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Tuesday, December 27, 2011

What does it mean to be 'addicted?'

In my previous post, I took issue with the proposed DSM-5 definition of addiction which is complex and confusing at best.

The Big Book of AA does not use the term 'addiction,' by rather only directly addresses alcoholism as particular problem and defines alcoholics in Chapter 3:

We alcoholics are men and women who have lost the ability to control our drinking. We know that no real alcoholic ever recovers control. All of us felt at times that we were regaining control, but such intervals-usually brief-were inevitably followed by still less control, which led in time to pitiful and incomprehensible demoralization. We are convinced to a man that alcoholics of our type are in the grip of a progressive illness.
Over any considerable period we get worse, never better.

We are like men who have lost their legs; they never grow new ones. Neither does there appear to be any kind of treatment which will make alcoholics of our kind like other men. We have tried every imaginable remedy. In some instances there has been brief recovery, followed always by a still worse relapse. Physicians who are familiar with alcoholism agree there is no such thing as making a normal drinker out of an alcoholic. Science may one day accomplish this, but it hasn't done so yet.

If we take alcoholism as a single type of addiction, and apply this definition to the whole of addiction, it looks something like this:

1) An addict is someone who has lost the ability to control his impulse to engage in his addiction.

2) Control over the behavior is not regained even with the realization that the behavior is destructive.

3) Repeated attempts using various methods to stop the addiction have failed, despite sincere efforts.

4) Even when the addict no longer enjoys his addiction, he is drawn back into it when given the means and opportunity.

5) The addict will immediately relapse into compulsive activity if he is allowed engage in the activity again even after a long period of abstinence.

6) When forcibly separated from the addiction, the addict will either obsess about the subject of the addiction or engage in some other obsessive behavior in place of the original manifestation of the addiction.

7) The addictive behavior is linked to specific fears which the addict avoids through the addiction.

As in the previous post, the term 'addict' come from this 'strong interest' aspect of compulsive behavior.  Addiction is an obsession, and it leads to a loss of control over one's behavior.  Thus, the human will becomes compromised.

This is a very serious problem, since the human will is the primary means we rely on to govern our behavior.  Once it is lost, the options to govern behavior are reduced usually to tranquilizers, violence, and other forms of force.  This is why many theorists have contemplated placing criminal activity under the category of addiction.

The Orthodox Church emphasizes the free will of man, and so the question arises as to how a man can lose control over his 'will power.'  Simply put, an addict is someone who makes the decision to hand over control.  An addict engages in the behavior voluntarily in the beginning, but then slowly descends into addiction.  There is a line which is crossed somewhere along the way.  Most of the time, that line is crossed while the person still enjoys the addiction.

This is why addiction is hard to treat: the enjoyment factor covers up the loss of control.  An addict who still enjoys his addiction cannot be convinced otherwise.  It is not until this loss of enjoyment comes that the loss of control becomes evident.  When enjoyment ends and the addict tries to stop, only then does he become aware of the problem.

If we examine this further, we can also see that most of us have the components necessary to become addicts.  We engage in compulsive behaviors all the time.  We get mad even when we don't want to, or we think thoughts we'd rather not.  Is this addiction?

No, it most often is not, but that is because the behavior is not yet entirely destructive. If someone cuts us off in traffic, we don't ram his car off the road when we get mad.  Someone may routinely party too much and get drunk, but if he can abstain before a job interview or decide not to drink without a problem, he's not an addict.

The most powerful human impulse is that of self-preservation, and the loss of this impulse in the face of an obsessive behavior is the clearest sign of addiction.  The addiction has become, at that stage, a type of self-preserving behavior, but not a healthy one.

This is why spirituality is so important: the spiritual path is one where the ultimate means of self-preservation is union with God.  This is why the saints are brave, and that the 12 Steps lead to sobriety.  With faith in God, the instinct to preserve one's self by one's own means diminishes, and the fears the trigger these faulty self-preservative addiction-impulses begin to subside.

The addict ultimately can be defined as a prisoner of fear.

This overcoming of fear is the basis for spiritual growth within the Orthodox Church, and it is also the cure for the addict.

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