Scott - Addiction

Understanding addiction is part of my therapy as a survivor of childhood sexual abuse. Most survivors, including myself, have addictive behaviors and use addictive substances to shield us from the demons of our trauma. Some of us are addicts. This is part one of a four part story about two men fighting to overcome their addictions, fighting for their lives.

The Men

I purposely chose addictive behaviors instead of substance abuse to describe addiction, intervention, treatment and after care. Drugs and alcohol are classic addictions but carry so much emotional baggage that it is almost impossible for most of us to think clearly about them. Behaviors can be addictive, and addictive behaviors can be just as soul destroying as substance abuse.

A young man in his twenties and an older man in his thirties are veteran rock climbers, with thin hard bodies and deeply weathered faces that make both appear at least a decade older. They have wives and children, whom they see for a few hours or days at a time between climbing expeditions. Their time, their energy, their focus is always on the next climb, where to get equipment, and visualizing the exhilarating path up vertical rock faces. They only feel truly alive on a climb and afterwards are bored and restless, waiting impatiently for the next excursion.

The older man begins climbing after he returns to civilian life from a desert war where his friends are literally torn apart by a roadside bomb. Two of his buddies die, one immediately and one later in a hospital far from home, and several others suffer severe wounds, losing limbs and eyes. The man feels profound guilt that he is uninjured and when he returns home he has a desperate need to put bloody body parts out of his mind. The younger man does not serve in the military but he also feels perpetual shame. As a teenager a car he drives from a high-school party flips and hits a tree, instantly killing his girlfriend. Now the men climb together.

Both men profess devotion to their families, but neither works steadily. Their unpredictable absences and general air of distraction while at work make them undependable employees with a decreasing number of opportunities for employment and longer periods between jobs. Somehow both men find sufficient resources for climbs although their equipment is wearing and breaking with infuriating regularity. The older man’s car sits on blocks beside his dilapidated house, and the younger man’s car looks as it belongs in a scrap yard but actually runs fairly well.

For years extended family members give the men emergency money for repairs, for food, for rent, and often, they suspect, for climbing equipment. Giving way to sullen resignation and resentment, their wives for the most part stop nagging about the lack of contributions their husbands make to their families and about their failings as fathers to children they barely know.

Their wives suspect that the men actually climb far more often than they admit. Lately there are newspaper and television stories about night time expeditions on the widow maker, an arduous and dangerous rock climb on closed federal land, and the wives suspect they know who is responsible although the men deny taking those kinds of stupid risks. It has become so common for local search and rescue to recover bodies of teenage climbers that strong ordinances are passed with severe penalties for trespassers. Two months previously a friend of the two men die in a hospital nearby the widow maker under circumstances that are unclear despite an investigation into the cause of his massive injuries. The two men are clearly shaken and stop climbing, but for less than a week.

The Bear Trap

Unresolved trauma may trigger addictive behaviors. Both of these men experienced emotional pain which produced unresolved guilt and shame. During childhood we learn to cope with inevitable conflict and disappointment, so that as mature adults we can form lasting, emotionally healthy relationships. If the psychic injury is too great or our coping skills too small, then we remain traumatized. Brain imagery confirms that the horror remains in short term memory until processed by decision centers and distributed to long term memory. If the trauma is stuck in short term memory we literally can’t “get over it,” with constant stress we will likely resort to self-medication just to forget for a time. That’s addictive behavior. We need drugs, alcohol, obsessive exercise, excessive shopping, whatever distracts us from unbearable emotional pain, for the moment.

Unresolved trauma may produce night terrors that prevent us from sleeping without a prescription sleep aid. While our trauma is unchecked we may “abuse” this drug, using it in great quantities or too frequently, but after our emotional pain no longer dominates our thinking and feelings we may be able to stop taking the drug. During medication of psychic pain the behavior of abusers is indistinguishable from the behavior of addicts. The difference is that in the face of great negative consequences, loss of job, loss of family, possible loss of life, the abuser can choose to stop and the addict cannot.

I quit smoking over thirty-five years ago. It was tremendously difficult, one of the hardest things I ever did. My wife’s experience was different. She smoked and quit multiple times with the same ease as choosing whether to drink orange juice. Smoking was bad for my health, it would shorten my life, and it was a dirty habit that many of my friends disdained. My desire to quit was very strong but it wouldn’t be long after stopping that my mind began to play tricks on me. “What difference does it make if I smoke? Why should others decide my behavior? Besides, I like smoking.” The longer I was without cigarettes, the more my will to quit waned. Ultimately it was the overwhelming fear that I would not be able to mount a successful campaign a second time that finally kept me smoke free. Months later my will had settled into quiet resolve, but I struggled with significant cravings for about seven years.

Was I addicted to cigarettes?

My tentative conclusion is that I was an abuser, at least with respect to smoking, although I may have genetic predisposition to other addictions. Clearly my ability to choose was compromised by not only enjoyment but an inexplicably diminished will, yet I was still able to follow through with a rational decision. When I told my friend who has been in recovery for substance abuse fifteen years that I could smoke a single cigarette without being trapped again, the hair stood up on the back of his neck. In fact I had smoked half of a cigarette within the first seven years, without going back to the dirty habit. Foolish? You bet. Risky? Definitely. Regardless of whether addicted it was a mistake to flirt with a habit that had me in thrall for years. I dislike breathing cigarette smoke now but don’t feel at risk occasionally being in the company of smokers. I can make a rational choice.

What is the difference for an addict?

All addictions may not be alike but they have important characteristics in common. About 15 percent of habitual drug users are true addicts (and the percentage may vary for other substances or behaviors) but all addictions produce changes in brain chemistry. These alterations are not the same as trauma. Trauma may introduce us to addiction but it is only the trigger. The trauma victim medicates to forget. The addict medicates to survive.

Addiction requires two elements. Genetic predisposition is like a bear trap with jaws wide, ready to spring shut. Exposure to the drug or the behavior, while under stress, is like stepping on the trigger pan so the jaws close with terrible force. The release of endorphins in the addict’s brain, the extraordinary relief from the stress, the incredible rush of pleasure, are many hundreds of times greater for the true addict than for the abuser. For abusers without those genetic characteristics the bear trap is not loaded.

Let’s explore the need to survive – it’s key to understanding the addict. The drive to survive comes from the deepest subconscious, even deeper than the part of our brain that can be trained by repetition. This part of our subconscious mind acts on instinct long before our conscious mind has time to become aware. We react before we think. Our fundamental needs for food and water, for shelter and safety spring from the deep subconscious. Would you break a window to steal a loaf of bread if you were starving? Would you tear away a plastic bag taped over your head just to breathe in sweet oxygen? The driving need, the certainty that you will die without food or air, comes from the depths of our brains. The choice to steal is conscious, the choice tear the bag from your head is conscious, but these “choices” are driven by the overwhelming need to survive, to avoid starvation, to avoid suffocation. You will choose to act, you will survive, you will deal with consequences later. The genetically triggered response in an addict’s brain categorizes the drug with food and water and air, as essential to survival. An addict’s subconscious whispers, “Without the drug you will die.” Over time, over an extended time of addictive behavior, the need for medication, whether substance or behavior, may eclipse all else.

Can an addict escape his addictions?