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The
Puzzle: why is recovery so hard?
A lasting recovery from a serious addiction
is made much more likely by an
accurate understanding of the nature of the addictive process and of the methods
that have been found, by long experience, to be effective in overcoming it and
keeping it in remission. In regard to addiction and recovery, as in most other
challenging tasks, knowledge is truly power. For the more the addicted
individual understands about what is actually going on with him and how to
overcome it, the better are his chances of long as well as short term success at
freeing himself from addiction.
But although the hard won experience of addicts and those who treat them is
freely available from a variety of sources, e.g. books, 12 Step Meetings,
treatment programs, friends or family members who have recovered &etc., the
very same experience also shows that one of the principal obstacles to making
use of this information is pre-existing misinformation about addiction that is
usually remarkably resistant to change. The typical addict can therefore be said
to be doubly ignorant, or negatively informed about his actual condition: for
not only are his ideas about what is wrong and what needs to be done almost
always incorrect, he is very likely to cling tenaciously to his false beliefs
and to resist enlightenment and thereby relief from the experiences of others.
It is as though a drowning man were deliberately to shove aside a life preserver
and even to actively fight the rescuers who are struggling to pull him to
safety.
The basic facts about addiction and recovery are neither complex nor
difficult to understand. Why, then, do addicts have such difficulty in grasping
and acting upon them? The answer to this question itself depends upon a correct
understanding of addiction and its influence upon the thinking and judgment of
the addicted individual.
Two
Views of Addiction
Although there continue to be many people who believe that there is no such
thing as addiction, i.e. that excessive or unhealthy involvement in a particular
activity is merely a matter of unwise personal choice, those who have had direct
experience of addiction either in themselves or in others are aware that matters
are not quite so simple as the "personal choice" model suggests.
Personal Choice
The personal choice theory of addiction denies that the use of the term
addiction adds anything useful to the understanding of behavior. Adherents of
the personal choice model may even regard the concept of addiction as an
unjustified evasion - an excuse for bad, unhealthy, or unfortunate personal
choices, e.g. the choice to drink more alcohol than is good for one. According
to such people there is nothing really different about alcoholics and other
addicts besides the fact that they choose to indulge in certain behaviors to a
degree considerably in excess of what is good for them and frequently those
around them. Believers in the personal choice model envision a smooth continuum
of behavior along which the entire population is distributed. In the case of
alcohol consumption, some people choose to drink more, others choose to drink
less. The only thing that differentiates them from one another is their choices.
To a believer in the personal choice model, the introduction of the term
"addiction" into the picture is both unjustified and unhelpful because
it blurs and confuses what is thought to be at bottom a simple and
straightforward question of choice.
Whether thought to result from personal choice alone or from a condition
called addiction, the behavior that is of concern in such cases exhibits the
following characteristics:
- Excessive
- Actually or potentially harmful
- Repetitive
- Stereotyped
- Chronic
- Highly resistant to change
- Prone to relapse and recurrence when interrupted
- Accompanied by denial and other psychological defense mechanisms
Although it is common to think of addiction only or mainly in connection with
certain drugs, the characteristics of addiction listed above are actually
manifested in a number of circumstances that need not involve drugs or alcohol.
Pathological gambling, compulsive spending, certain forms of over- or
under-eating and a number of other activities frequently display the very same
characteristics and can in such instances be described as addictive behaviors.
This broadening of the concept of addictive behavior is one of the things that
disturbs adherents of the personal choice model, for they fear that if
everything becomes a manifestation of a condition called addiction, no
individual moral accountability for unwise and even immoral choices will remain.
Addictive process, illness, disorder or disease
The term "addiction" derives from the Latin addictere, one
meaning of which is "to be bound to another." This refers to a process
in Roman law in which a person, formerly free, was given over to another as a
servant or slave. The modern understanding of addictive behavior is thus that
the individual afflicted is not wholly free in his choices. To a greater degree
than is the case with the non-addicted person, the choices of the addict –if
they can even be called choices- are constrained or determined by factors at
least partially outside his control. According to this view, the addict acts the
way he does, not because he is unwise, stubborn, foolish or bad, but because he
cannot help doing so. Whether it is called a disease in the strict sense of the
word does not matter so much as does the conviction that in such cases there is
something wrong with the addict that is not wrong with other, non-addicted
people. In some fundamental way, according to this point of view, the addict is
different from the non-addict.
