Don't Focus on the Consequences of Addiction
It's a waste of time.
Throughout my career as a therapist I've heard people describe the effects of their addictions — drinking, eating, gambling — with deep regret, shame, and anger. Anyone can understand their pain. And effects do matter: They color how we relate to the people in our lives, and how we gauge the risk of future behaviors. But focusing on consequences does not help to stop addiction. Indeed, it is a waste of valuable time that could be spent looking at its causes.
Looking at consequences also induces guilt. It's understandable that those who have been hurt by addictive acts will confront those who have hurt them. But no good therapist would make this mistake. Over the past 40 years I've never encountered an addict who was not already sadly aware of the damage he or she was causing. People suffering with addictions are neither evil nor stupid, and adding to their guilt is simply pointless. If guilt could solve addiction there would be no addicts.
It is far better to focus on the fact that addictive actions are not random. They are precipitated by emotionally meaningful factors: loneliness after being abandoned by a boyfriend or girlfriend, shame and anger after being treated disrespectfully, embarrassment after a humiliating loss, or a repeated feeling of being unheard, with a helpless sense you have no control over your own life. These emotional precipitants are what people need to recognize, explore and understand, so they can predict when they will next arise, always followed by addictive urges. If people can predict when their addictive drive will occur, they are much closer to being able to control it. (I described this process in detail in my book, Breaking Addiction.)
There are two other problems with focusing on consequences rather than causes. Since different addictive acts have different consequences, we have been misled into thinking they are different phenomena. Of course, this is not so, as we know from the fact that people regularly shift their addiction from one behavior to another. A variant of this misconception is that the dangerousness of the consequences matters to the cause of an addiction. I've heard people say that alcoholism couldn't possibly be basically the same as compulsive housecleaning, because alcoholism can kill you and housecleaning can't. But that's the result, not the cause, and in fact that very switch does occur (I wrote about one such case).
The closer we pay attention to the emotional reasons for the psychological symptom we call addiction, the closer we can get to mastering it. And in so doing, we save the time we would have wasted focusing on its consequences.
Lance Dodes, M.D.
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Reader Comments (4)
Dr. Dodes,
I have read 2 of your books and I am starting on the third. I am wondering is your use of the word displacement(as in displaced anger) is the same thing behaviorists mean when they say negative reinforcement or avoidance?
I have read your three books and am so deeply grateful to finally read an analysis that makes sense to me! Life-changing!
I read this article
http://www.alternet.org/personal-health/preventing-future-isla-vistas-sucking-out-poison?akid=11846.726952.Q-W8JL&rd=1&src=newsletter996164&t=11
and the paragraph that begins Leiberman...and talks about "affective labeling" seems to me to be consistent with your analysis. Is this right?
Also, what path do you see to acquaint people more widely with your work and how could individuals outside of related fields help you?
"But focusing on consequences does not help to stop addiction. Indeed, it is a waste of valuable time that could be spent looking at its causes."
I don't agree it is a waste of valuable time and with respect I think you're missing the point.
The point is the nature of 'help'. Help is an instinctive feeling that resides in everyone.
Help is communicated through relationship. A relationship is the means by which we help one another and ourselves in some way and at some level towards achieving a shared objective or purpose.
In the (inner) psychological relationship we have with ourselves, the same principles that apply to our relationship with others apply to us as well.
Relationship enables us to progress through life. A combination of the relationship we have with ourselves and others, together with the use of know-how, skills, talents, knowledge and resources, transforms intangible ideas into tangible reality. Relationships are not sacrosanct: they don't have to last for ever. They exist purely and simply for the purpose of the relationship which, ideally, should be defined at the onset but which in a personal relationship rarely is.
Life is designed to be simple, but we complicate it by the way we think. The way we think is often a product of social conditioning as distinct from how we'd think were we left to our own devices. Any difference between who we are, who we think we are and whom we're expected to be, will create a conflict of interest. It's the difference between what we think and do in private and what we say and how we behave in public. The conflict will also create a problem - a helpful signal that we're going the wrong way for us, or for others, or a combination of both. Essentially, a problem is a fault in direction, which is why it's impossible to have more than one problem at a time. Seemingly different problems are simply the same problem fragmenting so as to attract attention for us to do something.
