I have to admit that I feel some weariness as I wade into the ongoing argument about whether addiction (aka alcoholism, chemical dependency and so on) is a disease or a choice to drink or use alcohol or other drugs.
I can't speak for those who insist that addiction is simply a series of bad and selfish choices - stemming I suppose from some moral failure or weakness or bad character. But it seems to me that for them to accept that it is a disease means having to absolve addicts from responsibility for their actions - actions that have had personal, relational and social consequences throughout human history. And those consequences have been damaging, if not catastrophic.
Believe it or not, I get their argument. Anyone would be tempted to go there when faced with such inexplicable behaviour. "Can't you see what you're doing?" we plead, "why don't you just stop?"
But the behaviour doesn't get to the root of it ... that is, behaviour doesn't explain the nature of addiction as a disease. The drinker or other drug user has no volitional control over contracting addiction - any more than we have control over getting sick with diabetes, or hypertension and so on.
To help you understand what I mean, I'll call up the expertise of two medical professionals:
Dr. Raju Hajela is past president of the Canadian Society of Addiction Medicine, and chair of the American Society of Addiction Medicine's committee on the new definition of addiction.
Dr. Michael Miller is the past president of the American Society of addiction Medicine.
I'll quote Dr. Hajela to develop my argument that addiction is an illness and that the choices an addict makes - which are sick choices - are symptoms of the disease and not its cause.
Dr. Hajela: "There is longstanding controversy over whether people with addiction have choice over antisocial and dangerous behaviours ... the disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviours are a manifestation of the disease, not the cause."
If I understand Dr. Hajela correctly, the behaviours we see in addicts (all the crazy, self-centred, dangerous, thoughtless choices they make) are symptoms of the disease.
I agree, but I'll put it slightly differently: Simply having the disease is not a choice (a person is not responsible for being sick), but people are responsible for the choices they make (addictive behaviours).
[NOTE: A symptom is a characteristic sign or indication of the existence of something else. It is a sign or an indication of disorder of disease, especially when experienced by an individual as a change from normal function, sensation or appearance (Oxford English Dictionary)]
I have no problem agreeing that addicts active in their addiction make bad choices and behave badly. However, it is the biological, psychological, relational, spiritual nature of the disease that drives the behaviour - not innate moral weakness, sin, or bad character.
The good news is, no matter how sick an addict is, he or she can also make choices that make recovery from the disease possible.
Dr. Hajela again: "Choice still plays an important role in getting help. While the neurobiology of choice may not be fully understood, a person with addiction must make choices for a healthier life in order to enter treatment and recovery. Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviours is necessary.
Because we are a materialist culture that looks to the evidence of our senses and the findings of science to determine what is real and true, we are fascinated by the neurobiology of addiction. I don't have any quarrel with the discoveries of neuroscientists that are revealing how the chemical reactions in an addict's brain are different than those of a so-called normal person.
But it is interesting to note that choice - and consequent behaviours - plays a role in the field of biochemistry. While it is true that chemical processes in the brain cause behaviour - whether healthy or sick - it is an established, scientific fact that is works the other way around too: Behaviour causes a change in brain chemistry. In other words, addicts can put their disease into remission - get into recovery - through the choices they make.
The last word goes to Dr. Miller: "Many chronic diseases require behavioural choices, such as people with heart disease choosing to eat healthier or begin exercising, in addiction to medical or surgical interventions ... So, we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment."
And by treatment I'm sure he doesn't mean surgical or pharmacological treatment, but behavioural treatment that is about learning to make healthy choices - behavioural treatment focused on honesty, with self and others, responsibility to oneself and others and forgiveness of self and others.
Monday 26 August 2013
Monday 19 August 2013
LOVE CANNOT BE HELD HOSTAGE
It is perfectly natural and normal to love someone who happens to be sick with the disease of addiction. We don't stop loving someone just because they're sick.