Benjamin Rush (1745-1813), was a widely respected physician, signer of the
Declaration of Independence, and chief medical officer during the Revolutionary
War. Rush published An Inquiry into the Effects of Ardent Spirits on the
Human Mind and Body in 1784. "‘Drunkenness is the result of a loss of
willpower. Initially drinking is purely a matter of choice. It becomes a habit
and then a necessity.' His view was that habitual drunkards suffered from an
illness requiring medical rather than moral treatment.
Benjamin Rush's view differed from that of the famous preacher Jonathan
Edwards, who in 1754 had published his Freedom of the Will in which he
wrote:
"A man never, in any instance, wills any thing contrary to his desires,
or desires any thing contrary to his Will.... His Will and Desire do not run
counter at all: the thing which he wills, the very same he desires"
"Thus, when a drunkard has his liquor before him, and he has to choose
whether to drink or no . . . If he wills to drink, then drinking is the proper
object of the act of his Will; and drinking, on some account or other, now
appears most agreeable to him, and suits him best If he chooses to refrain,
then refraining is the immediate object of his Will and is most pleasing to
him."
"It cannot be truly said, according to the ordinary use of language that
a malicious man, let him be never so malicious, cannot hold his hand from
striking, or that he is not able to show his neighbor kindness; or that a
drunkard, let his appetite be never so strong, cannot keep the cup from his
mouth. In the strictest propriety of speech, a man has a thing in his power,
if he has it in his choice or at his election.... Therefore, in these things,
to ascribe a non- performance to the want of power or ability, is not just."
Thus in early America we find the very same competing views, personal choice
versus addiction, that even today continue to characterize our ways of looking
at behaviors now called addictive.
What
Do Most Addicts Themselves Think?
Although "personal choice" advocates fear that if individuals who
drink or drug or otherwise behave in a fashion that is called addictive are
informed by experts that they suffer from a condition or disease which
deprives them at least partially of the ability to control themselves, they
will interpret this as a blank check to throw off whatever remains of their
already diminished sense of moral responsibility for their choices, actual
experience with alcoholics and other addicts shows that this is far from being
the case. In fact, it is the very opposite of the way that active alcoholics
and addicts think. And it is this seemingly paradoxical or counter-intuitive
finding that gives a clue to the question raised above:
The basic facts about addiction and recovery are neither complex nor
difficult to understand. Why, then, do addicts have such difficulty in
grasping and acting upon them?
In 1741, Jonathan Edwards, the same fervent advocate cited above of the
"personal choice" model, preached his famous Sinners in the Hands
of an Angry God in which he said:
"The God that holds you over the pit of hell, much as one holds a
spider, or some loathsome insect over the fire, abhors you, and is
dreadfully provoked: his wrath towards you burns like fire; he looks upon
you as worthy of nothing else, but to be cast into the fire; he is of purer
eyes than to bear to have you in his sight; you are ten thousand times more
abominable in his eyes, than the most hateful venomous serpent is in ours.
You have offended him infinitely more than ever a stubborn rebel did his
prince; and yet it is nothing but his hand that holds you from falling into
the fire every moment."
Strange and incredible as it may seem to many, it is precisely this stern and
damning free –and therefore fully responsible- point of view of Jonathan
Edwards, not the kinder and more understanding medical model of Dr. Benjamin
Rush that the majority of active addicts hold of their own behavior. Rather
than viewing themselves as unfortunate sick people who cannot help themselves,
they cling fast, sometimes fatally to the vision of themselves as fully and
absolutely responsible and accountable for their actions, thus as sinners in
the hands of an angry God.
For there are no more passionate and determined believers in the
"personal choice" theory of addiction than practicing addicts
themselves. Nor is the belief of addicts a merely impersonal or abstract one:
they are prepared to risk, and do risk, their honor, their fortunes, and their
very lives on their belief in the complete freedom of their will.
