Unraveling

From "The Heart of Addiction" by Lance Dodes, M.D.:

I mentioned in chapter 1 that, despite all its terrible consequences, addictive behavior at its core has an element of emotional health. How can this be?

The answer is that acting against helplessness is, after all, a normal, and valuable, feature of life. A good example of the healthy nature of this kind of action can be seen in survivors of hostage situations or political prisons. When these imprisoned people found secret ways to express an aspect of their identity that was not controlled by their captors, they found they were able to preserve a sense of themselves. Sometimes they accomplished this by recalling events from their past, or just by keeping track in their own way of their history of imprisonment. But those who entirely gave up all sense of personal power tended to sink into a deep depression, or even died. The experience of these people underlies the fact that ACTING in some form when one is trapped and helpless is not only normal, it is psychologically essential. And attempting to act against powerful feelings of helplessness is just what lies at the heart of addiction.

Seeing things this way also points to another truth. Contrary to what you have heard, suffering with an addiction in itself does not make you fundamentally psychologically "sicker" or less mature than people with a wide variety of other difficulties, who generally are not so harshly judged. The feelings and conflicts that underlie addiction are easily understandable in human terms and do not set you apart from anyone else.

These are a couple of the most important ideas I came across in Dr. Dode's book. When I began having conflict within my family (before addiciton, at about age 11), not only did I have feelings of extreme isolation and loneliness; I had a sense of helplessness (aka powerlessness) and rage. Even at age 11, I tried to act in a direct way to the situation; actually I DID act in a direct way, but I did not receive cooperation and that's when the helplessness and rage became unmanageable. Then I discovered marijuana, and alcohol on a limited basis, and I could escape from these feelings and not feel helpless.

The problem I couldn't foresee at the time was that by turning to drugs and alcohol as a solution to the situation, I became even further estranged from the very things I needed. I became a "problem child" and unconsciously sunk deeply into the guilt of that. The fact that a large number of my peers were doing the same thing further fueled my revolt. My friends and I found comraderie in our illicit activities, providing me with the sense of community that I was so desperate for. This was the early '70's, the hippies were starting to get jobs and move into the mainstream but they left a wake of peace, love and happiness through drugs that my generation eagerly grabbed onto. I remain friends with a handful of these comrades, people that I love deeply. Every one of us has struggled, or continues to struggle, with addiction, emotional and societal problems. I feel the pain for all of us and I'm trying to work my way out of it for all of us.

Seeing the roots of my addiction in this way has given me a sense of personal power back. I acted in the only way possible to retain what small sense of self I had developed up until then. However, now, over 30 years later, I have, depsite my addiction problems, or maybe partially because of them, developed a core that is based on the very things I lacked at the time: trust in the people close to me, a strong sense of community, a belief in the goodness of the Universe and a belief in the goodness of myself. I don't always feel these things even though they are all around me and undeniable, but most of the time I'm able to act as if I do.

This also helps me understand why AA didn't work for me in the long run. If what I needed was a sense of personal power and to heal the underlying fracture that occurred in my psyche, then a program based on powerlessness, steeped in patriarchal language and ideas and with a good dose of punitive Christian morality thrown in for good measure was bound to fail. I'm afraid that for those of us who need a different model, AA can do much more harm than good. The field is changing, however, as is evidenced by all the new material available, the work of people like Dr. Dodes, Charlotte Kasl and many others and the insistence of people everywhere that they be given more choices.

This work is exhausting. I don't know when I've been so bone weary and fatigued. But it feels like I'm really getting to the core and I'm committed to stick with it - remaining interested, open and optimistic.

Can You Imagine?

Can you imagine a world in which no human being suffers from alcoholism or addiction? I can. Do you often feel that your personal struggle to overcome a particular problem could be important for humanity as a whole? I do. As I move forward with my exploration into healing my own addictions, I will be meditating on this future reality, one in which all sentient beings are free of the bonds of addictive thinking and behavior. This is a form of the metta or lovingkindness meditation that many Buddhists practice in which they extend their hopes for their own transcendence to the entire human community. First, to their family and friends, then to the larger community in which they live and on to the global family of which we are all a part. I'd also like to mention that members of AA often practice a form of this meditation in which they pray for a person they are having problems with. They are instructed to pray that the troubling person be gifted with all the same things that the pray-er would want for themselves - happiness, fulfillment, strong relationships, abundance and of course, freedom. This meditation, however, carries it a bit further. Whether you have already conquered your addiction problems, or like me, are still struggling for the answers that will work, I invite you to join me in this meditation.