And, even when a person behaves really badly while in the throes of the illness, it's understandable that friends and family still love them.
But it's really horrible - and sad to see - when an addict uses that love to serve their addiction. People will allow themselves to be used and abused in the name of love. Their heart tells them the truth but they still feel compelled to do what, in the end, is wrong. It feels like they are being held hostage by their love ....
It's one of the most difficult things to manage in any intimate relationship - to love without being manipulated. To love and still be able to say 'no'. To love and not be at the service of addiction.
In recovery language, someone who loves an addict is encouraged to 'detach with love'. But often the detaching feels impossible to do .... 'how can I be OK when my fill in the blank (son, daughter, spouse, sibling or parent) is so miserable? I can't stand to see them suffer."
People - for a multitude of reasons - take on the belief that love, real love, means that they must climb down into the muck along with people they love. Even when the misery is self-made - such as that created by active addiction - people feel compelled to share in it - in the name of love.
But the exact opposite is true.
The truth is, love, real love cannot be held hostage.
Let me explain what I mean with a little help from a book that has become a spiritual classic.
In 1946, C.S. Lewis wrote a fantasy story called The Great Divorce. It's about a man who, in a dream-like state, travels on a bus to heaven and observes people, who have recently died, face choices about whether to remain clinging to their earthly beliefs, opinions, desires and so on, or let go of them and enter heaven. It's a marvellous story in every sense of the word. Its most important lesson is that we have to choose - there is always, and everywhere a choice - even about whether or not we will enter heaven. The second important lesson is, once you make your choice, the door closes. We are faced with choices - and their consequences - throughout our lives. And ultimately, one chooses to remain in hell, or surrender into heaven.
I must point out too that Lewis implies that our choices create our heaven or hell here on earth, in this very life. Heaven or hell don't begin only after we die. They are with us in our choices right now, today.
One particular episode in the Great Divorce speaks to my point - that love cannot be held hostage by misery (misery created by self-pity, shame, addiction and so on).
It centres on a Lady who is Love. She personifies Love and lives in the heavenly realm, surrounded by adoring 'sons' and 'daughters'.
As Lewis explains, in her earthly life: "...every young man or boy that met her became her son - even if it was only the boy that brought the meat to her back door. Every girl that met her was her daughter. Those on whom her love fell went back to their natural parents loving them more ... it was the kind of love that made men not less true, but truer, to their own wives ... there is joy enough in the little finger of a great saint such as yonder Lady to waken all the dead things of the universe into life."
This remarkable Lady encounters her earthly husband - who has recently died - on the borders of heaven. Their meeting is memorable. She joyfully invites him to join her there, in Heaven. But he, portrayed as a ghostly phantom, refuses - demanding that she come down to him, in his misery - self-pity, resentments, playing the victim. He tries every trick he knows to get her to join him in his unhappiness and tries to manipulate her into believing that her happiness and joy is a sham. But the Lady refuses to buy in:
"Darling" says the Lady, ... you don't want me to be miserable for misery's sake. You only think I must have been if I loved you. But if you'll only wait you'll see that isn't so."
"Love!" says her ghostly husband, ..."Love! Do you know the meaning of the word?"
"How should I not?" said the Lady. "I am in love. In love, do you understand? Yes, now I love truly."
"You mean, ... you mean - you did not love me truly in the old days."
"Only in a poor sort of way," she answered. "... what we call love down there (in our earthly life) was mostly the craving to be loved. In the main I loved you for my own sake: because I needed you."
"And now! ... Now, you need me no more?"
"But of course not!" said the Lady; and her smile made me wonder how ... the phantom could refrain from crying out with joy.
"What needs could I have," she said, "now that I have all? I am full now, not empty. I am in Love Himself, not lonely. Strong, not weak. You shall be the same. Come and see. We shall have no need for one another now; we can begin to love truly."
Lewis then says: "I do not know that I ever saw anything more terrible than the struggle of that Ghost against joy."
