I began writing this article about unwanted chemical dependency and realized the ideas which initially seemed simple soon became very complex. I could not figure out what I wanted to say. Finally, I realized my dilemma – drug addiction is simple, but human beings are complex. That distinction is crucial in understanding and treating unwanted chemical dependency.
The complexity exists because we are all different. Different developmental histories cause different internal conflicts and capacities. We have different innate strengths and vulnerabilities. All of us have different desires, and different problems – and our external environments differ.
We are all also so much alike. We all want to feel good physically and emotionally, and to have minimal distress. Most importantly, we are all better when we are well connected with each other. We bring meaning to each other’s lives.
Drug Addiction and its Associations
The word “addiction” often carries tremendous negative connotations and associations. The narrative around the word has taken on mythological proportions – as if an addiction is a living breathing entity – a disease, an addictive personality. People become “addicts.” We need to remember that it’s just taking some damn chemicals. That’s it!
Addiction is a coping mechanism – that’s all it is. Primarily used to cope with some form of distress. Distress arises primarily from unmet needs. Typical unmet needs include the need to be out of pain, or to relax or cope with loneliness, or depression, or anxiety. Or the need to have something to look forward to or be excited about. Often, individuals have only partial knowledge or consciousness of these needs. Yet, because our needs never end the tensions that come with them never end. The question is can we understand, manage and maybe even creatively enjoy our needs? If we can figure out how to meet our needs well enough then the tensions of being alive can feel more like a wanted challenge rather than a burden – if this were to happen, we would no longer be moving away from life but wanting to engage and take it on.
Recently, I had a man say to me – ‘This is it for me. I can’t ever do this again or I won’t make it.’ He meant, I can’t ever take drugs again and have to go through a detox – I’d rather die. To which I replied, “Are you actually saying you’d rather die than spend some days in discomfort because you are taking some chemicals?” I also added, “I hope you never have to go through a detox again – but that is nothing compared to losing your life.” He said, ‘Wow when you put it like that it does sound crazy to think I would rather die than get off of some chemicals.’
Part of the mythology an “addict” is that you are stuck – stuck for life – why? Because you are an addict. Feeling stuck can lead to giving up.
Drug Addiction Research
There was a research project which was studying the brain using active MRI’s. The researchers were trying to determine factors which lead to compulsive or addictive behaviors. What they found was that there was one factor only that had a specific effect on the brain. When this “one” factor was present our frontal lobe, the part of our brain involved in decision making skills, planning, and related to attention span, began to shut down and eventually turned off completely. At which time our amygdala, which is our fight or flight brain lit up. The amygdala became the active brain shooting chemicals like adrenalin into our system sending our brain into a fight or flight response. The ONE factor that causes our brain to shift is PERCEIVED HELPLESSNESS. It turns out our brain responds quickly and drastically to feeling stuck.
I met with a woman who had struggled with unwanted chemical dependency for over 5 years. She had periods of sobriety but would eventually relapse. At times, her relapses were horribly dangerous. She had a loving and supportive family and attended AA based meetings regularly – the meetings seemed to be a real help to her.
In great detail she recounted all of her relapses and struggles with chemical dependency. I began to wonder who she was beyond those struggles. Finally, I asked her “What is it you want?” She looked at me and said ‘I don’t know.’ Two weeks later, after we had met many other times, she looked at me and said, ‘I do know what I want. I want to get married and have a family. It’s the only thing I’ve ever wanted.’ I said “Okay, that’s great.” She began profoundly crying and said, ‘No one would marry me. I’m an addict.’ I said “That’s not a given.”
Her need to get married and have a family was so frightening to her that, without realizing it, she relegated her most profound desire into her unconscious, and the damn chemicals helped her do it. Her relapses displaced her greatest need to get married and have a family. She felt it could never happen. The idea of trying and failing was too frightening until she could put into words both her greatest fear and her greatest desire. If I had reinforced the idea that she was an addict, and that sobriety alone was the goal, I would have unknowingly reinforced her greatest fear — that she was an addict and therefore not worthy of more.
Stigma and Labels placed on Drug Addiction
For some, the label of addict is not a limitation. In fact, for many people it can be empowering. The word addict can be a reminder of a real vulnerability, as if, one has intentionally drawn a line in the sand – danger never cross here. Seen in this way, the word does not necessarily cause a feeling of shame or helplessness. The word addict is meant to remind one of past behaviors and inhibit future unwanted behaviors. People are complex. It takes time to understand what is potentially helpful and what is potentially harmful to each individual. Many treatment models are too basic, a one size fits all protocol. One size and one treatment idea does not work for everyone. And worse, many treatments are damaging and actually mimic addiction by compulsively imposing a regimen or idea without regard for whether it is helping or damaging.
We are all better when we are accountable to each other — accountable because we want to be. Addiction is a type of confusion around who and what we want to be accountable for. When we feel cared about by others it is easier to care about ourselves. We feel most connected and cared about when we feel understood.
– Written by David Livingston M.F.T., M.A
Director of Mental Health Services at Domus Retreat