Brave New Kitty

After two and a half years, I am thrilled to say that I got a comment on this article. And not only a comment, but a thoughtful, well-reasoned out comment, from someone who put a lot of time and effort into making her point. I have so many ideas in response, I thought I’d write a post about it.

First of all, I’d like to say that this is almost exactly the response I expected to get on this piece, except a bit more polite than I’d imagined. I know it is dangerous ground to suggest that addicts and alcoholics can use or drink again. I know this offends many and provides a possible excuse for many more who are looking for one. And even though I would hate for these thoughts to give someone on the fence an incentive to relapse into a habit they’ve not yet conquered, I must stand by my ideas. In the past two and a half years, I have become more convinced, not less, that, while addiction is real, heartbreaking, and in many cases tragic, it is not a disease. More importantly, I believe that if we treat addiction like the poor personal choice that it is, then its treatment will be far more successful than it currently is under the disease model.

I hope I can make a case for these points here.

No evidence exists that addiction is a disease of the body–disease meaning that there is an organic cause which can be isolated, studied under a microscope, treated, or surgically removed. Yes, the current medical model is that addiction is a disease. But I think this has more to do with getting health insurance companies to pay for treatment than anything else (which is not necessarily a bad thing, but that is another topic). For at least thirty years, doctors and scientists have been saying that the “addict gene” is on the verge of being isolated. Many headlines have proclaimed this revolutionary find. But when the research once again proves fruitless, there are no headlines. In this way, people have been duped into believing that addiction is a literal disease in the same way that cancer or diabetes are diseases. But such evidence has never been found. It does not exist. No gene, no brain chemistry, no failing organs (except as a result rather than a cause), nothing.

And really, this makes sense if you look at how addiction “runs” in families, which is unpredictably. It is not like eye color or height, which are predictable inherited traits. Rather, some children of addicts become addicts and some don’t, and nobody can say, biologically, why this is so. It is just as likely that children of addicts become addicts by nurture rather than by nature; in fact, at this point in the research, it is the most rational explanation. That is to say, addiction is much more likely learned than inherited.

It also makes sense if you look at how Alcoholics Anonymous actually “treats” addiction. It does so by teaching the principles of honesty, hope, action, courage, integrity, willingness, humility, fraternal love, self-discipline, perseverance, spirituality, and service to others. These are the principles, in order, underlying each of the 12 Steps. No disease on the planet can be cured by following principles, and thinking one can be is to confuse metaphor with reality.

And, it makes sense if you look at addictive behavior itself. I have known many people who seemed unable to stay sober or who, having stayed sober for awhile, relapsed into old destructive patterns. But I also know people who, after a period of sobriety, are able to drink again in moderation without a problem. Both groups had identical addictive behaviors while using, yet some were able to outgrow them. Why? I believe it is because some had a “psychic change” and some didn’t. Also, there are just as many addicts who overcome their habit by attrition as by treatment and/or meetings; some experts believe there are even more. My point is that addictive patterns are as complex and difficult to predict as other human behavior; this is likely because addiction is a behavior itself, not a physical disease.

Addiction is only a disease in a metaphorical sense. Some would call it a “mental illness,” but this term also confuses the metaphorical with the actual. This is not to say that people with mental problems can’t be helped with medication, because sometimes they can. And because they can be helped with some medical treatments, doctors and psychologists and even treatment counselors just go ahead and treat mental problems, including addiction, like physical diseases. As I said, this isn’t necessarily a bad thing, if it means the difference between a person getting help or not getting help. But it doesn’t change the fact that the medical model for addiction is intellectually dishonest. And being so, I think that in the long run, it does people more harm than good. And maybe even in the short run too, if you consider the success rate over addiction that this model has thus far had, which is difficult to measure but which, everyone would agree, leaves much room for improvement.

