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[Introductory note on definitions: I will use “addiction” and “alcoholism” interchangeably, though strictly speaking, addiction is a general term for various compulsive chemical ingestions or for compulsive, repetitive behavioral acts. These acts are addictive in that they generate the same neurotransmitters in the pleasure centers of the brain as do ingested chemicals. The impulse to engage in such compulsive behaviors, as with addictive substances, proves to be irresistible, rendering will power ineffective as a means of continuing abstinence. In this scheme, alcoholism is but one form of ingestive addiction. For purposes here then, the terms “addiction” and “alcoholism” are used interchangeably.][I write as a student of 12-step recovery programs. I claim no affiliation with or membership in any of these fellowships].
Usually, as Friar Ockham suggested, the best explanation for a phenomenon is the simplest one. Here, I will suggest that what we call addiction in our present era is but the latest manifestation of an unsuccessful series of attempts to deal with what has been the human condition since our species first stood on its hind legs; in a sense, addiction represents a failed attempt to right ourselves; it is a failure to face the reality of our fragile and limited existence with a modicum of grace and dignity. Almost as soon as we mature enough to become self-aware - when we lose our childhood innocence - we are confronted with our vulnerability and mortality; we are subject to being hurt and that we will die.
Finding a way to live with such mortal knowledge is one of the central problems of our human existence. Addiction can be defined, then, as a non-effective effort to anesthetize the fear which arises from our knowledge of fragility and mortality. It is a condition which makes some form of self-actualization necessary if one wishes to live a meaningful and reasonable emotionally comfortable life. I go further. In light of history and the parlous world situation today, I will also assert it is just possible that these same ontological components of our individual selves scale up to national and international levels and cause irrational and destructive political actions - like tyranny and war.
To deconstruct this idea: I will suggest that individuals whose pride - best expressed as the impulse to obtain and maintain power over others - has run amok, leading like-minded individuals to act together to organize into political coalitions. These, then, wage aggression, violence, and finally war on any who dare to differ. This progression begins by forcing ideological conformity within, then eventually demands conquest of other nations to make them subservient. Just how the summation of addictive psychic impulses in individuals leads up to this state of affairs in entire societies (eventually the entire world)will, I hope, become clear below.
This process is rooted in not only the prevalent individual sin of pride/hubris. It may also transform into a group hyper-religious bond born of the same arrogance, but rationalized as (a bizarre form of) supposed altruism. It is still just another expression of addictive thought and behavior, elevated to Rococo proportion. It goes like this: I know what I need (identical to what I want), I know I must control you (what you do, say and think) on pain of harm or even death; I must control the entire political system; I must eventually control the world. The latter aim is the explicit goal of one religion, which conveniently encompasses an entire mandatory political system. Apostates are explicitly under penalty of death. HL Mencken encapsulated it: ”The urge to save humanity is almost always only a false-face for the urge to rule it”.
The fact that most addictive substances are forbidden by religious rubrics, in this sophisticated addictive system of extending control, merely frees the adherents to engage more completely in central behavior of all such process addictions: totalitarian control (of everyone, everywhere - worldwide). This effort has been underway since the seventh century; all strategies and tactics imaginable are permitted in pursuing success. The left in the west has successfully, so far, adopted this same game plan (remember the incessant “by any means necessary” mantra?). The only real exception is permission in the west for any and all mood-altering substances. The final destruction of the classically liberal and tolerant west is near. Only the final cause is open to question. Will it be by cultural/economic suicide? By the illiberal left? By Islamist conquest? The common denominator of all three is addictive thought patterns leading to obsessive and unrelenting behaviors. Let’s begin with the individual and then return to the communal.
In the background of the consciousness of every one of us lies a central component of human self-awareness: existential fear. It is ever ‘on call’ to conscious awareness as fight or flight, as incipient psychic pain, if not outright terror. I believe that the more one tends to explore one’s own consciousness, the more likely one is to experience such existential angst. Although this awareness, itself, can feel quite uncomfortable, that particular self-centered fear is a projection - an illusion - during most of our lives; that is, destruction is not actually imminent in the next moment throughout the vast majority of our lives; much of that fear, then, is illusory the vast majority of the time for those of us who live in modernity.
When it comes to real threats to life, we are equipped with a set of instincts, each of which had obvious survival value for our primitive ancestors - in those times during which our species’ formative emotional states and social organization evolved. The list of these instincts (and they may still offer some degree of survival value today), is best known for its extremes: pride, envy, gluttony, greed, lust, sloth, and wrath. Moderate degrees of each of these survival instincts remain active in our psyches today. Roughly, they function as furthering self-esteem, competition, hunger, entrepreneurialism, sexual reproduction, rest from work, and assertiveness - respectively; moderately expressed, these are usually useful and healthy.
