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Thoughts on Addiction

Quote for the Month
The most important of life's battles is the one we fight daily in the silent chambers of the soul.
- David O. McKay
 

By Steve Roberts, LCSW, CSAC

Being credentialed in Wisconsin to provide mental health and substance abuse services for almost 30 years (and working in the field for another 10 years), has given me a unique perspective on concepts of addiction, some of which I will share in this article.

WORDS ARE IMPORTANT

Drinking problem, alcohol addiction, alcohol abuse, alcoholism, irresponsible use of alcohol, alcohol dependence, problem drinking, binge drinking, misuse of alcohol, etc…

Are the terms that we use important? What distinguishes one term from another?

I often ask clients that I work with to give me their definition of drinking problem/alcoholism, etc; the common brief answers I hear often include: “the person has to drink all the time...can’t function without it…causes major problems in the person’s life.” I suggest that those answers are very limited and if I were asked the same question and had the time and energy, I could talk until tomorrow morning about the complexity of what defines this disorder. I suggest that person needs to have a good understanding of what this thing is; and it may be difficult for him/her to acknowledge that a disorder may be present. To begin, I suggest and offer services that I call an “education/assessment process”. We will determine together whether or not a problem exists, or to what degree, and recommend actions that can be taken to deal with that problem, if it exists.

Professionals in various fields (medicine, counseling, psychology, psychiatry, pastoral counseling) and concerned non-professionals (Alcoholics Anonymous and other self-help programs), based on training and/or experience, will have a specific definition of the above terms. I want to suggest that the similarities in all those terms are much more important than the differences.

It seems to me that all terms noted above have two major things in common:

1. the person experiences problems in his life directly related to the behavior and
2. in some way or another there is a loss of control.

PROBLEMS may be defined as harmful consequences that a person may experience directly or indirectly. They may be related to the alcohol use and may be external, internal, physical, severe, minor, etc. Describing problems that a person may experience related to his drinking suggests a continuum from relatively minor to very severe. Those problems could include: money spent on alcohol use, anxiety about driving after drinking, job loss or discipline, being uninvolved with children, loss of family, legal consequences, OWI, disorderly conduct, hangovers, memory loss (blackouts), a loved one’s concern or worry, little concern for physical health, nutrition and exercise, more serious physical / medical problems, etc., etc., etc.

LOSS OF CONTROL: There are different types of loss of control. Among those are:

1. Loss of control of the drinking itself
2. Loss of control evidenced by impaired thinking or distorted judgment
3. Loss of control as evidenced by becoming “drunk”.

As with many ideas I speak about, loss of control behaviors are on a continuum from relatively minor to very severe also. The word “drunk”, or the phrase “being intoxicated”, has different meanings for individuals. If my grandmother were still alive, her meaning of “drunk” would be having a very small amount of wine on a special holiday and feeling warm in her tummy. The other extreme may be a person who thinks of drunk as “wasted, falling to the ground, can’t stand up, nauseous and vomiting on his shirt”. To whatever degree, I would suggest that “drunk” implies experiencing something negative. Why would anyone drink past the point where it feels good & repeatedly do so? (Answer: see heading of this paragraph.)

HABIT, COMPULSION, & ADDICTION

“Problems and Loss of Control” is simply the beginning foundation of looking at one’s behavior of concern. This implies exploring answers to questions such as:

• What negative things have I experienced connected to my drinking?
• What were the obvious consequences or subtle negative effects?
• In what ways have I attempted to change my behaviors or control my behaviors?

Positive change can occur in my life when I am able to look clearly and honestly at the present circumstances.

OTHER ADDICTIVE/COMPULSIVE DISORDERS

It is beyond the scope of this article to go further than commenting on the basics of “problems and loss of control”, except to suggest that other “addictive/compulsive” behaviors can begin to be explored using these two factors also. Some behaviors that are normal for most adults may also be behaviors that, for others, can become addictive. I am referring, for example, to addictive/compulsive behaviors related to gambling, work, sex, eating, money, and computer.

If you are concerned for yourself or a loved one, take the step to positive change. The words and definitions of your concern may be different, but the concern is the same.

(TO BE CONTINUED…)
 

Recommended Readings

The Recovery Book by Al J. Mooney, M.D., Eisenberg & Eisenberg
Guide to Recovery, A Book for Adult Children of Alcoholics by Herbert Gravitz & Julie Bowden
Many Roads, One Journey by Charlotte Davis Kasl, Ph.D.