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Defining Addiction – We are all likely acquainted with the disease model of addiction. From the old days in which addiction was seen as inherent weakness or moral failure. Addiction is now widely accepted as disease. It fits the clinical definition as a condition which stems from a combination of genetic, environmental, and social factors to produce a set of symptoms. All of these symptoms, and indeed, the disease itself is treatable. However, there are other views of addiction which do not necessarily supplant the disease model, but add nuance to this idea which could be helpful.
One view states that addiction is combination of three main factors: habit, relationship, and narrative. Each of these ideas add some depth to our understanding of addiction.
Habit is simply that, it is the process of coming to repeat something even before we have given it any thought. We are pretty much hard-wired to respond to a reward system in terms of our behavior. If a specific action results in a reward or positive feeling, we continue to repeat that action. Over the course of our lives, we do not learn new ways of perceiving the world. Rather, we refine our ways of perceiving the world. What this means for habit is that early childhood motions and actions of reward will become reinforced in adulthood. If we begin to use a substance which provides a pleasurable outcome, we will continue to use that substance. Where addiction is concerned, people either begin to require more of the substance to obtain the same reward. Or, they begin to seek the reward with greater frequency.
Combined this with relationship and we see the problem compound. As we establish this action and reward system, we also develop a relationship with the substance. The critical feature here is that as the relationship becomes increasingly complex, the substance does not adjust to us. We adjust to the substance. The habit becomes more intractable as the relationship becomes more complex.
Finally, as these first two factors become enmeshed, a narrative emerges which accounts for the habits, the relationship, and our sense of self in relation to these ideas. We are constantly forming the narrative that is ourselves. It unfolds for as long as we are alive, and we readjust the past as we come to understand ourselves in new ways. As the habits and relationships which characterize addiction take over, we adjust the self-narrative accordingly and this can be absolutely defeating. We stop seeing ourselves as healthy people and begin to see ourselves as someone who drinks. Or someone who uses a specific drug. At this point the use of substances becomes a feature of our self-narrative.
The goal of understanding addiction in these terms is to first recognize that this last component, narrative, is not a final thing. The narrative unfolds for as long as we do. If we are able to see this, we can then begin to recognize that though the past cannot be changed. The future is completely open. We can take stock of our habits and our relationship to substances and re-write our narrative in way which does not include substances. We are not the sum of our drugs use.
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