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Is Addiction About Pleasure?

This is a very old mistake.

Pleasure has been confused with addiction for the last 5000 years.  The reason is that common forms of addiction, like drinking alcohol, taking other drugs, gambling, and seeking sex, are often pleasurable.  This surface connection has historically led people to conclude that anyone who is deeply driven to drink, take drugs, and so forth, must be seeking even more pleasure.  It's a short step from there to believing that addicts are immoral hedonists, people who pursue personal pleasure regardless of the cost to those around them or even their own future.  Of course that is all wrong.

Addiction is not about pleasure, even though some of the very people suffering with addiction believe it is.  I've known many folks suffering with alcoholism, for instance, who have told me their drinking was easy to understand: they just like the effect of alcohol.  But a moment's thought shows the problem with this reasoning.  Almost everyone likes the effect of alcohol.  In fact, many people love the effect of alcohol, yet are not alcoholics.  Indeed, if liking alcohol were the reason for alcoholism, most of us would be alcoholics.  Liking to drink cannot be the explanation for alcoholism.

Knowing this, there is a simple rule that is helpful to keep in mind if you are uncertain about whether you or someone else has alcoholism:

If you drink only because you like it, then you are not an alcoholic.

(I'm using alcoholism as an example, but this rule and everything I'm saying here applies to every addictive behavior.)

There is another reason that liking to do any behavior, or deriving pleasure from it, cannot possibly explain addiction.  Using alcohol as an example again, if pleasure were the reason alcoholics drank then they would stop or control their drinking once it started causing them trouble, just as they would stop or control their eating cake if their doctor told them they had diabetes.  After all, people with addictions are no more intrinsically self-destructive than anyone else.  Their lives may be ruined by their addiction, but in other ways they are as reasonable, careful, caring, and thoughtful as the rest of the world.  Yet, they don't stop or control their addictive behavior.  Clearly, there is something different and deeper than pleasure that is motivating them.

The drive to repeat addictive behavior is, in fact, completely different from a search for pleasure.  As I've described in earlier posts in this blog and my books, the drive behind addiction is linked to the evolutionarily normal need to get out of a trap, to reverse feelings of overwhelming helplessness.  Addictive acts temporarily relieve and reverse feelings of being utterly helpless.  This explains why people who have addictions keep doing them despite the harm they do to themselves and others.  From an emotional standpoint, they are responding to a far more important drive than concern for any long-range risk.

Addiction is actually nothing more or less than one very common way of trying to cope with feelings of intolerable powerlessness.  When coping mechanisms work poorly, as addiction does, we call them symptoms.  Addiction is neither more nor less than a psychological symptom, a way to deal with a difficult emotional state, like other symptoms we all have.  It has nothing to do with getting high, being gratified, or having any other kind of pleasure.

Understanding this should help to end the inappropriate scorn that has been directed at addicts for thousands of years, and help to end the inappropriate scorn that addicts too often heap on themselves.

Posted on Saturday, October 24, 2015 at 02:21AM by Registered CommenterLance Dodes, M.D. | CommentsPost a Comment | References16 References

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