You know, since my site is at least half-devoted to the concept of addiction, I recognize that I’m overdue for a comment on the subject. It’s not as if I don’t have daily reminders, but in case you wondered, this blog is far from being a conduit to the tales heard within my office. The unique stories are indeed private, though the themes are by now well in the public domain. The details vary, but the before and after descriptions have me nodding in recognition.
First thing is to distinguish the concept of addiction as a cultural one, not a medical construct like the term dependency. The term addiction befits the clinical focus of a private psychotherapist, a marriage and family therapist, because it connotes a relationship (with a substance or behavior) that can be discussed in relational and not strictly scientific terms. Not that I am opposed to science and how it informs the mental health army, but ultimately (and after 20 years I think the following more than ever), an awareness of how substances excite or inhibit the uptake of dopamine or serotonin, or else how mind-altering behaviors target the pleasure-reward centers of the brain is, in the end of the day, not that useful. Likewise, detox, psychotropic medication, or even 28-42-day rehab programs do not expel the ways of the agitated mind. Go read a book on the subject if you must, but recovery from dependency or addiction requires a sincere contemplation of problems, past and present, followed by a firm commitment to not block one’s emotional life.
Notice I didn’t write the word change in that last clause. That’s because I almost wrote the word change, which in turn is a result of having heard such rhetoric spoken or written multiple times over the years, by many in my field. Such language is not enough. It’s not specific enough. Afflicted individuals—those with addictions and troubled selves—lose consciousness through their habits, of both their thoughts and their feelings. Their lives are beset with self-doubt, anxiety, and tension. They lose their core and don’t notice the loss. They can appear calm, or else they can appear manic and preoccupied—neither is a genuine expression of who they are or could be, yet the feelings that accompany such states feel comfortable, familiar, and often necessary. Confusion sets in. What is normal? Medicating their semi-experienced distress, they use substances, engage in manic processes, abuse not only drugs, but food, sex…money. Don’t think sex is a mind-altering experience? Try concentrating on something while steering towards climax. You’ll lose focus, you might notice, lose continuity of what you want for yourself.
Sobriety for the addicted can be a drag, sometimes a quiet, unremarkable drag. Depression for some entails tears, crushing guilt, and a compulsion to distract at all costs. For others it is a flat, dull sensation followed by a need for excitement. Stimulation-seeking of this kind doesn’t avoid pain, as it is conventionally understood. It fills emptiness, a feeling few can label, but they can mutely agree when it’s reflected back to them. Craving secretly satisfies envy and hate—feelings people are not supposedly to have—only they do. The task of someone like me is to generate a pre-substance-using, pre-itch-consummating vocabulary for what’s happening, as in what’s reality, versus a fantasy of what people ought to be. Addicts and others who avoid their real, fuller, complex, undiscovered or forgotten selves, need the tools that post-verbal human beings have—words and a recognition of self—to express themselves fully, be physically alive, and connect with others, primarily so they can seek containment of risk-taking emotion, and thus spare themselves some of that alternative shame, guilt, and fear of which they are all too conscious on mornings after.