Tag Archives: addiction

Emotional Honesty

My father insisted that men were rational, women emotional, and therefore, women were irrational and inferior to men.  He liked to prove his point by provoking his wife and daughters into a rage, at which time he would sit back and smirk. I learned from his example that emotional expression showed weakness and inferiority, so hid or denied my emotions until I finally realized he was wrong.  Over time, I discovered that much of the maturation process involves un-learning beliefs and attitudes picked up almost by osmosis from early conditioning.

My father was not a bad guy, and he was probably rather typical of his generation.  Untold generations of men and women throughout history have believed and perpetrated the idea that intellect is superior to and at odds with emotion, yet this is fallacy.  The way the brain is wired, all sensory input travels through the pain (thalamus) and emotional (limbic) centers before reaching the frontal cortex, where intellectuality resides.  This implies that even the most intellectual and rational thinking is influenced by emotion.  What we choose to focus on, our interests, our skills, are all based on intent or desire, and their emotional significance to us.

Emotion gets a bad rap because it is associated with lack of control, as in the emotions of anger or fear.  But denial of emotion makes a person particularly susceptible to being manipulated by it, a major tactic used by advertisers and propagandists.  Targeting people’s insecurities, such as feelings of inadequacy or vulnerability, makes them more suggestible and more likely to buy the product or agenda being promoted.

The artificial split between emotion and reason is culturally created at an early age, when children are told what they “should” or “shouldn’t” feel.  The words “should” and “feel” do not go together.  Feelings are.  While it may be improper to act on certain feelings, to deny their existence only leads to repression, distortion, and dishonesty.   If allowed to run their course, emotions generally evolve into something else.

The greatest value of psychotherapy is that it helps people find words for their feelings.  A diary or journal can serve the same purpose.  The words help bridge the gap between emotions and intellect, by making the feelings conscious and less threatening.

Ideally, emotion and intellect work together to guide thinking and behavior, but for this to happen, emotional honesty is crucial.  Some experts claim addiction is a disease of lying.  A more fundamental explanation is based on the Freudian model describing the stages of psychosexual development.  In the anal stage, which occurs around two years old, the child begins to learn self-control, symbolized by potty training.  Here power-struggles with the parent can begin, as the child learns boundaries and the meaning of the word “no.”  This phase is thus termed the “terrible twos” because of the child’s resistance to new structure and boundaries.  Successful mastery of this phase allows the child to develop healthy attitudes towards authority.  If this phase is not successfully negotiated, the child may develop life-long issues with authority.  In an alcoholic or addict, this shows in the see-saw between overly controlled versus out-of-control behavior, as internalized authority struggles with the inner child in a contest for power over the will.

This is why one of the maxims of addiction recovery emphasizes changing the concept of “power over” to “power to,” in which the individual harmonizes the opposing forces to achieve balance.

There’s a mistaken belief that emotional honesty must be rude, crude, or uncivil.  I’ve had people insist that people want you to lie to them.  Some believe in telling people what they think  the other person wants to hear.  I disagree and claim that tactful honesty is actually a sign of respect.

This is another benefit of psychotherapy or of journaling.  Having the words for feelings provides a broader range of tools for communication, and allows for reasonable expression of emotion in a rational manner.

 

 

How Do You Define Crazy?

What is “addiction”?  What causes it?  There’s a lot of attention given, lately, to various forms of “addiction,” but definitions of it and its clues about its causes are rare.  The American Psychiatric Association (APA), the primary lobbying organization for the professional mental disorder labelers, claims it is a “brain disease” that is “complex” and characterized by “compulsive substance use despite harmful consequences.”  The official platform, published on line, says there are a number of effective treatments, and that people can recover.

The APA also asserts there are “changes in brain wiring” as a result of addiction, and that “brain imaging studies show alterations in judgment, decision making, learning, memory, and behavioral control.”

The psychiatric establishment, including the National Institute for Drug Abuse, states brain changes in the brain stem, cerebral cortex and limbic system cause addiction.

So that’s our answer, in a nutshell.  Satisfied?

