This is part three of a series looking at different mental models of understanding addiction (you can read parts one and two). As a reminder, the frame of this series is substance use disorders as a form of human behavior that is both prevalent and extreme. I am hoping these frameworks are helpful both for people directly impacted by substance abuse, and also as a window into human nature more broadly.
The frameworks below look at substance use in the context of how we navigate our life, and what we are trying to do with the time we have on this planet.
Presence
One way I think about the goal of life is just to be maximally present in every moment. During both the wonderful times and the difficult times, we are trying to be in that present, moment after moment. This sounds simple, but is in fact quite difficult to do. We tend to distract ourselves, daydream, or move away from whatever is in front of us. Go to a baseball game, a movie, or a restaurant, and look at how engaged people are with whatever is in front of them versus how engaged they are with their phone.
This happens with our emotions as well. We bring our past feelings and associations into the present moment, which often prevents us from really being present. We are holding onto the conversation we had with our boss when we get home to our family. Our irritation with the driver that cut us off prevents us from enjoying our child’s happiness to see us when we get home.
In this context, addiction is the ultimate opposite of being present– it is the ultimate way of checking out of reality. We can be in any situation, good or bad, and not be fully aware of what is happening, cut off from our surroundings.
Within this framework, the goal of recovery is less about not using (although that unquestionably true), but instead really about fully being present in our lives– in the good moments and the difficult. What we are looking for is not just avoiding chemicals in our life, but instead working to fully engage with whatever is in front of us. This is difficult, and requires practice and training. In fact, it is largely as a consequence of this framework that I teach meditation, or the practice of being as present as possible at a given moment. Being fully present is the opposite of addiction.
Honesty
Most people think of addiction-related dishonesty as lying to other people, and certainly that happens. People hide their use, minimize the amount they are consuming, conceal consequences, and make promises they cannot keep. But I find dishonesty almost always starts with ourselves.
Human beings are remarkably good at explaining away things we do not want to see. We tell ourselves we have things under control, that the consequences are not that bad, that we can stop whenever we want, and that nobody knows. We compare ourselves to people who seem worse off. We focus on evidence that supports our current behavior and ignore evidence that challenges it. We usually know when we are being dishonest with ourselves, and it makes us uncomfortable, so we lie to ourselves further.
In this framework, recovery is fundamentally a process of becoming increasingly honest with ourselves. On the superficial level, this means being honest about what and why we are using, about the consequences. Over time though, this is about looking deeper at our fears, desires, struggles, and failures.
This honesty is often uncomfortable, and so is often necessarily paired with learning to be kind to ourselves. While it involves confronting things we would rather avoid, it is also profoundly liberating. The energy required to maintain denial is enormous. Recovery often begins when people stop spending that energy defending a story and start spending it addressing reality. In this context, recovery is really a process of becoming more honest and more honest with ourselves, every day, for the rest of our lives.
In a larger context, all of us struggle to be honest with ourselves, and all of us have to work on being truthful. Addiction, in this context, is just an extreme version of that.
Growth and Learning
One way of looking at life is that it is a continuous process of growth and learning. In this framework, the problem with addiction is that it interrupts and undermines this process. In this framework, challenges and difficulties that arise in our lives are learning opportunities, times where we can grow and develop. The challenge with addiction is that instead of engaging with this learning, we use chemicals instead. This has two profound consequences.
First, in the context of repeated use we learn that the way to respond to difficulty is to use a chemical, to numb out, to disengage. This is a powerful cycle that is difficult to interrupt. This also helps explain why often, when people stop using their drug-of-choice, other chemical coping mechanisms become prevalent. People might stop drinking, only to start eating or gambling in the face of distress. We have learned to take something– anything– to make ourselves feel better.
The second difficulty that arises is that when distress is solved via a chemical, we deny ourselves the opportunity to learn other ways of managing. In isolation, that’s not a big deal, but substance abuse frequently lasts for months, years, or even decades. During that time, learning is minimal, because every opportunity to learn to sit with difficulty, to have hard conversations, to build skills is instead solved with a substance. We both reinforce the negative cycle, and at the same time, fail to learn other useful strategies.
Over years of living in the absence of drugs, we learn more and more ways of navigating life. Put differently, we are better at sitting with grief at age 30 than at age 15. Hopefully we have more perspective when we are 60 than we do at age 30. But acquiring this learning and perspective happens in the context of being engaged with life. When substance abuse starts, learning stops. In this model, the biggest problem with chronic substance abuse is that it prevents the normal learning that is the business of being alive. This creates a real backlog of work once we stop. It also means that recovery is really just the process of learning.
More broadly, this model means our job, as humans, is just to learn as much as we can for as long as we are alive.
The point of these models is not that any single one is “correct,” but that each becomes useful in the right context. No single framework is sufficient on its own; different situations call for different ways of understanding the same behavior. Taken together, they help us make better sense of our own actions, and of the people we care about. Next week, in the final installment of the series, we will look at a few widely used models of addiction that are popular but, in my view, often less helpful in actually explaining substance use disorders.
Love,
Doc
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