In passing, I want to emphasize the term self-centered fear. This implies that one senses that one must conquer or control this fear alone. That, in turn, requires calling forth one or more of the survival instincts in its extreme form. In fleshing out the seventh step of Alcoholics Anonymous (“…humbly asked [our higher power or God] him to remove our shortcomings”), the AA founders suggested that “…the chief activator of our character defects (= instincts in extreme form) was ‘self-centered fear’”. This means that when addicts (or addicts in-the-making) feel fear, instead of sharing, discussing, or asking for help from another, or from God, they try to ‘fix’ it themselves - usually with the result of getting drunk or high. It’s no surprise, then, that is where the term ‘fix’ comes from, though ‘fix’ also refers to ending/preventing withdrawal by using again, before the symptoms worsen.
Historically, belief systems and religion offered solace of many kinds to soften this inescapable, painful knowledge of vulnerability and mortality; such is a task of living an examined life. To the extent religious beliefs are/were sincerely held, they were effective for our ancestors. Religious means of dealing with existential issues, however, are beyond the scope of what I want to say here. What I do hope to convey is my premise that understanding addiction is so elusive precisely because it is so deeply rooted in human ontology. Addiction arises from the most fundamental components of our humanity - our survival instincts - which are invoked when they are, in reality unnecessary. “Alcohol is for people afraid of going to hell”. “Recovery is for people who have already been there”.
Those of us who temperamentally find existential issues ever close to conscious awareness can tell you that - even for the “well-adjusted”, some respites are occasionally necessary; life sometimes needs to be just lived spontaneously and not defended against - through family, work, play, social activities, etc., for example, with the “introspectoscope” turned off. A dysfunctional alternative to acceptance of life’s unpredictability and to personal growth is to artificially blunt one’s consciousness with chemicals or mood-altering behaviors (like excesses of sex, eating, spending, gambling, controlling others, etc.). The alternative for many nowadays is simply rolling “bread and circuses”. Modernity lumps these together as “drugs, sex and rock ‘n roll”. These are emblematic of addiction in modern parlance, though now, we must add video games, social media, extreme displays of virtue - like advertising one’s self-righteousness - especially at organizational, administrative, and political levels. These have recently generated unprecedented levels of illiberal, coercive, even tyrannical actions - like blatant censorship in a once fairly open-minded society.
Otherwise put, addiction of some sort has always been with us, though it has varied throughout history - constrained only by the technology and social mores (substances and behaviors available) of the times. It has always been an ineffective means of attempting to solve the universal human problem of dependency. Dependency is actually the key concept in understanding addiction. That understanding begins with the peremptory fact that every one of us is born literally dependent for our lives on other human beings - usually biological parents. We absolutely do need others for our very survival at birth and for some time after. It is a stark fact that, without food, shelter and clothing provided by others, every human baby/toddler would die. It follows that some degree of psychological dependency is at work throughout our lives in at least some of its facets. In healthy individuals, dependency needs are diversified among a number of people and activities rather than upon no one (as in self-centered isolation characteristic of addiction) or one single individual - like a romantic partner, for example, or on a cult. More on that may be observed in considering sex and love addiction, below.
While knowledge of this imprinted dependency of infancy remains mostly beyond our ken and is rarely articulated, it is surely recorded subconsciously in the brain of every one of us. It is thus our unconscious, empirical model of dependency and is literally within the realm of life and death. Recall imprinting of the salmon, whose memory is hard-wired to return from the ocean to spawn in the very stream in which it was hatched. Such is the innate and also the experiential, subconscious model of dependency of every human being. In normal development, children slowly learn to shift the ordinary dependency of infancy from parents to others and eventually become an “independent” (really interdependent or intermittently-dependent) adult member of society.
So far, I have addressed only the material/physical dimension of human survival and development. There are intangible components of human ontology as well and “spiritual” is as good a word for these as any. Except for psychopaths and sociopaths, each of us needs a sense of personal worth, of meaning in and of our lives, and we naturally need the acceptance or love of others; our self-image is formed in large part from how others respond to us. Our ancestors might have called this “the love of God”, but that view seems to have fallen into disuse. So, spiritually, too, I believe we have a type of dependency - one that is existential and life long; few of us, after all, would live comfortably alone, say on an island, even if we enjoyed sufficient food, shelter and clothing. This is why solitary confinement, per se, is considered to be punishment. To my way of thinking and to the founders of Alcoholics Anonymous, some kind of longing for fellowship is a normal part of our all-too-human longings or cravings - for a life with some psychic and spiritual comfort. Addicts often refer to this as “comfort in my own skin”.
