Moving Beyond Being in Recovery

I disagree with the disease model of addiction and with the idea that people are powerless against their addictions. Whether someone is an alcoholic, drug-addict, or compulsive eater, gambler or shopper, addiction is not a disease but a choice, albeit a dysfunctional one. Let me explain:

In my professional experience, the 12-step program model, which has its benefits, unfortunately also maintains its participants forever “in recovery.” This “disease model” perpetuates an identity as slaves to the addiction, and either fails to free people from a particular compulsive behavior, or simply enables them to transfer one addiction to another.

In my years as a psychotherapist and in working with addicts of all types, one common theme has emerged: all addicts have two main agendas:

These people are trying, although they don’t necessarily realize it, to heal the emotional wounds they developed during their childhood. The unconscious purpose of their addiction to soothe or stuff down feelings of pain, anger, frustration, fear, loneliness or confusion which resulted from a less-than-ideal childhood.

They are also trying to compensate for the love and care that was missing or absent in their childhood; engaging in their addictions is a sadly ineffective attempt at self-nurturing. Eating fills an emotional void; shopping is supposed to bring pleasure; gambling is stimulating; drugs are soothing; and so on.

During childhood, everyone needs certain things in order to grow up emotionally healthy and whole. These include love, understanding, affirmation, protection, guidance and encouragement. If these things are unavailable or if there is trauma in the form of loss, violence or boundary violations, emotional wounds are formed.

Addicts are all individuals who’ve suffered some degree of either neglect, abuse or trauma while growing up. Whether they had addict parents who modeled drinking, drugging, or some other addiction to them; parents whose emotional problems prevented them from loving their children, or parents who meant well but were overwhelmed by the task of child-care, these individuals grew up hurt and in need of love and healing.

People who were deprived of the childhood necessities for emotional well-being in adulthood, or who experienced any type of trauma during childhood will be highly susceptible to developing an addiction. In my experience as a therapist, people turn to addictions as the only way they know of dealing with what happened to them while they were growing up.

The psyche of the child is very primitive and since these emotional wounds occur during childhood, the coping strategies people adopt will be simplistic and illogical. This will result in people developing addictions which don’t make sense to a rational adult, but which correspond to child-logic.

The psyche turns to that which seems, on the surface, like it will soothe hurts and bring positive feelings. For the most part, these addictive behaviors do so, at least initially. The wounded psyche is focused on what it needs and doesn’t stop to think about the consequences of the addictive behavior; it just hopes and believes that it will provide the love and healing that is so desperately needed.

Experiences which are wounding to a child may be so upsetting that they are blocked from the adult memory. By the time many people reach adulthood, they could have no idea of the hurts, neglect or trauma that they experienced while growing up. Human beings have a built-in defense mechanism of denial, as a protection from experiences which are too upsetting to hold in conscious awareness.

This is why many addicts find themselves compelled to keep repeating behaviors which they know are self-destructive and not particularly helpful, without really understanding why they’re doing this, and without being able to stop.

The psychological need to finally heal and get the love that was lacking during childhood is very strong. It’s a basic survival mechanism to compensate for what’s missing and to heal emotional wounds. Because addiction is not an effective way of self-nurturing or healing, people are compelled to keep repeating the addictive behavior in the false hope that eventually, it’ll do the trick.

If one addiction is taken away, either through AA or through stomach-stapling, for example, a person will be deprived of the only way they had of dealing with the unmet needs and unhealed wounds of their childhood. Unless a valid substitute is brought in to compensate for this loss, it is inevitable that the addict will unconsciously turn to another addiction, until the necessary love and healing has been obtained.

Addictions are geared to particular personality structures and emotional needs. Drinkers use alcohol because it relaxes and soothes them. Drug abusers hope to escape from the painful emotions which hover just beneath the surface, threatening to emerge into conscious awareness.

Over eaters binge to comfort themselves and to fill the emptiness within, mistaking this feeling for physical hunger. Compulsive shoppers seek to compensate for having been deprived of love by accumulating material possessions. Still, it’s not difficult for addictions to be interchangeable. The ultimate goal is the same in each case.

Whatever the addiction, it has the same root cause and the same purpose. An addiction isn’t a disease because it’s not contagious; nor is it transmitted genetically. Alcoholism may run in families but it’s far more likely that this is because children of alcoholic parents experience neglect and perhaps trauma and then adopt the coping strategy which they’ve observed as their way of dealing with emotional wounds.

Addiction isn’t a disease because it doesn’t respond to medications. It isn’t a disease because all addictions have a clear emotional cause and respond to emotional treatment. Every addiction is merely an unconscious compensatory behavior. Furthermore, no-one can cure a disease by dealing with emotional wounds, but this is actually the only way to cure an addiction.

The disease model assumes that people are powerless in the face of their addiction, and that they require the intervention of a higher power in order to deal with it. This means that no-one can be empowered to actually heal their addiction, let alone the emotional trauma beneath it.

This model also says that once someone is an addict, they will be forever “in recovery.” The disease model forever dooms people to struggle with their attempts at sobriety and never to actually address the root cause of their problems or finally achieve a lasting cure.

Addictions are meaningful in that they emerge not from a self-destructive, diseased part of the psyche, but from a primitive, wounded part that wants to heal and to be loved. If people were to recognize that addiction is a dysfunctional attempt at a cure for emotional wounds, they could then seek a more effective and less destructive cure for their addictions.

Otherwise, we’ll continue to see people standing outside of their AA or NA meetings, chain-smoking cigarettes and downing multiple coffees; having simply replaced one addiction with a couple of others. Or we’ll see more examples of people who’ve had stomach-stapling surgery who, when they could no longer over-eat, have switched and are now alcoholics, compulsive gamblers or shopping addicts.

The first step in obtaining a real cure for addiction is to face the past honestly, and acknowledge any emotional wounds. This can be challenging, because, as I said above, there may be little recollection of the events which caused these emotional wounds.

The next step in healing is to grieve the loss of any love, affirmation or protection, in order to ultimately let go of the hurt and pain associated with them. By this I mean actually shedding tears and taking time to mourn. Pent-up anger must be released in a healthy and constructive manner, as well. Finally, self-love, self-care and new methods of self-soothing and self-reassurance must be developed.

Unless people become empowered around their addictions, true healing is impossible. The disease model, on the other hand, stresses the use of will-power, facing one’s defects and atoning for any “wrongs” as the way to overcome addiction. In some ways it might seem easier to adopt this model, because it can be very painful to face one’s deep emotional wounds.

Still, doing the work of facing and grieving the hurts and losses of childhood; letting go of sadness, anger and pain and learning self-love and good self-care will keep a person from being forever “in recovery.” Meaningfully dealing with the emotional wounds underlying any addiction will eliminate the compulsion to continue engaging in it.

Rather than being in a constant, ongoing struggle to suppress the urge to eat, drink, shop, drug or gamble, understanding the true nature of addiction can finally lead to being free. Instead of forever being “in recovery,” a person can be fully and truly healed.

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About the Author

Marcia Sirota MD FRCP(C) is a board-certified psychiatrist, that does not ascribe to any one theoretical school. Rather, she has integrated her education and life experiences into a unique approach to the practice of psychotherapy. She considers herself a realist with a healthy measure of optimism. Sign up here for her free monthly wellness newsletter. Listen here to her latest podcast. marciasirotamd.com