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I used to think addiction was an obsession with pleasure.
Growing up with a stable upbringing, secure mental health, and a relative lack of any enduring hardships, I assumed people regularly used drugs because they loved the pleasure of getting high.
It never occurred to me that perhaps people are not addicted to pleasure; people are addicted to a way of escaping pain.
This way of thinking about addiction changed everything.
Rather than a form of overindulgence, I began thinking of addiction as a form of self-medication. Thinking about it as merely an overindulgence only recognizes the tip of the iceberg, neglecting the massive invisible pain underneath.
What are the underlying causes of addiction?
The underlying causes of addiction can be classified in each of the following areas: psychological, biological, and social/ spiritual.
Although many people might use substances to escape from psychological pain caused by trauma, not everyone who has suffered a trauma will form an addiction.
Also, one could argue genetic risk factors cause addiction. But this still didn’t answer the question of why some people with a genetic risk don’t form an addiction.
As a sociologist, I decided to look at how our social environments also contribute to addiction.
Our brains don’t operate in a vacuum. Our minds are continually sending and receiving signals within our social worlds. We are social beings and therefore need to look at our social context to understand addiction better.
Everything I learned from my research on veterans in transition to civilian life as taught me that social life matters… a lot. Without strong social ties, we risk feeling isolated, and life loses meaning.
Feeling isolated is different than being alone. We can feel isolated within a crowd, and we can feel connected while alone.
When we feel isolated, we experience a lack of meaning. Meaning comes from being connected with something larger than ourselves. Some people may think of this as a form of spirituality. Our social environments may also fill this function.
Becoming obsessed with the social roots of addiction, I needed to create a model of how this worked. I felt like I was on the verge of figuring it out.
One evening, everything seemed to click. I’d been thinking about the individual, society, and the interaction between the two. But what was the missing link?
I believe the missing link is purpose.
Treating addiction by rebuilding purpose
Addiction closes us off to the outside world. We are so preoccupied with self-medicating, we cannot see beyond ourselves.
We are also closed off to our inner world. We lose touch with our unique skills and ability to contribute to the world. We lose touch with our values and no longer focus on our prior interests.
Our basic psychological needs go unmet, feeling isolated, trapped, and on a downward spiral. Meaning collapses, and we fall into despair.
Addiction is a way of coping with the pain of this despair.
Luckily, addiction doesn’t need to be the answer. Overcoming despair requires connecting with a sense of purpose.
Rebuilding purpose takes time. It requires gaining a certain level of awareness regarding our unique abilities, values, and interests. It then requires connecting our capabilities to a social context where we can gain a sense of contribution and belonging, two major ingredients of purpose.
Someone with an addiction may feel so preoccupied, self-concerned, and isolated; the word “contribution” and “belonging” is the last thing they can think about.
Although it may take time, I believe rebuilding purpose should be the central long-term treatment goal for persons with addiction.
Purpose builds meaning
Addiction is a problem of meaning.
Rather than merely looking at addiction as a disease, we need to broaden our understanding of what drives addiction so we can better address its root causes.
How is addiction a problem of meaning?
Without a sense of meaning and purpose, a person may turn to drug use and addictive behaviors to fill the void of an existential vacuum. The problem is that this void is infinite. In eternal torture of this infinite void leaves a person feeling like they can never get enough.
As one goes further down this infinite rabbit-hole, one takes on an increasingly distorted view of themselves and the world. Not only can they never get enough, but they themselves are never enough.
In this void, defense mechanisms protect the ego, perpetuating self-destructive behaviors. They are rationalized, minimized, and justified at all costs.
As one’s former self becomes a faint glimmer at the beginning of a long tunnel, the descent into addiction reorients one’s sense of meaning and purpose. If it takes over, the addiction becomes the sole guiding principle.
Why get up? Why leave the house? Why do anything? Engaging in the addiction becomes the sole purpose.
It is paradoxically a nihilistic sense of purpose. It answers the why question but leaves the person caught in a self-referential loop of desperation and despair. Like Victor Frankl said: “suffering without meaning is despair”.
So how do we get someone out of an addiction?
The answer is not simple, nor is it easy. Beyond potentially useful medical treatments, we need to look at rebuilding the persons “why”. As Friedrich Nietzsche said: “He who has a why to live can bear almost any how”.
Victor Frankl proposed his concept of logotherapy as a treatment for addiction. Put simply, it is a form of talk therapy that attempts to rebuild a person’s sense of purpose by exploring things that are meaningful to them.
Although this concept is not often used in the addictions field, the more recent concept of motivational interviewing builds on the same ideas, becoming a gold standard counseling technique with hundreds of studies showing its effectiveness.
Motivational interviewing is a collaborative conversation focused on helping a person gain motivation to change. This is done by eliciting their reasons for change and collaborating on an action plan. See Miller and Rollnick’s book for more information on this counseling method: Motivational Interviewing: Helping People Change.
If you’re struggling to support someone with an addiction, you may be interested in reading my article: The Ultimate Guide to Helping Someone Change.
When talking to a loved one suffering from an addiction, it is important to remember that they already likely feel socially isolated, so harsh judgments, criticisms, and tough love are generally counterproductive.
Ideally, a person struggling with an addiction accepts treatment and can find a high-quality counselor or psychologist. Counseling can help someone connect with their “why”, rebuilding purpose, in addition to building helpful coping tools for dealing with painful thoughts and emotions.
Although counseling can be helpful, it still focuses on the individual. Increasing the use of counseling while neglecting an unhealthy social environment is like trying to fix an overflowing sink by buying more mops. Instead, we need to look at the source of the problem and work on turning off the tap.
Purpose is found in community
How do social environments produce addiction?
Unhealthy social environments produce addiction when there is a lack of community. When people no longer feel like they belong, and their sense of purpose is lacking, they are left with the existential vacuum mentioned in the beginning. In his book Suicide, Sociologist Émile Durkheim states:
“Man cannot become attached to higher aims and submit to a rule if he sees nothing above him to which he belongs. To free him from all social pressure is to abandon him to himself and demoralize him.”
Community is essential to our “why”. At its root, community means being integrated into a network of individuals who you feel have your back, and therefore, you have theirs. On the one hand, this is a sense of belonging; on the other hand, it is a sense of service. This is what gives us real meaning.
As we all continue to reach out every day to the things that save our lives from utter meaninglessness, we need to be mindful of how our social environments foster this sense of resilience through purpose and belonging.
No one randomly wakes up one day and rationally decides to become addicted to something. Addiction is a symptom of larger forces.
Rather than looking at addiction as an individual disease, we need to understand addiction as a social disease.
Individual counseling needs to help connect individuals to their broader social environment, while politicians, business owners, and everyday citizens need to work at facilitating better communities.
Practically speaking, this may involve counseling for the family of someone suffering from an addiction. According to a Canadian study, family counseling is the most neglected aspect of treatment.
Other unique treatments include cultural interventions, specifically when supporting indigenous populations. A review of the literature on cultural interventions found “benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies.”
When we have a why (purpose), we figure out the how. It is community that helps us connect to this why.
Since I’ve come to this understanding of addiction, I’ve noticed how many misconceptions still exist.
When we blame addiction solely on the individual, narrowly viewing it as excessive pleasure-seeking, we neglect the deeper reasons driving the addiction.
In the treatment field, this is also neglected. Individual counseling to develop coping skills is essential, but these coping skills cannot answer the deeper question: what will fill the void of meaning?
Expecting someone to give up an addiction without offering a source of meaning is a recipe for relapse.
If you are interested in reading more on my approach to developing a purpose, you can check out my article here: What Does It Mean to Have a Purpose?