Addicts are people who’ve lost control over their relationship with a substance or behavior. They use when they don’t want to. They use when they have promised themselves and others they will stop. They use when it pushes them away from family, friends, and other important people. They use when it impacts their work, schooling, finances, reputation, freedom, etc. They tell egregious lies to themselves and others to rationalize and justify their actions. They do this no matter how abominable their behavior gets, no matter how many problems their addiction creates.
Addicts do this not to feel good; they do it to feel less. They use addictive substances and behaviors to self-medicate and self-regulate unwelcome and uncomfortable emotional states. They cope with stress, depression, anxiety, loneliness, boredom, attachment deficits, and unresolved trauma by getting high instead of turning to loved ones and trusted others who might provide emotional support. They do this even when their behavior clearly (to an outside observer) creates significant life problems.
Active addicts choose addictive substances and behaviors rather than other people as a coping mechanism because, for them, unresolved childhood trauma has poisoned the well of attachment. Other people can (and often have) hurt them, let them down, and left them feeling abandoned, unloved, or intruded upon. Thus, they fear and don’t feel secure with emotional intimacy, and they refuse to turn to others, even loved ones, for help when they’re struggling or feeling down. Instead, they self-soothe by numbing out with an addictive substance or behavior.
Thus we see that addictions are not moral failings; addictions are not weakness; addictions are not a lack of moral fiber. Addictions are an intimacy disorder.
When addiction is conceptualized in this way—as an intimacy disorder—we can clearly see that the best treatment for addiction is not the dogged pursuit of sobriety, it’s pursuit of ongoing prodependent connections. Thus, a fundamental task of treatment, once we’ve gotten addicts through their denial and established a modicum of sobriety, is helping them develop and maintain healthy and supportive emotional bonds (which, if they remain sober, will serve as the emotional comfort that their addiction never fully provided). It is this approach—not willpower, or babysitters, or shaming, or threatened consequences—that is most likely to lead to lasting sobriety, emotional healing, and a happier, healthier life.
Connection vs. Addiction
One of the all-time great illustrations of addiction as an intimacy disorder occurs in Canadian researcher Bruce Alexander’s famed “Rat Park” study. Prior to Alexander’s work, it was generally believed that pleasure, as wrought by addictive substances and behaviors, was the primary driver of addiction. Bolstering this belief was the fact that most early research on the root causes of addiction centered on the neurochemical pleasure response, and on the fact that lab rats, when given the choice, would almost always choose to drink opiate-infused water over regular water. For a long while, even the National Institute on Drug Abuse espoused this “pleasure drives addiction” viewpoint.
However, based solely on the fact that most people do not become addicts (for instance, the Substance Abuse and Mental Health Administration estimates that almost every American adult has tried alcohol, but only about 6.8 percent become alcoholic), it seemed clear to at least a few addiction treatment specialists and researchers that pleasure was not the primary driver of addiction, that the desire for pleasure was not what caused some (but not all) people (and rats) to return to a potentially addictive substance or behavior over and over, compulsively and to their detriment.
Recognizing this, Alexander re-examined the results of then-existing rat studies, where test subjects were placed in empty cages, alone, with two water bottles to choose from—one with pure water, the other with opiate-infused water. In those experiments the rats uniformly got hooked on and eventually overdosed on the opiate water, leading researchers to conclude that the out-of-control search for extreme pleasure drives addictions. This led to a belief that addicts were just weak people, and if they could only develop some willpower things would be OK.
Alexander disagreed. He was bothered by the fact that the cages in which lab rats were isolated were small, with no potential for stimulation beyond the opiate water. He thought, “Of course they get high. What else are they supposed to do?” In response, he created The Rat Park, a cage approximately 200 times larger than the typical isolation cage, with Hamster wheels and multi-colored balls to play with, plenty of tasty food to eat, and spaces for mating and raising litters. And he put not one rat, but 20 rats (of both genders) into the cage. Then, and only then, did he mirror the old experiments.
And guess what? Alexander’s now apparently happy rats ignored the opiate water, expressing much more interest in typical communal rat activities such as playing, fighting, eating, and mating. Even rats who’d previously been isolated and drinking the drugged water left it alone when they were placed in the rat park. With a little bit of social stimulation and connection, addiction in rats disappeared.
My interpretation of Alexander’s experiment vs. prior experiments is as follows: Putting a rat in a small cage, alone, is a form of exile. That exile mirrors what some traumatized, insecurely attached human beings choose to do to themselves—shutting themselves off from emotional connection and intimacy because they’ve learned that others, even family members, cannot be trusted. In those circumstances, emotionally and socially isolated humans are exactly like emotionally and socially isolated rats, choosing to use a drug to dull the pain of their exile.
The Human Rat Park
One of the reasons rats are routinely used in psychological experiments is they are social creatures in many of the same ways that humans are social creatures. Happy rats require stimulation, company, play, drama, sex, and social interaction to stay happy. Humans are the same, though the process is more complicated.
Placing human addicts in a room full of people and stimulating activities (as Alexander did with rats) is not quite enough. Human addicts must earn a sense of security and attachment. Rats don’t really need to do that because their brains and their psyches are considerably simpler. You can take an addicted rat and toss him into the rat park and he will quickly and easily assimilate, pushing his addiction to the curb in favor of healthier rat connections and activities. Humans? Not so much. With human addicts, there is further work to be done. Human addicts must learn to connect in healthy ways via long-term therapy, 12-step groups, and various other healthy and healing relationships.
Interestingly, addiction treatment specialists and the 12-step community have (often unconsciously) operated with “addictions are an intimacy disorder and healthy connections are the antidote” as an underlying principle for decades. In fact, much of what occurs in well-informed, group-focused addiction treatment programs and 12-step recovery programs (beyond breaking through the addict’s denial and putting a stop to the addictive behavior) is geared, either directly or indirectly, toward the development of reliably healthy social bonds.
That said, developing healthy intimate connections can be difficult for addicts, who, as stated earlier, nearly always have histories of chronic childhood trauma and other forms of early-life dysfunction that make intimate attachment uncomfortable and difficult. For addicts, learning to trust, reducing shame, and feeling comfortable with both emotional and social vulnerability takes time, ongoing effort, and a knowledgeable, willing, and empathetic support network (therapists, fellow recovering addicts, friends, employers, and, of course, prodependent loved ones). The good news is that both research and countless thousands of healthy, happy, long-sober addicts have shown us that such healing can turn an isolated and addicted life into a life of joy and connection.