Wednesday, April 09, 2008

Addiction: Follow-up

Only a couple of comments on the first addiction post but they were good ones and brought up some stuff I missed in the first post. I wanted to respond in a new post to flesh out some of that stuff.

I think Shana's comment really illustrates the stigma addictions can create for the addicted. In addition, it brings up something I totally forgot to talk about but is so critical in addiction treatment, and that is shame. Shame comes internally from hating the power the addiction has over you and not wanting to let people know about it. It is re-enforced by people who don't know how to deal with addictions and do look upon it as a weakness. It's a huge obstacle to recovery.

It is interesting to me that Mel brought up the following:
i had a friend who spoke of the social strata of rehab: heroin and cocaine addicts, top of the totem pole. Then alcoholics, gamblers, sex addicts, others. Last, eating disorders and cutters.

I thought about touching on this although from a different perspective. Namely from which are more 'social acceptable' or have less stigma around them in society from my POV. I would stick drug and alcohol addiction, particularly alcohol with AA and such, at the most 'accepted' forms of addiction. Eating and gambling probably in the middle with sex addiction towards the bottom. I think cutters are more an example of personality disorder than addiction, although I suppose it could be all stuffed together. Not real sure there.

I am totally in agreement with the need for understanding the commonalities between addictions. I believe they have more in common than they do differences. The 'acting out' behavior is simply the sympton, not the cause.

Very good stuff. Keep it coming.


SuperMel said...

Shame. I've been pondering the origination of shame. I wonder if there's a kernel of shame from the original issue, which then gets reinforced and grows with addiction, or if the addiction is the cause? I think addiction can start as a short-term remedy to feeling shame over being your natural self. I think there's more acceptance of diversity and less pressure for kids to conform now, but then I haven't been in a primary school lately.

Stigma/social acceptance. I think the rankings depend on POV, yes. And perhaps a correlation to number of 12-step meetings available/publicized/level of anonymity. That would be interesting to research; depending on the issue it sometimes takes a concentrated effort to locate a meeting, even in this area.

I also think there's divisiveness within groups, sometimes focusing on differences instead of commonalities. For example, some functional alcoholics feel that they're not "as sick" as full-fledged alcoholics. A lot of anorexics consider bulimics to be weaker and not like them, even though they're both all about control. A lot of it is probably human nature, to compare yourself to others and figure where you stand. Some of it might be denial. Maybe it depends on level of recovery; my experience has been that most people in recovery focus on that common goal, respecting but not emphasizing differences.

Ryan said...

The more I think about it the more I think you can't have shame without negative (or perceived negative) societal pressure. That is to say, if the society approves of something why would you feel any shame for it? At some point you had to have learned/internalized that x behavior isn't acceptable or normal, etc.

I think it is easy to start thinking about behavior and asking what makes some behaviors acceptable/desires and others not. That's a topic that can go all over the place but I think it relates to what we are talking about here.

CMS said...

A lot to say... much of which may be random.

Acceptance of anything comes from knowledge about it. It is hard for the public to accept addictions, etc without understanding them. It is much easier to disavow something or to trivalize it than to take the time to research and understand or to humble oneself with the idea of ignorance.

The shame idea, I think, needs behavioral/social psych study to really discuss. Otherwise, it's speculation. Intrinsic. extrinsic. Morally driven. Innate. Who really knows?

Acceptance, I feel, is a general life need. Being left out (of everything), equals demoralization. I've always felt that people need people, although there are people in my acquaintance that might argue that sentiment. However, I maintain that people desire the thought that they are likable. They know they are likable when they are accepted.

Lastly,( permit the use of a possibly offensive term) I believe addition, avoidance, etc all to be varying forms of 'mental illness'. That term can range from hallucination, obsession, depression, suicidal, and the like to "stressed out". With so many degrees of variation, determining the level and frequency is important. That being done, in the perspective of those things being illnesses, if medication is needed to treat illness,and can actually treat the illness and not simply mask the symptoms, then it should be used. Social illness ( inability to socialize or interact with others) is behavioral and, if needed, should also be treated, but, in my opinion, not with medication, but rather with therapy and behavior modification.

Sorry if I went of topic. Time for bed :-)

James said...

Supermel mentioned people comparing themselves to others, and I think that can be a big source of addiction. I think most people are probably guilty of this to some degree, even if it isn't at the level of addiction. Look at the current housing crisis. A lot of that is the "keeping up with the Joneses" phenomenon...if all my friends have a big house, by comparison, I should have one too. Swap out house with big screen TV, designer purse, BMW, etc. Same concept can be applied to weight as a source of eating disorders. That comparison thing is a hard one.

Ryan said...

Good stuff.

Addiction, like I said before, is merely a symptom of something else going on...a coping mechanism gone nuts. It is always escapism from something and that something is what needs to be addressed. Whether it be a social disorder and can be addressed traditionally, or a mental illness that requires medication, these are the things that ultimately alieviate if not cease the addiction.

Regarding shame. Shame is a learned response, it is not intrinsic. In order to feel shame you have to feel like someone (something?) else will judge you for something you did. That is a learned response, it doesn't happen in a vacum. With that said, even if you could take shame away the addiction would still be there and the underlying issue would still be there. Shame is just an obstacle to people being able to heal from addiction, not a cause of.

Finally, at the root I would argue that all addictions share a common feeling of powerlessness. Ultimately, that powerlessness is what keeps the addiction fed. Whatever the root issue is I bet it always deals with powerlessness in some fashion.

A voice from the wilderness said...

Well ... I suppose I should come out of the shadows here, as this touches on areas that I struggle with and have done a fair amount of self-work on.

IMHO, there are two forms of shame. First is healthy shame - as you touched on your post, Ryan, shame can be a useful tool. It can help us shape our behavior into ways that better conform to the norms. But what if, because of where we come from, we don't know or never have learned quite what "normal" is? That touches on the second form of shame.

Shame is one of the first emotions that we form as children. If we are able to make our parents smile, we feel joy - if not, we feel shame. Young children who have grown up in abusive homes during this formative time learn to hide who they are, and come away with a basic sense that there is something wrong with them or that they are basically broken. Because they don’t feel the unconditional love that a parent SHOULD show his/her child (or at least enough of it to help form a healthy core), this child now has no fame of reference of a “home” or “safe place”. If uncaught (thankfully, teachers now are trained what to look for, but a generation ago, there wasn’t any such training), they grow into adulthood and may suffer from any number issues. He or she “guesses” what normal is, and assumes wrongly that the world knows of all his/her faults, failures, and weaknesses and thus it can be very hard for people like this to allow others close. Behaviors that can lead to additions can often come into play, to “manage” the anxiety.

Ryan said...

Wilderness, thanks for your comments, they give me something to think about. I do like the idea that shame can develop into anxiety/addictions.

However, what I do wonder about is how 'normal' is defined? Normal certainly isn't a universal absolute since it can vary between cultures signifcantly. It also can vary within a culture depending on what 'tribe' you hook-up with, in my opinion. So what exactly is normal?