I’m not.  In fact, it’s embarrassing to admit I’m associated with such pretenders, because this propaganda campaign is nothing more than pandering to a group of people who probably know more about addiction than the “experts” do.  First, “addiction” per se is not listed among the growing list of “mental disorders” in the latest bible of psychiatric diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, version V.  (DSM-V).  We have “substance use disorder,” and specific diagnoses related to the type of substance (mis)used, such as “opiate use disorder.”  We do have “internet addiction,” a new, DSM-V, excuse to seek funding for treatment.  But my rant here is not about addiction or the “opioid epidemic,” or even the marketing blitz that characterizes modern strategy for creating and perpetuating insanity.  It’s about terminology and the ocean of irrelevance that is pawned off as information to an under-informed, misinformed, and gullible public.

I first heard the term “brain disease” from members of the National Alliance for the Mentally Ill (NAMI), a lobbying group that prides itself on its family-associated organization, lobbying efforts for “mental health parity,” and its disassociation from mental health professionals.  NAMI has especially wanted to “de-stigmatize” mental illness by insisting it’s a “brain disease,” caused by a “chemical imbalance” in the brain, thus equivalent to physical diseases, even though there is little physical evidence for such conditions.

The psychiatric establishment, assisted by the pharmaceutical companies, the government, and to some extent, the insurance companies, has jumped on this opportunity to legitimize (and fund) research and treatment for a variety of mental disorders, and the list keeps growing.  Since the first DSM was published in 1952, the number of official mental disorders has steadily expanded, apparently to accommodate the tide of new medications flooding the market.  Homosexuality, formerly listed, has been expunged since 1987, but we have added problems you didn’t know were disorders, such as ‘social anxiety,” “adult attention-deficit hyperactivity disorder,” and “hypoactive sexual desire disorder.”  Insomnia is now an official psychiatric disorder, maybe thanks to the efforts of researchers and pharmaceutical companies that want to study and profit from it.

Lately, we are told the national suicide rate has gone up.  Army suicides are up, and there’s a question about whether some of the opioid-related deaths were intentional suicides.  We have the controversy over what used to be called “physician-assisted suicide,” which is no longer a politically or socially correct term, because it stigmatizes those who get a physician to help them die.  This is now called “medical aid in dying.”  Who remembers when Jack Kevorkian, a pathologist, went to prison in 1999 for helping patients die, convicted of second-degree murder?

Psychiatric terminology is tossed around with the same carelessness of standard epithets but carries the unsubstantiated veneer of insider knowledge.  Who hasn’t heard the president called a “narcissist?”  Look in the DSM-V to find out that “narcissistic personality disorder” could probably fit many people, depending on how one interprets the list of vague criteria, such as grandiosity or lack of empathy.  There are no “brain imaging studies” that prove it, and there’s no treatment.

To say the APA is misrepresenting itself, psychiatry, the mentally ill, and is flooding the public with irrelevance seems like a drastic claim, but here are the “facts.”  In its bid to align itself with “medical science,” such as it is, psychiatry likes to talk about “evidence-based” findings, but the evidence for most of its claims is based on subjective screening tools, such as Beck’s or Hamilton’s Depression scales, which depend on the patient or observer to assess symptoms or signs believed to contribute to clinical depression.

Also, the APA’s claim that “brain imaging studies” have identified specific areas of malfunction related to various mental disorders, is simply not true, but they keep trying, and the “psychiatric industry” is hot to obtain more funding for more research into the various potentialities of such tools as functional MRI and PET scans.

It is true that people under the influence of certain drugs and alcohol show more or less activity in certain brain areas, and autopsies of those with significant alcoholism, for instance, have brain changes consistent with long-term damage.

A great deal has been made over neurotransmitters, in order to justify the “chemical imbalance” hypothesis.  The class of antidepressants termed “serotonin-selective reuptake inhibitors” or “SSRIs”, led by the introduction of Prozac (fluoxetine) in 1989, quickly followed by copycats Zoloft (sertraline), Paxil (paroxetine), and others, spawned a new wave of psychiatric drugs that targeted specific brain chemicals (neurotransmitters).  Do they work?  There is increasing evidence that they don’t work for long, especially in children, and they may do more harm than good.  Approval by the FDA of direct-to-consumer (DTC) advertising in 1997 may have contributed to the upsurge in use of psychiatric as well as a host of other medications, and to the misperception that there’s a pill for every ill.

