Ruth Marcus, of the Washington Post
, has written a column about sexting-fool Anthony Weiner's entering treatment. Called "In Rehab Nation, sin becomes addiction
," the column bemoans how, in contemporary America, "rehab has become an all-purpose laundromat for irresponsible behavior, an infuriatingly easy substitute for accepting blame and living with consequences."
Here is the heart of her argument:
"Especially when it comes to actual addictions, to drugs and alcohol, I'm sure rehab can be a helpful, if not surefire, remedy. However many times it takes Lindsay Lohan, I hope it works.
The Weiner situation is different.
I'm skeptical about the entire notion of sex addiction or Internet addiction or whatever addiction might explain Weiner's behavior. Addiction in these circumstances seems like a highfalutin, after-the-fact excuse for self-indulgence and lack of control, whether by Tiger Woods (actual sex) or Weiner (the virtual variety)."
Here are my top seven reactions, and my own responses to my reactions (I know -- kind of self referential).
Based on the distinction between real and fake addictions, should people be allowed to plead addiction for any misdeeds they perpetrate whenever they are taking drugs and alcohol?
What if they kill someone?
How do we know whether someone who is intoxicated on drugs and alcohol is actually an addict?
Do people not have any choices when they are addicted to drugs and alcohol?
Is this analysis affected by the fact that 12-step rehab, which is overwhelmingly dominant in drug and alcohol treatment in America, prays for the addict's spiritual awakening?
Would rehab be more acceptable for Weiner if he went to a therapy program that was actually effective in reducing his dysfunctional behavior?
Has the American Psychiatric Association gone insane by proposing inclusion of at least one non-substance addiction (gambling) in its new diagnostic manual?
Here are my reactions to the questions raised by Marcus' column.
Punishment and treatment, recovery, and making amends have to be separated -- they are parts of different systems and world views.
Most people are not too favorable to, say, an alcoholic who drives drunk and kills someone -- they might say, "Fine, get all the treatment you want in jail."
If the argument that addiction to drugs or alcohol is a better excuse than whatever the hell drives Anthony Weiner, then we are put in a position of deciding whether intoxicated behavior is the result of addiction or of something else. For example, how do you judge a deadly drunk driver if he got drunk every month, but didn't otherwise demonstrate compulsive drinking?
In the drunk driving case, of course, we have to ask whether even an alcoholic is obligated to make provisions not to hurt others when drinking. This is called harm reduction, where people are given tools to separate addicted behavior from harmful conseqeunces -- like killing people.
Saying that we're confusing moral and therapy questions if Weiner enters treatment as a way out of his embarassing predicament is a day late and a dollar short -- the American treatment model for drug and alcohol addiction is bedecked with moralism.
Let's return to point 1; treatment and punishment are two different matters. There may indeed be effective therapies for Mr. Weiner (which certainly won't be 12-step). But he must pay whichever pipers judge him to have done wrong, whether the government and politics, his wife and other individuals, or whomever he prays to.
The reason the APA has decided to make gambling an actual addiction is because it cannot be distinguished in any significant way from alcohol and drug addiction -- all involve people who are enmeshed in experiences they find overwhelmnig for at least a time and lead to intensely negative consequences.
I say these things as the person who wrote Love and Addiction in 1975. Some might accuse me of having begun the avalanche that has become Rehab Nation. But in Love and Addiction and since, I have reduced addiction to human terms -- by which I mean recognizing that it isn't caused by drugs, but is a phenomenon that appears throughout our lives. This allows us, as individuals and a society, to deal most effectively with addicted behavior, both in scientific and therapeutic terms, and in moral ones.