None of this addresses the more pertinent point, though, which is that anyone who has had a psychic change has no desire to get high, while those who have not will use any excuse to do so–and they could find it among these ideas! I know this is true, and I know that it is dangerous ground for any addict. It is a real problem. But I believe intellectual honesty is more important than avoiding truths that might give some people an excuse to do what they really want to; after all, if they didn’t find the excuse here, they would find it somewhere else, because that’s how excuses work.

In my mind, truth, clarity of thought, and rationality trump intellectual dishonesty every time. And in the end, I believe, truth will help more people than will trying to protect them from themselves.

And the truth is that addiction is a problem of will. It is a problem of choice. And being such, people can learn to use their will to make better choices. Even though AA pays lip service to alcoholism being a “disease of the body,” every aspect of it involves people using their personal will to triumph over their personal difficulties. First people learn honesty. Then they learn hope. Then they learn to take action. Then they concentrate on specific actions to take: inventory, confession, amends, helping others, developing a spiritual life…all undertaken voluntarily, by  people who want to change.

I am not saying that people with addiction issues are weak-willed or have a flawed moral character. Far from it. In fact, this dichotomy of disease vs. moral weakness is a false one, and it has probably caused more problems for addicts who want to get sober than anything else. Addiction is so much more complicated than either of these polarized views. It involves our thoughts, our feelings, our past conditioning, our sense of self, our spiritual lives (or lack thereof), our ability to care for ourselves, and so much more. Human beings are complex, multi-layered creatures, thus, so must be addiction, and all other problems of the mind, will, or psyche. No simple labeling or pigeon-holing, from any point of view, is going to be helpful.

If we could move past this false dichotomy, begin to see treatment and 12 Step programs as teaching people life skills rather than as curing a disease, and forget about judging addicts as weak, dishonest, or otherwise, then maybe, just maybe, we could begin to deal more honestly with addiction and thus get down to its core causes and conditions, something AA and treatment programs do only marginally well (and will continue to do only marginally well as long as they use the disease model of addiction). We could make room for emerging ideas that enhance current treatment models and help people better understand why they are how they are. We could have language that was truthful and direct without being shaming. We could create a better, more comprehensive understanding of addiction, and thus, of ourselves.

And if we did all these things, then asking the question, “If addiction isn’t a disease, can you drink again?” wouldn’t be seen as dangerous but rather, as a viable query in the ongoing struggle to understand addiction and human nature itself. My point is not that former addicts can or should test themselves with drinking. My only point is that, if we value truth-seeking, critical thinking, and personal growth, and we stay that path to its logical conclusion, then asking the question is an inevitable result for many of us. And, that this is a very, very good thing, because it means we are continuing to grow and change and expand our worldviews. And just as importantly, it means that we trust our own power of choice, and have a sense of autonomy developed enough to exercise it.

Note:
Please, don’t take my word for any of this. Do your own research. Here is a list of reading material that has helped me form my opinions. And don’t forget to google for the “addict gene,” too.

“Take what you like and leave the rest” is a cliche heard often in Alcoholics Anonymous meetings. At first glance, this seems ironic, because AA literature is adamant that a person must commit to the whole program if he wants to get and remain sober. For example, the book “Alcoholics Anonymous” has phrases like “half measures availed us nothing,” and “rarely have we seen a person fail who has thoroughly followed our path.” And when a person chooses an AA sponsor to help them get sober, he is expected to put himself under the care and guidance of that sponsor almost completely; certainly, at least, for how he maintains his sobriety, which usually comprises most facets of a person’s life.

So where does “take what you like and leave the rest” fit into this scenario of total commitment? Well, it’s kind of an interesting question, I think, and pondering its meaning can lead us to ways of thinking about how we attain, absorb, use, and discard information in general. In AA as in life, it is always useful to consider such “meta-questions” about how we learn what we learn. Doing so helps us to become better thinkers not just about the topic at hand, whatever it may be, but about our thinking in general. This is why I’m calling it a meta-question: because it involves thinking about how we think.

