by Candice Shelby, Ph.D.. Associate Professor of Philosophy, Univ. of Colorado, 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many people who have suffered serious injuries become dependent upon narcotics to stop their pain, but when the drug is withdrawn, although they may experience discomfort initially, they never again use, or obsess about using the drug.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.
[i] Andrew Newberg, Michael Pourdehnad, Abass Alavi, and Eugene G. D’Aquili. Cerebral Blood Flow During Meditative Prayer: Preliminary Findings and Methodological Issues. Perceptual and Motor Skills (2003) 97, 625-630 addresses the short-term changes. See Andrew Newberg, nancy Wintering, Mark R. Waldman, Daniel Amen, Dharma S. Khalsa, and Abass Alavi. Cerebral Blood Flow Differences Between Long-term Meditators and Non-meditators, Consciousness and Cognition (2010), 19, 4, 899-905.
[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.