SECRETS: ADDICTION

Contents:

The Addictive Process
Psychosomatic Interpretation of Addiction
Disease Model of Addiction
Addiction and Heredity
The Sociocultural Context of Addiction
Spiritual Basis of Addiction
Recovery

References and Resources
In the past the term addiction was reserved for the compulsive and uncontrolled use of certain psychoactive substances, notably alcohol, cocaine, narcotics and other mood-altering drugs. In recent times the term has been used as an overall label for a set of diverse addictive behaviors to objects, people, relationships, ideas or pursuits. So we now talk about addictions to food, work, sex, perfection, religion, ministry, gambling and even computer games. It is commonly believed that there is an underlying similarity among the entire spectrum of addictive behaviors—that all addicts desire a sense of well-being, a temporary heightening of self-esteem, a transient experience of ecstasy, a state of oblivion or some measure of relief from pain or tension.

The Addictive Process
The first step in a potentially addictive process is the individual’s encounter with the addicting “object” and the mood-altering experience it produces, the so-called peak experience. This affects different people in differing degrees. Those who are more susceptible to addictive behaviors tend to seek repetition of the peak experience until they become mentally obsessed by this emotional craving and preoccupied by the euphoric recalls, often fed with fantastic imaginations. Because of the mental obsession, the individual begins to lose contact with self and the environment; this is most obvious in the person’s denial of his addictive relationship to the peak experience by saying, “I am not an addict.” Other forms of denial may present themselves as a tendency to minimize the problem, to find an excuse for the preoccupation or to blame others for it.

The next stage in the addictive process is a loss of control. This is manifested not only in the frequent mental recall of the peak experience but also in an escalation of the frequency of acting out. In this stage, seeking peak experiences has become a behavioral obsession, and the individual usually develops observable personality changes, becoming defensive and irritable. Although the addictive behavior may still be within socially acceptable limits, the individual begins to feel shame and remorse and may make repeated resolutions and compulsive attempts to control his or her own thought patterns and behaviors. There is a need to create an illusion to oneself and to others that he or she is still in control.

Nevertheless, repetitions of the peak experience require an increasing amount of the addictive object (for example, alcohol) to be established and maintained. (This process is known as tolerance—a form of physiologic habituation in which the nerve cells become less sensitive and responsive to repeated stimuli so that an increase is required in order to produce a similar level of satisfaction.) When this stage is reached, the addicted individual’s loss of control becomes obvious, as it is accompanied by personal and social breakdowns. Often the addicting behaviors have to be interrupted abruptly due to a number of possible reasons, including financial exhaustion or repeated troubles with the law leading to incarceration. The individual will experience a state of withdrawal that can be mentally, emotionally and physically terrible. The physical withdrawal from some substances can be life threatening.

Psychosomatic Interpretation of Addiction
Throughout the last century, a number of theories have been advanced to explain the causes of addiction. One approach starts from the observation that addicted persons commonly exhibit one or all the following attributes: (1) exaggerated emotions and inability to deal with them, (2) difficulty with forming and/or maintaining normal relationships, (3) inability to look after oneself and (4) low self-esteem. A psychodynamic interpretation following the Freudian tradition suggests that the addicted person may be seeking to counterbalance an unfulfilled need experienced in infancy or a developmental defect due to either a physical or a psychological deficiency; in this view an addictive behavior serves as an affective prosthetic designed to strengthen the individual’s self-esteem. In this sense, addictive behavior is seen as a form of self-medication.

Disease Model of Addiction
While the psychodynamic model is valuable in explaining certain psychological aspects of addiction, it tends to disregard any biological factors as possible determining forces in addictive behaviors. In contrast, the biologic/disease model views addiction as a form of physiologic-genetic abnormality more or less beyond the control of the individual. This has been proposed since 1933 as a cause for alcoholism, with the result that hospitals were opened to treat alcoholics. The biological basis of addiction has since been corroborated by an enormous amount of neurophysiological and genetic research.

One of the most fascinating and significant studies was undertaken by James Olds and Peter Milner, who accidentally discovered in 1954 that stimulation of certain parts of the brain in experimental animals was able to elicit a pleasurable response. When allowed to self-stimulate through an electrical device, a variety of animals would seek these stimulations until they collapsed from exhaustion.

These brain areas are now referred to as reward centers or pleasure centers, and the activities within these centers are mediated by neurotransmitters such as serotonin, GABA and a number of opioid peptides. It is postulated that defects in these centers are linked to a loss or impairment of the sense of well-being and induce in the animal or human a craving for a substance(s) or activity that will relieve the feeling of dysphoria. Heroin, cocaine and amphetamines are known to interact with these centers, making them good candidates for substance abuse. Studies have also shown that activity-related elations and mood upswings associated with physical exercise, such as jogging, are related to an increased release of certain opioid/peptides (for example, endorphins known to be active in these brain centers), thus making health conscious compulsive joggers classic addicts.

