I attended a half-day workshop on the subject of addiction last week. I was quite shocked at some of the things that I learned.
During the workshop we were asked to consider the question of whether we considered addiction to be a disease, or whether it is more a lifestyle choice.
As a professional who has been working with the givens of human nature for ten years, I have both relevant training and significant experience in this area. I spend my working hours helping people to change their behaviour and / or mindset around thought patterns or “issues” that they intellectually know are not “useful” to them. This is sometimes in relation to addiction, but it also includes depression, anxiety, panic attacks, phobias (a press article featuring a video showing the dramatic success of a recent client can be seen here), eating disorders, Post Traumatic Stress Disorder (PTSD), relationships, anger, parenting – in fact any situation where someone feels stuck. So what is the answer? Is addiction a Disease or Choice? Can we catch it? Are some people born with an addictive personality type? Can it ever be cured?
What I find shocking is not the answer – but the question. I am amazed that people working in the field of addiction still need to ask the question at all. Why? Because the answer has been publicly available for many years now, has been widely exploited by the advertising and media industries and yet somehow appears to remain some kind of secret – even to those specialists (the counselling and therapy professionals) who should be using the knowledge on a daily basis in their work.
How Much Choice Do You Really Think You Have?
I want to make a point here. Imagine you are crossing a familiar road. You look left and right and proceed to cross. Suddenly there is a loud screeching of tyres and a car which you completely failed to notice skids to a halt, only two feet behind you. You are shocked and startled. You may jump back, break into a run, fall, gasp, shout out loud or even swear. Did you choose your response?
Your response in this situation was most likely an emotional one – probably based on a combination of surprise and acute fear. We all know that in a situation like this, emotions come before thought. We also know that if the emotions are very strong, they override our cognitive processes and we act on impulse. Sometimes you see this in the news when a reporter asks: “Why (or how) did you do that?” and the answer comes back “I don’t know, I just didn’t think!“. This is sometimes know as “emotional hijack” and can be true of any situation where emotions are strong. Sometimes our very survival depends on this type of automatic response. The human species evolved an emotional brain long before the neo-cortex – it is as if we have a Ferrari engine bolted into the chassis of a Ford Model-T car. Emotions were here first, and they still take priority – they come first.
So the point is simply that many of our actions are simply not the result of conscious choice – we are all emotional creatures of habit and a lot of what we do (including when we have really learned something – like how to drive) is done on autopilot.
Back to Addiction
So what if addiction is neither a choice or a disease. It may be something else entirely – perhaps a conditioned response. Those professionals working with the human givens approach will be familiar with the idea that it is due to a mal-adaption of the human brain’s natural pleasure and pain reward system*.
[* Very briefly; the “carrot and stick” reward system in our brains works like this. Our brains naturally generate chemicals which reward new experiences – this encourages us to explore our world and discover new possibilities. But our brains also reduce the pleasure experienced with repeated exposure to the same stimulus. This discourages us from simply repeating the same thing over and over – but also means that we will need “more” of the same stimulus in order to experience the amount of pleasure we used to get from it. The fact that the pleasure / pain reward system is involved explains why humans are able to get addicted to anything, regardless of the properties of the substance or activity involved (e.g. internet gaming, porn, foot fetish, shopping)]
Anyone who suffers from addiction knows that there is a strong element of “automatic” behaviour involved. And if they are also aware that the addiction is damaging them or their relationships there is usually a strong emotional component. As illustrated above, strong emotions prevent us from making rational choices – by design.
Is Addiction a Disease?
Albert Einstein once said: “Everything should be kept as simple as possible – but no simpler“. Working with the two ideas that a) brains have a natural pleasure / pain reward system and b) that strong emotions have the capability to override rational thought – provides a fully adequate explanation of the mechanism of addiction. Crucially, it also gives us real insights about how to help people overcome any destructive habits. We simply do not need to go into question of disease, genetics or blame in order to effectively help sufferers. We also know from recent studies in neuroscience that the brain is far more “plastic” (i.e. re-mouldable, changeable) than we ever dreamed possible even fifty years ago and that habits of a lifetime can be changed quickly with the right understanding, motivation and support.
Perhaps the addict’s first drink / first cigarette / first spliff / first bet was a choice. But no one adopts a destructive habit unless it has within it something of positive benefit – usually a relief from one or more stresses we are facing. This is why a thorough understanding of stress is also a key element in helping anyone to beat addiction.
I look forward to a time when this knowledge is shared and used by professionals working to help people overcome suffering. If you are struggling to make a change in your life that you know would be better for you in the long run – why not contact us right now to find out if our understanding fits with your own (hard earned) experience?