“I can’t tell you why I’m an alcoholic. But I can damn sure tell you why I drank.” That’s pretty much been the AA line for the past 85 years. I’ve been clean and sober for 33 of those years, which frankly amazes the hell out of me (and, I expect, a bunch of other people as well.) The 12-step recovery model pioneered by Alcoholics Anonymous — alcohol being the 800-pound gorilla of substance abuse — doesn’t give a crap about why anyone is addicted to the stuff. It just tells you what to do about it once you decide you are. This perspective covers addiction to food, to gambling, to sex and romance, or any of the other 50 or 60 things there are anonymous programs for.
By the way, there is a Bloggers Anonymous. I’m debating whether or not it’s a parody site.
The point is, “you’re an addict because you do addict stuff” isn’t enough for me. Like a lot of addicts, I’m an overthinker. I want to know, why me? And, if it had to be me, why couldn’t I have picked a more attractive addiction? I’m thinking anorexia and compulsive shopping. Great clothes, and they’d fit beautifully.
But it’s been almost a century (sheesh!) since publication of the Big Book “Alcoholics Anonymous,” and science has advanced. There are theories now about what causes addiction. Often, the theories don’t agree with one another. Occasionally, very loudly.
The main division, as I see it, falls along three lines: the Biologists, the Psychologists, and the Sociologists. Each team has data to support its position, and each team is pretty sure the other teams have their heads up their butts.
The Biologists tell us that addiction is a brain disease; they have fMRI’s and PET scans and DNA tests to prove it. The wiring in the addict’s basal ganglia, the reward center, is screwed up. Their dopamine is out of balance. Like any disease, addiction should be treated medically. The Biologists want to treat us by writing a prescription for psychoactive meds. Get those neurotransmitters firing on all cylinders, and the addict can stop self-medicating.
They are not wrong.
The Psychologists present reams of anecdotal data showing that what addicts have in common is early life trauma. Abandonment. Childhood neglect or abuse. A narcissistic wound that cannot be healed. Attachment disorder. Fantasy bonds with toxic parents. The vocabulary changes according to the treatment modality, but it all comes back to some deep pain or shame the addict is trying to numb. The treatment: talk therapy. If you can discover it, you can discard it.
They are also not wrong.
The Sociologists promote the idea of addiction as a condition of the environment. They point to studies that show rats compulsively pressing the lever for cocaine when they are in a boring cage, only to stop abruptly when put in a fun cage. They talk about the Vietnam-era soldiers with heroin habits who got clean when they left the stress of active duty. Give an addict something stimulating to do, say the Sociologists, and the addiction will just… fade away.
They, too, are not wrong.
But… IMO, none of them is entirely right, either. That ancient AA Big Book said alcoholism has three components. It is “an allergy of the body, an obsession of the mind, and a malady of the spirit.” You could call it a tripod. I call it a fire.
Hence, this 30-year-old photo of me dressed as a flame for Halloween.
Here’s why I like my analogy. First, your fire needs kindling. That’s the bad brain wiring that is a gift of our DNA and messes up our neurotransmitters. Then you need a match: childhood trauma flips an epigenetic switch and activates the addiction. Finally, it needs oxygen to feed, like an environment that consistently retriggers the compulsion to use.
Take away any leg of the tripod, and the addiction cannot stand. Your brother had the same crap parents as you, but isn’t an addict? Maybe he wasn’t diddled by the piano teacher, or just hung around with a nicer crowd. The same community breeds a petty thief and a hero firefighter? Different daddies, different brain wiring. Etc., etc. You can’t make an addict without including all the ingredients – and you can’t treat one without addressing them, either.
No one ever put out a forest fire by peeing on a single log.