Why Can’t People Just Quit their Addictions?
When Margie (not her real name) went in for knee replacement surgery, she was concerned about the amount of pain she would have. Fortunately, her doctor prescribed sufficient opiate pain medication to lessen much of her discomfort. However, the doctor gave her a prescription for 90 days. At the end of 70 days she found that her prescription had run out and she needed more. A year later Margie was ‘doctor shopping’ for more and more pain killers. After one physician discovered this, Margie was diagnosed with opiate addiction.
Most individuals do not realize that they are being drawn into an addiction. Some people become addicted after having minor dental procedures and then receiving a prescription for Lortab or some other medication. Oddly enough, there are other individuals who never become addicted to pain killers even after undergoing surgeries and using high dosages of prescribed opiate medications. We might ask; why do some become addicted while others don’t?
Neuroscience cannot yet give us a complete understanding of why this happens. However, in working with hundreds of clinically diagnosed addicted individuals, there is a common issue that is observed in virtually every case – unresolved trauma or chronic distress. Consider:
- Trauma psychologically overwhelms the individual and changes how they see themselves and results in shame
- Chronic distress is defined as a series of events over time that changes the individual’s self- perception and also creates shame
- Shame results in a change of thinking (e.g. a shift from; “I acted badly” to “I am bad,” “I did something dumb” to “I am dumb”, “I drank too much” to “I am a louse,” etc.)
- Shame negatively impacts a person’s perceptions, thoughts, feelings, and actions
- Chronic distress or trauma can be experienced at any age
- Addicted individuals have low self-worth and shame before they become addicted
- Recovery from the grip of drug or alcohol addiction requires attention to overcoming addictive thoughts, feelings, and behaviors that are based in shame self-beliefs
- Individuals who resolve the underlying shame beliefs of their addictions have a significantly increased ability to remain sober
This was true for Margie. For over two years she could not kick her addiction. She worked with two therapists, participated in a 12 step program, and even went to a residential rehabilitation facility. She almost gave up but then she found out about a treatment program that focused on both her addiction and the underlying causes of it.
While in treatment, Margie learned that when she was a child and a teenager her parents constantly urged her to succeed. They continually encouraged her to do well in school but criticized her if her schoolwork was not done perfectly. Margie became an outstanding student by working extremely hard and devoting every hour to her studies. She excelled in school and also in her first job. Everyone was extremely proud of her. Unfortunately, all she could think about was that no one understood that she was a phony. Sooner or later they would find out that every day she made a bunch of mistakes and then covered them up. Sooner or later they would find out that she needed opiates to deal with her relentless anxiety.
Using a treatment approach called EMDR adaptive processing, Margie realized that her shame belief was; “I am fake.” She worked with a counselor until this was changed to; “I am capable.” With this realistic and positive belief, Margie emerged from her addiction and found peace within herself. Enjoying a new sense of confidence, she pursued a new profession, developed a number of amazing relationships, and started dating. For Margie, life became truly worth living.
By Dr. H. Gray Otis, Licensed Clinical Mental Health Counselor & Trauma Specialist
Clinical Director, The Phoenix Recovery Center