Criteria for addiction and Nonaddiction

Just as a person can be a compulsive or a controlled drug user, so there are addictive and nonaddictive ways of doing anything. When a person is strongly predisposed to be addicted, whatever he does can fit the psychological pattern of addiction. Unless he deals with his weaknesses, his major emotional involvements will be addictive, and his life will consist of a series of addictions.

A passage from Lawrence Kubie's Neurotic Distortion of the Creative Process dramatically focuses on the way personality determines the quality of any kind of feeling or activity:

There is not a single thing which a human being can do or feel, or think, whether it is eating or sleeping or drinking or fighting or killing or hating or loving or grieving or exulting or working or playing or painting or inventing, which cannot be either sick or well.... The measure of health is flexibility, the freedom to learn through experience, the freedom to change with changing internal and external circumstances . . . the freedom to respond appropriately to the stimulus of reward and punishment, and especially the freedom to cease when sated.

If a person cannot cease after being sated, if he cannot be sated, he is addicted. Fear, and feelings of inadequacy, cause an addict to seek constancy of stimulation and setting rather than to chance the dangers of novel or unpredictable experience. Psychological security is what he wants above all. He searches for it outside himself, until he finds that the experience of addiction is completely predictable. At this point, satiation is impossible??"because it is the sameness of sensation that he craves. As the addiction proceeds, novelty and change become things he is even less able to tolerate.

What are the key psychological dimensions of addiction, and of the freedom and growth which are the antitheses of addiction? A major theory in psychology is that of achievement motivation, as summarized by John Atkinson in An Introduction to Motivation. The motive to achieve refers to a person's positive desire to pursue a task, and to the satisfaction he gets from successfully completing it.

Opposed to achievement motivation is what is called "fear of failure," an outlook which causes a person to react to challenges with anxiety rather than positive anticipation. This happens because the person does not see a new situation as an opportunity for exploration, satisfaction, or accomplishment. For him, it only holds out the threat of disgrace through the failure he believes is likely. A person with a high fear of failure avoids new things, is conservative, and seeks to reduce life to safe routines and rituals.

The fundamental distinction involved here??"and in addiction??"is the distinction between a desire to grow and experience and a desire to stagnate and remain untouched. Jozef Cohen quotes the addict who says, "The best high . . . is death." Where life is seen as a burden, full of unpleasant and useless struggles, addiction is a way to surrender.

The difference between not being addicted and being addicted is the difference between seeing the world as your arena and seeing the world as your prison. These contrasting orientations suggest a standard for assessing whether a substance or activity is addictive for a particular person. If what a person is engaged in enhances his ability to live??"if it enables him to work more effectively, to love more beautifully, to appreciate the things around him more, and finally, if it allows him to grow, to change, and expand??"then it is not addictive.

If, on the other hand, it diminishes him??"if it makes him less attractive, less capable, less sensitive, and if it limits him, stifles him, harms him??"then it is addictive.

These criteria do not mean that an involvement is necessarily addictive because it is intensely absorbing. When someone can truly engage himself in something, as opposed to seeking out its most general, superficial features, he is not addicted.

Addiction is marked by an intensity of need, which only motivates a person to expose himself repeatedly to the grossest aspects of a sensation, primarily its intoxicating effects. Heroin addicts are most attached to the ritualistic elements in their use of the drug, such as the act of injecting heroin and the stereotyped relationships and hustling that go along with getting it, not to mention the deadening predictability of the action that narcotics have.

When someone enjoys or is energized by an experience, he wishes to pursue it further, master it more, understand it better. The addict, on the other hand, wishes only to stay with a clearly defined routine. This obviously does not have to be true for heroin addicts alone. When a man or woman works purely for the reassurance of knowing that he or she is working, rather than positively desiring to do something, then that person's involvement with work is compulsive, the so-called "workaholic" syndrome.

Such a person is not concerned that the products of his labors, that all other concomitants and results of what he does, may be meaningless, or worse, harmful. In the same way, the heroin addict's life does include the discipline and challenge entailed in obtaining the drug. But he cannot maintain respect for these efforts in the face of society's judgment that they are nonconstructive and, worse, vicious. It is difficult for the addict to feel that he has done something of lasting value when he works feverishly to get high four times a day.

From this perspective, while we might be tempted to refer to the dedicated artist or scientist as being addicted to his or her work, the description doesn't fit. There may be elements of addiction in a person's throwing himself into solitary creative work when it is done out of an incapacity to have normal relationships with people, but great achievements often require a narrowing of focus.

What distinguishes such concentration from addiction is that the artist or scientist is not escaping from novelty and uncertainty into a predictable, comforting state of affairs. He receives the pleasure of creation and discovery from his activity, a pleasure that is sometimes long deferred. He moves on to new problems, sharpens his skills, takes risks, meets resistance and frustration, and always challenges himself.

To do otherwise means the end of his productive career. Whatever his personal incompleteness, his involvement in his work does not diminish his integrity and his capacity to live, and thus does not cause him to want to escape from himself. He is in touch with a difficult and demanding reality, and his accomplishments are open to the judgment of those who are similarly engaged, those who will decide his place in the history of his discipline. Finally, his work can be evaluated by the benefits or pleasures it brings to humanity as a whole.

