Saturday, October 22, 2011

What Is This Thing Called Addictions? by Helga Matzko

When I began working in the field of addiction 30 years ago, most clients were automatically labeled addicts, (yes, shocking but true) just as most clinicians were either recovered individuals or members of addiction-troubled families. Of course, the field has evolved and what was once held to be gospel truth has been modified and re-labeled. The purpose of this brief paper serves to highlight the confusion and complexities inherent when assigning the label “Addiction”.

Addiction may be:

• Disease/illness; Disorder DSM-IV-TR, (insurance reimbursement)

• Not illness but can create lots of physical illnesses

• Myth of Alcoholism (Herbert Fingarette; scientific data)

• Concept, not illness (Jellinek)

• Spiritual depravity, character defects – AA fellowship only salvation (AA)

• Hedonism – following the pleasure principle – feels good (our limbic system)

• Everyone is addicted (Andrew Weil, Harvard Conference presentation)

• Genetically programmed (unproven, research not universally validated)

• Big multi-billion dollar business

• Treatment and discomfort depends on the health care providers’ projection (Ellen Langer, Harvard)

• Resulting from abuse and trauma

• Life-style issues

• Once an addict – always an addict vs. once a human being – always a human being

• Organismic self-regulation, creative adjustment to what is

• My theory is better than yours philosophy !

The above bullet points are not inclusive and perhaps none speak to each reader. My heart goes out to clients and clinicians for both are, one might say forced, to give a diagnosis that pretty much will stay with an individual for life i.e. failed attempts to purchase life or health insurance etc. Are any of our noble attempts really helpful? Statistics vary hugely; it all depends on who provides them – each program is the best on the web. The questions really become: Can a label alone define anything? Who is the client? What is his/her experience; a good question because some will say addicted individuals can’t think clear enough for recall or have warped perceptions. Others will claim that there is no cure; what does that mean? Why bother? Who is the individual who has learned to overuse substances? Are they embodied in their drinking, drug-using activities?

In conclusion, my professional belief is that what is, is and whatever works, works. I see each individual as a wonderful, complex, highly unique individual who trusts or learns to trust me that s/he is deserving. Kierkegaard wrote that “if you label me you negate me”; a powerful statement that invites all professionals to have an open mind, an open heart, to see and experience the client/professional relationship not as two separate, isolated human beings but in an I/Thou co-created dialogical relationship. This is how we both experience our working together. Believe me, it isn’t always easy. You may see it differently and I would really love to hear your experience and position on the issue of “Addiction.”