In Praise of Integration

Isolating Addiction from Other Issues Might be a Part of the Problem

“Work the steps” is a refrain you might hear when you enter the rooms of Alcoholics Anonymous. But first: “get a sponsor.”

What this means can seem a little bit puzzling, but when you see it from the outside looking in, it can become quite clear: Your addiction is not simply about the “disease” of “alcoholism,” it’s about your relationship with the world. (You’ll sometimes hear it called a “spiritual malady.”)

If you are having trouble with substance abuse, in addition to the patterns built into your body (which includes your brain), and intensified by the risks and displeasures of withdrawal, there is a very high chance that you are in some way lying to yourself. It may just be that you think you’re “in control.” It may be that you’re in denial about much bigger things.

We Sapiens have great capabilities. Possessors of Imaginations, we are able to rationalize our situations and make predictions for the future based on past experiences. But when we find ourselves confronted with real existential angst, not all of us can be Kierkegaard. And if there is a very fundamental anxiety (say, some foundational and irresolvable resentment with our parents, or growing up in a violent neighborhood) we can easily rationalize in a far more toxic way: we can repress. Soon enough, we may be denying that we’re experiencing anything negative at all, while all the while we’re over-eating, cutting, hooking up, drinking, smoking, or popping pills.

Thus AA builds into its system another member who can call your bluff. Further, it guides you through a 12-Step process whereby you re-integrate yourself back into the world, creating a new foundation by which you can more successfully withstand the “slings and arrows of outrageous fortune.”

SMART Recovery does a similar thing, only differently. Its Four Point plan helps you learn how to manage thoughts and behaviors, but only after you have established the real will to quit by assessing the pros and cons of your use, deciding that you really do in fact want to stop, and are prepared to cope with urges. Their very useful and affordable handbook is also more or less available for free online (albeit broken up). With the exercises they provide, one can self-empower with a commitment to developing healthier patterns of thought and behavior via the principles of Rational Emotive Behavior Therapy. These skills, in addition to helping with your addiction issues, might also assist you with many other aspects of your life.

But what if both of these excellent technologies suffer from the same problem: they are “top-down” strategies that begin with the addictive behavior itself, rather than building from the bottom up, looking at life as it is and realizing that your addiction is a manifestation of other fundamental issues.

Perhaps that is too much to ask. When one is in the throes of substance abuse, it really can be a life or death situation which demands them to quit immediately. And for that purpose, sure, get us into the rooms post-haste and let’s start with keeping the poison out of our mouth.

A good deal of problems will become easier, simply because of that basic action.

But once you’re past that initial step, there is another issue which can arise: a pre-occupation with the substance itself, and a subsequent reframing of one’s life in terms of the addiction.

For many people, this doesn’t seem so bad. Listening to Will Arnett and Robert Downey Jr. bond over their shared experience can make it seem like there is an exclusive club that you might have the good fortune to be a part of if you have some vaguely defined malady.

But for many of us, a life wherein which we are punished by church basement visits for the rest of our lives seems a little severe. Furthermore, it may in some instances be maladaptive, sometimes holding people back from flourishing by consigning them to a shame that can only be treated by the support of a secret society, or allowing them to coast on a superficial idea of social connection centered only around a loose affiliation with an unhealthy behavior — rather than enjoying a full life with solid relationships built on mutual affection and support.

These are worst-case-scenarios, to be sure. And I want to be clear that I am NOT arguing that AA and SMART are bad, or that they shouldn’t be utilized. Both are very GOOD and they should.

But we are reaching a point as a culture where addiction is no longer the stigmatizing issue it once was. While no one thinks an addict should get off the hook for their bad behavior due to their affliction, people generally do see it as a psychological issue, and are generally compassionate about it. (Although I do understand there are still many issues concerning liability, such as who will be willing to hire you. In this respect there is still a great utility in being able to prove “I’m in a program. I’m working on this specific issue with professionals.)

Soon, and I really don’t think I’m being naively optimistic here, our collective efforts to de-stigmatize mental illness will reach a critical mass, and we will be able to focus more on mental health, and less on creating identities for ourselves as characterized by our illnesses. We’re not there yet, but we are at a place, I think, where we can begin to look at our relationships with one another, and see how our thoughts influence our emotions and behaviors, developing more strategic techniques for our interactions.

There are many obstacles in the way, and it may still take a decade or two, but I have faith, in the wake of the opioid epidemic as well as the recent legalizations of recreational marijuana, that we are beginning to develop a more sophisticated cultural language around the issue of substance (ab)use.

I have recently found, in my own life, that by focusing more on my larger psychological issues, I can manage my drinking issue more easily. I’m not saying this is the same for everyone, and I’m not making a recommendation for others to follow in my footsteps. But by making the shift to focusing on my personality disorder, my work with my therapist is empowering me to be able to withstand life with a little more ease. As this cultural shift continues to progress, more and more individuals will be able to make similar pivots.

Robert Wright’s writing on Buddhism almost makes it sound like, to some extent, we’re all really addicts. We’re all, whether or not we consume illicit or mind-altering substances, in some sense deluding ourselves about a lot of life, and chasing pleasures while avoiding pain. I think most of us, if we’re being reasonable, can concede that that’s more or less the case. And if we can move in the direction of reason and compassion, some of these issues might begin to resolve themselves.