The Trick is Knowing Where the Power Is
by Candice Shelby, Ph.D.. Associate Professor of Philosophy, Univ. of Denver.
Much literature regarding addiction appeals to the assumption, established nearly 100 years ago, that alcoholics are powerless over alcohol. In fact, admitting this “fact” is the first step in the ubiquitous 12-step approach to treating addictions. Like all “facts”, though, it is true only in a sense, and that sense is usually left undefined, with the result that addicts are left feeling that they can do nothing about their condition but put themselves in the hands of others, real or imagined. This has resulted in a not-better-than-chance rate of success in treatment on most professional counts.
It is true that while one is actively high, or drunk, if addicted, one cannot refrain from having another drink, or dose. But while high, one has very little control over one’s mind at all—over speech (either the content or the mechanics, or both, depending on the drug in question), or over movement, or judgment. One’s brain is malfunctioning in the same way that one’s other systems do when infused with arsenic. That’s no surprise. It is also true that one stays under the influence of the physiological craving for different substances for various lengths of time; we all know that heroin and meth users, for instance, and drinkers of certain varieties, undergo serious physical withdrawal symptoms for some time immediately after ceasing use. No one has control over this, once the body has become dependent.
But addiction is not defined by the professionals in terms of this kind of powerlessness; many people who have suffered serious injuries become dependent upon narcotics to stop their pain, but when the drug is withdrawn, although they may experience discomfort initially, they never again use, or obsess about using the drug. What is more, it is well known that significant numbers of Vietnam veterans who used heroin and other drugs regularly while in battlefield conditions, and became dependent in this sense on them, but then upon returning home, never again used these drugs. So, in general, people are not powerless to stop use of even strongly addictive drugs—physical dependence does not in itself constitute addiction. What makes an addict an addict is the inability to stop thinking about the substance (let’s just stick with substances for this discussion) in a certain way, which in most cases inevitably results in the addict’s reversion to use. It is in this sense that the famous 1st step of Alcoholics Anonymous means that addicts are powerless: no matter what her intentions, or how hard she thinks about the good things that accompany remaining abstinent, the yearning for the addict’s preferred substance will prevail, if someone or something doesn’t intervene. The addict has no control.
This characterization, of having “no control,” is said to be true regardless of how rational the addict may be, or how convinced she may be that to revert to use is to welcome certain self-destruction of some kind. Thinking about continued abstinence, seeing the irrationality of reverting to use…in fact, understanding anything and absolutely everything about one’s addiction does not provide power over the substance. Why is this? It is because of the unrecognized fact that everything we think about, every thought whatsoever, is as much emotional as it is intellectual, but our emotions operate largely unconsciously. The very way we learn the meanings of things — what things are, what makes up the world –is already emotional: for example, the first “object” of our knowledge, the mommy or caregiver, does not arise in the child as a purely intellectual concept. Babies develop the concept of this “object” by interacting with someone who soothes, comforts, and makes him feel safe and warm–GOOD–in addition to everything else that enables him to distinguish this person from all the other colors, shapes, movements, etc., entering and exiting his field of experience. In other words, people don’t start by distinguishing objective things in the world, and only later decide on what kind of emotional “tags’ they will have. Rather, the initial distinctions that we make among the entities that come to constitute our world are already full of meaning; things are comprehended in terms of their value or disvalue to us (GOOD or BAD; YAY! or YUCK!), and we perceive those values as attending their objects, whether consciously or not. (Keep in mind that we perceive all kinds of things every day, all day long, that we don’t consciously recognize, such as the pressure of the floor under our feet, the air against our skin, and the thousands of details about objects in our range of vision that we don’t pay attention to.). When we say that something doesn’t mean anything to us (suppose that the police bring to you the tie of a missing neighbor whom you never knew), we are saying that it bears no connection to other meaningful things in our lives. That is, it rings no bells—it has no particular value or disvalue, nor any connection to any other thing with special value or disvalue for us. Emotion, on this analysis, is the perception of the value that things have for us (even if that value is very low-level) and this perception may be totally unconscious—which is what often happens, since the world is far too rich for us to devote our full attention to, or even care about, everything.
