A reader recently challenged my practice of criticizing the ideas and methods of the recovery culture, saying:
I applaud your efforts to spread your message and try to help others that find themselves in the same situation you were in. All commendable. What I find disturbing is that you find it necessary to do so by denigrating other methods to prop up your theories and methods.
If you truly thought your method was so effective, you wouldn’t find this necessary.
I find that last self-righteous sentence to be intentionally ignorant. The reader drops the whole context in which we deal with people with substance abuse problems in this country. Every person I have ever talked to about addiction has at least heard the idea that addiction is a disease, and every person I’ve ever talked to who has a problem with substance abuse, is well versed in the disease theory and it’s logical offshoots. Furthermore, a Gallup poll in the 1990’s found that 90% of people believe that alcoholism is a disease, and a more recent poll found that 76% of people who have a substance abuser in their family, believe that addiction is a disease, and I think it’s fair to assume that the family member in question also believes it is a disease. After all, most conventional treatment programs make it their stated goal to teach the substance abuser that addiction is a disease. So the context which must not be dropped, denied, or ignored – is that people in the US who have substance abuse problems or have loved ones with substance abuse problems, are at least highly aware of the disease theory, if not in full belief of it. These are the exact people for whom I write this blog.
Then again, as the reader asks, if I had a good solution for substance abuse, then I should just present that solution, without concerning myself with the other methods. That would be nice, if we could drop the context I just presented, but can we? Let’s look at my method. I can sit down with a person who has a substance abuse problem, and present them an educational course on the nature of choices & values. I can teach them the difference between the nature of choices which lead to substance abuse, and the nature of more long-term focused choices. I can give them cognitive exercises which help them build awareness of the thought processes which lead to their personal choices. I can give them goal-setting exercises which help them to generate and implement alternatives to their current lifestyle. I can also use coaching techniques to actively guide them through a process of ending their old behavior and moving ahead with life. There are many things I can teach which set a person with a substance abuse problem on the right path, and empowers them to build a better life for themselves.
There is a growing body of research on self-changers (people who end their substance abuse problems without treatment or 12-step programs), both on the prevalence of this phenomenon, and the factors which make it successful. These people make up the vast majority of substance abusers who successfully end their problems (75% to be exact). My current method is a combination of an educational approach which teaches them these keys to self-change, and uses personal coaching to guide them through and accelerate the process of change (a process they would most likely naturally experience at some point, as long as they stay away from the recovery culture). My method rests on the above premises, and the premise that human beings have free will, that they choose their own behavior.
In contrast to this, the disease theory and it’s proponents teach that the substance abuser has a disease which causes compulsive substance abuse, that drugs have “hijacked” their free will, that they are powerless, that the only way to solve their problem is through treatment, that “relapse is a part of recovery”, that they will be a lifelong addict, etc. The reality is that the disease theory and these other myths of the recovery culture are thoroughly entrenched in our society and the minds of the people I’m trying to help. I cannot drop this context. My clients cannot afford for me to drop it. I can teach them whatever I want about choice and self-empowerment, but if I don’t tackle these hurtful ideas which they’ve already been taught, then they may continue to believe this nonsense, if not on a conscious level, then at least on a subconscious level (where it will breed an insidious feeling self-doubt). If they believe the disease theory, then they may continue to fall into it’s traps – my view on addiction is directly contradictory to the prevailing view, a person can’t follow both at the same time and hope to succeed. Furthermore, the preponderance of evidence shows that a person’s chances for success are greatly reduced by attending programs which teach the disease theory.
So, why do I find it necessary to denigrate other methods and programs? Because they are wrong, they are spreading falsehoods, they are ineffective – because they are directly standing in the way of success. I guess it’s fair to say I’m denigrating them, but I see it more as debunking. I am trying to remove the bad ideas that stand in the way of success for my clients, my readers, and all people with substance abuse problems. We who have better methods, cannot escape these ideas, because everyone we come into contact with has been taught these ideas. The recovery culture is creating new victims every day, leading people astray with their lies. As a practical matter, we have to point out the errors in these claims and their resultant methods and programs, so that people can free themselves from learned powerlessness and make progress in solving their problems.