Many people believe “take what you like and leave the rest” means that, in evaluating information, you should accept what you like or agree with and ignore what you don’t. This is one interpretation, but it is not the most useful one. If we only pay attention to what we like and agree with, how will we ever learn anything new? How will we come to understand how other people see the world? How will we grow beyond our present capacity?

While this is true, it is not true for every situation. The truth is that we are all, all the time, taking what we like and leaving the rest. We have to in order to function in daily life. We are constantly sorting through all the different external stimuli that are trying to make it into our awareness. By a process we rarely notice, we “leave” what doesn’t interest or help us and “take” what does. In this way, we filter information in order to make the best decisions possible for ourselves on a regular, almost momentary, basis. For instance, if you are reading this, you probably aren’t aware of all the things going on around you in the room you’re in. There’s lighting, heating (or cooling), sounds, windows to look out of, maybe other electronics, maybe other people, and countless things going on. But of all these things, you only pay attention to those things that are necessary or matter to you. How comfortable your chair is, maybe, or whether your computer is plugged in, or whether your kids or spouse are demanding some attention from you. You “take” all of these, and you “leave” whatever else is happening that is of no concern at the moment. If we weren’t able to do this, we would be bombarded with too much sensory information to process.

Applied to critical thinking, though, taking and leaving should be done with a little more conscious awareness than this. When confronted with an idea, we can certainly “take” what we like about it, but we should also “take” what we would prefer to leave (or dismiss). Sometimes, we dismiss aspects of ideas because we disagree with them; sometimes, we dismiss them because we dislike the person they’re coming from; sometimes we dismiss ideas because don’t realize their significance; and sometimes we dismiss them because we don’t understand them and don’t want to make the effort to do so. When we take what we like and leave the rest for any of these reasons, we miss an opportunity to increase our knowledge and improve our understanding–of whatever the topic may be.

The point is that, concerning ideas and learning new things, we should pause to consider as many aspects as we can before we decide what is actually worth taking and what we can leave. We should be aware, to as great a degree as possible, of our own biases and prejudices and how they might affect what we want to take and what we want to leave. And rather than indulge what we like and don’t like, out of habit or intellectual complacency, we should instead bend over backwards to challenge these indulgences: Are they preferences based on rational ideas? Or are they rooted in outdated beliefs which we hang onto because it is too much work, too much bother, or too much stress to change? And if we aren’t sure, then shouldn’t we figure out why that is, too?

In other words, we should acquire the habit of conscious awareness about taking and leaving ideas. Even if we discover that what we believed was right (for us) all along, the process has value, because unless we undertake it, we can never know, for sure, if this is the case. Also, by developing conscious awareness about how we derive our ideas and opinions, we are honing our intellectual tools and making ourselves better thinkers on all levels. We are, in short, becoming more confident.

The best way to develop the habit of conscious awareness is to challenge your own ideas and opinions. Question their origins and validity. Make a point to educate yourself–at least somewhat!–about opposing points of view, however distasteful you may find them. And read, read, read–and this means books, because only in books will you find in-depth perspectives which television and other short-article formats simply cannot offer.

If you do these things, you will inevitably find that your ideas and opinions aren’t as set in stone as you thought they were. And if you don’t do these things, that’s fine, too; we don’t all have time to devote to such study. But if you don’t do them, then be aware that your opinions are unlikely to be based on anything substantive enough for you to feel very strongly about, so you should practice some humility about how you express, share, and think about those opinions.

Back to AA, what does “take what you like and leave the rest” really mean? I am certain that the phrase is not referring to the ideologies of the organization but rather, to what happens at individual meetings: you may have experiences at meetings that you don’t like, but you shouldn’t let these stand in the way of your willingness to stay sober. So not only is the cliche not saying you can take the ideas of AA piecemeal, according to your liking, it is saying the opposite: that if you understand and practice the principles of AA, then you will be able to withstand the vagaries of individual occurrences without putting your sobriety at risk.

