From Psychology of Disease to Psychology of Choice

Sunday, December 13, 2009

Addictive or compulsive behavior (whether it's substance use or overeating) is experienced as feeling un-free: a substance user feels compelled or driven to use. Compulsion is experienced as a state of being enslaved in a pattern of repetitive behavior.

This forced, driven, un-free nature of the compulsive experience is reflected in the cattle-prodding history of the verb "to compel" which derives its meaning from the Latin compellere "to drive together."

But who is this invisible driver that shepherds (sheep-herds) the addicted mind? What is this ominous entity that takes over the steering wheel of human volition to drive us into a functional abyss as we take the backseat to our appetites and drives?

Is addictive behavior really compulsive, in the sense of being driven by an external force that is outside of our control? Or is addictive behavior nothing more than a choice that has become a habit (whether it is with or without a physiological signature of dependence/tolerance/withdrawal)?

How you answer these questions to yourself determines the therapeutic ceiling of your recovery.

If you have previously thought that your boozing and using was by choice but then you have come to think of your behavior as being compulsive (i.e. driven), then, you have , in a sense, shifted away from the position of Free Will (a responsible stance of being the driver of your life) to a position of Existential Passivity and Determinism (a victimized stance of being driven).

The key humanistic challenge of recovery from substance use and other compulsive spectrum disorders is the Recovery of one's Sense of Freedom to Choose, to act freely, to determine one's behavior, and to control the controllable aspects of one's life.

And, indeed, without a regained sense of freedom-to-change, how can a journey of change even begin?

Change, after all, is based on a perceived freedom to choose a novel path, an alternative course of action, a different way.

Recovery from compulsive behavior without the recovery of one's sense of control and self-efficacy is merely behavioral rehabilitation without Existential Rehabilitation.

Indeed, if we - therapists and clients - diagnostically define addiction as being accompanied by a sense of loss of control, then substance use treatment that only eliminates the compulsive behavior of boozing and using without reinstating a sense of control falls short of recovery and is nothing more than symptom management.

Open your mind to the possibility that you are not sick with an incurable disease - but just stuck in ineffective coping.