It has been said that an alcoholic is a fellow who can take it or leave it –
so he takes it. And why not? For the majority if not the entirety of his
drinking career, the typical alcoholic is completely convinced that he can
stop drinking any time he truly desires to do so. In most cases, in fact, he
has a private plan to stop drinking – when or if matters ever truly become
bad enough to warrant his taking what seems to him such a drastic step.
Nor does the addict –of which the alcoholic is merely a convenient and
familiar example- usually doubt his ability to control or moderate his
substance use when he desires to do so. "Personal choice" advocates
fear that telling alcoholics that they are "powerless over alcohol,"
that they cannot in fact drink responsibly no matter how hard they may try,
will only make a bad situation worse as the "problem drinker" takes
advantage of a false notion of powerlessness in order to drink even more and
more irresponsibly than he did in the first place. But the reality of
alcoholism and other addictions is that in the vast majority of instances the
practicing addict retains a confidence in his ability to cease or moderate his
substance intake that can only be described as baffling to observers who have
watched him repeatedly try and fail to do so.
What is meant by "Denial" in Addiction?
The principal reason that the alcoholic or addict continues to believe
something that is, at least in the eyes of those who have observed him over
time, at times almost ludicrously untrue, is that his judgment and critical
thinking are clouded by the psychological defense mechanism of denial. Thus
the alcoholic who has never yet been able to control his drinking for any
period of time, who has in fact repeatedly and quite predictably gotten into
serious difficulties whenever he began to drink, believes in an almost
unbelievable way and with a confidence that seems to others misplaced and
bizarre, that "next time, it will be different." He shows a
remarkable inability or unwillingness to learn from his own experience in
regard to the consequences of his repeated unsuccessful attempts at normal
drinking.
The concept of "denial" is complex and contains at least two
distinct but overlapping notions, distinguished by the degree of conscious
awareness involved in the denial of reality. In ordinary usage
"denial" means the deliberate and manipulative disavowal by the
denier of facts known by him to be true. Thus a criminal when caught by police
will almost always deny having committed the crime with which he is to be
charged. Used in this way the term "denial" is synonymous with
lying.
The other usage of "denial" refers to an unconscious mental defense
mechanism, one by no means limited to the phenomenon of addiction, in which
the individual is said to deny some aspect of reality that is too distressing
or painful for him to bear. The distinction here is that such denial does not
involve conscious deception or lying but is more akin to a primitive form of
wishful thinking. The mind in such cases holds fast to what it desperately
desires to be the case and avoids that which it dreads and despises. Such
denial is frequently found in the immediate aftermath of some sudden and
unexpected catastrophe before the mind has had time to adjust to the new and
unpleasant facts. It is called a "defense mechanism" because its
evident function is to prevent the mind from being overwhelmed by intolerable
negative emotion.
These two separate but still related usages of the term "denial" are
further reflected in the grammar by means of which their meanings are
expressed. The person who is thought to be more or less consciously and
deliberately disavowing the truth of his addiction is said to be denying his
problem – while the addict who is himself deceived by his denial is said to
be "in denial" of his difficulties. But although these distinctions
are useful and important, the fact is that both forms of denial are usually
encountered. They may be present in the same person at the same time, making
it all but impossible for therapists and others to distinguish how much useful
insight the patient actually possesses versus how much he simply chooses not
to use. And matters are made still more confusing by the well-known habit of
addicts of all kinds to deceive others about their addictive activities, as
when an alcoholic who has been drinking denies that he has done so.
Nevertheless, it is important for an understanding of addiction to bring into
focus as sharply as possible the type of unconscious denial that deceives the
addict himself about his problems – for it is this type of denial that poses
the principal obstacle to recovery from addictive disorders.
Unconscious or involuntary denial is classified as a psychotic defense
mechanism because it involves the denial or major distortion of reality
itself. And a psychosis –state or condition of insanity- consists of being
out of contact with reality, i.e. of believing something that is not true, or
disbelieving something that is true.