Now, our emotional connection to some things is very high indeed, and for addicts this is perhaps especially true. We should remember, and I argue this in other places, that addiction is our condition as humans—it’s inherent in the way that we are built. The basic structures underlying addiction are the same structures that keep us seeking food, sex, and other things essential to life and the reproduction of our species. My point, then, is that addicts are not different from other human beings, except in some small but important details. Insofar as we are all potential addicts in this more general sense, the very shape of our world is affected by the emotional value (or meaning) inherent in those substances which, at least in the beginning, make us feel so very GOOD. Places, people, and things are seen as opportunities or obstacles to satisfaction, even if we refuse to acknowledge them in that light. Arguments and reasons have no power over emotion, which operates at a deeper level in our brains than does the higher reason of which we are so proud. That’s why people can know more about recovery programs than anybody they’ve ever met, and yet be more susceptible to relapse than the simplest just entering into recovery. Once we understand the mostly unconscious operation of the emotional values connected with things in our lives, we understand how people’s actions often move in precisely the opposite direction of what they know is good for them. Often, addicts know what is good for them, plan in good faith to do it, and then do exactly the opposite. Recognizing the unconscious influence that emotion has in shaping their world, as well as in planning and executing their actions, can help addicts make sense out of ways of acting which would otherwise seem crazy, senseless, and/or uncontrollable.
All this may seem to argue for the opposite of my stated point: it may seem to show, that is, that addicts are, in fact, powerless over their addictions, and that they should run as fast as they can to some higher power, to prevent them from doing further self-harm. But that is not the case. While it is true that addicts are unlikely to succeed in overcoming their addictions with no additional support, it remains true that the addict alone is the one who actually has power over his or her addiction. But to exercise this power, what must happen is that there be a shift in the meanings the addictive substance (and its uses) has; this shift of meaning takes place not in the rational mind but in the heart–in the emotional response—that the substance elicits. How and when does this happen? Admittedly, it happens slowly, and with much practice and reflection. But it can happen—the brain is very plastic, as it is all the rage to say today—and so addicts can re-organize the meanings of things in their world. Indeed, people do it all the time: when they fall in love, find out that a spouse has cheated, or unexpectedly become unemployed. It is striking, but acceptance of just one fact, profoundly emotional in nature, can cause major changes in the meanings of things in a person’s world. This fact suggests that once past the immediate stage of physical dependence, it is possible for addicts to change our emotional attitudes toward substances and activities that we know have nothing good to offer, and to change our lives altogether.
How can we do this? One way is by making use of some of the good recommendations that 12-step programs have to offer: for instance, (a) making lists of people that we have harmed through our addiction, people whom we honestly may care about but whom we have nevertheless caused pain as a result of this substance that seemed so good due to the feeling of satisfaction it provided at some point. It also helps to (b) make amends (where possible) to these people; at the very least, making amends feels good because being “clean”—honest and open, and fixing things that we have broken, or at least apologizing—feels good. Such feelings start to rewrite our emotional experiences and associations, which in turn has subtle effects on the way that we see the world. Another method is (c), stating over and over out loud (the actual physical action of stating the truth) the bad things associated with the (formerly alluring) substance helps us to feel that badness as associated with the substance; in this way, the substance is invested with a meaning different than what it formerly had for us. Making these statements aloud also helps to project that negativity into the world, to remove it from our own characters, and make it something objective, something no longer part of our identities. And it is perhaps particularly helpful (d) to have friends around to remind us of what we have done under the influence of the substance, so that if our brains start (out of habit or discomfort) to perform the subtle Gestalt –type of switch familiar to so many addicts, reverting to the old way of seeing the world—feeling the old feelings, experiencing the old meanings of the substance of addiction and its associations—they can play an important role in helping us maintain this all-important shift in meaning.
