You might be surprised by how often I hear people ask why an addict can’t “just stop.” Usually, though I hate to say it, people ask the question not as a real question but more as judgment — with disdain and disgust in their voices. The internal dialogue (and often, sadly, external dialogue!) sounding something like this:
I don’t do that. How hard can it be? They must be weak. It’s their own fault.
Imagine someone saying those things about a person who has cancer.
Why don’t they just get better? It’s not that hard. They must be weak. It’s their own fault.
Never in a million years do we hear that, right? Yet people with addiction (though addiction is considered a disease by medical and psychological professionals) are often stigmatized. There is this “thing” about placing blame on addicts. They are seen as merely “unable to control themselves” without an understanding as to why that is! This blog is to address the people who may struggle with understanding the “why.”
Let’s start with the basics: One definition of “illness” is “poor health resulting from disease of body or mind.” (Webster’s). This is the first, simple piece of information that many people seem incapable of taking in: that the mind, just like the body, can be ill and it does not make the illness the person’s “fault.” In addition, when something is termed a “disease,” that term does not just attach itself to a word without a whole bunch of really motivated, intelligent people (say doctors or psychologists) having looked into the subject in some sort of extensive way; say, for example, a few thousand dissertations, research papers and laboratory studies. In fact, in order to call something a “disease,” certain criteria need to be met. Now, I don’t know a whole lot about how that works in the medical profession, but in the psychological world, there is a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM). Inside it, there are criteria (i.e. a checklist of sorts) that an individual would have to meet in order to be considered having a specific disorder or diagnosis. It is the same with Addiction; it is called a disease because there are symptoms that all addicts have, the main symptom being an inability to stop the behavior despite a desire to stop and numerous attempts. So when people who do not understand addiction or how it can be a disease, and mistakenly connect addiction to willpower or lack thereof, they are very much contributing to the horrific self-blame, self-hate and shame that are the very things keeping an addict stuck in perpetuating the cycle.
That leads me to pose the questions: Who would choose to be an addict? And, along those lines, who would choose cancer?
I can only speak from personal experience when I say that I am an addict (food, my main drug of choice) and also big on personal responsibility. People who misunderstand the disease often can’t hold that both of these facts can be true. I made this mistake for 15 years. It HAD to be “my fault,” “my choice.” How could I not have control of what I was doing, when I functioned fine in other aspects of life? I made a private vow that I would never “play the victim.” I vowed to take responsibility for my binging and purging: I was choosing this. The problem? I wasn’t. I spent 15 years of my life trying to fix the very thing my brain had gotten me into! Imagine that: trusting in a brain that led me to the coping mechanism of bulimia. That’s part of what makes addiction so dicey — “But, wait! I can trust my brain to finish this paper…to drive me to my friend’s house…to speak in a fairly cohesive way!” But I can’t trust it when it comes to my drug of choice. That split is enough to drive a person mad. And because I was convinced I had the power to stop the cycle myself, I spent many years in it — attempting desperately to prove that I could. I came to realize that there are greater forces than willpower — forces like nature, illness, unconsciousness, even emotions like fear or love. As they say in 12-step programs, I came to see I was powerless and therefore needed a power greater than myself to restore me to sanity. That power, for me, wound up being a belief in yes, a Higher Power (although I find it important to mention that one need not believe in “God” to recover from an eating disorder or addiction — even community or a support group can be a “power greater than (your)self.”) It also meant a whole lot of personal work. In other words, I treated my illness. A person with cancer generally does not get better without chemotherapy or some form of treatment; a person with diabetes must inject insulin and a person with addiction must do the emotional and mental work it takes to get better (which for an addict may be a myriad of things — such as step-work, therapy, awareness work, medication, and of course living without a once very effective coping mechanism). Is a disease of the mind or spirit still a disease? My bias would be “yes.”
If you are not an addict, and you have trouble comprehending it, I would ask you to think of a personality trait or habit you have that you have had since you were very small. I know a woman who is a crazy-multi-tasker; she quite literally cannot do one thing at a time. I asked her to imagine that for the rest of her life, she could ONLY do one thing at a time. She could not even conceptualize this. This is the task of an addict — to transform the ingrained.
In the end, and I know I’ve said a lot, I wonder most about why we make it about semantics. Is it an actual “disease?” Is it not? Is it more a disorder, less a disease? Since the person initially moves toward it, can it be a disease since there is the element of choice there? (Although, with myself, I cannot remember the first time I threw up or why — so how is that a conscious choice?). But really, I find my heart screaming: WHO CARES? Call it whatever you like. For me, it winds up being just one thing: the sound of human suffering.