About addictions

What is addiction?

The word addiction is both useful and inappropriate in describing the nature of compulsive substance or process misuse. It is useful because it provides an umberella term for any number of very painful disorders; it is inappropriate because it over-simplifies an extremely complex and misunderstood set of conditions.

Addictions can be loosely divided into two categories: Substance addictions and Process addictions. Substance addictions are those that involve chemicals such as cocaine, alcohol and methamphetamine (crystal meth);  process adictions are concerned with behaviours such as gambling, pornography and shopping or relationships such as food and love. 

Once it develops, addiction is a chronic disorder. It can be slow and subtle, sudden and severe, or intermittent. All these courses are common; as is recovery.

Anyone having had any experience of addiction, either personally or by proxy (such as a family member, friend or employee), will recognise the profound and bewildering personality change that addiction brings about. It is as if the loved one, valued friend, or respected colleague is absent and has been replaced by a self-centered, manipuative and destructive "It" that will stop at nothing to get Its way. This is not just a metaphor. In real terms in addiction a part of the mind that should not be in control of the whole takes over. Let's call it the "reptile brain".

This reptile brain cares nothing for anything except its own survival and well-being.

It can neither think nor feel; it just knows how to use people for its own dark ends. This reptilian "It' is by nature very fearful. Its world view is one of danger, threat and survival. There is a chemistry to this which involves neurotransmitters such as cortisol and dopamine. The ingestion of drugs or alcohol and the acting out of certain addictive behaviours changes this chemistry so that the reptilian "It" no longer feels like an endangered, insane outsider. This is the basis of addiction. It can be viewed as a misguided form of self-care in which the survival brain, the reptilian "It", believes it needs the substance or the behaviour in order to survive and so produces what are known as cravings in order to get what It believes It needs. Anyone doubting the power of cravings should try holding their breath for ten minutes or going without water for three days!

Is it a disease?

Although the exact nature of addiction is not yet fully understood, there are many who strongly believe it has genetic components. This would infer that individuals are born with a predisposition to the condition and cannot drink, drug or behave themselves into alcoholism, drug addiction or compulsive behaviour/relationships; however, chronic dependency represents a group of very complex behavioural disorders and the possibility of a genetic pre-disposition is just one factor. Addiction is not an ordinary biological disease. 

The assumption by the general public and the psychiatric profession that chronic dependency has a strong genetic or biological element may be misleading. It fosters the hope that a medication may one day be found to treat addiction; however, in the words of the psychiatrist Roger Vailant in his book The Natural History of Alcoholism, " A person stands as much chance of inheriting alcoholism as of inheriting the skill of being a good basketball player." 

The disease model of addiction maintains that the dependent person is the victim of an illness. The afflicted soul is neither morally corrupt nor irresponsible, but suffering. This means that addiction is not freely chosen; rather the excessive behaviour is beyond the control of the sufferer. This is the condition called Powerlessness.

How does addiction affect the sufferer?

The dependent individual greatly overvalues their substance or behaviour of choice. They are literally in love with the drink, the drug or the behaviour. There is a high expectation of a rewarding experience. The difficulty is that the relationship the addict has with the mood-altering chemical or behaviour is dangerous and pathological. "Much as wine symbolises communion, the alcoholic has taken the symbol for the reality and uses drinking as a substitute for the relaxation, fusion, surrender and security of deep personal relationships." Charles Hampden-Turner, "Maps of the Mind".

Smokey Robinson sums it up thus:

"I don't like you, but I  love you

Seems I'm always thinking of you

Though you treat me badly

I love you madly

You really got a hold on me

Conceptualising addiction as a disease makes it much less painful to bear and reduces the posible shame and guilt engendered by a chaotic and often distructive past. From a family persepctive this infers that addiction is in no way the fault of the parents. There is a saying "You didn't cause it, you can't control it, you can't cure it."

Treatment

It makes sense to treat the addict with the same care and compassion as one would treat an individual suffering from any other painful disease, whilst holding them responsible for the problem and empowering them to own the solution. However, it is not compassionate to encourage addicts to deny their power to change, they are not helpless; they can take control of their lives.

Recovery

Although addiction may be difficult to overcome, recovery is the gift of addiction. recovery rests on a foundation of honesty, open-mindedness and acceptance.Very often recovery from dependency leads to a fuller, more meaningful way of life with a deepening of relationships. The old narcissistic, self-centered world view is replaced with a more altruistic and mature attitude to life. Happiness, peace of mind and contentment without the use of substances or behaviours can be expected. 

Recovery truly opens the way to a life worth living. 

 

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Addiction butterlies

 

Small things matter.

What may look like a small act of courage is courage nevertheless.

The important thing is to be willing to take a step forward.

Daisaku Ikeda