It is worth adding that activities like (e) meditating or performing yoga (or some other activity requiring integration of mind and body) can, when done on a regular basis, helps us to separate ourselves from those emotions that, when we give ourselves over to them, drive our actions before we even think–or, what is worse, while we are consciously thinking of something else! Slips, real slips, do happen—and they are explicable in terms of our emotional grasp of objects and events in the world, and the connections of those emotional parts with the planning and acting parts of our brains. Slips are possible, that is, because our attention is finite and our brains are very busy little bees, doing millions of actions per second. So, while we might “officially” think that we have a certain view toward a substance, our emotions may be operating in the background quite contrarily, moving us in a direction quite different from the one of which our conscious thought and judgment would approve. Being tired, stressed, hungry, or having had an interaction with someone that has left us hurt, disappointed, or angry, can distract us from our real good, and can bring “online” emotional effects that drag us away from our true and helpful perception of the world, and back toward the one that did us such harm. For these reasons, mindfulness practice has great potential as a primary tool of sobriety whether undertaken as part of one’s meditation, or as a separate practice—and note that none of these practices implies any religious connection. Indeed, any number of simple, secular, practices can be employed to separate the conscious self from emotional frenzies, and to increase our ability to pay attention to what is going on with us. Learning to pay attention to our feelings and inclinations without engaging them is probably the most powerful tool currently available in treating addiction. These claims are supported by several studies done over the past dozen years, which show that the brain actually undergoes changes, both temporary (during the time of meditation) and permanent.[i] Additionally, one recent study showed that the amygdalas, (areas deep in each hemisphere of the brain, which are associated with stress, strong emotional responses and memory) of participants shrunk significantly, over just 8 weeks, as they engaged regularly in a set of three meditative and mindful exercises. Although these people were chosen for the studies based on stress levels, rather than anything associated with addiction, the fact that they were able to physically change their brains through conscious practice should offer great hope to addicts.[ii]
In conclusion, it is not the case that addicts first have to admit powerlessness in order to become and remain sober. The unfortunate fact is that the power does not arise where or how we wish it would–immediately, and simply by thinking or deciding. We have the power to overcome addiction, but the route is demanding, and requires time and effort. We cannot just decide on a different set of meanings; they must, as one philosopher famously said about beliefs, be imposed upon us by nature. That is, they must happen to us, because the changes in the way that we experience the world must come from a deeper and older part of what is responsible for making us, us. They must happen at the deeper emotional level, operating beneath our conscious perceptions and judgments about the world, a level which actually makes those perceptions and judgments possible. Still, we needn’t just wait for change to happen to us, for setting up those changes is within our power. If the addict can’t change herself, no one can. The power is ours.
[ii] Britta K. Holzel, james Carmody, Karleyton C. Evans, Elizabeth A. Hoge, Jeffery A. Dusek, Lucas Morgan, Roger K. Pitman, and Sara W. Lazar, “Stress Reductioni Correlates with Structural Changes in the Amygdala. Social, Cognitive and Affective Neuroscience (2010) 5, 11-17. Follow-up studies have supported the conclusions of this first one.
Sorry, Char, but, even if it’s not a cult to you, to many people it is. That would be exemplified by your statement that all an alcoholic needs to do is “work the steps and get a sponsor.” As for things like getting support and ending isolation, we offer plenty of that right here at Lifering.