Working, socializing, eating, drinking, praying??"any regular part of a person's life can be evaluated in terms of how it contributes to, or detracts from, the quality of his experience. Or, looked at from the other direction, the nature of a person's general feelings about living will determine the character of any of his habitual involvements. As Marx noted, it is the attempt to separate a single involvement from the rest of one's life which allows for addiction:

It is nonsense to believe . . . one could satisfy one passion separated from all others without satisfying oneself, the whole living individual. If this passion assumes an abstract, separate character, if it confronts him as an alien power . . . the result is that this individual achieves only a one-sided, crippled development. (quoted in Erich Fromm, "Marx's Contribution to the Knowledge of Man")

Yardsticks like this can be applied to any thing or any act; that is why many involvements besides those with drugs meet the criteria for addiction. Drugs, on the other hand, are not addictive when they serve to fulfill a larger purpose in life, even if the purpose is to increase self-awareness, to expand consciousness, or simply to enjoy oneself.

The ability to derive a positive pleasure from something, to do something because it brings joy to oneself, is, in fact, a principal criterion of nonaddiction. It might seem a foregone conclusion that people take drugs for enjoyment, yet this is not true of addicts. An addict does not find heroin pleasurable in itself. Rather, he uses it to obliterate other aspects of his environment which he dreads.

A cigarette addict or an alcoholic may once have enjoyed a smoke or a drink, but by the time he has become addicted, he is driven to use the substance merely to maintain himself at a bearable level of existence. This is the tolerance process, through which the addict comes to rely on the addictive object as something necessary to his psychological survival. What might have been a positive motivation turns out to be a negative one. It is a matter of need rather than of desire.

A further, and related, sign of addiction is that an exclusive craving for something is accompanied by a loss of discrimination toward the object which satisfies the craving. In the early stages of an addict's relationship to a substance, he may desire a specific quality in the experience it gives him. He hopes for a certain reaction and, if it is not forthcoming, he is dissatisfied. But after a certain point, the addict cannot distinguish between a good or a bad version of that experience. All he cares about is that he wants it and that he gets it.

The alcoholic is not interested in the taste of the liquor that is available; likewise, the compulsive eater is not particular about what he eats when there is food around. The difference between the heroin addict and the controlled user is the ability to discriminate among conditions for taking the drug. Zinberg and Jacobson found that the controlled drug user weighs a number of pragmatic considerations??"how much the drug costs, how good the supply is, whether the assembled company is appealing, what else he might do with his time??"before indulging on any given occasion. Such choices are not open to an addict.

Since it is only the repetition of the basic experience for which the addict yearns, he is unaware of variations in his environment??"even in the addictive sensation itself??"as long as certain key stimuli are always present. This phenomenon is observable in those who use heroin, LSD, marijuana, speed, or cocaine. While light, irregular, or novice users are very dependent on situational cues to set the mood for the enjoyment of their trips, the heavy user or the addict disregards these variables almost entirely. This, and all our criteria, are applicable to addicts in other areas of life, including love addicts.

Groups and the Private World

Addiction, since it avoids reality, amounts to the substitution of a private standard of meaning and value for publicly accepted standards. It is natural to bolster this alienated worldview by sharing it with others; in fact, it is often learned from others in the first place. Understanding the process by which groups coalesce around obsessive, exclusive activities and systems of belief is an important step in exploring how groups, including couples, can themselves comprise an addiction. By looking at the ways in which groups of addicts construct their own worlds, we gain essential insights into the social aspects of addiction, and??"what directly follows from this??"social addictions.

Howard Becker observed groups of marijuana users in the fifties showing new members how to smoke marijuana and how to interpret its effect. What they were also showing them was how to be part of the group. The initiates were teaching the experience which made the group distinctive??"the marijuana high??"and why this distinctive experience was pleasurable, and therefore good. The group was engaged in the process of defining itself, and of creating an internal set of values separate from those of the world at large.

In this way, miniature societies are formed by people who share a set of values relating to something which they have in common, but which people generally do not accept. That something can be the use of a particular drug, a fanatical religious or political belief, or the pursuit of esoteric knowledge. The same thing happens when a discipline becomes so abstract that its human relevance is lost in the interchange of secrets among experts.

There is no desire to influence the course of events outside of the group setting, except to draw new devotees into its boundaries. This happens regularly with such self-contained mental systems as chess, bridge, and horse-race handicapping. Activities like bridge are addictions for so many people because in them the elements of group ritual and private language, the bases of group addictions, are so strong.

To understand these separate worlds, consider a group organized around its members' involvement with a drug, such as heroin, or marijuana when it was a disapproved and deviant activity. The members agree that it is right to use the drug, both because of the way it makes one feel and because of the difficulty or unattractiveness of being a total participant in the regular world, i.e., of being a "straight."