Yet is it really that simple? Is psychosis nothing but believing something
that is false or not believing something that is true? If this were the case
many human disagreements might be considered forms of mental illness rather
than rational differences of opinion. And the question naturally arises: who
is to determine what is true and what is false in such matters?
These and other difficulties are responsible for the cumbersome definition
that is usually given of a delusion(a false idea due to mental illness): a
delusion is a false belief, not shared by the patient's peer group, that is
not corrected by reason or contrary evidence. The qualifications are
necessary to avoid labeling simple mistakes or religious, political or
philosophical differences as indicators of mental illness.
In the case of the alcoholic the delusion usually involves the false belief
that he will be able to manage his drinking without a recurrence of past
problems, or that the problems involved are not as great as they appear to
others. He is absolutely convinced of this to the point that no amount of
contrary evidence or reasoning presented, sometimes beseechingly by others can
change his belief or his behavior. In regard to alcohol, he thinks and acts
like a crazy person.
Paranoid Projection of Blame: Another Psychotic
Defense
Simple denial, whether conscious and voluntary or unconscious and involuntary,
is seldom able to handle the progressive and relentless divergences from
reality that the maintenance of a serious addiction usually requires. Other
psychological defenses therefore are usually called into action as
reinforcements to back up the primary defense of denial.
The other principal psychotic defense is called paranoid projection. This is
considered a psychotic or reality-altering defense because of its massive
distortion of reality. Like denial, paranoid projection actually revises the
individual's perception of reality in a direction more acceptable to his
desires – including the desire of his addiction.
Paranoid projection can be considered a kind of auxiliary or backup defense in
the struggle to maintain an addiction. For while denial attempts to create the
impression that there is no problem, or that the problem is not nearly as bad
as other people claim, paranoid projection aims to dispose of any problems
that cannot be altogether denied. Thus the alcoholic who gets his third
citation for driving under the influence attempts to rationalize this away by
blaming the police for unfair or corrupt enforcement policies. And addicts in
general are prone to blame other people for their own actions – especially
those relating to their use of mind altering substances. When confronted about
their behavior by family or friends concerned about them, addicts typically
become angry and defensive, believing that they are being unfairly accused or
ganged-up upon by people with suspect motives. They find fault with those who
question their behavior and convince themselves that it is the other people,
not themselves who are to blame for what has happened.
Non-Psychotic Defenses: Rationalization; Justification;
Minimization
Not all mental defense mechanisms that are invoked by an addiction to defend
itself involve a total disregard or revision of reality. The defenses of
rationalization, justification and minimization may be thought of as a form of
non-psychotic "spin control" in which the best possible face or
interpretation is put upon events which are acknowledged to have happened. By
using these defenses the addict –actually, the addictive process itself-
accepts those aspects of reality that cannot be completely denied or blamed on
others, while at the same time "spinning" them in such a direction
as to make them more palatable. The aim of all mental defense mechanisms is to
reduce or eliminate conscious psychic conflict and dissonance with reality.
The non-psychotic defenses function to smooth down or buff off the potential
problem areas left untouched by the principal psychotic defenses, denial and
paranoid projection.
Of course, not only alcoholics and other addicts make use of such mental
defenses. When one strongly desires to believe something, the mind operates
automatically to find reasons for such belief and to minimize or invalidate
contradictory evidence. The problem for the alcoholic and addict is the
powerful attachment they have to their addiction, hence the pressing need to
construct a case that supports the continuance rather than the cessation of
the addiction.
Addiction,
Like Love, is Blind
There is more to addiction than simply the type or quantities of a substance
consumed, or the frequency of a behavior such a gambling, spending or sex. Nor
are the frequently encountered "negative consequences" of addictive
behavior the essential element of addiction itself. For serious addiction may
be present in the absence of any of the usual and customary external negative
consequences such as adverse health effects, job difficulties, or marital or
legal problems. Such external indicators are in fact relatively superficial
and accidental. Their presence is useful in suggesting or confirming
addiction, but their absence by no means rules out addiction. One of the
commonest errors addicts and others make is to suppose that if such external
complications are not present, neither can be a serious addictive disorder.
