Compliance and defiance typically have been the poles between which the patient has been running back and forth for years, inside a family system which is stuck in that pattern. His compliance seems to be movement forward into adulthood, so long as most of what he complies with happens to be good advice, and reasonable rules, from exasperated elders who may well love him. But compliance is never really as good as it looks, because it's not autonomous, so it is not sustainable; it builds resentment that comes out sooner or later. His defiance appears to be much worse, of course, because it's often full of hostility, self-destructive, anti-social, risky, and debilitating. Part of the reason this pattern is so terribly stable and hard to break up, is that the family's response to the young addict's defiance is usually a call for a return to compliance, this time a new-and-improved compliance that will last. That never works, because even if he does produce a good lengthy chunk of compliance, it's still mere compliance. The solution is, in most such cases, to bring in a therapist whose client is not the family, but the patient himself. That way, the patient can continue doing the only two things he knows how to do, but in a whole new way which will permit him to learn new skills: he defies the family, and (for the time being) complies with the therapist in a private, collaborative search for what the patient really wants from life.
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