Sadly, the Ghost continues to do his pathetic best to guilt and manipulate the Lady into coming out of Love into his misery. In the end though, he can't win ... and he fades into nothingness - in spite of the Lady's persistent invitation to join her in happiness and joy - free of emotional blackmail.
"Come to us," she says, "We will not go to you. Can you really have thought that love and joy would always be at the mercy of frowns and sighs? ... I cannot love a lie, I cannot love the thing which is not. I am in Love, and out of it I will not go."
The episode comes to and end with a reflection between Lewis and his Teacher who is with him on this journey:
"And yet . . . and yet ... ," said I to my Teacher, "even now I am not quite sure. Is it really tolerable that she should be untouched by his misery, even his self-made misery?"
"Would ye rather he still had the power of tormenting her? He did it many a day and many a year in their earthly life."
"Well, no. I suppose I don't want that."
"What then?"
"I hardly know. What some people say on earth is that the final loss of one soul gives the lie to all the joy of those who are saved."
"Ye see it does not."
"I feel in a way that it ought to."
"That sounds very merciful: but see what lurks behind it."
"What?"
"The demand of the loveless and the self-imprisoned that they should be allowed to blackmail the universe: that till they consent to be happy (on their own terms) no one else shall taste joy: that theirs should be the final power; that Hell should be able to veto Heaven."
"I don't know what I want." "It must be one way or the other. Either the day must come when joy prevails and all the makers of misery are no longer able to infect it: or else for ever and ever the makers of misery can destroy in others the happiness they reject for themselves. ... The choice of ways is before you. Neither is closed. Anyone may choose eternal death. Those who choose it will have it."
This is a metaphorical, imaginative way of explaining the meaning of 'detaching with love' and 'setting boundaries'.
"It must be one way or the other. Either the day must come when joy prevails and all the makers of misery are no longer able to infect it: or else for ever and ever the makers of misery can destroy in others the happiness they reject for themselves".
I know that's what it feels like sometimes when we are confronted with the disease of addiction in someone we love: that their misery is the ultimate power.
But hopefully we can learn to see that it just isn't so.
And, even when a person behaves really badly while in the throes of the illness, it's understandable that friends and family still love them.
But it's really horrible - and sad to see - when an addict uses that love to serve their addiction. People will allow themselves to be used and abused in the name of love. Their heart tells them the truth but they still feel compelled to do what, in the end, is wrong. It feels like they are being held hostage by their love ....
It's one of the most difficult things to manage in any intimate relationship - to love without being manipulated. To love and still be able to say 'no'. To love and not be at the service of addiction.
In recovery language, someone who loves an addict is encouraged to 'detach with love'. But often the detaching feels impossible to do .... 'how can I be OK when my fill in the blank (son, daughter, spouse, sibling or parent) is so miserable? I can't stand to see them suffer."
People - for a multitude of reasons - take on the belief that love, real love, means that they must climb down into the muck along with people they love. Even when the misery is self-made - such as that created by active addiction - people feel compelled to share in it - in the name of love.
But the exact opposite is true.
The truth is, love, real love cannot be held hostage.
Let me explain what I mean with a little help from a book that has become a spiritual classic.
In 1946, C.S. Lewis wrote a fantasy story called The Great Divorce. It's about a man who, in a dream-like state, travels on a bus to heaven and observes people, who have recently died, face choices about whether to remain clinging to their earthly beliefs, opinions, desires and so on, or let go of them and enter heaven. It's a marvellous story in every sense of the word. Its most important lesson is that we have to choose - there is always, and everywhere a choice - even about whether or not we will enter heaven. The second important lesson is, once you make your choice, the door closes. We are faced with choices - and their consequences - throughout our lives. And ultimately, one chooses to remain in hell, or surrender into heaven.
I must point out too that Lewis implies that our choices create our heaven or hell here on earth, in this very life. Heaven or hell don't begin only after we die. They are with us in our choices right now, today.
