We can summarize the conditions
that create addictions this way:
Risk Factor(s) + Attitude + Dark
Feelings + A Trigger = Vulnerability to Addiction
If someone
is careful in taking an inventory of risk factors, attitudes, feelings and
triggers he or she will have a pretty good idea of what creates the soil in
which addiction will grow. Hopefully, the addict will begin to see some of the
things that can be done in order to avoid or end an addiction. Given an
understanding of how addictions develop, we can take a look at how they operate
in the daily life of an addict to see what keeps them going even when the
results are disastrous.
Addiction
puts people on an emotional roller coaster and affects every aspect of daily
life. Once someone is fully addicted, the addictive cycle runs through three
repeating phases: (1) periods of non-use in which anticipation of the next use dominates thinking, (2) intoxication—the effect, altered state
or high produced by the trigger, and finally (3) the post-use depression. In this way the addiction
cycle modifies every part of life: health, emotions, thought and behavior.
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Anticipation
Phase
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Intoxication
Phase
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Depression
Phase
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Physical
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Emotional
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Behavior
|
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The
changes that occur in each phase can be very different for different addictives
and for different individuals, so it is not possible to fill in the cells in
the table above in a way that would apply to all addicts. The Action Phase for
a gambler might include physical tension, racing emotions, delusional thinking
about the chances of controlling use and over-active behavior such as playing
three slots machines at a time. The Action Phase for someone abusing a
tranquilizing drug probably include total physical relaxation, an absence of
any strong emotions, a decrease in mental activity and slow or retarded
behavior.
The
intoxication phase, sometimes called the action, is the goal of
addictive behavior, but it is a goal that doesn’t last.
Artificially
induced physical changes, repeated over and over, can result in serious physical
stress and chronic illness. Serious disturbances of any sort in emotions,
thinking and behavior eventually make normal living impossible.
The
anticipation phase is often called craving. It is a period of planning in which
the next episode of use occupies thinking. Huge amounts of time, energy and
resources are often spent in planning. As soon as the preferred trigger is
available, use begins and results in the altered state called intoxication;
this is the high or the action phase. Ordinary cares are forgotten as the
addict lives very much in the here and now giving little thought to
consequences. The customary dark feelings are lifted and put aside until, as
must inevitable happen, the period of use ends because of exhaustion,
unconsciousness, financial crisis, incarceration or hospitalization. Next comes
rebound depression in which dark feelings return with profound severity. Guilt,
self-reproach, anger, thoughts of suicide, fear—all these and more swamp
rational thinking during the depression phase. Using an addictive, as it always
does, has made the dark feelings even darker.
What can
the addict possibly do to end this unbearable period of rebound or post-use
depression? Anticipation, of course. Never stopping to seriously consider
abstinence, addicts begin to pull their bootstraps recapturing energy and hope
by thinking about the next chance to use. The excitement of planning ends the
depression, energizes life again and drives the addict on to further use. The
vicious cycle repeats again and again, sometimes slowly and sometimes within
days or even hours.
The
physical and emotional stress of the addictive cycle is enormous and results,
over time, in physical and mental disorders. Livers gradually fail, cardiac
problems develop, teeth are neglected—it’s a down hill slide that can be ended
eventually only by death or abstinence. As the slide continues, the addict may
lose family, job, children, self-esteem, financial security, even memory,
attention span and impulse control. Of course, thoughts of quitting come often,
but in thinking about abstinence the addict can see only unending emotional
misery, a cloud of dark feelings that will descend and create a life of permanent
misery and craving.
In an
earlier note I used the word euphoria
to refer to the normal, happy state of mind that can be achieved in the process
of simple daily living without using mind altering activities. How this is
accomplished in normal life will be the subject of later articles, but I
believe it can be accomplished by any determined recovering addict. The
advanced addict may experience normal euphoria only briefly during the
addictive cycle. There may be a kind of familiar excitement during the
anticipation phase that is mistaken for happiness, and again early in a period
of use, but these feelings are fleeting and artificial.
As I use
the term, hyperphoria is an
artificially elevated, giddy, unrealistic altered state in which the addict may
be capable of acting like an antisocial personality, popularly known as a
psychopath. There is no time for real love, little devotion to duty and inability
to think about important events. Behavior is impulsive and without planning.
There is no concern for consequences of foolish, impulsive acts. The addict is
either oblivious or having fun while others think they are looking at a fool.
Finally,
the word hypophoria means the extreme low of mental and physical existence
reached after a period of hyperphoria. Of course, everyone experiences periods
of elevated, moderate and low excitement, and we all cycle through such times,
but except for extreme moments of grief or elation we seldom experience altered
states and we do not need to produce them artificially with additives.
Over
time, in normal life, moods move comfortably from mild euphoria to a moderate
state of relaxation and sometimes through feelings of discouragement and
depression. But, most people, growing up, become skillful in managing their
moods, and they can be assertive socially without being aggressive. They know
when to summon their energies and when it’s time to power down and rest. They
know how to talk to themselves and how to tell others they want a break, a time
of rest. They have psychological resilience and flexibility, and, if they use
intoxicants, they do so with in great moderation. In fact, for many people, any
state of intoxication is a negative experience since they resent and fear any lose
of control.
In the
addicted life style, we see violent swings from artificial hyperphoria to
hypophoria with little calm or happy time in between. Permanent damage may
result in terms of neurology, cardiac function, physiology and psychology to
say nothing of a deteriorating social and financial life.
Beyond
the difficult tasks of abstinence lies the even more difficult-looking problem
of learning the skills non-addicts use to deal with feelings and events in
life. Addiction-free living looks very complex and threatening to the addict, but
these same skills are often taken for granted by those who have them. They look
easy and obvious to non-vulnerable people.
An
abstinence program, of course, will end the addictive cycle, but the addict’s
thinking has become narrow so that the choice of getting help may not be an
option they can see. When others suggest abstinence or self-help groups,
addicts may view this as a plot against them. People wanting to help are seen
as interfering, meddlesome and lacking in understanding. In fact, many would-be
professional helpers do not understand the addictive cycle because they simply
have not spent much time actually talking with and listening to addicts.
The
addict is most comfortable in the company of other, similar addicts who will
sympathize, encourage further use, and understand what one is going through.
The social horizon is increasingly limited. Isolation results, an extreme
example of which is street life in which the addict is dependent on others for
small change, food and a place to sleep, but in which there are almost no
enriching social contacts.
How can
such a self-defeating and deadly way of living develop? Whose fault is it and
where does responsibility for recovery lie? In the next note I will step back
and look at the big picture, at the long term stages of living an addict moves
through, stages that can produce vulnerability, addiction and, in many cases,
eventual recovery.
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