¶ … Kurt Cobain; his personal history, substance abuse history and a description of the interventions he attempted in order to decrease or eliminate his substance use. A description concerning the circumstances of Cobain's untimely end is followed by an application of relevant addiction and change guidance to identity Cobain's "journey through the stages of change to addiction" and to provide the basis for an individualized relapse prevention treatment plan. Finally, an explanation concerning how this intervention through the stages of change model would have worked with this celebrity taking into account his personal history is followed by a summary of the research and important findings concerning Cobain and addition treatment and relapse prevention in the conclusion. Review and Discussion

Biography of Kurt Cobain

Kurt Cobain was born on February 20, 1967 in Aberdeen, Washington (Mustian, 2014). According to one biographer, "Kurt Cobain dragged (screaming) the Alternative/Grunge Rock revolution into the American home" (Dean, 2003). With his Seattle-based band, Nirvana (a Buddhist term meaning to "extinguish desire"), Cobain released "Smells Like Teen Spirit" in December 1991 which was subsequently voted the No. 1 Song of the 1990s in an October 2000 VH-1 poll (Dean, 2003). A string of other major recording hits, including "Come As You Are" and the "Nevermind" album followed (Dean, 2003) which sold more than 10 million copies (Ali, 2002).

The band members of Nirvana included Cobain playing the guitar and his "strident, angst-glutted, and tormented vocal wail," Chris Novoselic on the bass, guitarist Jason Everman and Chad Channing and Dave Grohl, both drummers, who all hailed from Aberdeen, Washington, the most overcast city in the contiguous United States (Dean, 2003, p. 455). A graphic of the chain-smoking Cobain with his signature cigarette (he stopped smoking prior to his death) and guitar is provided in Figure 1 below.

Figure 1. Kurt Cobain

Source: http://i.huffpost.com/gen/1072378/thumbs/o-KURT-COBAIN-DEATH-ANNIVERSARY-facebook.jpg

In 1992, Cobain married Courtney Love, soon had a baby daughter and his performing career seemed enormously promising at the time (Dean, 2003). For instance, Dean notes that, "Cobain was a young man with great promise, a charismatic personality, and a brilliant and ironic wit" (2003, p. 455). Following a suicide watch after one unsuccessful attempt, Cobain committed suicide with a self-inflicted gunshot on April 8, 1994 at age 27 years in his Seattle home (Dean, 2003). According to Dean (2003), "A whole musical movement mourned its leader and spokesman" (p. 455), but not all observers were of a like mind in this regard. For instance, Karas (1994) reports that, "Many fans believed Cobain was less an icon for his generation and more an addict who tried to beat his depression with heroin and abandoned a young daughter" (p. 10).

Notwithstanding this unsympathetic view, though, the majority of journalists wrote of Cobain's death in reverent terms following his suicide and widely acknowledged his contributions to the grunge musical genre and talent as a performer (Dean, 2003). These mixed views about Cobain are not surprising given the fact that although he had much going for him, his personal life and substance abuse were a source of major concern. Indeed, Ali (2002) points out that, "Anyone who thought Cobain was an easy read probably wasn't a Nirvana fan" (p. 60). Despite not being "an easy read," Cobain did provide several warning signs that are characteristic of suicides. For example, besides a failed suicide attempt, Ali also notes that Cobain wrote in his journal that, "Hope I die before I turn into Pete Townshend" and adds that, "The tragedy is, he got his wish" (2002, p. 60). These warning signs could have been used to develop an intervention that might have been effective in preventing him from taking his own life and these issues are discussed further below.

Application of Addiction and Change Guidance to Kurt Cobain

Although the specific reasons for any individual suicide will be unique, there are some factors involved in Cobain's background that are salient with respect to his suicide in 1994. For instance, Cobain's hometown, Aberdeen, Washington, has the nation's highest suicide rate which is attributed in large part to the gloomy atmosphere created by persistent rain and 300 cloudy days each year (Dean, 2003). Despite his wealth and seeming success otherwise, some biographers maintain that Cobain was faced with some significant challenges and dilemmas in his career that may have contributed to his suicide. For instance, besides being from a hometown with the nation's highest suicide rate, Burnett (1995) reports that, "Cobain hated the fact that frat boys were cranking his songs at kegger parties. These were the sort of...