One particular episode in the Great Divorce speaks to my point - that love cannot be held hostage by misery (misery created by self-pity, shame, addiction and so on).
It centres on a Lady who is Love. She personifies Love and lives in the heavenly realm, surrounded by adoring 'sons' and 'daughters'.
As Lewis explains, in her earthly life: "...every young man or boy that met her became her son - even if it was only the boy that brought the meat to her back door. Every girl that met her was her daughter. Those on whom her love fell went back to their natural parents loving them more ... it was the kind of love that made men not less true, but truer, to their own wives ... there is joy enough in the little finger of a great saint such as yonder Lady to waken all the dead things of the universe into life."
This remarkable Lady encounters her earthly husband - who has recently died - on the borders of heaven. Their meeting is memorable. She joyfully invites him to join her there, in Heaven. But he, portrayed as a ghostly phantom, refuses - demanding that she come down to him, in his misery - self-pity, resentments, playing the victim. He tries every trick he knows to get her to join him in his unhappiness and tries to manipulate her into believing that her happiness and joy is a sham. But the Lady refuses to buy in:
"Darling" says the Lady, ... you don't want me to be miserable for misery's sake. You only think I must have been if I loved you. But if you'll only wait you'll see that isn't so."
"Love!" says her ghostly husband, ..."Love! Do you know the meaning of the word?"
"How should I not?" said the Lady. "I am in love. In love, do you understand? Yes, now I love truly."
"You mean, ... you mean - you did not love me truly in the old days."
"Only in a poor sort of way," she answered. "... what we call love down there (in our earthly life) was mostly the craving to be loved. In the main I loved you for my own sake: because I needed you."
"And now! ... Now, you need me no more?"
"But of course not!" said the Lady; and her smile made me wonder how ... the phantom could refrain from crying out with joy.
"What needs could I have," she said, "now that I have all? I am full now, not empty. I am in Love Himself, not lonely. Strong, not weak. You shall be the same. Come and see. We shall have no need for one another now; we can begin to love truly."
Lewis then says: "I do not know that I ever saw anything more terrible than the struggle of that Ghost against joy."
Sadly, the Ghost continues to do his pathetic best to guilt and manipulate the Lady into coming out of Love into his misery. In the end though, he can't win ... and he fades into nothingness - in spite of the Lady's persistent invitation to join her in happiness and joy - free of emotional blackmail.
"Come to us," she says, "We will not go to you. Can you really have thought that love and joy would always be at the mercy of frowns and sighs? ... I cannot love a lie, I cannot love the thing which is not. I am in Love, and out of it I will not go."
The episode comes to and end with a reflection between Lewis and his Teacher who is with him on this journey:
"And yet . . . and yet ... ," said I to my Teacher, "even now I am not quite sure. Is it really tolerable that she should be untouched by his misery, even his self-made misery?"
"Would ye rather he still had the power of tormenting her? He did it many a day and many a year in their earthly life."
"Well, no. I suppose I don't want that."
"What then?"
"I hardly know. What some people say on earth is that the final loss of one soul gives the lie to all the joy of those who are saved."
"Ye see it does not."
"I feel in a way that it ought to."
"That sounds very merciful: but see what lurks behind it."
"What?"
"The demand of the loveless and the self-imprisoned that they should be allowed to blackmail the universe: that till they consent to be happy (on their own terms) no one else shall taste joy: that theirs should be the final power; that Hell should be able to veto Heaven."
"I don't know what I want." "It must be one way or the other. Either the day must come when joy prevails and all the makers of misery are no longer able to infect it: or else for ever and ever the makers of misery can destroy in others the happiness they reject for themselves. ... The choice of ways is before you. Neither is closed. Anyone may choose eternal death. Those who choose it will have it."
This is a metaphorical, imaginative way of explaining the meaning of 'detaching with love' and 'setting boundaries'.