The addict's subjective mental state consists of an obsession and
preoccupation with his addiction that has been likened by many observers to
the state of being in love. It is this peculiar obsessive mental state that
leads to the obvious and external behaviors that are commonly identified as
addiction. But the real origin of addiction lies in the mind, and in the
thinking, dwelling, planning and anticipating the addict engages in in regard
to his specific addiction(s).
Like an ordinary lover, the addict is obsessed with the object of his love,
misses it when separated from it, exaggerates its positive qualities and
minimizes or ignores its negative qualities. It becomes the center around
which his life revolves and the goal toward which he is constantly striving.
Obstacles between the addict and his addiction only increase his desire and
devotion – for "absence makes the heart grow fonder." And efforts
by third parties to separate the addict from his beloved addiction invariably
lead to renewed efforts by the addict to become reunited with what has become
the most important thing in his life.
And also like the everyday lover, the love of the addict for his addiction
does not always run smoothly nor lead to the blissful happiness that once
seemed to be promised. In fact, the course of an addictive illness can closely
resemble that of an unhappy, unhealthy love affair of the well known type in
which the lover can neither live with nor without the beloved. There are
repeated honeymoons, turbulent sequels, recurring breakups followed by grief
and then by ecstatic reunion – and the whole cycle begins over again and
repeats itself. Not without reason have some forms of love and infatuation
been compared to an addictive process from which the lover is either unable or
unwilling to free himself, and for which he appears almost insanely willing to
suffer tribulations and pains – including at times, death itself.
The comparison of addiction to a love affair can assist the understanding of
the addict's otherwise at times inexplicable behavior. If, for example, one
merely substitutes "that woman" for "alcohol" in the
typical pleas and lectures delivered to alcoholics by families, friends and
therapists, it is easier to understand the actual predicament of the obsessed
and "love struck" alcoholic who is being urged, for his own good and
also for that of those who care about him, to break off a relationship which
to him may mean more than life itself. He hears what is said to him by others,
does not altogether deny that it has some truth to it, is perhaps even willing
to concede that he is not acting as wisely and prudently as he otherwise
might; but he nevertheless feels that no one but himself truly understands
"that woman" and the real nature of his relationship with her, which
he feels to be far richer and more worthwhile than mere outside onlookers
could ever hope to know. And thus he resents criticisms and attempts to
interfere with his relationship with his addiction, even as he may be willing
to admit that there are some difficulties to be faced and that the fulfillment
of his love does not necessarily come without a steep cost to him. But it is a
cost that he considers himself willing, even honored to pay because of the
intensity of his feelings for his beloved.
Another implication of the analogy of addiction-as-love is that when the
attention and the emotional energies of the addict are captured by an
overriding and dominant love for his addiction, there is less and less of him
left over and available for other relationships. And in fact in all cases of
even moderately advanced addiction, the primary relationship of the addict is
in fact with his addiction, no matter how different matters may appear from a
surface perspective. For in addiction, the Biblical observation that "no
man can serve two masters" is truly confirmed. When push comes to shove
it is the loyalty of the addict to his addiction that is likely to prevail
over even the most intense and important of his other relationships and
interests. Addiction is indeed a jealous mistress, and one that will brook no
real competitors.
Still another similarity between a certain type of romantic love and addiction
is the capacity of addiction, like love, to mobilize and capture the total
resources of the self. Everyone knows that an individual "in love"
is thinking, feeling and acting in a transformed and energized state that is
not, in the ordinary sense of the terms, rational or logical. Therefore no one
–or very few people, and those not for long- speaks to such a person in such
terms. For it is understood that a person "in love" experiences
himself, his life and his priorities in a different fashion altogether from
the way he did before he "fell in love." The mythology of romantic
love is replete with images and suggestions of affliction, illness, blindness,
even madness – all conditions that radically alter the "victim's"
sense of reality, and over which he is in the last resort powerless.
