By Aidan Maloney
Where is the Sweetness?
Where is the sweetness in chocolate? Is it in the sugar? Where is the sweetness in the sugar? There is no sweetness in sugar. Is the sweetness in the person? No. The sweetness is in the taste. The sweetness occurs when the sugar and the individual interact.
Addiction is “the compulsive use or abuse of any substance sometimes producing withdrawal symptoms (anxiety, craving, sleep difficulties, aches and pains) when use is discontinued”.1 When we think of addicts we often imagine junkies gasping for a fix or alcoholics dying for a drink. Those who treat addiction know that people can be addicted to all sorts of substances. It may also be true that the process called addiction applies equally to activities. For example, a workaholic is someone who is addicted to work.
To understand addiction, should we include only those drugs and activities that we perceive as doing damage to our health? Distinguishing addictions by the damage they cause is useful for deciding which addictions we should offer treatment for, but it is not very useful for understanding the process. Defining addiction in terms of the damage it may cause diverts our attention to the more notorious side-effects of the addiction rather than clarifying what is going on in the process.
The Substance Model
There is a popular misconception that addiction in some way is inherent in the substance. It is like saying that heroin, or any other substance associated with addiction, has an addictive element in it. Advocates of this theory recommend banning addictive substances on the assumption that if they are prohibited there will be no addicts. While there may be a decline in addiction to particular substances under prohibition, we do not know whether this represents an absolute decline or a shift from one substance to another. In the US during Prohibition, hospitalisation rates for cirrhosis of the liver dropped substantially. Whether this compensated for the increase in criminal activity is debatable. More recent evidence from research by Dr. Frits Ruter, Professor of Criminal Law at the University of Amsterdam, suggests that a hard-line approach to drug use leads to more abuse and addiction. He found, when he compared the Dutch and German approach, that cannabis use is decreasing in Holland and increasing in Germany.2 The Dutch have a much more tolerant approach to drug use than do the Germans.
One might imagine according to the addictive substance theory that the power of the substance would at least remain constant, maybe even increase. Surprisingly the effects of substances associated with addiction decline with use. In practice, the more one takes of a substance over long periods, the less effective it becomes and one requires more of the substance to get the same effect.
The substance model confuses the substance with its effect. It is the effect rather than the substance itself that is sought after. One of the biggest challenges to the substance model of addiction is the fact that individuals vary so much in their response to a given substance. Some people become addicted to a substance and others do not.
The Person Model
Once we dispose of the proposition that the addiction resides in the substance the next presumption is that it resides in the person. Theories at this opposite extreme perceive the addiction residing in the genetic make-up of the addict. Some people are born addicts. The search can begin for an antidote to whatever is the missing ingredient that creates addicts.
The genetic model fails to explain why so many people get over their addictions without requiring any chemical intervention. People stop smoking, drinking and drug-taking, every day.
Proponents of the less extreme versions of this addiction model begin to search for addictive personalities, without necessarily attributing the source to genetic factors. However, to restrict the consideration of the addiction to the boundaries of the self, ignores the scope of the addictive process. Are there different addictive personalities for coffee, tea, cigarettes, alcohol and drugs? Why does it matter to the addict what the substance is? Will not any substance satisfy an addictive personality?
If we consider the definition of addiction we started with, we can ask has not everyone felt addicted to something at sometime in their lives? Is there anyone who has not experienced the compulsive use of a substance? So, are we all born with addictive personalities?
These two approaches, the substance and the addictive personality approach, try to split addiction and find its source in one or other of the two factors that make up the addiction. Addiction is not a thing, although the term addiction misleadingly implies that it is a thing. You cannot hold an addiction in your hand. If you divide it in two, you cannot find it in the substance or the person in isolation. Addiction is a lot like sweetness. Addiction describes a relationship. It is a process. The models that describe only one half of the equation make the process impossible to understand, just as it would be difficult to understand tennis if one only told someone what was happening on one side of the net.
To explain addiction we need a model that takes into account the person, the substance and the relationship between them.
What happens when people who are used to living in low altitudes climb mountains? Oxygen in the atmosphere declines with the increase in altitude and people experience breathlessness, increased heart rate, etc. Moving slowly at high altitudes has the same effect as running at lower altitudes. However if one spends a long time at such altitudes the body achieves a new balance with the environment. A person becomes acclimatised to the new lower levels of oxygen. Somatic change occurs. What was once a lack of oxygen now becomes sufficient for us to perform the tasks with the same ease we performed them at lower altitude levels.
If after becoming acclimatised to higher levels of altitude we descend to lower levels we now experience an abundance of oxygen enabling us to extend our physical performance at these lower levels. Coaches who train athletes to extend their performances like to exploit this effect by training them at high altitudes and then bringing them back down to compete at lower altitudes.
Those of us who live at lower altitudes are mostly unaware of the adjustments and accommodations we have made to live in a low altitude environment. Of course these adjustments only have a meaning compared with some other environment. We always think of the one we are in as the natural environment. It is like asking a fish what is it like to live in water?
We are systems seeking balance in whatever environment we find ourselves.
