SALT LAKE CITY — John, an alcoholic, promised his spouse as he went out of the house, “I am not going to stop for a drink, I promise, I will be right back.” He felt like he really meant it.
He repeated to himself, “I am not going to drink, I am not going to drink,” as he attended to his errands. He felt confident he would not break his promise. Half an hour later, John was in a bar drinking shots of tequila.
Family members and helpers can't help but ask in frustration, “Why can’t they just say no? Why can’t they just stop?” The answer, it turns out, is that there are some pretty powerful reasons why they can’t.
As with many other conditions and diseases, vulnerability to addiction differs from person to person. Your genes, mental health, family and social environment all play a role in addiction. Risk factors that increase your vulnerability include:
- Family history of addiction
- Abuse, neglect, or other traumatic experiences in childhood
- Mental disorders such as depression and anxiety
- Early use of drugs
- Method of administration—smoking or injecting a drug may increase its addictive potential
"Addiction is loss of control," explains Stephanie Brown, Ph.D. She points out that addiction is about more than behavior. An emotional bond is formed within the individual with the drug of choice, whether that be alcohol, drugs or one of the process addictions like gambling, sex or pornography. A compulsive attachment is formed, which means the urge to use or act out is greater than one’s will to say no.
Brown explains that addicts cannot do without their drug of choice. “It becomes the best friend, lover and the demon that will destroy the addict," she says. "Stated another way, addiction is a deep loss of self.”
Patrick Carnes, Ph.D., offers this perspective: “At some point, excessive use becomes compulsive use. The highs become so compelling that the person cannot do without it.”
Once the addiction develops, it comes to regulate the emotional life of the addict. As Carnes puts it, “The addict can not act ‘normal’ without the high.”
Carnes last warning is, “Once this point is reached, addicts cannot undo all the damage, even with help. Significant shifts have occurred, which leave them forever to their addiction. Compulsive use always remains an option.”
The compulsion is grown through the process clinicians call conditioning. Pavlov and his famous dogs established the existence of conditioning. He noticed his dogs' mouths would water when he brought them food. He added the ringing of a bell to the feeding process. One day he brought no food but only rang the bell, and the dogs' mouths watered right on queue, without food being present. They had been “conditioned” to do so.
Pavlov “extinguished” the behavior by continuing to just ring the bell without bringing food. Eventually the dogs figured out that salivating just wasn’t necessary when a bell sounded.
Extinguishing a compulsion or addiction is centered on reversing the urge- is-greater-than-the-will equation. Efforts are made to reduce the intensity of the urge and raise the power of the will. The resulting equation states, “The will to say no is greater than the urge to use.”
Interventions that help reduce the urge to act out center on eliminating anything that “triggers” or strengthens the urge. Porn addicts must eliminate their access and throw out their porn stash to eliminate their presence being an invitation to act out. An alcoholic must stay out of his favorite “watering hole” and avoid his drinking buddies. Someone addicted to illegal drugs must lose contact with his drug dealer and destroy any paraphernalia that facilitates using.
Managing what the mind is doing is an important piece of reducing the urge. If the mind is allowed to re-live acting out exploits, for example, the addict's brain can produce an anticipatory high that often figuratively throws gasoline on the urge fire, causing it to grow exponentially.
A goodly number of interventions can assist in strengthening the addict's will to say no. A surprising one, to some, is structure. Structure, or day planning, eliminates the addict having to make some spur-of-the-moment decisions. Addicts don’t have a good track record when it comes to decision making, so making as few decisions as possible is helpful, especially in the early stages of recovery.
An example might be when an alcoholic plans and takes his lunch to work to be eaten in a very specific “safe” place. Without that structure, when lunch time comes and there is no plan, his favorite bar may come to mind as a lunch possibility. His mind will say, “They have really good food...” but they also have really good alcohol. The urge to drink can get out of control and claim him in that environment.
Other “will strentheners” are attendance at recovery meetings, spiritual connection and religious worship, 12 Step work, therapy, and accountability.
Sometimes the value of accountability is overlooked. Addicts want to live without accountability, it makes using much easier. When addicts are accountable they reveal their secrets. One of the tenets of Sexaholics Anonymous is, “When you kill the secret you begin to kill the addiction.”
Perhaps the most important thing to remember is that the addict can learn to say no. The equation can be righted. It is a process and not an event, meaning there is often a fair amount of time and effort involved in achieving it. But the rewards of sobriety, healthy self regulation and once again finding balance in life makes the effort ever so worthwhile.
In the process of recovering from addiction Roger became a licensed addiction counselor and wrote the LDS recovery guide, “The Waterfall Concept, A blueprint for addiction recovery.” He blogs at his recovery website www.waterfallconcept.org.