The Addicted
Self
Addiction is -or becomes- a disturbance of the entire self. In its earliest
stages it may appear localized and confined to a small sector of behavior –
but even at this stage, a careful examination of the way the addict thinks and
feels about the substance or process to which he is becoming bound demonstrates
that there is a hidden and extensively ramifying root system just beneath the
surface. Unfortunately, the chief source of this insight is retrospective: those
addicts who have eventually, usually after much suffering and difficulty, gotten
into recovery from addiction are frequently able to look back upon their own
experiences and recognize that right from the start, something deeper, more
subtle, and ultimately more sinister was beginning to happen to them than they
realized or could have realized at the time. In fact, it was only in light of
their subsequent experiences with the full development of the addictive process
that they were able to spot the earliest signs of the addiction. Addiction, like
life, must be lived forwards but can only be understood backwards, i.e. from the
shores of recovery itself.
The natural history of an addictive process resembles the progression of an
invasive malignancy. In the beginning the tumor is small, localized, and
seemingly easy to remove. As time goes on and it spreads relentlessly to the
remainder of the body it becomes difficult or, at times, impossible to remove.
And it may prove fatal.
Addiction invades and destroys the self the way a malignant tumor invades and
destroys the body. Time is required for this process to develop, just as time is
required for a tumor to spread and infiltrate healthy tissue. In the case of
addiction, as in the case of most cancers, the longer the process has been
underway, the more difficult it is to halt or reverse it. And also like most
cancers, addiction may recur and spread further even after initial efforts to
treat it appeared successful.
As time goes on and addiction is continuously active, the self becomes
progressively warped, distorted, and organized around the goals of the addiction
rather than the normal and healthy goals of the free and growing personality.
This resembles the shift from a pluralistic democratic society to a monolithic
totalitarian dictatorship. At the extreme limit of the addictive process the
individual has become an obvious and often pitiful slave of the addiction and
has relinquished or subordinated every other interest and value in his life to
his absolute ruler, addiction. But long before matters reach such an obvious
stage, the personality has been under the spell of addiction and thus has been
directed insidiously toward the goals of the addiction rather than the
legitimate ends of the individual himself.
The addicted self is by definition an inflexible and unhappy self.
Flexibility is impaired because everything is ultimately subordinate to the
demands of the addiction; and happiness is undermined because the directing
authority of the self is no longer the self but the addiction. These alterations
in the orientation and operation of the self are often subtle and hence easily
overlooked in the early stages of the addictive process by the addict himself as
well as observers – but in the more advanced stages they are painfully obvious
to onlookers and even, in some cases, to the addicted individual.
In addiction, the self steers and navigates according to a psychological
false compass controlled by the addiction. The needle of the addictive compass
always points in the direction of the addiction – and by so doing, it causes
the self invariably to steer toward the addiction. The non-addicted self is
flexible - and its compass is therefore free to find the psychological
"North" by which it can navigate toward healthy waters.
The addicted self is an inflexible and at bottom unhappy self, no matter how
carefree and spontaneous it may seem to others and even to itself. It is quite
common for the earliest stages of addiction to be accompanied by a feeling of
enhanced freedom and happiness. But as time goes on and the addiction acquires
total mastery of the individual, the truth of Shakespeare's warning is all too
often confirmed:
And oftentimes, to win us to our harm,
The instruments of darkness tell us truths,
Win us with honest trifles, to betray's
In deepest consequence.
Macbeth, I.iii
Once addiction is established the prime task for the self is to maintain
itself at a level approximating normalcy. Like the character in "Alice in
Wonderland," the addict must run as fast as he can just to stay in the same
place. Long gone are the days, if they ever existed, of "highs" and
special pleasures as a result of drug or alcohol consumption. Now the main thing
is to avoid feeling bad. But because this cannot be done unless the addict is
continuously "under the influence" of his addictive substance or
process, much of his life is necessarily spent between drinks, drugs or other
addictive behaviors. And when he is between such temporary remedies for bad
feeling he is actually in withdrawal from them, hence feeling bad, thinking
about getting relief, and unable to participate fully in whatever he happens to
be doing at the time. His mind is always projected forward to the time when he
will be able to obtain relief by engaging in his addictive behavior.
