Reflection on Addiction as Disease and Community as Cure

Addiction is an organic disease. The primary causes appear to be heredity and trauma. None of us can hope to escape either as we pass through life. Those of us who fall victim to this disease do not, in my view, bear any greater or lesser responsibility for their own condition than those who suffer from diabetes, lung cancer, or heart disease. This is to say simply that much of the stigma attached to addiction is misplaced.

It follows that co-dependency is likewise a disease, the predictable result of intimacy with addicts. Families cannot entirely avoid exposure to it without avoiding intimacy. Such a solution is of course no solution at all, and we are confronted with a paradox: both addiction and codependency are diseases of relationship, and relationship is what is necessary to cure them.

What kind of relationship? One of loving kindness.

In the rooms of AA, NA, and AL-ANON, newcomers are told and shown one thing over and over, in a seemingly infinite number of words and ways:

“You have lost the ability to love and trust yourself. We will do our best to love you until you get it back.”

Each and every single carrier of that message has, at some time in the past, felt the desperate need to hear and believe it. The sense of deep failure, sometimes near self-loathing, is common among addicts because of their seemingly uncontrollable behavior. Such feelings are equally familiar to the family and friends of the addict, who find themselves asking what they have done to cause or may do to prevent the obvious harm caused by the disease.

What becomes clear in time to those fortunate enough to regain some capacity for self-acceptance is that the feelings and behaviors which can be so crippling are the proximate result of the disease. To say that addiction and co-dependency are organic is not to say that they have only to do with the brain and nothing to do with the mind; rather, that the brain is the organ of origin, the experience of “mind” is the product of brain function, and that the functions of both brain and mind are to some extent plastic and modifiable over time. The problem lies in getting the mind of the sufferer back to the point where it can have some beneficial effect on the brain.

We have now begun to approach a theory of recovery, not merely from addiction and co-dependency, but from their agonizing symptoms: grief, anger, helplessness, and hopelessness. The last of these is surely the most troublesome because it carries with it a nearly overwhelming sense of permanence, a belief approaching certainty that it may be coterminous with our very lives. Such settled, pervasive, and compelling hopelessness has a name. It is despair.

But what lies beneath despair if not the arrogance of apparent certainty? Here is mind at its most pernicious; here is intelligence turned against its possessor. Here is the absence of that much-misunderstood quality known as humility.

“He was too smart to get better,” is a phrase one sometimes hears at the funerals of active addicts. High intelligence is not preventive of addiction, and may in fact contribute to its persistence. Intelligence and addiction are both, however, positively correlated with cynicism in its modern sense; as Oscar Wilde said, a cynic is someone who knows the price of everything and the value of nothing. The end-stage addict is certain that everything is for sale and nothing except his personal needs have value. Those needs are infinitely valuable to him, or, more accurately, to the disease which has possessed him. He is almost entirely cut off from the influence of outside ideas and entrapped by the belief that those things of which he is certain are unalterably true.

As his disease has progressed, there is yet one notion whose truth he may have begun to doubt. That is the idea that its cure lies entirely within himself. The gradual loss of confidence in that proposition is one source of his despair, for in his cynicism and isolation he has come to the conclusion that if he cannot trust himself, surely, he can trust no one else. Isn’t he the smartest person he knows?

His problem is arrogance. He may be strong-willed, brave, and perseverant, but his disease has affected his judgment to the point where he lacks the clarity of mind necessary to make two critical distinctions: one between intelligence and wisdom and the other between pleasure and happiness. Likewise, his unhappiness may well have exacerbated many of the defects of his character, pride likely being chief among them.

Remember, his disease has isolated him, and his attempts to cure it by his own efforts have only deepened his isolation. As an individual, he appears to himself to lack the ability to make meaningful changes to his circumstances, which are dire. If his sense of personal helplessness can be coupled with an honest awareness that his illness, left unchecked, will be mortal, he may become able to ask for help. If not, death follows.

In biological terms, addiction is improper brain function. In psychological terms, however fuzzy they may seem, it may be useful to regard the disease as a morbid over-reliance on ego, on the persistent idea that “because I got drunk by myself, I must be able to get sober the same way.’

Fortunately, it is now possible to say that the experience of a very large group of addicts contradicts this assertion. Their shared experience has also revealed a countervailing truth, an answer of sorts to the following questions.

If the addict, in his individuality and isolation, has lost any capacity for humility and with it any ability to accurately assess his own needs, where can hope and help be found? How can he experience enough ego-deflation to achieve renewed balance?

Perhaps In community. What sort? The sort that has altered the minds of humans for as long as they have been human and perhaps longer. Families, tribes, monastic communities, political parties, nations, cults, communes, and clubs have one thing in common, which is that they are social groups. Social groups exist primarily for the purpose of mutual support, and in performing that function, they can change the minds of their members.

Clearly, membership in a community can harm as well as heal. (As an example, one need only point to some families!) In larger groups of mostly unrelated individuals, this can be particularly true when a community originally formed for some beneficial purpose loses sight of that purpose and falls victim to the ego-driven flaws of individual members, often leaders. Healing communities can survive as such only when each member understands that acting in accordance with his selfish needs will lead to renewed illness for himself and for the society whose reason for being is to help him heal.

But what sort of internal coherence does a healing community need to maintain its utility? Discipline of some sort is clearly necessary for group survival; yet, it is not a discipline of the will, whether group or individual, nor a discipline resulting from the judgment of the group to expel or punish an “erring” member. Rather, each member has been educated by his own experience and achieved, in some measure, a new way of understanding his own life in relation to his disease and his fellow sufferers. He has glimpsed a set of principles which, if practiced with dedication, will not only restore him to health but will enable others to achieve health at least in part by his example. Extended deviation from those principles, he has become convinced, will lead to renewed illness and death.

This form of discipline is more accurately called discipleship. However, the type of group under discussion here cannot become a personality cult, or even a semi-rigid hierarchy, lest pride of place within it erode its foundation. The members of our hypothetical community are disciples to a set of principles which, taken together, appear to maximize the likelihood of both individual and group survival. These rules are not arbitrary. They arise entirely from shared experience and are not enforced so much as known to be self-enforcing.

These observations may now seem only loosely related to our original topic. They may also strike some readers as paradoxical, counterintuitive, or both. They are not meant to be. Rather, they are an attempt to provide a useful distillation of the lessons learned by one addict and co-dependent who has been fortunate to recover a measure of well-being as a result of participation in Twelve Step Groups.

This has occurred as the direct result of the compassion of others. These, my fellow travelers, have over the course of many years, gently and persistently drawn me back and away from my manifest and manifold inclinations to self-harm. You know who you are, and I dedicate this little essay to all of you with gratitude.

To those of you who have not been so fortunate, to those still suffering, I can say this: certainty is not necessarily truth, and profound distress is not necessarily permanent. Despair is the belief that pain is both endless and meaningless, and that proposition is not self-evident. Find your community, or found it if you must, and draw into it those whose condition seems worse to them than your own. In so doing, you may find and provide strength which can have no other source than shared experience.

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