Real love cannot be held hostage: I couldn't put it any better than to repeat Lewis' words:
"It must be one way or the other. Either the day must come when joy prevails and all the makers of misery are no longer able to infect it: or else for ever and ever the makers of misery can destroy in others the happiness they reject for themselves".
I know that's what it feels like sometimes when we are confronted with the disease of addiction in someone we love: that their misery is the ultimate power.
But hopefully we can learn to see that it just isn't so.
Monday 12 August 2013
INVITING THE LOVER IN TO LIVE
A couple of weeks ago I wrote about addiction being an exclusive love-affair.
Let's take the metaphor of the love-affair one-step further.
Imagine this:
Let's take the metaphor of the love-affair one-step further.
Imagine this:
You're in a committed, long-term relationship (a.k.a. marriage, common-law or otherwise). You know things aren't perfect between you - never have been, never will be. But compared to some, you have a pretty happy life together.
Your partner has always had weaknesses - like flirting. You've never liked it, but you're sure the behaviour is harmless. After all, you can't really complain because that's how you got together in the first place - by flirting with each other.
Then, and you can't even exactly remember when, you start to feel really uncomfortable. Things begin to take a more serious turn - you become suspicious that there's an affair going on. You watch, you listen carefully to your partner's tone of voice when making excuses about being late or not calling. You start to investigate - checking into alibis, looking at telephone records ...
Finally, it all comes out - there is an affair going on, and it's been pretty long-term. Betrayal. Recriminations. Anger ... Hurt ... Disbelief ... Devastation ... Despair.
What do you do?
Well, after considering everything, including your own fear of many things ... You invite the other person in to live with you - into your family home. Into your bedroom.
You make every accommodation you can think of to fit this third person into your marriage:
You give them space for their time together (which is nearly every evening and weekend.)
You soothe your partner when they have a squabble.
You protect the lovers from outside interference from employers or the police.
You keep the children clear so their noise and questions don't annoy the lovers.
You make excuses to the kids.
You protect their privacy.
If your children are teens or adults, you do everything you can to convince them this arrangement is best for everyone.
You always have your inner antennae out to detect any and all of your partner's emotional needs.
You keep secrets from friends and extended family - or you come up with clever excuses if they become suspicious.
You endure the abusive comments - or worse - to keep the peace.
Then, and you can't even exactly remember when, you start to feel really uncomfortable. Things begin to take a more serious turn - you become suspicious that there's an affair going on. You watch, you listen carefully to your partner's tone of voice when making excuses about being late or not calling. You start to investigate - checking into alibis, looking at telephone records ...
Finally, it all comes out - there is an affair going on, and it's been pretty long-term. Betrayal. Recriminations. Anger ... Hurt ... Disbelief ... Devastation ... Despair.
What do you do?
Well, after considering everything, including your own fear of many things ... You invite the other person in to live with you - into your family home. Into your bedroom.
You make every accommodation you can think of to fit this third person into your marriage:
You give them space for their time together (which is nearly every evening and weekend.)
You soothe your partner when they have a squabble.
You protect the lovers from outside interference from employers or the police.
You keep the children clear so their noise and questions don't annoy the lovers.
You make excuses to the kids.
You protect their privacy.
If your children are teens or adults, you do everything you can to convince them this arrangement is best for everyone.
You always have your inner antennae out to detect any and all of your partner's emotional needs.
You keep secrets from friends and extended family - or you come up with clever excuses if they become suspicious.
You endure the abusive comments - or worse - to keep the peace.
In the end, you lose yourself in their relationship.
But somehow, it all makes sense to you.
I'm sure you're asking yourself where I'm going with this ...
Well, it seems to me that all the accommodations we make to our loved-one's addiction are exactly those we would make if we invited the person they were having the affair with in to live with us.
Addiction is a relational illness. The disease lies in the relationship a person has with their substance of choice. It's an emotional relationship that is more important to the addict than all other relationships in their life. That's why it affects all their other relationships. That's how families become alcoholic, or addicted families.
