by Katharine C. Otto, M.D.
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.