I’d come across most of the conditions treated by the addiction service at my current hospital: alcoholism, drug addiction – whether to illegal or prescription drugs, eating disorders (which can be seen as an addiction to bingeing or restricting intake). But although most of the patients have come in for one or more of these addictions, within the unit several others are discussed. Workaholism, co-dependency, compulsive helping and what is referred to in the trade as ‘SLA’ – sex and love addiction – are all recognised as features of an addictive personality. SLA is particularly topical at the moment (though I’d never heard of it before) with the release of Steve McQueen’s film about a sex addict, Shame, this week. The BBC news website even ran a first-person article written by a sex addict a couple of days ago.
But what does it mean to be an ‘love addict’ or addicted to ‘compulsive helping’? Normally we think of addiction in terms of chemicals. Historically, the definition of addiction was essentially a pharmacological one. To be an addict you had to show 1) craving 2) tolerance (i.e. needing progressively more drug to get the same effect) and 3) withdrawal (unpleasant symptoms when you stop taking the drug). Since then, however, it’s been recognised that it’s not just ‘substances’ you can be addicted to. Work, food, coffee, exercise, sex, romantic love and co-dependency… they can all be addictive.
DSM-IV gives a set of modern criteria for assessing addiction. Someone is diagnosed as an addict if they meet at least 3 out of the 7:
(1) Tolerance, as defined by either of the following:
(a) A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
(b) Markedly diminished effect with continued use of the same amount of the substance.
(2) Withdrawal, as manifested by either of the following:
(a) The characteristic withdrawal syndrome for the substance (refer to Criteria A or B of the criteria sets for Withdrawal from specific substances).
(b) The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.
(3) The substance is often taken in larger amounts or over a longer period than was intended.
(4) There is a persistent desire or unsuccessful efforts to cut down or control substance use.
(5) A great deal of time is spent in activities necessary to obtain the substance (such as visiting multiple doctors or driving long distances), use the substance (such as chain smoking) or recover from its effects.
(6) Important social, occupational, or recreational activities are given up or reduced because of substance use.
(7) The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
Diagnostic and Statistical Manual of Mental Disorders, Text Revision, Fourth Edition, (Copyright 2000). American Psychiatric Association.
Addicts are utterly controlled by their addictions and find their lives consumed by pursuing them, while that pursuit progressively bankrupts them, emotionally, physically and spiritually. They may endanger their families or their physical health, or they may remain in abusive relationships, because they are unable to break the addiction. Whatever they are addicted to takes on supreme importance in their lives, so much so that it pushes out everything else.
Until I started this placement I tended to think of addicts as people ‘out there’, living in a world very different from my own. Thing is, as I’ve spent time discussing addiction with addicts and observing group therapy, I’m starting to feel uncomfortably like addicts are also people ‘in here’ – slap-bang in the middle of my world, and even my heart. Seeing these addictive patterns up close has made me recognise much of the same vulnerability in myself. It’s just that the things I’m addicted to aren’t so obviously destructive. But socially acceptable addictions like caffeine, or work, or chocolate, or helping people are still addictions. We get addicted to things because they promise us happiness and security, and we take them at their word and entrust ourselves to them, then they destroy us. Does that remind you of anything? I’m starting to wonder whether addiction differs that much from the Biblical definition of idolatry. Whatever particular our particular ‘poison’, if we’re trusting it for our happiness and security then it’s still an idol, and it will still take possession of our lives; promising us everything and leaving us with nothing.
Addiction counsellors will tell you that often, when someone gets off alcohol or drugs, they will start to ‘act out’ in some other way – becoming a chain smoker, a workaholic or an exercise-freak. It seems like we’re not very good at not being addicted to anything. I don’t know about you, but I’ve definitely experienced that in my own life: one ‘security’ crumbles and I scrabble to replace it. Why? Well, the Bible tells us we were made for an all-consuming passion, and one that would meet our deepest needs: the Triune God. Our problem is not that we are obsessed, but that we are not obsessed with Him.
He is the only obsession that does not ultimately destroy us. All the other addictions suck the life out of us, make us less than human. He, instead, is the only One who gives us life and makes us whole.