AA is not a cult. AA provides something for alcoholics that others either can’t or don’t wish to because they don’t trust the alcoholics ; because of in some cases the damage they caused while caught up in their addiction. Many people who are alcoholics of the hopeless variety need AA to recover because nothing else was working for them. The need the support of people who have traveled the same path. The need the underlying support to beat what is to them a very highly addictive substance. As someone phrased is after that first drink they are powerless. People while attending AA if they actually participate in the program learn to live life differently and obtain new ways of cooping with life’s stress. They come out of isolation by finding new friends and winning back the old friends they lost through their addictions; but not always. You hear the experience, strength and hope for another alcoholic and from this we learn. What is was like? So you can see if you relate, What Happened? When did the substance of choice (for some) stop working to lessen the pains of life, What they are like now? (How they changed by coming into the program). Every single time I attend a closed, open AA meeting or any other type of 12 step meeting I learn something. Type 2 diabetes is classified as a disease. If a change in the body chemistry in response the certain foods. When the person eats differently the body’s chemistry response it removed. The brain when toxified by alcohol is in a diseased state. Once the alcohol is removed the brain will being to repair it’s self; however we need to be careful because some changes can caused permanent damage to certain areas of the brain. The sooner regardless of how someone stops drinking to place their body in harms ways the better opportunity for greater long term health. What ever works. Just like life take what you like and leave the rest unless you an alcoholic of the hopeless kind. If you are get a sponsor, attend AA meetings and work the steps.
Once and addict NOT always an addict. I WAS an addict, not now. We can grow out of an addiction. Yes healed completely! To view yourself eternally as an addict is counter productive and not accurate.
PROOF THAT ADDICTION IS NOT A DISEASE
I attended a disease model 12 step treatment program a couple of years ago. One day the Medical Director gave his “Brain Lecture”. It described the current medical or disease model. This model states that there is a genetically inherited type of “switch”, for lack of a better word, that is activated in the Limbic system and that once activated by an addictive substance your an addict and stay an addict for life. It attributes great “control” and “power” to the primitive drive of the Limbic system and power to at least initially override our will(mind). This doctor went on to talk about his addiction to the opiate Dilaudid which is very similar to Heroin. This addiction started at age 41. However, he mentioned that his dad , grandfather and great grandfather were all alcoholics. He himself started to drink at age 16. He never had a control issue with alcohol. So right there is proof that the disease model is false. The switch he supposedly has in his brain was not set off by alcohol. It should have been after his very first drink , as the disease model says. Loss of control should have started at least by age 20. However, he drank for 26 years socially with no issues. It took the powerful opiate Diluadid to get him addicted to a substance ….why…because it’s perceived “rewards” are far stronger than those of alcohol. In other words it’s more addictive!
Fantastic article ! Someone asked if addiction is a disease. The current medical “belief” is that it is. Nothing could be further from the truth.
Just believing that it is a disease and that you are powerless and that you must attend 12 step meetings forever almost guarantees you that you will relapse. It can be and usually is a self fulfilling prophecy. Addiction is emotional and it involves choices, perceived benefits, self medicating etc etc. There is NO genetic switch that is turned on in the Limbic brain that somehow forces you to use! I highly recommend the works of Dr Marc Lewis Neuro Scientist and his book “Memiors of an addicted Brain”. There are changes in the brain ONCE addiction starts( not before) that reenforced the reward system of use, but addiction is not a disease. Also the brain is plastic
and thus changes and heals.
I can really relate to this article, thank you so much for all your research on the subject. I was one of those people forced by the system to go to 12 step meetings. The idea of being powerless over my addiction made me feel so sad and helpless. It kept me in a victim mode. I relapsed many times before finally putting together 6 years. It was not until I stopped going to 12 step meetings and took responsibility for my own recovery that I was able to do this. With each relapse, I now believe that whether consciously or unconsciously I was challenging the 12 step fundamentals. Finally I realized I am the only one that can keep me clean and sober. Slowly I changed and made new associations. Thanks again for this empowering article !