To understand what I mean by this spiritual dependency, we must explore further: how is it that we really know ourselves; how do we derive and maintain an honest and accurate self-image? Is it fixed or does it evolve over time and circumstance? Built into our consciousness is surely some degree of an innate sense of self - of who I am, separate and different to some degree from everyone else. This self image is an experience shared by every one of us. It is subject to modification, to some extent, by intentionally-amplified, cynical, divisive, modern tribalism, in the form of “identity politics” - to encourage group political behavior - but remains important to one’s psychic economy, nonetheless. As long as one lives, then, self image is a work in progress. It is rarely, if ever, completely static. After all, the physiological homeostasis of all biological systems depends on feedback. So, I submit, is every human being’s image of self, and the most effective feedback comes in the form of open-mindedly experiencing how other people honestly respond to us, both verbally and non-verbally.
The power and validity of such feedback to help me ratify and/or modify my present self-understanding, further depend upon two things: honesty and boundaries. Each of these, in turn, require explanation. Honest interactions between individuals, sadly, are often not the rule. Too many people cast themselves in roles, play games (particularly power games and/or manipulation), or are too subject to various psychopathologies to be able to give honest responses or feedback to another without a self-serving agenda. Much of their response is about themselves, their own needs and their own wish for power (or a feeling of superiority), rather than about genuine response to another.
At the same time, the potential recipient of feedback that is proffered must be able to sift through such responses with what are called “boundaries”. These are neither walls nor porous fences through which anything may pass. Rather, they are filters, which separate those responses which are actually about me from those which are really more about the other person. Here is a clear example: somebody says to me, “Bob, I think you are an axe murderer”. Since I’m not an axe murderer, I say to myself, “That statement has nothing to do with me, it’s about them, their misperception or imagination. That is the other person’s imagination, illusion or fantasy. I need not allow it to have any effect on how I see myself”.
Now, that’s an obviously easy case, but most feedback consists of much closer calls. Suppose someone tells me they think something I did was selfish. If I have good boundaries, I must be willing to let in at least the possibility they may be right, at least to some extent (few things are 100% “right” or “wrong”) and honestly examine the assertion. I must weigh it and allow that it might need to affect my self-image, at least to some degree. If many people tell me I’m selfish, it is more likely valid and I ought to allow it to affect me. I needn’t conclude then and there I’m a selfish person, just maybe some of my actions were selfish. A good rule of thumb is to ask myself to what extent I feel the need to defend myself from an accusation and tell the other person they are wrong. To the extent I need to persuade them they’re wrong, I need to look more readily at myself. Defensiveness is a valuable clue I have been told something valid about myself that I don’t like. My anger in response is a dead giveaway they are correct!
Compare this with the axe-murderer accusation. I had no need at all to persuade them they’re wrong and I wasn’t angry because I know it was not about me, it was about them, their misperception or delusion. In short, this is how a healthy person continually measures him/her self before the “mirror” held up to them in the form of other peoples’ responses to them - verbal and otherwise. The honesty part also requires a degree of mature judgement of both the individual involved and the context of the feedback. Sadly, families are often places where honest feedback may be in short supply as a result of unresolved dependencies and power relationships. But that is beyond what I want to say here. Because such unhealthy dependencies and power relationships are generally reduced within recovery communities (like 12-step groups including AA), one usually receives the most honest, reliable feedback there. That is a big component of their value - as to both recovery and as to normal human growth and improvement as well.
So, what, then, do self-image, boundaries and honesty have to do with addiction? Addiction is usually defined as performing a compulsive set of behaviors despite repeated negative consequences. What prompts addicts, then, to keep using? Pleasure-inducing chemicals (and behaviors like sex, love, eating, etc., - which generate the exact same chemicals in the pleasure pathways in the brain), instantly shut down the normal human awareness of existential vulnerability and mortality; they instantly and temporarily create the illusion that all my problems are solved! Existential issues dissolve. I’m “fixed”. Many recovering individuals say that the hallmarks of recovery can be summarized as practicing self-care and keeping good boundaries - instead of ingesting mood altering chemicals or repeating harmful behaviors.
All the normal human drives and motivations - material and spiritual - are thus shut down in active addiction, resulting in functioning at what can quickly descend to sub-human levels, where behavioral risks (like safe sex) are ignored and basic self-care needs are no longer tended to - like nutrition, hygiene or medical care. At the same time, boundaries become irrelevant (self-care and boundaries are also good markers of mental health). Use of the substance begets nothing else than craving for more of it and in addicts, this may well be pursued unto death. That is why most of us call addiction a dis-ease; the opposite of “ease” in our own skin - rather, we secretly feel we are inferior, broken, and defective. The phenomenon of craving more following use does not occur in non-addicts. Such chemically-induced, temporary euphoria also artificially extinguishes those normal human longings which, left unfettered, would lead one toward growth, self-actualization and wholeness. As part of that process, one usually participates in something larger than one’s self, like a community of like-minded people. Herein, too, lies the power of voluntary communities of recovering people. By contrast, active addicts experience extreme isolation and loneliness, even when in the physical presence of others.
