Well, once again it’s my readers who are instructing me just as much as (if not more than) the other way around. Thanks to all who take the time to read and comment on my blog articles. Your feedback is much appreciated.
Based on the verbal and written feedback I’ve gotten on my last post, I’ve learned 3 things – more, really, but these seem to be the headlines – about the “disease” concept of addiction/alcoholism, whether it truly is a disease, whether the concept is helpful or hurtful, and so on. And they are, in no particular order:
1. The debate may be moot. I’m now beginning to think it doesn’t matter what you call the problem: a disease, malady, allergy, an “issue”. In fact the disease concept may work best for those who are already committed to getting help for their problem; that way they can end the tireless debate about whether they are a “bad” or “good” person and simply seek and follow a treatment plan (much like a prescription from a doctor). In fact, the concept may do more harm than good if the struggling person simply calls it a “disease” but continues to act harmfully to themselves and their loved ones. Talk is cheap, in other words, and seeking blame and avoiding culpability certainly adds fuel to the fire. Seeking treatment it is the essential thing, whatever label you decide to use.
2. Addiction hurts everyone. Whenever I hear from a person whose loved one is struggling with alcohol or drugs, I am reminded in Technicolor of why most experts call alcoholism a “family disease”. It is, as I suggested last time, akin to a virus that infects everyone in the family-system: those who struggle with substances may be more obviously “infected”, due to their behaviors, but those who live with active addiction struggle and suffer just as much, perhaps more subtly, or beneath the surface. People living within such a system are adept at masking the pain and day to day humiliation of active addiction. (Many of my own childhood friends, for instance, are to this day shocked at how I hid my dad’s alcoholism from them: never inviting them over to my house, acting as if everything were hunky-dory, and so on. Families of alcoholics learn to be good actors, to maintain normalcy and sanity.)
The shame and frustration of living with untreated addiction creates a powerful pain and rage that seeks release, like lava; sooner or later, it’s going to erupt and boil over. I felt those searing feelings from readers who live with drinkers or users, especially when the latter give lip service to having a “disease”, but don’t really do anything about it. It can feel like the most painful and self-centered behavior imaginable, though (and this is part of the problem) the struggling person never intends to cause so much harm. But often, sadly enough, they do. Which only fuels fear and anger, and the system’s “stuck-ness”.
3. Many who need help don’t seek it. A study published in 2003, in a leading addiction journal, found that only 1 of 3 problem drinkers ever seek help. If one estimates that most drinkers have at least 3 or 4 family members, close friends or other people within their relationship network, one begins to get a sense of the staggering number of people who could really use al-anon, counseling or other such support, but also never seek it. I was especially moved by a couple of readers who stated how angry they were at the “enablers” in the family, those who looked the other way or rationalized –out of their own fear – while the struggling person continued wrestling with addiction, trying in vain to stop or control it. Even if that person refuses help, how beneficial it might be for both family members (the “enabler” and the one who angrily bears witness to it) to seek some sort of assistance. It might produce a shift in the system, a step in the right direction.
The good news in all this is that any member within an addictive system can initiate change by seeking help themselves. One change within the system often creates a “ripple effect” that shakes things up and challenges homeostasis.
Many of those we might call “enablers” are usually struggling with the terror of inadequacy, since they and their herculean efforts to help are not enough to bring the drinking/using to a halt. Ironically, both research and clinical experience tell me that these folks are often the last to get help, even if and when their loved one gets sober. The protective façade of normalcy is often hardest to surrender for those who don’t drink or use themselves but have learned to live with the disease of addiction on a daily basis. If, that is, you agree it is a disease. In the end, I suppose, it really doesn’t matter what you call it. Sanity and serenity are more important than semantics.
© Copyright 2011 by By Darren Haber, PsyD, MFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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