Addiction and Heredity
Furthermore, to some extent deficiencies and imbalances in the pleasure centers have been shown to be inheritable. A degree of heredity in addictive behavior was postulated as early as the 1940s, when studies showed that the children of alcoholic parents often underestimated the amount of alcohol they consumed and usually drank considerably more than others before sensing any effect. Recent genetic research has shown that children of alcoholics have an unequal and increased susceptibility to alcoholism or other addictive behaviors when compared to their peers, even if they are raised by a nonalcoholic family.

In a thorough study based on the statistical analysis of the families of 2,651 alcoholics and 4,083 nonalcoholics, parental alcoholism was correlated specifically to alcohol problems in the children. Other adoption studies have shown a high incidence of alcoholism among the children of alcoholic parents, even if they are raised in a nonalcoholic home. These and other studies strongly suggest a possible genetic predisposition for addictive disorders, although the biological mechanism has yet to be elucidated. While the biologic/genetic model is scientific and rational and provides clear explanations for a relatively complex phenomenon, it is too much influenced by a modern paradigm of biomedicine and as such is reductionistic. Specifically, it overlooks social context and personal responsibility in health and sickness.

The Sociocultural Context of Addiction
The sociocultural/behavioral model emphasizes the impact of the social and cultural environment upon the behavior of the individual and its role in the development of an addiction. This approach regards addiction as a socially acquired habit carried to the extreme. Because family plays the most significant role in one’s psychosocial well-being, the stability of the family and particularly its interactive patterns, between parents and between parents and children, may be regarded as the main psychosocial determinant for addictive susceptibility. On the whole, research has shown that a family in which adolescents are living with both biological parents represents a low-risk family environment because it allows secure attachment patterns to be established; children growing up in such an environment are less susceptible to addictive behaviors than those living with single parents or stepparents. High-risk family environments are those in which anxious and fearful parents are extremely protective and restrictive, emotionally abusive parents are contradictory and misleading in communication, or parents are physically and emotionally abusive. Marital and psychiatric problems or conflicts with the law on the part of the parents are also factors in promoting addictive behaviors in children. Outside the family, societal values and worldviews also contribute to a person’s sociocultural milieu and thus play crucial roles in causing addictive behaviors. An example of the influence of social values is seen in the spread of eating disorders, which is correlated to the idealization of slimness in modern society.

Spiritual Basis of Addiction
Finally, there is the moral/spiritual model. This interpretation takes into consideration the importance of human desire as a basic determinant of human life. It views human desire as created by God and for the purpose of relating to God (Genesis 1:26; Psalm 42:1-2; John 17:5). Saint Augustine’s prayer “You have made us for yourself, and our soul is restless until we find rest in you” testifies to this basic human desire. But this desire has been distorted by our sinful nature. When we are disengaged from desiring God, our proper desire is derailed. Turning away from the Creator, we look for created things, objects and relationships to replace God (Exodus 20:3-5; Romans 1:18-32; 1 Cor. 8:4). We seek peak experiences and tend to indulge in them even when they are harmful to ourselves and others. Ultimately, human desire is corrupted to lust, worship to idolatry, devotion to addiction. This model views all addictions as sinful and all sins as addictive. A true test of grace is, therefore, freedom from all our addictions. The Christian life is a pilgrimage from lust to desire and from addiction to freedom.

It is unlikely that an adequate theory of addiction will be provided by any one single model. To the extent that humans are created and redeemed to be whole (see Healing; Health), any satisfactory analysis of addictive disorders must include biological, psychological, social and spiritual dimensions.

Recovery
The first step to recovery is to overcome the denial of addiction, not only by the addict but also by the significant others, who often act as codependents. This may involve painful but necessary confrontations, for which prayer, education and counseling are useful preparation. Next, a modification of one’s sociocultural milieu by avoiding addictive environments (for example, bars, casinos) and joining a specifically antiaddiction group (for example, Alcoholics Anonymous) is important. There is also a need to develop new skills and activities to fill the void after addictive behaviors are removed and to relearn to attend to such basic needs in life as relationships, family, physical health, housing, work and finances. At the same time, one needs to develop new skills to cope with stress, tension and inner hurts involved in feeling one’s true self, which has been masked by the addictive process in the past.

The popular Twelve Steps is a powerful and indispensable program in addiction recovery. Christians may recapture its Christian roots and put the biblical foundation back into this program. Many have witnessed it to be a life-transforming spiritual journey in which they have met God. Admission of one’s powerlessness and surrender to God (steps I, II, III; Proverbs 3:5-6; Romans 12:1) is followed by an honest self-examination and a taking of one’s personal moral inventory (step IV; Psalm 139:24-25; Lament. 3:40). Confession of wrongdoings and asking for forgiveness ensue (steps V, VI, VII; Psalm 37:4-5; James 4:10; James 5:16; 1 John 1:9), which also includes making restitution to those who have been harmed (steps VIII, IX; Luke 19:8). Ongoing recovery involves an ongoing journey of sanctification by continuing personal inventory and confession whenever necessary (step X; 1 John 1:7-8), and this means daily prayer and meditation to maintain conscious contact with God and to seek his will and power to carry it out (step XI; Col. 3:16). Having been visited by grace and set free, one also tries to share the good news with others who are in bondage and reach out to others who may need help (step XII; Galatians 6:2).