I met with my therapist yesterday and am happy to say that I think we will be able to work well together. She did not, as was my fear, say "Get thee to AA." We spent two hours in a general assessment and have an appointment scheduled for next week. In the meantime, I have obtained the hypnotherapy CD's from the My Way Out program and started those yesterday as well. In addition, I am using the nutritional supplements recommended in this program and will be using the anti-craving drug, Topamax, which I will start in a week or two. I started an exercise program several months ago and will continue with it as part of this holistic process. The meditation is my way of adding a spriritual component, which I believe is vital, into the mix.

This idea, that one individual's healing can imprint the entire fabric of humanity, is being brought home to me in a book I'm reading called, "Dark Night, Early Dawn" by Christopher M. Bache. Before reading this book, it all just seemed like a somewhat utopian idea, but the more I read the more real it becomes. This book is not for the faint of heart, but it rings with a truth that my soul can't deny.

Moving Forward

I finally have an appointment with a therapist this Tuesday morning. I'm eager to see her and have started a list of things I want to explore with her. In the meantime, and since it's taken a month to get an appointment, I began taking St. John's Wort for the depression I'm experiencing, along with Valerian for anxiety. These are both proven, safe and effective herbs for dealing with both of these issues and they do seem to be helping.

I've also made some decisions and I'm sure that's helping, too. I took a good look at the things I was feeling depressed about and the ones I can't do anything about - like aging - I prayed over and accepted. But there are a few things I can do something about and one is my job/career situation. I've been working two part-time jobs since I was able to after knee surgery, all the while looking for full-time work and applying for a few things. I realized that taking one of these jobs was as depressing as continuing to live without full-time work so I started looking into other options. There is a community college an hour from here that offers one and two-year programs in everything from graphic arts to medical coding. One or two years is doable plus I'm already used to being poor so what's another year or two below the poverty level? So I've got my application all filled out and am planning to start this summer. I'm thinking graphic arts but haven't fully decided yet. It sounds a lot more fun that medical coding!

As for drinking, I've been abstaining some, moderating some and still over-drinking some. I've done a lot of reading, some of which I shared in the previous post, plus I've read two other books: "The Alcoholism and Addiction Cure" by Chriss Prentiss and "My Way Out" by Roberta Jewell (not her real name). Both of these books recommend an approach that engages the physical, mental and spiritual aspects of addiction. I'm putting together a plan for myself that includes recommendations from these two books plus "The Heart of Addiction" by Lance Dodes, M.D. I'll be writing more about that in the coming week.

A New Way of Thinking

In his book, "The Heart of Addiction", Lance Dodes, M. D. asks us to consider that addiction may be a behavior designed to reverse a sense of helplessness. Dr. Dodes gives many good examples of this in his book, but I don't have to think long about my own history to discover that my first addictive impulses were directly related to feelings of helplessness.

I was eleven or so when a situation occurred in my family which left me feeling very alone, helpless and angry. Unfortunately, I wasn't old enough at the time, nor emotionally mature enough, to find an effective way of dealing with this sense of powerlessness and rage. I lost my connection to the very things I needed most to sustain me through adolescence - that emotionally-fraught passage of life when everything is new and wonderful and scary as all hell! The most important thing I lost during this time was an ability to speak up for myself and feel that I would be backed up by those closest to me. Over the next couple of years I basically shut down in order to outwardly conform to what I thought family needed me to be.

I had to be quiet. I was told I had to be quiet, or else. I found that the most effective way to be quiet was to get quietly and totally fucked up as often as possible.

I've finally realized that I can explore these issues without assigning blame. I hold nothing but the greatest love in my heart for the family that raised me and continues to be a constant source of support and strength. I had some crazy idea that looking at the past was a betrayal, that being honest about my own experience would hurt those I love, but I've come to realize nothing could be further from the truth. It's a betrayal of myself to not look, to not examine, to not understand.

From the book:

The action of addictive behavior to reverse helplessness explains its purpose, but it is only one factor in the new way to understand addiction. The second factor is an explanation of the drive behind addiction. When anyone is trapped, physically or emotionally, he or she will sooner or later feel a great anger - a rage, really, at being helpless. It is this rage at helplessness that is the nearly irresistible force that drives addiction.

