Personifying Addiction: Can Viewing One’s SUD as a Toxic Relationship Aid Treatment?

Who does this sound like?

·       Has a sense of entitlement and require constant, excessive admiration

·       Exaggerates achievements and talents

·       Is preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate

·       Expects special favors and unquestioning compliance with their expectations

·       Never takes responsibility, blaming others for mistakes, oversights, or poor judgment

·       Has an inability or unwillingness to recognize the needs and feelings of others

·       Behaves in an arrogant or haughty manner, coming across as conceited, boastful and pretentious[1]

No, I am not referring to a contemporary politician—that is grist for another discussion mill. I refer to Al K. Hall, to Mary Juanna, to C.O. Cain, to Ox E. Contin, to Herr O’Wynn, to P.K. O’Cette…you get my drift. A personification of a substance use disorder, A.K.A. “addiction,” as some malevolent other that possesses an individual is not new. Robert Louis Stevenson’s famous The Strange Case of Dr. Jekyll and Mr. Hyde is semi-autobiographical in which the transformation of Dr. Jekyll when consuming the potion made of a “fine white power” to the murderous Mr. Hyde has become a familiar euphemism for addiction[2].

Although my personifications of a substance use disorder (SUD) may seem silly when compared with Stevenson’s more literary heavy, an important point remains: when characterizing addiction as a malevolent being, doing battle with that anthropomorphized image of an identifiable villain becomes more plausible than attempting to challenge some nebulous disorder. To view addiction as simply a social construction of inappropriate or otherwise described deviant behavior leaves the individual with that disorder little choice but to view the self as at best somehow defective if not a failure as a human being. Likewise, not only do those with an SUD tend to then label themselves as addicted with all that pejorative term implies, historically those who have attempted to provide treatment have tended to treat the addiction rather than the individual with the disorder.

Although interventions with the personification of an SUD may seem logical—who wouldn’t seek to confront the villain in any drama—when the addiction and the individual who has that disorder are indistinguishable in the eyes of the practitioner, such interventions become confrontational with the individual the focus of the practitioner’s assault. As William Miller suggests, this is when practitioners wrestle with their clients rather than attempt to dance with them. When confronted most individuals with an SUD will react instinctively, defensively recoiling from the practitioner whose treatment is perceived as a threat.

Interestingly, there may be two strategies that when employed in tandem may help avoid such

confrontations. The first is a given and has become quite well known over the last 30-years and for that reason not discussed in detail here; motivational enhancement therapy where empathy, collaboration, an appreciation of client autonomy, and evoking change talk are the hallmarks of effective treatment. The second is as yet unknown and argued in this essay as the personification of an SUD as an entity with which the addicted individual has a toxic relationship.

This “entity” manifests many if not all the characteristics of narcissism as outlined in the introduction above. As difficult as treating SUDs may be, inviting individuals to understand their dependency as a conflict with a self-absorbed parasitic nemesis can free one’s client to begin viewing change as a battle that can be won as opposed to a disorder that must be endured. Likewise, framing treatment as a struggle between the individual with the disorder and the personified disorder enables the practitioner to assume the role of mentor, guide, strategist, or counselor but definitely not the client’s adversary.

When seeing clients with SUDs I would often ask them to imaging their disorder as a gremlin sitting on their shoulder, constantly whispering in their ears, saying whatever was necessary to justify taking the next drink or pill or “hit.” I would then ask that they write a letter to their gremlin and tell it everything they ever wanted to say to get it to “shut up.” Once written, I would ask that the letter be read in group and for the group to comment and provide feedback, the point being that the personification of substance use dependence was a bully and that bullies can be silenced but only when confronted and when the one doing the confronting is supported by peers who understand how difficult the bully is to overcome.

What do you think?

To read how Dracula is an allegory for alcoholism/addiction, consider my essay Al K. Hall as Dracula: Film as a Clinical/Pedagogical Device[3]

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[1] Based on Mayo Clinic’s website’s “signs and symptoms” of Narcissistic Personality Disorder

[2] See Wright, Daniel. “The Prisonhouse of My Disposition’: A Study of the Psychology of Addiction in Dr. Jekyll and Mr. Hyde.” Studies in the Novel. 26.3 (1994): 254–267.

[3] If the link fails, the essay’s URL is https://robertchapman.blogspot.com/2012/07/alk.html

Keeping Up with The Field

My grandfather used to say, “Wisdom is the gift received when recognizing the limits of one’s knowledge.” The more aware I became of the limits of my knowledge related to addiction and AOD issues in general, the more I sought out direct and indirect sources of that information. When first entering the field of addiction treatment in the early 70s I invested time in several activities that continue to pay dividends to this day. This entry is intended to share a few of this "FYI."

(1)Attend open 12-step meetings. It is at such meetings that one can learn about addiction and recovery (and the “early years,” perhaps before addiction, which can be useful when doing counseling with collegians).

(2)Training opportunities where funding may very well support doing so, but also look into “free” workshops and seminars that were available in the community. In the 21st century, this is somewhat easier in that there are online seminars and discussion groups as well as workshops run by different treatment programs and such. NOTE: Addiction treatment programs or hospitals in your area sponsor free monthly free workshops. NOTE: Not only are such workshops useful for what can be learned, but also (and perhaps more importantly) for who you can meet professionally.

(3) Read as much as you can on the topic(s) of your choice. Although no one can ever read “everything” that is available to be read, here are some tricks you can try to increase the amount of information you can expose yourself to. For example, you can do a key word search for journal articles that have several keywords that related to a topic of interest. For example, you can search “collegiate drinking,” “prevention” and “strategies.” You can do this at http://scholar.google.com (or just plain google.com) or one of the online databases, for example, project CORK at Dartmouth (http://www.projectcork.org/) or NIAAA’s ETOH database (see http://etoh.niaaa.nih.gov/). If you search at a database and get “X” hits, read the abstracts for the more interesting ones or just the first 5 or 10 or however many. These abstracts give you a sense of what is happening as well as what is being published.

For those abstracts you find interesting (or for anything else you may find online that is interesting and in print form) you can download the .doc or .pdf (or “.whatever” text file) and then convert it to a mp3 audio file at http://zamzar.com and then listen to it on you mp3 player when commuting or exercising, etc. NOTE: It takes a few minutes to get used to listening to the computerized “text-to-speech” syntax, but once you catch on, it is an easy way to “read" more stuff related to a topic of interest.

(4) As they say in AA, look around for someone who has what you want and then get to know that person. In AA it is called “getting a sponsor”; in professional development it is called finding a mentor(s). Ask that person if you can meet and chat. Invite the person to coffee. Ask if you can exchange emails. In short, do what you can to learn from that individual(s). You may need to invest some time in traveling to that person’s office or suggested location, but once a month or however often you do this can be a small investment for what you get in return…and you are not restricted to one mentor at a time 

(5) Join several listserv discussion groups and/or sign up for daily or weekly email reports on “what’s what” in your chose field. For example, you can get daily news from http://www.JoinTogether.org or “drug and alcohol findings” at http://findings.org.uk/ In short, there are likely “countless” places where you can have folks send you snippets of information on a regular basis and you read what you have time/interest to read. Add to this the countless blogs and pod
casts that are available and you have more than enough to keep you busy with your “knowledge quest” for years to come

If you have additional suggestions,please leave a comment.

Robert