215). Moreover, Cobain's recording and performance success created another professional dilemma for him. In this regard, Burnett (1995) suggests that, "It was an impossible tightrope: writing angstful music when he was a millionaire, trying to write songs which couldn't be co-opted by corporate rock and teeny-boppers, while at the same time avoiding these very pretensions" (p. 215).
Although some observers were alarmed by Cobain's mental status, particularly in view of his substance abuse and following his failed suicide attempt, others maintained that rather than being a suicide-waiting-to-happen, Cobain was in fact a well-adjusted young man, especially given his celebrity status lending further support to the "not an easy read" characterization. For example, Hansen (2012) notes, "Some journalists focused on his personal problems and anxieties that led very neatly to a suicide, while others wrote that Cobain was happy and looking to his future" (p. 267). It is also noteworthy that some observers believed that Cobain was far more humble about his success than outward appearances might suggest and did not view his life as being worthwhile. As Ali (2002) points out, "Cobain never thought he was worth as much as we did" (p. 60).

Despite the mixed views about Cobain's background, his "journey through the stages of change to addiction" from first being disinterested to becoming involved finally becoming addicted can be readily understood by an application of the addition and change guidance provided in chapter 4. For example, according to this authority, "The road to addiction begins with an individual's exposure to the behavior and with personal views about the value of engaging in the behavior" (p. 68). Given the "impossible tightrope" that confronted Cobain in his personal and professional lives, the phases of his addictive behavior can be linked to these challenges and his attempt to respond through substance abuse. In this regard, chapter 4 adds that, "Risk factors represent problems and issues in various areas of functioning that interact with thinking about and engaging in the addictive behavior" (p. 69). This observation is congruent with the contents of a letter Cobain wrote to his fans in 1992 following a stay in a rehabilitation center that was not released until 2002, 8 years after his death. In the letter, Cobain explained his use of heroin to treat an "uncomfortable stomach condition" thusly (typographical errors are left intact):

So after protein drinks, becoming a vegetarian, exercise, stopping smoking, and doctor after doctor I decided to relieve my pain with small doses of heroine for a walloping 3 whole weeks. It served as a band-aid for a while but then the pain came back so I quit. It was a stupid thing to do and Ill never do it again and I feel real sorry for anyone who thinks they can use heroine as a medicine because um, duh, it don't work. (cited in Inside Cobain's Heroin Letter Never Sent, 2002, para. 4)

Unfortunately, Cobain's addiction to heroin overcame his stated commitment to his fan and large amounts of the drug were found in his system following his suicide (Inside Cobain's Heroin Letter Never Sent, 2002). Furthermore, noticeably absent from the analyses concerning Cobain's death are mentions of the demands of fatherhood on young men and the enormous pressures this can create in their lives (Baskerville, 2004). Despite his wealth, it is reasonable to suggest that Cobain experienced these types of problems in his own life as well in ways that contributed to his substance abusing behaviors.

Again, although every situation is different, people tend to go through five stages of change as they attempt to resolve their addiction as set forth in Table 1 below together with corresponding tasks and goals for each.

Table 1

Five Stages of Change, Tasks and Goals

Stage

Tasks

Goals

Precontemplation: The stage in which there is little or no consideration of change of the current pattern of behavior in the foreseeable future.

Increase awareness of need for change, increase concern about the current pattern of behavior, envision possibility of change.

Serious consideration of change for this behavior.

Contemplation: The stage wherein the individual examines the current pattern of behavior and the potential for change in a risk-reward analysis.

Analysis of the pros and cons of the current behavior and the costs and benefits of change. Decision-making.

A considered evaluation that leads to a decision to change.

Preparation: The stage in which the individual makes a commitment to take action to change the behavior pattern and develops a plan…