In another post, I tackle another claim made by this same reader:
As a former substance abuse counselor (CADC, DePaul, 2004) I'd have to disagree with this. AA is not the only game in town, although, granted, that most successful. I've seen examples of sobriety through religion, exercise, even determination. And while I personally happen to believer alcoholism is a bona fide disease it's important to remember the AMA called it such, not because they actually thought it was, but because they very much wanted the insurance companies to call it that so they could get paid for treating it. Wilson, like L. Ron Hubbard, found something that worked for him. It has also worked for millions of others around the globe. It works for me. But to discount anyone's quality of life because they don't subscribe to the same set of moral principles as we do is a tad silly, Steve. And let's face it, after all is said and done, after the smoke and mirrors, after the initial traveling salesman approach to AA, it IS simply a set of moral principles. It would be nice to think we have found one of the few inalterable truths left in the world with AA, but shamedly ignorant to do so.
Thanks for the input, Last Tango. I'm not sure where we disagree though.
I never said in this post that anyone's quality of life is worse because they follow a different set of moral principles than me, and if it read as if I was implying that, I apologize for not being more clear. I am speaking purely to the fact that if my goal is to help substance abusers, I must show them how to avoid the pitfalls of the conventional views on addiction. I must do this because those views are so widespread and influential.
I don't think I singled out AA either, nor did I say that it was the only game in town. AA was included as an organization which promotes the disease theory, but certainly not the only one. I referred to conventional treatment programs, the recovery culture, and I even linked to some information from a government agency, the NIDA, which expresses the disease view. I don't believe AA itself is the only game in town, but programs which promote the disease theory have for all intents and purposes, been the "only game in town". Sure, there are exceptions, but they are exceptions. The programs which don't teach or operate on the disease theory are few and very far between.
Furthermore, by implication, the fact that when a person seeks help for a substance use problem, they are directed to institutions full of medical professionals – implies that a medical disease is to blame, and that the substance abuser's problems can only be solved externally, rather than from within.
We can honestly disagree about anything, such as the topics of whether or not addiction is a disease, whether or not treatment works, and whether or not any number of ideas are the optimal ones that we should be teaching to substance abusers. But I don't know why we would disagree on the fact that the disease theory and it's corollaries, are actually widespread in our culture. Just look at any television show (fictional or non) which deals with addiction, look at any news story on addiction. It doesn't take long to see that the idea that addiction is a disease is taken for granted as true.
My ideas are in direct contradiction to these more popular ideas, and I meant with this post, only to explain that their prevalence necessitates my debunkery. If I have misread you, I apologize. But please let me know where I've gone wrong, so that I may address your true concern.
This really hit home for me. I think that these other theories do need to be addressed- and not only because of their prevalence. I think that the reason they are prevalent is because it seems to be in human nature (or modern human nature, at least) to want it to not be our faults. I think that the idea of disease/victimhood must be addressed not only because it is a trend in addiction theory but because it is something that we all seem to cling to as humans.
I've seen the damage done by the "disease theory" among addicts in my own family. It lead to decades of guilt, grudges, fear, and all-around confusion. I wouldn't wish any of it on anyone.
I have a question and please dont take offense to it, are you a Christian?
Are you asking me? If so, the answer is no, I am not a Christian. I’m not religious. No offense taken. Why do you ask though?
-Steven Slate
Interesting that Herman chose not to respond to admin Steve’s reply to Christianity question…Just sayin’ ;0)
St Jude retreat cost up to $30,000 for six weeks, although they say they get donations and have a scholarship program. They teach a program of CHOICE. Since it is not “medical treatment” they can’t bill and do not accept insurance. That also prevents their records from being audited. If you fail their treatment it is the client’s fault for not CHOOSING to get better. You can also be asked to leave with no refund. What bothers me the most is their web site clearly states mental health issues frequently go hand in hand with addiction. Since they are not a medical facility I do not see how they could possibly treat mental illness…. which one cannot just chose not to have.