’s systematic aesthetic produced an indelible impact on fin de siècle artists such as Vincent van Gogh, Paul Gauguin, Henri de Toulouse-Lautrec, Henri Matisse, and later Pablo Picasso, Robert Delaunay, and André Breton’s Surrealism, firmly establishing him as integral to the 20th-century avant-garde. Seurat’s oeuvre includes approximately 500 drawings and 6 major figure paintings, an astonishing output for a career that lasted only 11 years.

Neo-Impressionism

Neo-Impressionism (1886–1906) comprised a group of avant-garde painters in France who explored a systematic approach to painting that revived Classical ideals while critiquing Impressionism’s prevailing aesthetic of spontaneity and improvisation. Led by the young, Parisian-born Georges Seurat, a rebellious École des Beaux-Arts-trained painter and anarchist, the Neo-Impressionists first gained attention at the eighth and final Impressionist exhibition in Paris in 1886. There, Seurat and his student Paul Signac, accompanied by the older Camille Pissarro, and his son Lucien, staged their bold new work. Its centerpiece was Seurat’s monumental Sunday Afternoon on the Island of La Grande Jatte (1884–1886), a visual manifesto to Neo-Impressionist precepts. In his review, art critic and activist Félix Fénéon coined the label néo-impressionisme to describe compositions that forcefully advanced Impressionism’s vibrant coloristic experiments. He detailed Seurat’s method of juxtaposing small, regularized touches of adjacent and complementary colors as ‘optical painting." Termed "divisionism," unblended pigments would theoretically "recombine on the retina" of the observer, resulting in a brilliant synthesis of hue and light on the painted surface. The methodical application of dots was termed "pointillism."