12 Step Programs
A word about communities. Counter to the present boldly fascist and coercive corporate/governmental ethos, the first (only?) rule of community is that it cannot be coerced into existence from above or by claim of authority. The very healing power of a community sought by those who would become part of one, derives from its voluntary nature. That is a significant part of the reason that institutional, bureaucratic state programs largely fail to reduce addiction. About the best officials can say is “We’re doing something”, though harm reduction programs in the form of substitution of safer opioids like buprenorphine or methadone are likely reducing deaths at least marginally. The sad fact is that the help available for individuals in voluntary communities does not scale up to large, mandatory, bureaucratic or government entities. These are by their very nature, controlling and coercive; such control repels rather than attracts addicts (and everyone else). At best, forcing someone to attend meetings may result in a very few staying on.
Twelve-step programs are completely voluntary (“attraction rather than promotion”) and begin with the first step: “We admitted we were powerless over (alcohol or other ingested substance or addictive behavior) and that our lives have become unmanageable.” What does this mean? The second part, unmanageability, is usually quite obvious to observers of the addict - family, friends - before it is to the user. Others see the chaos (loss of job, friends family, DUI’s’) to which the addict is somehow oblivious (denial is at work here). Powerlessness is a critical concept and has a specific meaning, which few actually understand or articulate. If an alcoholic is confronted with a drink, it doesn’t magically levitate and pour itself down his throat. Powerlessness, at heart, is not about the act of drinking, you see, it is about thinking - the desire, the inevitable, recurrent, irresistible craving for a drink - whose conscious emergence is completely impervious to will power. That is powerlessness.
Let’s now back up for a moment and look at the nature of human thought. The fact is that no one has the power to determine in advance just what the next sequence of their thoughts/feelings/desires will be. These have a life of their own and it are not under our volitional control. My will power simply cannot prescribe what my next series of thoughts will be. That is simply how our brains work. For addicts, it is far more likely that given any change in location, persons present, mental state, however minor, be it pleasurable or painful or simply boredom - the desire to use or drink is very likely to occur spontaneously at any time. Addicts, like the rest of us, cannot ban any thought or desire from entering their consciousness. Then, once the first use/drink occurs, there is no stopping. No amount of willpower can overcome the well-established neural pathways demanding “more”. Again, this does not happen to those who are not addicts and why it is useful to call it a dis-ease.
Further, once the thought (desire, craving) occurs, it quickly becomes an obsession. It literally forces any other thoughts or behaviors out of one’s consciousness and can be extinguished only by using. Left to one’s own devices, resisting such impulses is all but impossible, regardless of past negative consequences. Part of this phenomenon of craving is the fact that when it strikes, the sufferer just cannot seem to remember or call to mind any of the prior negative consequences of drinking/using! This is a clear departure from the normal, rational thought process which permits choices (like abstinence) to non-addicts in a similar situation.
This peculiar memory deficit while craving is part of the mental defect in addicts/alcoholics. How else does anyone get 3 DUI’s in 6 months or OD 3 times in a month (and fortunately get rescued each time)? Such stories are not rare! Self-actualization is very far from the conscious mind of such people, but that doesn’t mean the desire for it has been completely extinguished. In fact, in clearer moments, many addicts have spontaneously observed they are trying to “fill a God-shaped hole” in themselves with their substance. At some level, then, they still know they have an illness which is spiritual as well as physical.
As an aside, I want to suggest that considering addiction to be a disease rather than a weakness or moral failure is - at the very least - therapeutically useful (It may be that solipsism of non-addicts makes it difficult for them to accept this, as they have never personally experienced it). Among addicts, it is axiomatic that shame is a substantial contributor to continuing addictive behavior. To the extent shame can be reduced, then, using may be marginally curtailed. At present, there is no objective diagnostic test which can confirm disease diagnosis of addiction, so any diagnosis is clinical and subject to error. I want to suggest that erring on the side of considering addiction a disease has significant benefit to those with the problem. Diabetes serves as a useful example. There is no shame in the status of being diabetic and the disease requires a set of behaviors in order to reduce its sequelae. To the extent the diabetic patient is shameful, (s)he tends to overeat and reduce chances to remain healthy. The analogy to addiction is apparent.