From The San Francisco Chronicle, May 20, 2019: www.sfchronicle.com/opinion/openforum/article/Open-Forum-What-is-addiction-13856770.php
With the nation’s drug problem attracting huge media attention, and having spent 11 years addicted to opiates myself -- now three years clean -- I’ve increasingly come to consider what addiction is, exactly.
That’s to say, why do people become addicted, or what fundamentally causes it? There are plenty of theories on this complicated subject, and my own perspective continues to evolve.
In Alcoholics Anonymous and other 12-step groups, addiction is widely accepted as a “disease,” though the term is somewhat ambiguous. AA’s original text describes alcoholism as a three-fold problem: a “physical allergy, mental obsession and spiritual malady.” The word “spiritual” always raises a few eyebrows, and its definition may depend on whom you’re talking to. I’m not sure, however, that modern science has a better word for explaining what addiction represents or might represent. As with other matters of personality, it seems to have, in part, an abstract and mysterious quality that eludes things like questionnaires or brain scans.
There is a debate in recovery communities about whether addiction is in fact a primary “disease” or just the product of life experiences – specifically, traumatic events or circumstances whose emotional toll causes people to seek refuge in drugs or other compulsions. While 12-step philosophy does not clearly weigh in on what specifically causes addiction, it approaches addiction as a nebulous and incurable – though potentially manageable – condition, whereas advocates of the trauma theory, led by Dr. Gabor Maté of Canada, say their more scientific view opens the possibility of reversing addiction by addressing an identifiable origin.
But the trauma theory also raises questions. What exactly qualifies as trauma, and why do only some traumatized people become full-blown addicts? Also, why do certain people seem more vulnerable to traumatization? If one explanation is a natural sensitivity, that could bring us back to seeing addiction as also having hereditary or other more obscure causes.
Of course, there have always been those who view addiction as simply a hedonistic impulse or failure of resolve – fair enough, as far as it goes. Most addicted people start on that road because they are enticed by a long-missing sense of pleasure, comfort or self-confidence that the drug or other stimulus brings on. It’s worth noting that, though we tend to hear mostly horror stories about addiction, it can have a paradoxical upside for people who might otherwise feel maladjusted to the world. Maté argues that addiction is often the best choice that can reasonably be expected of people in the face of extreme emotional hardship.
At the same time -- and now we’re really splitting hairs -- 12-step philosophy holds that neither choice nor individual willpower plays any part in addiction whatsoever. Rather, addicts are inherently “powerless” within their own means against a force that eclipses their conscious will. And it may be that addiction is primarily a brain disorder, or the elaborate work of unconscious forces. But then, maybe everything is.
I suspect that to truly understand what addiction is – for me, at least – I would have to experience what it isn’t. My sense is, despite the extensive self-work I have done in recovery, some of the complicated feelings that gave rise to my addiction are still floating around and manifesting in certain, more subtle, ways. In today’s society, where most everyone is supposedly addicted to something (drugs, internet, work, junk food, extreme exercise, whatever) it’s a quaint idea to think of what being truly unaddicted would entail.
However you think it all germinates, addiction does not appear to be a self-standing condition but an outgrowth of common personality problems like obsessiveness and malaise. Such feelings seem to block psychic expansions like intimacy, engagement and fascination. Instead, our cyclonic thoughts grab us up into the same dull patterns, which may feel like the best thing we have going.
With this in mind, considering the question of addiction could be a valuable exercise for anybody, or at least an interesting one. Yet, for people trying to recover from drugs or other problems, it may come down to advice that an old 12-step sponsor told me as an unhappy young philosopher: Recovery is about action. It’s making substantive changes in your life. So tell your intellect I said hello, and you’re not thinking your way outta this one.