The addict may protest that it's not true - but all the evidence and behaviour points to an emotional, love connection with a substance (or substances and behaviours) that is the first priority in an addict's life.
And it is an emotional, love relationship.
When you make the decision to live with a loved-one in active addiction (and the same holds true if the addict is your son or daughter) you are making accommodations to a relationship that is as emotionally deceitful, disrespectful and devastating as inviting the person with whom your partner is having an affair into your home - to live - 24/7.
www.dalemacintyre.com
Well, it seems to me that all the accommodations we make to our loved-one's addiction are exactly those we would make if we invited the person they were having the affair with in to live with us.
Addiction is a relational illness. The disease lies in the relationship a person has with their substance of choice. It's an emotional relationship that is more important to the addict than all other relationships in their life. That's why it affects all their other relationships. That's how families become alcoholic, or addicted families.
The addict may protest that it's not true - but all the evidence and behaviour points to an emotional, love connection with a substance (or substances and behaviours) that is the first priority in an addict's life.
Addiction doesn't lie solely in the substance
Addiction doesn't lie solely in the person.
Addiction lies in the relationship between the addict and the substance.
And it is an emotional, love relationship.
When you make the decision to live with a loved-one in active addiction (and the same holds true if the addict is your son or daughter) you are making accommodations to a relationship that is as emotionally deceitful, disrespectful and devastating as inviting the person with whom your partner is having an affair into your home - to live - 24/7.
www.dalemacintyre.com
Monday 5 August 2013
MY NEW WEBSITE - AND SOME HOLIDAY THOUGHTS
I launched my new website this past weekend as a support to my private counselling practice. I invite you to visit it.
Of course I welcome any feedback you can offer that'll help make it better.
We're enjoying a warm, sunny weekend (warm and sunny all summer long so far!) here on Vancouver Island. And today's a holiday (BC Day), a chance to enjoy ourselves and reflect on all the things in our lives we have to be grateful for.
I hope wherever you are that you're able - that you have the space, the safety and security in your life - to do the same.
There
are only two ways to live your life.
One is as though nothing is a miracle, the
other is as though everything is a miracle.
~ Albert Einstein
BUT all the same, even in the midst of lovely weather, good physical health and the safety and security of everyday life, there are many people who are suffering through deep emotional pain. Some of it is their doing - either that which they inflict upon themselves, or, very often it is caused by the guilt and sorrow they experience for having inflicted pain on others - even on those they love. A person in that state might even feel - and believe deep in their heart - that what they have done is, and they therefore are, unforgivable.
Making amends is often impossible and one may discover that some of the people he or she loves seem like they are unable to be angry and hurt and still love them. One finds out that many of the people in their life can only like, love and accept them if they do what pleases them.
This is a very dangerous place to be.
Why is it dangerous? Because a person in that situation may go beyond guilt and sorrow - to shame. And shame will have one believe they are worthless, it will have them believe the words of others - that they are beneath contempt. Wallowing in shame makes it very difficult to live a creative and productive life.
How can one help others (which is the whole meaning of a creative and productive life) if a person believes they are not worthy of anything? Shame will have them believe - "I am not capable any longer, on account of what I have done, of being honest, responsible and forgiving". Shame would have them believe that they are not worthy of helping others.
It is during these times that one has to turn inward.
In the depths of his or her heart, in the midst of their guilt and sorrow, they learn to dedicate and encourage themselves, every day, maybe every minute of the day, to believe and accept themselves as a good person who did wrong. In order to transcend the guilt and sorrow, indeed in spite of their guilt and sorrow, they dedicate themselves to helping others more passionately and - this is important - more humbly.
I have decided to stick with love.
Hate is too great a burden to bear.
- Martin Luther King
Have a great week in whatever weather you are enjoying.
And please, don't forget to check out my website.
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