The “opioid epidemic,” deserves particular note, because it has been deemed by the Powers-That-Be as a “public health crisis,” deserving of broad-scale funding, research, special treatment protocols, legislation, and lawsuits against the pharmaceutical companies deemed most responsible for creating the problem.

Here, the psychiatric establishment–along with the government and media–has gone out of its way to misrepresent and inflate the problem, as well as its preferred solution, which is to hook people forever on different opiates.  The Need-To-Be-Needed crowd indirectly admits it has no cure, yet, but more funding will provide for better access to “care,” and for more research, such that maybe someday we will know enough to cut people loose from their psychiatric problems.

 

 

 

 

 

Addictive Thinking

by Katharine C. Otto, M.D.
January, 2002

Loosely defined, addiction is any attachment that compromises free will.  Addictive compulsions become problematic when they take precedence over more important life concerns, in defiance of reason and good judgment.

Everyone can identify with some measure of addictive thinking. Understanding your own compulsions – whether eating, exercising, working, television, sex, lifestyle, or even a prevailing mood, like anger, sadness, or guilt – helps to appreciate that the difference between addicts and non-addicts is merely a matter of degree.

With addiction you feel powerless, victimized, or lacking in free will. Thus, the first of the 12 steps of Alcoholics Anonymous states, “We admitted we were powerless over alcohol – that our lives had become unmanageable.” The key words here are “powerless” and “unmanageable,” because the substance could just as easily be tobacco or food.

When your compulsion becomes your priority, affecting more important areas of your life, such as health, relationships, work, or society at large, you become diagnosable. At this point every choice you make is colored by your addiction. For this reason, addiction treatment and AA emphasize making recovery a priority – a concept hard to grasp by many addicts, who fight this step because it is so powerful. Making recovery a priority and “walking the walk” on a day-to-day basis requires conscious choice and confers over time confidence in your ability to change your life. This subtle change in thinking from “power over” to “power to” reflects a shift from the role of victim to that of a responsible, self-directed individual.

Recovery is a growth process, requiring time to mature.  Building a healthy sense of self within the context of the environment takes patience.   We live in an addictive society, and enablers abound. Our systems foster and perpetuate dependency. Mainstream assumptions that the answers are “out there” lead us to doubt our own inner wisdom, yet relying too heavily on external authority eventually results in disappointment, victimization, and power struggles. Power struggles with either internalized or external authority eventually must be balanced by a cooperative spirit.

Relapse is part of the disease of addiction. Addictive thinking includes a rigidly held set of rules, whether consciously acknowledged or not. When these perfectionistic – and frequently unrealistic – rules are violated, the addict will often give in to his underlying sense of powerlessness and intensify his self-destructive activity, becoming a victim once again. Here, the power struggle is within himself, but the whole self loses in the see-saw struggle between “absolute control” and “out of control.”

In the past, addiction treatment took a punitive approach to relapse, but the winds are shifting. The addict who relapses already feels like a failure, and the punitive approach reinforces his negative self-image. At this point he is likely to run from treatment, if he is not reassured about the relapsing nature of addiction and the importance of keeping the relapse short.

Addictive thinking presupposes boundary confusion, a lack of definition of where you end and the next person begins. This inability to establish and maintain appropriate boundaries contributes to the escapism of addiction, and this leads to physical and/or emotional isolation. The “higher power” of Alcoholics Anonymous can just as easily refer to society as it does to a god, because the group is stronger than the individual. It helps set boundaries when the addict is unwilling or unable to do so. It’s also good for supporting the recovering addict in his strengths. For this reason, addiction treatment relies heavily on group process.

Everyone is susceptible to negative attachments, to situations and circumstances that lead to unwise choices. Addictive belief systems perpetuate those attachments, employing such tactics as victimization, power struggles, perfectionism, impatience, and deception. As the recovering addict walks the walk, he learns through everyday experience how to avoid those pitfalls and live a more fulfilling life.