In the "hip" subculture of the drug user, this attitude constitutes a conscious ideology of superiority to the straight world. Such groups, like the hipsters Norman Mailer wrote about in "The White Negro," or the delinquent addicts that Chein studied, feel both disdain and fear toward the mainstream of society. When someone becomes a part of that group, accepting its distinct values and associating exclusively with the people in it, he becomes "in"??"a part of that subculture??"and cuts himself off from those outside it.

Addicts need to evolve their own societies because, having devoted themselves entirely to their shared addictions, they must turn to each other to gain approval for behavior that the larger society despises. Always fearful of and alienated by broader standards, these individuals can now be accepted in terms of internal group standards that they find easier to meet.

At the same time, their alienation increases, so that they become more insecure in the face of the outside world's values. When they are exposed to these attitudes, they reject them as irrelevant, and return to their circumscribed existence with a strengthened allegiance. Thus, with the group as well as with the drug, the addict goes through a spiral of growing dependency.

The behavior of people who are under the influence of a drug is explicable only to those who are likewise intoxicated. Even in their own eyes, their behavior only makes sense when they are in that condition. After a person has been drunk, he may say, "I can't believe I did all that." In order to be able to accept his behavior, or to forget that he had appeared so foolish, he feels that he has to reenter the intoxicated state.

This discontinuity between ordinary reality and the addicts' reality makes each the negation of the other. To participate in one is to reject the other. Thus, when someone quits a private world, the break is likely to be a sharp one, as when an alcoholic swears off drinking or seeing his old drinking friends ever again, or when political or religious extremists turn into violent opponents of the ideologies they once held.

Given this tension between the private world and what lies outside, the task which the group performs for its members is to bring about self-acceptance through the maintenance of a distorted but shared outlook. The other people who also participate in the group's peculiar vision, or in the intoxication it favors, can understand the addict's perspective where outsiders cannot.

Someone else who is drunk is not critical of a drunk's behavior. Someone who begs or steals money to obtain heroin is not likely to criticize someone similarly occupied. Such groupings of addicts are not predicated on genuine human feelings and appreciation; the other group members in themselves are not the object of the addict's concern. Rather, his own addiction is his concern, and those other people who can tolerate it and even help him pursue it are simply adjuncts to his one preoccupation in life.

The same expediency in forming connections is there with the person addicted to a lover. It is there in the use of another person to shore up a beleaguered sense of self and to obtain acceptance when the rest of the world seems frightening and forbidding. The lovers gladly lose track of how insular their behavior becomes in the creation of their separate world, until such time as they may be forced to return to reality.

But there is one respect in which the isolation of addicted lovers from the world is even more stark than that of other alienated groups of addicts. While drug users and ideologues support each other in maintaining some belief or behavior, the relationship is the sole value around which the private society of the interpersonal addict is organized. While drugs are the theme for groups of heroin addicts, the relationship is the theme for the lovers' group; the group itself is the object of the members' addiction. And thus the addicted love relationship is the tightest group of all. You are "in" with only one person at a time??"or one person forever.

References

Atkinson, John W. An Introduction to Motivation. Princeton, NJ: Van Nostrand, 1962.

Becker, Howard. Outsiders. London: Free Press of Glencoe, 1963.

Blum, Richard H., & Associates. Drugs I: Society and Drugs. San Francisco: Jossey-Bass, 1969.

Chein, Isidor. "Psychological Functions of Drug Use." In Scientific Basis of Drug Dependence, edited by Hannah Steinberg, pp. 13-30. London: Churchill Ltd., 1969.

_______; Gerard, Donald L.; Lee, Robert S.; and Rosenfeld, Eva. The Road to H. New York: Basic Books, 1964.

Cohen, Jozef. Secondary Motivation. Vol. I. Chicago: Rand McNally, 1970.

Fromm, Erich. "Marx's Contribution to the Knowledge of Man." In The Crisis in Psychoanalysis, pp. 61-75. Greenwich, CT: Fawcett, 1970.

Kolb, Lawrence. Drug Addiction: A Medical Problem. Springfield, IL: Charles C Thomas, 1962.

Kubie, Lawrence. Neurotic Distortion of the Creative Process. Lawrence, KS: University of Kansas Press, 1958.

Lasagna, Louis; Mosteller, Frederick; von Felsinger, John M.; and Beecher, Henry K. "A Study of the Placebo Response." American Journal of Medicine 16(1954): 770-779.

Lindesmith, Alfred R. Addiction and Opiates. Chicago: Aldine, 1968.

Mailer, Norman. "The White Negro" (1957). In Advertisements for Myself, pp. 313-333. New York: Putnam, 1966.

Winick, Charles. "Physician Narcotic Addicts." Social Problems 9(1961): 174-186.

_________. "Maturing Out of Narcotic Addiction." Bulletin on Narcotics 14(1962): 1-7.

Zinberg, Norman E., and Jacobson, Richard. The Social Controls of Non- medical Drug Use. Washington, D.C.: Interim Report to the Drug Abuse Council, 1974.

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From Peele, S., with Brodsky, A. (1975), Love and Addiction. New York: Taplinger. ? 1975 Stanton Peele and Archie Brodsky.