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  Obstacles to Recovery From Addiction
Floyd P. Garrett, M.D.
 
 

The principal obstacles to recovery from any addiction are ignorance, shame, guilt, dishonesty, pride and personal exceptionalism.

Unfortunately for the addict these roadblocks to recovery are almost always cleverly situated and sited like military forts to provide mutual support in fending off all attempts at recovery.

Simple ignorance of addiction and recovery, for example, is in theory easily remediable by exposure to accurate medical information on the topics – but the adjoining and interlinked "forts" of shame and dishonesty serve to limit the amount of understanding the addicted individual can acquire about his real condition. Similarly, the rectification of the dishonesty and evasiveness that is a central and necessary part of the psychology of addiction is rendered far more difficult by the co-existence of the addict's ignorance of addiction and his resulting shame about his addictive behavior.

The personal exceptionalism of the addict permits him to outflank facts and moral considerations that would normally prove decisive in halting or at least decelerating his addiction. Because the addict believes that he is "not like those other people" and that "his case is special," he has a virtual blank check to rationalize and justify behaviors on his part that contravene his personal values and beliefs.

The price of such personal exceptionalism, however, can be quiet steep: when he keeps bruising himself against the stubborn facts of the case, the addict experiences intense shame and humiliation. Precisely because he is an exception, he is "not supposed to be like that." His personal grandiosity merely makes him a bigger target for "the slings and arrows of outrageous fortune." Every time he tries to walk on water he gets wet, an unpleasant and embarrassing experience that requires the assistance of the neighboring "fort" of dishonesty to explain away(the water was too cold, he wasn't in the right frame of mind, onlookers were making too much noise, &etc.).

Personal exceptionalism makes it difficult for the addict to seek or accept help for his problems. Other people, people unlike himself, can and should receive help in overcoming their addictions – but he, precisely because of who he is, should neither need nor obtain such help. To do so would be a serious threat to his entire system of uniqueness.

The addict is caught between the proverbial rock and a hard spot in regard to his personal exceptionalism, for if he fails to live up to the grandiose and unrealistic expectations it requires him to fulfill, he experiences feelings of failure, shame and humiliation – but on the other hand, if his personal exceptionalism itself is threatened, he feels precisely the same feelings for not having been what he thought he was but instead an ordinary person "like everyone else."

An alcoholic having serious problems such as health, marital, legal and job difficulties from his drinking may feel that his drinking is both justified and necessary because of his exceptional situation, that other people(doctor, spouse, judge or employer) are exaggerating and "making too big a deal" out of admittedly real but in his opinion minor difficulties, that he can and will stop drinking or cut back whenever he decides to do so, and that he doesn't need any help, professional, AA or otherwise in managing his drinking. At the same time he may be deeply ashamed of himself and the problems his drinking has caused him and others – but his dishonesty makes it impossible for him to admit this to himself. He develops paranoid defenses of the "why is everybody out to get me?" and "why do I keep getting the shaft?" variety that permit him to hide behind a victim smokescreen of resentment and self-pity and thus to avoid coming to terms with his own behavior.

The psychology of addiction is by no means limited to alcoholism. In order for the increasingly irrational and harmful effects of an addiction not to stop the process dead in its tracks, a complex and sophisticated set of ever-changing rationalizations, loopholes, exceptions and special considerations must be developed to explain away what otherwise would be inexplicable: the simple question that the addict is frequently asked by amazed and bewildered others, "Why do you keep doing it?"

This of course is precisely the question to which the addict has no truly rational or even sane answer. But though he has no good or even sensible answer to the question "Why do you keep doing it?" the addict is seldom at a loss for rationalizations, justifications, excuses and explanations for his harmful and irrational behavior.

Addictive rationalizations and justifications usually involve both denial or minimization of the actual negative consequences of the addictive behavior together with a displacement of responsibility for it. The addict begins to feel like a misunderstood, unfairly treated and criticized victim of Fate - and of the mean-spiritedness of other people. Resentment, self-pity and the resulting sense of addictive entitlement –"If I am going to be treated this badly, I might as well drink, drug, or do whatever it is I like to do!"- provide emergency justification for still more irrational addictive behavior.

The effect of the various psychological defenses that protect the addictive process is to prevent the addict from grasping what is actually happening to him and thus to prevent him from learning from experience. Individuals suffering from addictive illness display a remarkable inability to "connect the dots," to see the big picture, and to recognize the forest rather than the trees. They certainly realize that something is going seriously wrong in their lives as the negative consequences of the addictive process continue to mount up – but it is very difficult for them to see that the addiction itself is the chief source of their multiplying difficulties. Only in retrospect, after some period of recovery from their addiction, do they usually begin to understand how pervasively harmful it was to them.

The shame, guilt, pride, dishonesty and personal exceptionalism of the addict may result in a grandiose and defiant false self that serves to protect the addict from his often intense underlying feelings of personal inadequacy and guilt. This addictive false self functions like a suit of armor to conceal the vulnerabilities of the real self – but in many cases the protective armor grows so extensive and cumbersome that the real self is completely covered up by it. The result is inner as well as interpersonal alienation and the virtual cessation of emotional growth. And because the addictive false self is constructed and maintained to meet the requirements of the addiction and not of the living individual, the real self becomes progressively isolated, diminished and devitalized as the addictive self expands and grows stronger at the expense of the weakened and fearful real self.

Recovery from addiction thus means recovery of the real self and the resultant resumption of healthy inner and interpersonal connectedness and emotional growth. The addict is psychologically estranged not only from others but first and foremost from himself. The overt and obvious behaviors of the addict represent at most the tip of the iceberg so far as the actual consequences of his addiction to him are concerned. (See "Getting Away With Addiction?" for an analysis of the actual negative consequences of any addictive process upon its host psyche.)

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Original Papers

The Addict's Dilemna

Addiction, Lies and Relationships

Addiction and the Mechanisms of Defense

Alcohol Addiction

Drug Therapy of Alcohol Dependence

Excuses Alcoholics Make

The Female Partner of the Male Alcoholic

Getting Away With Addiction? 

Intervention for Alcohol and Drug Dependence

Obstacles to Recovery from Addiction

Prescription Drug Abuse

Prolegomenon to the Metaphysics of Recovery

What is Recovery?

Why is Recovery So Hard?

Worried Sick About His Drinking?

Your First AA Meeting: An Unofficial Guide for the Perplexed