Pretty good article, however, as with 99% of most everything written about addiction, a tremendous amount is missing. First off, is addiction a disease? I seriously doubt it as the evidence suggests that chronic addictive behavior (drugs, alcohol, sex, food, etc) will bring about profound physiological changes that will slowly revert to normal given enough time. For example, when a person “lights up” their brains pleasure center with an orgasm, or a drug, or a highly pleasurable activity, they simultaneously “cool down” the regions of the brain responsible for critical and protective thinking. This can be done without actually engaging in the activity, and by only thinking about it! What this means is that in the heat of thinking about getting high or having sex with your best friends wife, rational thought processes are severely muted making resisting “temptation” more difficult. Studies done in the Netherlands on people during orgasm have demonstrated just this physiological phenomenon. So we are not actually “powerless” we are just much more vulnerable, especially so with chronic use. Is addiction a genetically inherited “disease?” Once again, I don’t think so. I assert that many of the psychological predispositions to addiciton are themselves inheritable but not addiction itself. In support of this is the recent discovery of the DRD4 gene which when inherited predisposes one to more risky behavior, and not surprisingly, increased rates of drug abuse. And finally, one doesn’t just decide not to have a disease anymore and quit having it. This last observation has been repeated too many times to count in people with serious addictions to everything from cigarettes, to sex, and yes to drugs. Again I make note of the powerful physiological changes that occur with prolonged, intense, involvement in any highly pleasurable activity. I caution against those who would think that our brains would revert back to normal quickly, but addiction is not a disease over which one is powerless (unless you truly believe it to be so!)
Hey GOOD artical above, man all this whining about AA good AA bad, blah, blah, blah. I’ve seen AA from the best to the VERY WORST!! I used to LOVE AA and would still be there, trying to help anyone I could, and volunteering for EVERYTHING that came down the pike. Set up chairs wash dishes, chair my home-group. In my situation the old- timers di not appretiate some-one who actually tried. They seemed to feel that it somehow took THEIR power away. Aren’t these guys suppose to be power-less??? Guess not. Good thing my sobriety is solid or I guess I’d be dead now so a bunch of NARCISSISTIC FREAKS could all have a big laugh over it at the coffee shop. On May first of this year 2011 I have 24 years of sobriety and maybe some of the “true believers ” out there NEED to hear this. As long winded as this comment might be, People need to be warned. I’d still be there if I could, but now I use a bunch of other stuff to stay sober. And I also found out who where real friends and who where not (most of them)!!!!!
Thanks Gary B
Didnt mean to offend anyone. No one commented on the actual findings from studies showing AA to be ineffective and at times harmful in what it teaches alcohol dependent (or other substances) people. I do love the above article though, even though AA people may not like what it says.
This is something I say over and over, addicts are not powerless. In fact they are generally afraid of the power they have.
Alcohol or drugs are an inanimate object, it will sit on the table until hell freezes over if a person doesn’t pick it up and put it into their system. It has NO power over anyone, the choices we make define our lives, if we choose to be an alcoholic or drug addict we are. As soon as we choose not to be we can start moving froward in our life and become “recovered” not eternally “recovering”.
For more information check out our site for a program in Thailand for English speaking clients that does not use the 12 steps.
Alcohol Rehab Thailand
“If this works for you more power to you. For me, I personally…”, Mark, I could not ask for more. You tried the secular route and found AA is working for you. AA is an option just like Lifering is an option. Lifering is sure working for me. Anything so stunning about a world with multiple solutions/pathways/choices/non-choices?
Yes, are you referring to the first 3 steps at which most of the early binges occur in AA. Admit youre powerless, accept a god, devote your life and will. 1, 2, 3, drink. The rest of the 95% of the world drops out by the 12th month. Source: AA world services info, and supported by studies everywhere. Don’t blame us, Dr. Vaillant who supports AA found the same thing, more people recover without AA than with. And 16 states now ruled it is Illegal to require someone to attend AA because of its religious nature. Of course in the rooms, you’ll never hear that. It would be embarrassing.
I am constantly amazed by the level of animosity I see towards the 12 steps. If you don’t like them, don’t use them. I’m sober through AA for 22 years and have never heard some of the stuff I hear about AA at AA. I must be going to different meetings. I do appreciate this article though. It’s one of the best explanations of the first three steps I’ve ever seen.
Thank You! I have been told too many times to count that only a spiritual experience will conquer my addiction to alcohol. I am powerless. Well, even after many years of drinking, i have put down a drink half way through. I have been abstinent for over a year now. If i “lapse” I can surely regroup after one sip or drink and not turn into a raving alcoholic zombie that AA tells me i would be. I can still stop and go back to recovery and abstain. However, AAs will tell you you will be that mad zombie after just one sip, so when AA people “go out” they go out with a total vengeance because they believe they are totally helpless after that first sip.
