I believe that addiction is the most complicated and complex disorder out there. Now, I’m not a doctor, but I’m an addictions specialist and a person with substance use disorder, and throughout my own experience and years of professional development, I’ve learned that there’s no one box or definition that addiction could neatly fit into. It has as much explanation in the scientific realm as it does in the social, environmental, economic, or psychological. And some clinical professionals and most 12-step groups would add spiritual as well (or especially spiritual—which is not a bad way around it all considering it simply covers the impossibility of it and simple way of explaining it).
We define things that puzzle us so that we can solve them—but this one is one of those puzzles that seems to have hundreds pieces of Blue that all look similar and could either be the Sky or the Ocean part of the whole picture. Or if you’d like another metaphor, from In The Realm of Hungry Ghosts, where Dr. Gabor Mate’ writes:
“To get anywhere near a complete picture [of addiction] we must keep shaking the kaleidoscope to see what other patterns emerge.”
I’m not discouraged by the monumental task of solving this puzzle or shaking the kaleidoscope—even though it seems at times overwhelming—because I know that in order to deepen our understanding of addiction, we must continue to investigate it. Armed with investigation and knowledge, it is only then that we are able to dismantle it and try to remove the stigma of it.
When I think about addiction in terms of my own experience I come to the following conclusions:
- To say that I am an alcoholic is inadequate.
- To say that I have a disease that has genetic and environmental etiology with bio psycho social spiritual symptoms is only a partial diagnosis.
- To say that I have a chronic brain disease that produces dopaminergic deregulation is incomplete.
- To say that my addiction is characterized by my inability to consistently abstain, impairment in my behavioral control, craving, diminished recognition of significant problems with my behaviors and interpersonal relationships, and that I produce a dysfunctional emotional response is also insufficient.
- To say that I had a trauma as the result of being relinquished is only a partial explanation.
- To say I have adoption attachment and identity issues as the result of chronic developmental/relational trauma is true, yet only a fragment of that kaleidoscope that Dr. Mate’ describes.
All of these things are accurate, but I need to consider them together in order to gain a more comprehensive picture of my complex identity and that of the people who suffer from substance use disorder.
When I look at all of those pieces and keep in mind how complex this puzzle is, I am able to address it properly and deal with it accordingly – but it hasn’t always been the case. I’ve been sober for quite some time now and in recovery, but my beginnings were difficult. I had relied on a program, a 12-step program, that eventually turned out to be lacking in many departments, and I had to add other means to improve my recovery—therapy, education, exploration.
Being in recovery means having to manage a lot of areas of one’s life that other, non-addicted people, do quite naturally—for someone with substance use disorder, something as “simple” as having a family holiday can be an ordeal as it can bring on all kinds of triggers that can lead one to relapse or less drastically, cause a lot of negative thinking that will cause disturbance.
So in my recovery, I am a full-time manager of my addiction, making sure all of the departments work together to create a coherent plan of recovery. That means meditating to calm my thoughts and deal with my emotions, talking to other people with addiction to strengthen my connections, reading about it to educate myself about the workings of my brain and understanding what happens when, for example, I have “unhealthy” sudden thoughts or get sentimental about my use, or understanding how medication affects me and how to take care of my health. I’ve also read many memoirs about other people’s experiences with addiction so that I can feel less alone and understand how others have dealt with it. And I take a great interest in my own family history to further understand my trauma (of having been relinquished) and be able to draw parallels between early experiences of my life that provide some explanations as to how I react to life situations. In other words, I am always “at it,” always schooling myself on my condition and always working on getting better.
Yes, it is a tall order but if you think about it, it’s no different than dealing with any other disorder—you would want to educate yourself about it in order to know how to manage it or treat it; no one would purposely ignore learning about asthma or hypertension or diabetes if they had it, and stay ignorant about it. I’m not saying that all people with substance use disorder need to have such regimented and busy treatment plan as I do, but I’m here to tell you that it has helped me tremendously to understand myself better and understand the workings of what ails me, which in turn reduces the shame—and the stigma—of having addiction. I keep shaking the kaleidoscope and I keep working on my puzzle and I will continue to do so as long as I am in recovery. For me, it’s the only way to survival.
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