Thus the active addict is never normal: not when he is "using," and
not when he is "not using." His mind and brain have fallen under the
control of an artificial external mood-regulator(drugs, alcohol, gambling
&etc.) and thus are no long free to respond spontaneously and normally to
the ever-changing, subtle, and not easily recognizable demands of reality
itself. Because of his artificial mood regulation the addict feels bad when,
naturally speaking, he ought to be feeling good – and he feels good when,
again naturally speaking, he ought to be feeling bad. His "hedonic
(pleasure) compass" is no longer reliable and one of the basic functions of
mood and feeling, that of supporting the survival of the individual, is under
the control of the addictive process rather than the actual welfare of the
person.
It is possible to view the powerful addictive drive as an extra instinct,
equal in strength to those of hunger, sex and aggression but lacking their
essentially self-preservative functions. In a sense, addiction is a case of the
instinct to live or survive gone wildly astray: the same energies, the same
urgency, and the same relentless determination found in the drive to survive and
avoid harm are found in the addictive process. But in addiction the welfare of
the individual is no longer a consideration, only the satisfaction of the
addictive impulse itself. Thus addicts are known to risk their lives and
well-being with apparent indifference, a mirror-image of the normal
self-preservative instinct which under ordinary conditions steers individuals
away from and not towards potentially harmful or lethal circumstances.
From this perspective "recovery" means, among other things, the
recovery of the normal, flexible and healthy hedonic regulative functions of the
self.
Were Addicts Ever Normal to Begin With?
The concept of "recovery" implies restoration to a prior and
presumably normal state. But evidence from a number of sources suggests that in
many cases the future addict was in trouble, recognized or not, well before the
emergence of his manifest addiction.
Alcoholics and other addicts in recovery frequently report that from the
perspective of hindsight they now can see that they never actually felt quite
right or like other people appeared to them to feel. When, therefore, they
finally found their particular addictive substance or process, they experienced
what might be called both a sense of relief and a "shock of
recognition" at what it feels like to be "normal," i.e. free from
negative or unpleasant affect, calm, relaxed, self-confident and secure.
Naturally they commenced to repeat the behavior that at first brought them
relief and good feelings. Over time the Faustian Bargain –selling of one's
soul to the Devil for earthly satisfactions- began to come due, and less and
less relief was obtained at higher and higher cost. Like cash advances on a
high-interest credit card, addiction lures the addict deeper and deeper into
"hedonic debt." Finally the bills can no longer be paid at all and
bankruptcy –"hitting bottom"- occurs.
Conclusions
By combining the observations above, i.e. by understanding how the obsessive
"romantic" relationship of the addict to his addiction is supported
and defended by the mental defense mechanisms of denial, paranoid projection,
rationalization, minimization and justification, an answer emerges in response
to the question posed at the beginning of this paper:
The basic facts about addiction and recovery are neither complex nor
difficult to understand. Why, then, do addicts have such difficulty in
grasping and acting upon them?
The addict exists in the grip of a desire("love") every bit as
powerful, if indeed not more powerful, than that of the benighted lover for
his beloved. His entire self is involved, tilted on its axis so to speak, by
the tremendous force of this desire. He therefore faces in a direction that he
would not otherwise face – and he views matters, including himself, his
world, and everything in it through the lens of his desire. He is therefore
neither rational nor, in a certain sense, sane. The center from which all
radii emanate and around which his entire circumference is constructed, is
nothing else than his addiction.
The mental defense mechanisms described above function to smooth the path for
the fulfillment of his desire. The addict's mind has been taken over by his
addiction and becomes an instrument for the addiction to use to protect and
advance itself and its interests. He has become a hostage in his own house, an
unwitting victim of a secret kidnapping by which his very self has been
hijacked by the addictive process and enslaved to its endless and irrational
demands for gratification. This means, among other things, that what once was
human has been subjected to the rule of the inhuman, i.e. of the blind,
ruthless, unconscious, and utterly unethical force of the desire of addiction.
The process of recovery involves the recovery and restoration of the self. The
human, i.e. the existing individual with all of his values and aspirations,
displaces the inhuman force of the addictive desire that had insidiously taken
over the personality of the addict and converted him into a mere puppet for
the execution of the demands of the addiction.
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