Anything anyone says or does to us is helpful (even though it may not come across as such), but when for whatever reason others are unable to be honest with themselves, they are unlikely to be honest in communication with us. We learn literally, we take what others say at face value; and in the absence of any reason to be distrustful we also take things personally. But there's no certainty that what we hear is in fact what the person would say if they could be honest - and that includes what we'd say to ourselves if we too were completely honest with ourselves.
It is easy to protect ourselves from seemingly hurtful or over-negative remarks but there's no point in developing an emotional self-defence system if that results in an unwillingness to trust because that could backfire by making life harder for ourselves. So it's not about stop taking personally anything untoward said to us. The challenge is to decipher double-messages.
When relationships go wrong or fail prematurely is not the fault of help. It is our fault for some emotional reason that is caused by misunderstanding through taking a double-message literally. For example, people generally don't understand why rejection is a compliment.
I don't profess to having any practical experience of helping people with addiction but that doesn't mean having bow to your superior knowledge. Based on the principles of help, I do know that the consequences of addiction are the benefit, both to the addict and others affected by the addiction. The outcome may not be the best for the addict or others but is nevertheless of benefit. If you ignore the benefit then that's tantamount to saying the consequential experience was pointless, which would create all manner of (superficial) problems in furthering understanding of ourselves because it's impossible to have a pointless experience.
Personality duality (or disorder?) arises from conflict of interest as a consequence of relieving the pressure by separating or disconnecting the emotional states. Ignoring the physiological consequences of poor diet and the fact we are creatures of light for whom darkness is for sleep and hibernation, depression, for example, in when the 'weight of the world' is so powerful that it crushes and we hide ourselves away deep inside ourselves. It is not only the addiction that is intended to be helpful (by drawing attention to the existence of an emotional disturbance), but also the consequences of the addiction. Without the consequences, there would be no progress: the contribution or the message we are wanting to convey and that each individual makes to the world as a whole wouldn't be acknowledged and acted upon; it would be rejected for the wrong reasons and we'd feel dejected. Therefore, the consequences are also intended to be helpful.
If you focus on the cause and ignore the benefit then there's a risk that the means of addiction remains as a residual unexpressed feeling.
In my spare time, I am a gifted healer, working with words. Nowadays, I contribute here and there but years ago I used to provide counselling services to psychotherapists, psychoanalysts, etc: people all professionally trained, letters after their names, had themselves undergone counselling and were psychologically-equipped for helping others with emotional and psychological problems. The thing they had in common was a residual feeling. In every case, the residual feeling had left its mark and was creating problems for them.
Guilt is nothing more than thinking others would disapprove of behaviour and show their disapproval in some way, for example by withdrawing love and support. Most people do not have what it takes to be themselves and do whatever is true for them because they're inhibited by a desire to be popular. To always be yourself and say or do what's true for you, rather than be accommodating of others, may not be realistic in the context of social conditioning and 'civilisation' but it doesn't mean that it's not worth striving for. The more people are themselves the happier they become, the easier it becomes for others to follow suit.
I define 'happiness' as being at peace with your direction in life. Think about it!
Thank you Dr. Dodes, for this incredible tip. Too often we focus on the consequences and feel bad because of it. It becomes a constant loop, and then we feel even more trapped and helpless!
I have not focused on my own emotional response to things in a long time, if ever. My emotions were something to be ignored, and were not allowed in Alcoholics Anonymous at all. Our emotions are something that makes us truly unique, and there is no tolerance for uniqueness in AA. In fact it is disparaged and labelled 'terminal uniqueness', which is used in a derogatory way by them.
I love your system of recovery for precisely these reasons. Focusing on my own uniqueness is challenging but it can also be a fun and creative act. It is also nurturing and empowering, because I believe in myself through this system.
Thank you for your great contribution, Dr. Dodes.