Is addiction of any kind a disease, or does overusing substances, food, etc. cause diseases? Is a disease of addiction a mere concept, as Jellinek suggested in the foreword of his book The Disease Concept of Alcoholism (1960) because he was himself reluctant to call this addiction a disease? Or is it a lifestyle issue as some suggest, a character flaw and the result of spiritual depravation? Certainly there are many such views and more in this hotly debated topic.
Having worked, taught, and written about this thing called addiction for thirty years, I have gained a totally different view. And who taught me? None other than every one of my clients. Kierkegaard wrote that “If you label me, you negate me,” and labeling, my clients taught me, diminishes one’s being. Consequently, I no longer see addiction as a disease as it is commonly described, but rather a courageous search for meaning and an ultimate quest toward wholeness.
Here are some of the insights I have gained from my clients:
1. The foundation for addiction was laid in early childhood prior to the actual onset of addictive habits, and in the context of the family and social mores. From the beginning, the child and caretakers co-created behaviors and relationships.
2. Yet, there existed support and use of internal strengths for the child to live long enough to survive and become sober. Strengths in the life of an addict? Absolutely, yes! Consider, surviving a difficult childhood, using one’s own creativity to modulate and survive experiences while simultaneously evolving into full-blown overuse of substances in an effort to assert a self and attempt to make sense out of a senseless life. Then embracing sobriety, with or without treatment or self-help programs, they still have stamina and drive to want more, fulfill unmet needs, and design a life to make unrealized dreams become a reality. That demonstrates strengths of perseverance, resilience, creativity, and hope par exemplar.
3. Contributing Factors to the Onset of Addiction:
In addition to the possibility of genetic vulnerability (at this point unproven, however, possible), most people who develop addictive habits come from an environment that disallows for the natural flowering of a child’s developmental potential. Without detailing all possibilities, many children grew up in dysfunctional families and many have experienced to various degrees trauma; familial mental illness, i.e. depression; violence; physical, emotional, mental abuse; or poverty. Minimally, the impact of these toxic experiences on the developing child limited their healthy progressive developmental phases. Similarly, at the opposite extreme, are families who overindulge their children without ever setting limits and teaching age-appropriate responsibility.
Sounds dismal? At first glance, yes, until individual innate human strengths and creativity in action is stressed, surfaced, and evidenced when making changes.
4. Creative Use of Options: barrowing from Gestalt therapy, a creative adjustment is what one does and how one responds to situations and people. It is a creative response, because one chooses from among the possible options available developmentally, and in doing so, changes the situation in some way and makes it personally manageable. For example, a child may be sensitive and cry easily. Rather than being reassured, she is yelled at and told that if “you don’t stop immediately, I’ll give you something to cry about.” That little one may hold its breath, not cry, withdraw, or start smiling when hurt. Another may be curious, energetic, and enjoy exploring—and—may break a new toy someone just gave him. He is yelled at for being bad and hit, told that he is a terror and hopeless. That little kid may learn to fight back throwing temper tantrums, hit and kick, or begin acting and feeling exactly what he internalized and become a loser.
Most of us have memories of some experiences of injustices during our childhood. Luckily, human beings from infancy on are wired and capable of experiencing a lot before we actually internalize a distorted self-image. Yet, when these insults are heaped upon the child incessantly, the once adaptive and age-appropriate modulations become automatic and eventually deeply anchored in the child’s reality, behavioral repertoire, and belief system.
When a larger social system like school requires an expanded repertoire of behaving and responding, the children we are describing lack the experience of flexibility and response-ability other youngsters may have or easily learn. Most likely, the school-age child will simply intensify what already exists and ironically recreate experiences that are familiar from at home and ironically reinforce what s/he already knows and believes about the world and his or herself in it.
Adolescence, while difficult for most teenagers regardless of mental health, paradoxically holds the potential for bringing some relief to the troubled kids because they find a cohort of similar kids who are lost, distraught, violent, and depressed. Together, they introduce each other to alcohol and substances, form a tight group or gang where they are accepted, experience a sense of belonging, and identity. The shy, quiet child may find alcohol and realize she is funny and desirable and has a ball. The wild kid may become a powerful gang leader, use uppers and/or smoke pot to calm down and feel one with the universe. Still others began addictive habits to numb their bodies, or to eliminate boredom, anger, depression. When this population reaches twenty-something, many will become troubled by addictive habits, wind up in AA or other self-help or treatment groups, either self-referred or court mandated.
Final Thoughts: This all sounds simple, very pat and unrealistic when it definitely is not. A book could not do the topic justice. I intended briefly to demonstrate the complexity and co-created inevitability, almost natural evolution of a path to use-and-abuse addictive behaviors within the context of family/environment. Throughout this process I wanted to stress the presence of many strengths of creativity, perseverance, courage, determination, and awesome resilience that will assist the client to discover a clean and good life fulfilling his wants and dreams.
Let’s go; a life of freedom from compulsion is ready and waiting to be realized!