There is also a third, critical, aspect of the new way to understand alcoholism and other addictions. It arises from this fact: if the purpose and drive behind addictive behavior - an effort to preserve one's power and control against helplessness - make sense, and if an addictive act is merely a very unfortunate way to express this sensible function, then it follows that there must be a better way to achieve this sensible aim. That is, addictions must be substitutes for some other, more useful actions to respond to the helplessness. Indeed, I have found that every addiction results from a redirection of energy to a substitute or displaced action (usually because another, more direct, action is not considered permissible.)

~~~~~~~~~~~~~~~~

Put another way, knowing that every addiction is displacement means that there is always another, specific behavior that is being ignored or denied by the substitute behavior of the addictive act, and that this alternative can be found. This idea of looking for the specific alternative is very different from finding general "triggers" to addiction, such as walking into a bar or being with drinking friends. It also differs from the usual advice to distract yourself or keep busy when the urge is upon you. Those efforts often fail because they do not address the individualized issues that are driving the addiction.

A final word about displacement. The fact that all addictions are displacements, or substitutions, is of great importance because without this displacement, addictions would not exist! It is precisely the shifting of the effort to reverse helplessness to another activity, such as drinking, that creates the phenomenon that we call addiction. When actions are taken directly to deal with helplessness, there is no addiction.

The Heart of Addiction

The following is an excerpt from a book I just finished titled, "The Heart of Addiction" by Lance Dodes, M.D.

As you know, 12-step programs have helped some people, but they also have significant limitations, many of which I have already discussed. I will first briefly review some of the limitations and problems of 12-step programs, then discuss how and why they can be helpful for those who make use of them.

To begin with, as a one-size-fits-all approach, these programs tend to be uninterested and unhelpful in understanding the individual emotional factors that determine addictive behavior. Just as serious, they tend to shame those who do not benefit from their approach. People who do not improve are regularly told that they have not "gotten it" or have not "worked the program" hard enough.

Making people feel foolish or bad if they do not benefit is consistent with AA's uncritical attitude toward itself. Unlike professional approaches, there is no effort within 12-step programs to advance their understanding of the treatment of addiction, alter their program based on its results, or suggest other treatment if theirs is not working well. Such an approach would obviously be unacceptable in any medical, psychological, or other professional treatment. It reflects the self-reinforcing nature of having a group of people all of whom believe in the same program. Without attempting to understand their successes and failures, AA and other 12-step programs are insular by nature. Put another way, these programs do not seem to recognize the nature of their "sampling bias." By attending only to their own success stories, they create an impression that everyone outside their group, if they only believed or worked hard enough, would do as well with their approach.

A corollary of this is that a number of people who have done well in AA have written or talked about it, while, needless to say, one does not see many articles from people who have not been able to benefit from AA. (You could consider this entire blog an article to that effect.) This is another kind of sampling bias, unscientifically tilting public impression toward the correctness and usefulness of AA. One particularly unfortunate result of this has been its influence on people in positions of authority to make health care decisions.

Some of the traditions and advice of 12-step programs are also harmful. For example, advice such as try to avoid being angry is particularly unwise counsel to give to someone struggling to understand and master an addiction. Likewise, myths of needing to surrender your willpower, or that you should count your days of sobriety - both tenets of AA - are also frequently unhelpful or even harmful. Surrendering your willpower suggests that because you have an addiction you should give up on your ability to manage it, and is the opposite of what is needed if you are to use your understanding to actively take control over it. Counting sober days contains the moralistic and often destructive idea of returning to zero after a slip, which inappropriately gives the message that you have failed and that you deserve this harsh punishment. As I said earlier, many people have told me of how injured they have felt by this, with its punitive character sometimes even precipitating further addictive behavior.

Indeed, there is quite a bit of unfortunate moralizing in 12-step programs. For example, in step four, you are directed to take a "fearless moral inventory" of yourself. From a positive standpoint, this may be helpful to some people who have difficulty examining themselves. But this also carries the unmistakable message that having an addiction means that you had better spend time looking at your moral failings, as if either addiction or the emotional factors contributing to it were at heart moral issues.

After my last slip, I found myself sliding into a deep depression as many of the above factors came into play for me. I once again felt like an abject failure and that my moral character must be so flawed as to render me hopeless. I was on the verge of totally giving up. Thank god I have the sense to continue to seek the answers that will fit for me. I know there are scores of people out there, who like me, continue to struggle with their addictions; who, like me, were indoctrinated that the 12-steps were the only viable option; and who, like me, know without a doubt that that program will not work for them.

I went on-line and ordered three books, two of which I have now read and one still to come. I have found "The Heart of Addiction" to be the most helpful thus far, but the other one has many good ideas which I will be discussing here in the coming weeks, along with more of Dr. Dode's understanding of addiction. He is one of the most thoughtful, compassionate, and practical writers about addiction that I have come across in a long time. A welcome advocate for us "12-step failures."

I have moved forward with seeking professional help, but it's through the state mental health department and may yet take a couple of weeks to obtain an appointment. I hope that the therapist I'm assigned will be willing to explore new treatment options with me and I have decided that if they don't, I will seek assistance elsewhere.

Sometimes it's very difficult for me to write about my experiences with AA because I have many good friends who have maintained sobriety with the 12-steps. Not only do I have no desire to alienate these people, I want and need them in my life. But it's time for me to work through all of this and I think finally time to express the whisperings of my own heart without restriction. As a matter of fact, I think that is what lies at the heart of my addiction.