“The addict is pushed like the altitude pushes the athlete undergoing acclimatisation to maintain the new homeostatic levels. A constant supply of some externally induced element is required – in this case the drug – just as a constant environment of reduced oxygen level typical of high altitude, is required to maintain the homeostatic level that is finally achieved through acclimatisation.”3
Who would argue that the person who moves to a higher altitude is independent of the environment (the lack of oxygen)? The human body, once it has found a new homeostatic level will strive to conserve it and operate as efficiently as possible in a given context. Similarly once a person introduces a substance that affects the body sufficiently to achieve a new homeostatic level then, any departure from it, within a certain range of flexibility is experienced as traumatically as someone who is going through an acclimatisation process. The tendency is to return as quickly as possible to the current homeostatic level. Homeostasis is “the principle of negative feedback at work in all living organisms, from amoeba to human. When any body process goes too fast or too slow, or creates a surplus or a deficiency, mechanisms are set in motion that restore the ideal balance.” The principle of continuous balance seeking is fundamental to understanding the innate conservative nature of our relationship to our environment.
Addicts who are without the substance they are addicted to are like people who have moved to higher altitude. While a person is acclimatising s/he is at the limit of his/her resources. Just as a person acclimatising dreads any exertion or effort, the addict even contemplating withdrawal, fears any strain that forces him/her beyond his/her current adaptation to the use of the substance.
The Physical Metaphor
Because addicts ingest substances in quantifiable doses we tend to think of addiction as a physical metaphor. For example the dose is like someone being hit by an object. In physical terms one can predict the effect of one physical object hitting another. However if you think of one person hitting another the physical impact does not predict what the response will be. A person who is hit could respond angrily and hit back, could behave submissively and cower, could run away, could ask what had upset the assailant and so on, until we exhaust the possibility of human response. The effect of the substance cannot be predicted unless one considers the meaning attached to the assault by the person assaulted.
If one person is talking to another the impact of the communication has very little relationship to the physical impact of the sound waves on the listener’s eardrums. The significance is almost entirely attributable to the meaning the listener attaches to the words. In one context a whisper can cause far more response than a shout in another.
In order to appreciate the difference between looking for answers at a purely physical level and answers at a mental level, consider the following task which Gregory Bateson set one of his classes:
“A certain mother habitually rewards her small son with ice cream after he eats spinach. What additional information would you need to be able to predict whether the child will: (a) Come to love or hate spinach; (b) Love or hate ice cream, or (c) Love or hate Mother?”4
The model of addiction that sees the relationship between the addict and the substance in terms of the physical analogy misses the significance that mental processes, of which addiction is one, operate on different principles to events that are purely physical or inanimate. This explains why some people become addicted to substances that others give up easily. Some people find giving up cigarettes harder than others find giving up heroin. Why is alcoholism a major problem in some cultures where only a minority drink and in another where alcohol consumption is widespread there is relatively little alcohol addiction? Obviously the meaning attached to the consumption by one culture rather than another is an important consideration in determining whether the substance is abused or not.
Addiction depends on meaning – it is a meaningful relationship between the person and the substance. Although substances have effects at the physical level, changing the relationship requires changing the meaning that is attributed to the substance. In some cases of addiction, the person operates out of a set of beliefs that makes them prone to abuse quite a variety of substances. It is as if they cannot conceive of the possibility of moderation within their epistemological framework.
How do we change our epistemology?
Why is it that athletes willingly submit themselves to the difficulties of acclimatisation? How does Wang Junxia, (the Chinese athlete who shattered the 10,000 metre world record by 42 seconds last year), eat worms, caterpillar fungus and the blood of soft shell turtles? The answers must lie in the first case to the benefits attributed to the effects of acclimatisation and in the second case to the diet. The meaning depends on the context. Athletes, more than most, are prepared to endure whatever change is necessary to improve their performance. Of course, as a corollary to the above, it is not only perceived benefits that are significant in influencing change but also perceived disadvantages of remaining in the current state.
In treating addiction we are primarily interested in the set of assumptions by which an individual construes his/her experience and how to change them. “Alcoholics are philosophers,” says Gregory Bateson,5 “in that universal sense in which all human beings are guided by highly abstract principles of which they are either quite unconscious, or unaware that the principle governing their perception and action is philosophic.”
According to the cybernetic model, all interventions contain the possibility of success, since any intervention can theoretically change an individual’s perceptual position. However the probability of success increases with those interventions that address the addict’s problem of shifting perceptual frameworks. The interventions with the highest probability of success are those which find paths to the addict’s new map of reality from within the boundaries of his/her current predicament.
1. Kristal, Lenoard, General Editor, The ABC of Psychology, Pelican Books 1982, p.111
2. “Use of drugs should be legalised, says Professor”, Irish Times, 8th February 1994, p.2.
3. Grinder, John and Judith DeLozier, Turtles all the way Down: Prerequisites to Personal Genius, Grinder, DeLozier and Associates 1987, p.51.
4. Bateson, Gregory, The Science of Mind and Order in Steps to an Ecology of Mind, Ballantine Books, New York 13th Ed., 1985, p.xvii.
5. Bateson, Gregory The Cybernetics of Self: A Theory of Alcoholism in Steps to an Ecology of Mind, Ballantine Books, New York, 1985 13th Ed., p.320.
Aidan Maloney studied at UCD and as a post-graduate at Trinity College. He trained in Neuro-Linguistic Programming under one of its founders, John Grinder, in California. He works as a psychotherapist and management consultant in the Centre for Creative Change, 14 Upr. Clanbrassil St., Dublin 8.