Just
as I ask addicts to consider all the different addictions, I urge them
to think in a very general way about potential risk factors, situations
that may help set the stage for the development of an addiction. These
risk factors, like triggers, make up another important group of
conditions that lead to addiction. Once I have described
all the important general conditions in the chain, we can put them
altogether later in a simple formula that describes all addictions.
Below
is a very long list of life events that seem to be risk factors for
some individuals. The mere presence in life of a difficult or unusual
event does not by itself cause an addiction or any other life
problem, but it can put the individual at risk for addiction or mental
illness. Many experts have focused on a single class of events such as
trauma or genetics, and have built their theories around that one
limited class of events. However, there are no simple explanations for
addiction, no single causes that can operate without other conditions
being present. Most of us have experienced many of the events on the
following list in some degree, but few of these events become important
to us. For example, most people find themselves near an accident, flood
or large fire at some time in life. We all experience unusual and
impressive events from time to time. What we remember and what we make
of our experiences is far more important than the experience itself.
Once
we take a detailed look at possible risk factors we can try to assess
what impact they may have had on life and why the same event will have
very different effects of different people.
The
following list of risk factors was composed using a number of other
lists in the psychological literature. We added quite a few of our own
and we reworded each in building a comprehensive inventory. You are
invited to place a check in the blank before any item if it applies to
you, but please remember that you should check only those items that,
for whatever reasons, are most significant in your memory and
experience. Try to look, in other words, for actual life-shaping events
about which you had or still have serious concerns.
Events before age 18
101_____Death of a parent or guardian
102_____Death of a brother or sister
103_____Death of a close relative
104_____Having a major physical illness before age 18
105_____Divorce of parents/guardians
106_____Adults in the home unfaithful to each other
107_____Bitter arguments between adults in the home
108_____Alcohol and or drug abusing adults in the home
109_____Major failure in school
110_____Social rejection due to physical or intellectual problems
111_____Beatings or extreme punishment by adults in the home
112_____Torture or severe mistreatment by others than parents
113_____Severe racial, ethnic or religious prejudice
114_____Serious malnutrition or starvation
115_____Severe restrictions in freedom of body movement
116_____Abandoned by parents or guardians
117_____Adults in the home with other addictions such as over-eating, gambling, etc.
118_____Adults in the home with severe emotional problems
119_____Frequent geographical moves
120_____Sexual abuse or molestation of self by others in the home
121_____Incest, sexual molestation of others in the home
Other events either of childhood or adulthood excluding military service
201_____Continuing financial problems and/or poverty
202_____Separation from or loss of a close personal friend
203_____Rape or sexual assaults
204_____A flood with serious risk or actual harm to self
205_____A storm with serious risk or actual harm to self
206_____A earthquake with serious risk or harm to self
207_____A fire with serious risk or harm to self
208_____An accident with serious risk or harm to self
209_____An explosion with serious risk or harm to self
210_____Serious and determined suicide attempt(s)
211_____Torture or prolonged abuse, mistreatment, etc.
212_____Seeing the death or serious injury of another person
213_____A severe sports injury to you
214_____Death or serious injury of another that you caused
215_____Broken engagement
216_____Time spent in jail or prison, other legal problems
217____Chronic pain
Adult Family Life
301_____Death of a spouse or life partner
302_____Death of a child of yours
303_____Miscarriage or still birth
304_____Forced or unwanted abortion
305_____Disabling illness/accident of spouse or life partner
306_____Having a retarded or permanently disabled child
307_____Prolonged responsibility as a care-giver to a disabled person
308_____Spouse or life partner unfaithful
309_____Divorce or involuntary separation
310_____Unwanted or unexpected pregnancy
311_____Constant arguments and fights
312_____Spouse or life partner abusing alcohol, drugs, gambling, etc.
313_____Physical and/or emotional abuse by spouse or life partner
314_____Continuing misbehavior of your child
315_____Frequent forced relocations and moves
316_____A child of yours leaving home
317_____Severe and prolonged overcrowding at home
Events on the job or at home
401_____Fired or demoted from you customary position at work
402_____Unexpected long lay-off
403_____Involuntary job transfer
404_____Extremely poor or hazardous working conditions
405_____Failure to obtain a long awaited promotion
406_____Stressful, prolonged competition on the job
407_____Prolonged unemployment
408_____Severe conflict with a boss or co-worker
409_____Too much time away from home because of job demands
410_____Forced or unwanted retirement
411_____Frequent unwanted changes in assignments or tasks
412_____Overwhelming job demands or responsibilities
413_____Extreme stress caused by promotion or personal ambition
414_____Racial, sexual, and/or religious conflict or discrimination on the job
415_____Forced by the job to deal with abusive, hostile or irrational people
416_____Loss of a license or the right to practice your profession
417_____Work requiring constant contact with seriously injured, mutilated, dying or institutionalized people
Military service
501_____Inducted into service against your will
502_____Assigned to a job incompatible with your preference or experience
503_____Constant conflict with authority
504_____Time spent in the brig or stockade
505_____Severe injuries unrelated to combat in service
506_____Combat related injuries or wounds
507_____Inabililty to return home during a family crisis
508_____Demotion or reassignment against your will
509_____Loss of close friends in combat or because of accident
510_____Exposure to the enemy in hostile territory
511_____Direct combat with an armed enemy
512_____Saw or took part in the killing of civilians
513_____Exposed to shelling, bombing, torpedoing, etc.
514_____Forced to kill individuals in combat
515_____Taken and held as a prisoner of war
516_____Exposed to chemicals, gas, radiation or other toxic agents
517_____Dishonorable discharge or force separation from service
Health problems
601_____Prolonged painful dental problems
602_____Cancer
603_____Lung disease
604_____Blood disease
605_____Kidney disease
606_____Stroke, heart failure, severe cardiac prolems
607_____Major surgery or painful medical treatment
608_____Loss of a limb, sight, hearing, etc.
609_____Paralysis
610_____Mental illness requiring hospitalization or continuing treatment
611_____Serious burns
612_____Gunshot wound
613_____Multiple bone fractures
614_____Head injury
615_____Glandular disease
616_____Painful/disabling effects of aging
617_____Continuing joint disease with pain and/or disability
618_____Severe skin disorder
619_____Other significant health problems
Legal Problems
701_____Long and/or difficult divorce litigation
702_____Serious legal charges placed against you
703_____Lawsuit filed against you
704_____Court appearance for serious legal violations
705_____Long jail or prison term of over three months
706_____Being brutalized while in prison by guards or inmates
707_____Controlled probation
Spiritual life
801_____Forced to change or abandon your religion
802_____Excommunicated from church
803_____Persecuted for religious belief or background
804_____Loss of faith
805_____Religious conflict at home
If I missed something important to you in the lists above, please write it in your journal or on a piece of paper.
If
you are in doubt about the importance of any given factor in your life,
this might be a good subject to discuss with a qualified counselor,
group sponsor or trusted friend. Your confidant probably should not be
someone with whom you shared the experience or who is a family member.
In summary: up to this point I have discussed two of the important conditions that set the stage for addiction: triggers and risk factors. The next article will consider another broad range of human behaviors that include attitudes, beliefs and values. These, too, seem to influence addiction and recovery from addiction in very important ways.
A
suggestion: Start a personal journal by entering your triggers, and
then enter the risk factors you checked above. Continue to record in
your journal as we go on describing how addictions develop.
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