This is apparently why even studies by George Vaillant, member of AAs board of directors found that AAs have the highest binge rates of any other treatment and even more than people who get NO treatment at all. Ive seen it many times.
Fortunately, AA is no longer the only option in town. SOS, SMART, LifeRing, MFS, WFS, RR, have come to help the vast majority of society that saw no sense in the faith based AA. How many recoveries has AA blown with its difficult to accept faith healing, powerlessness, and meetings for life disease ideas? I believe this is why the AA fellowship is having trouble growing now. AA world services even acknowleges this. I know why. More has now been revealed.
There seems to be a false contradiction here. If people can function without a 12 step program they do not need one. The AA-book defines those people as heavy drinkers, give good enough cause they may stop drinking or start to drink in moderation. This is not the case for alcoholics.
Too many people are today sent to AA to deal with being a heavy drinker where as it was constructed as a last stop for hopeless alcoholics who had tried everything else. This is problematic as it has a tendency to waters down the solution of the program, as well as it has a tendency to keep people in a false selfidentification as alcoholics.
This however does not contradict the fact that powerless alcoholism exists and there needs to be a clear solution for the alcoholics, which is substancially different from the solutions for the heavy drinkers. Like the solution for anorexic people need to be different from those of people with malnourishment, and a different approuch is needed for those who are overweight to those who are clinical over eaters.
If this works for you more power to you. For me, I personally don’t see how addicts can stop completely without a belief in a higher power. Even your article refers to a study on “Cerebral Blood Flow During Meditative Prayer” as a positive method for relieving addiciton but you left the Prayer part out. I tried the secular route you propose but it was ineffective for me. I wish all who try your method the best. If it doesn’t work for them, maybe they are truly powerless over the drink (substance). The 12 step program worked for me and is an option for people who fail on your method. I personally know people with over 20 years of complete absitinence using the 12 step method. Best of luck.
Great article! Although a member of AA since 1985, I was not ‘de-programmed’ until a couple of years ago. In my practice as a clinical social worker, about 8 or 9 of every 10 persons who presents with a substance use disorder (SUD) & is motivated to change, has already begun the reversal of valence necessary to stop addiction in its tracks. Most of these people need only brief interventions – certainly no lifetime of powerlessness – to either reduce substance use to harmless levels or achieve total abstinence.
Now we need more empowerment for addicts in the form of groups like LifeRing, SOS & SMART Recovery. Professionals can refer persons with dependent personality disorder, or even simply an external locus of control, to AA. All the rest of us can leave the cult, maintain our recovery through healthy habits & enjoy our personal power!
I am an alcoholic and I have to agree I am totally powerless over alcohol only if and AFTER I take that first drink. I am NOT powerless over my choice wether or not to take up the first drink. People try to complicate what is a simple statement by trying to analise it and to analise is to paralise where addiction is concerned!!
As the originators of the tgwelve step program said == Keep it simple!!
Thank you so much for this article — I am an addictions treatment provider and all too often I feel like the lone voice crying in the wilderness. The subconscious mind can understand powerlessness, if we tell it to. It cannot understand powerlessness over alcohol, no matter how many times it is chanted, it merely becomes an affirmation for one to go limp and become feeble to a presumed all-controlling God over whom we have no influence or choice. What a lousy way to run a recovery! Warm regards, Patrick Dieter.
Thank you for posting this article Dr. Shelby.
I appreciated how you identified the significance of our emotional associations we attach to our addiction.
I also liked that you gave some strategic ways to change our emotional mind set.
I posted your article on my Good Things Addiction Facebook page
http://www.facebook.com/pages/Elisabeth-Davies-MC/168307950101?v=wall&ref=pdem
Thanks for posting this article. I wish I could have attended the conference in Denver. Her poignant idea of the emotional part of addiction really resonated with me.