Addiction: Is It a Choice?

Rob — and others — say its a choice. Terry — and others — say we have lost the power to choose.

Who's right?

I never gave it much thought, which is weird because I overthink everything. And when it comes to recovery, I believe that my tendency to overthink came in handy. I needed to understand this disease and the solution to be able to manage it.

I got the impression the other day that it was important for you to know if Rob or Terry is right about choice. When you drink or you pick up, is it a choice? Are you accountable?

Well I started to wonder, too, and I think I have an answer. I hope this makes as much sense to you as it does to me.

The question of choice, I now realize, is related to a statement that Terry made in one of our first sessions together when I went through Back to Basics with him in the summer of 2013:

"You still think you have power over this disease."

I didn't understand what he meant by that until very recently. That's why I'm writing this.

"You still think you have power" is just another way of saying "Lack of power, that was our dilemma."

That line, by the way, is from chapter 4, We Agnostics and I have understood what it means for a long time. I am able to manage this disease because I understand what that line means.

It is one of the main underpinnings of the belief system that I use to stay sober.

What follows is a summary of that belief system. It is my understanding of the true nature of this disease and why the 12 steps work to manage it.

I haven't shared this with many people because it takes a while to explain and it requires a certain familiarity with recovery, a little psychology (CBT), and — to get the full dose — Eckhart Tolle's ideas about ego and religion.

I have shared a version of this with you before. You might remember me saying, for example, that the steps are "cognitive behaviour therapy with a twist of God"?

First off, my understanding of this disease is based on a few core beliefs:

• Addiction has nothing to do with drugs: addiction is the symptom of a bigger problem. That problem is my thinking.
• I am not just powerless over drugs: I am powerless over people, places, things, and, unless I use the 12 steps, I am also powerless over my thinking. In other words, the steps gives me power over my problem thinking.
• It says in The Doctor's Opinion that "Men and women drink essentially because they like the effect produced by alcohol." I used drugs because they altered my mood. If they didn't alter my mood, I would have had no use for them. In other words, I self-medicated.
• My problem thinking is a by-product of my defects of character (fear, self-pity, false-pride, resentments, self-centeredness, sense of entitlement). The problem thinking that I refer to here, is what cognitive behaviour therapy refers to as "cognitive distortions."
• My problem thinking (cognitive distortions) leads to negative emotions. Before I got into recovery and developed my current understanding of addiction and why the 12 steps work, I could only cope with a small amount of negative emotions. Beyond that small amount, I turned to the maladaptive behaviour familiar to all addicts: I used a mood altering substance (or behaviour) to anesthetize unwanted emotions.

So, is addiction a choice?

Until you understand the link between problem thinking, negative emotions, and self-medication, it is not choice. You don't know any better. Drugs are still going to be the solution.

But if you understand that the steps can be used like CBT to correct/neutralize problem thinking (cognitive distortions) and, by extension, to manage emotions, then you now know better and drug-taking is a choice.

I use the steps today for the same reason that I used to abuse mood altering substances: to deal with the unwanted emotions that result from problem thinking.

I have a choice. I use the steps to fix my problem thinking and keep negative emotions to a minimum. If I don't use the steps to do this, its only a matter of time before I resort to drugs to deal with negative emotions.

There is a solution. Either the steps or drugs. There's the choice.

The first three steps can be summed up like this:

Step 1: the problem is my thinking.

Step 2: the solution is the steps.

Step 3: if I don't use the steps (God's will), I will use drugs (my will).