As far as AA goes, you may or may not agree with the need to submit to a greater authority completely; my opinion is that although I disagree with some of AA’s core principles, people in early stages of sobriety could do far worse than taking those principles to heart and trying to live by them. And if they are able to apply “take what you like and leave the rest” to their own thinking in an analytical way, they will eventually be able to make a good decision about staying in or leaving the AA program.

In AA or beyond it, the point is that “take what you like and leave the rest” should be practiced with conscious awareness, with the knowledge that we all lean toward our own biases regardless of their validity, and with the desire to expand our limits of knowledge rather than contract them.

If you can keep your head when all about you
Are losing theirs and blaming it on you;
If you can trust yourself when all men doubt you,
But make allowance for their doubting too:
If you can wait and not be tired by waiting,
Or, being lied about, don’t deal in lies,
Or being hated don’t give way to hating,
And yet don’t look too good, nor talk too wise;

– If, by Rudyard Kipling

Respect is the most important thing human beings can give each other.

It is more important than love or kindness. It is more important than tolerance, patience, understanding, or education. It is even more important than any help or material goods you can offer someone (unless a person is in an emergency situation).

This is because respect contains all of these elements. Within respect can be found love and kindness, tolerance, patience, understanding, education, and help. If you give a person respect, then you are giving him all of these at once.

By respect, I mean allowing a person the dignity to make their own choices and behave as they see fit. You may not like the choices she makes. You may think she’s screwing up her life or hurting the people she cares about. But if she is an adult, and she is not causing harm to anyone except perhaps herself (your emotional anguish from watching notwithstanding), then it is your obligation, as a respectful person, to let her make her own choices.

This is the key concept: you don’t allow people the dignity to make their own choices because they are respectful; you allow people the dignity to make their own choices because you are respectful. Other people may or may not be respectful; if they are doing things that drive you crazy, chances are they haven’t learned a lot about respect yet. But if you hold respect as a value, then you will behave respectfully towards all people, whether they deserve it or not. Respect is what we choose for ourselves, regardless of how other people behave. We may not always achieve total respect all the time (doing so is hard), but we should understand why it is a worthwhile ideal to work toward.

If you conduct yourself respectfully, you will command respect from people. Such respect is powerful. People will perceive you as trustworthy. They will believe you to be honest, straightforward, and kind. They will feel “safe” talking to you, like they won’t be judged or told what you think they want to hear. Such an image of respect has what Stephen Covey would call a powerful “circle of influence;” that is, the areas of our lives over which we have some control. When you behave respectfully, everyone from your children to your bosses will want to know your thoughts and opinions. Respect is the basis for all satisfying relationships, personal or otherwise, absolutely essential for true connection and intimacy. And when that person who’s “throwing her life down the drain” is ready to change, she is going to go to the most respectful people in her life for the help to do so.

Respect, both getting and giving, is a big deal. All effective human interaction is based on it.

What does being respectful look like? Pretty simple, really. Good manners are a large part of it, which makes sense if you consider that manners are all about treating others in ways that make them feel comfortable in social situations. Being kind, honest, and tolerant. Being a good listener. Making an effort to understand what people are saying and what they want. Not imposing your views on someone who didn’t ask for them. Offering help, but not insisting on it. Forgiveness. Also, in heated situations, not reacting in kind to other people’s bad behavior (no matter how much they provoke you), or even excusing yourself. In short, being respectful is about behaving with dignity no matter what the situation may be.

Simple as the idea is, it is a difficult thing to carry out consistently. We all get anxious and scared and lose our composure at times. Being respectful doesn’t mean we can’t be human, it only means we maintain control over our reactions while in the presence of others. The respect we get from other people will grow according to our ability to do this, as will the respect we have for ourselves. We should always forgive ourselves when we fall short of respectful behavior, as we inevitably will, but we should also recognize respect for the important value that it is, and continuously strive for an ever greater ability to practice it in our everyday lives.