The Heart of Addiction

How psychology drives addictive behavior.

Alcoholics Are Not Powerless Over Alcohol

Alcoholism is not even about alcohol

The myth that people with alcoholism are powerless over alcohol is deeply misinformed, and just as dangerous. Addiction arises from inside of people – their drive to excessively drink, use other drugs, eat, gamble, and so on. To think that alcohol is the problem in alcoholism is to believe it has a magnetic power to enslave people. This is sheer nonsense. And when people think that their problem is a chemical in a bottle, they focus on trying to resist the chemical rather than doing what is truly useful: trying to understand their minds.

Of course, if we are talking about physical dependence then the chemical is relevant, but as readers of this blog or either of my books (“The Heart of Addiction,” and “Breaking Addiction”) know, the real problem in addiction is not physical addiction, which can affect anybody and is readily treatable, but why some people compulsively repeat their addictive behaviors even when there is no physical dependence at all.

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Addiction is all about seeking a remedy for overwhelming feelings of helplessness, and the exact form of an addiction, whether drinking or eating or watching online pornography, is no more than a focus for the addiction, not its cause. This is why people so often change the form of their addiction, moving from alcoholism to compulsive gambling to compulsive shopping, and on and on. Wouldn’t it be strange if people really were powerless over the focus of their addiction? When a person switched from alcoholism to compulsive gambling we’d have to say he was now powerless over something new. As the focus shifted there could be no end to the things he was powerless over – his powerlessness could spread like wildfire! (“I used to be powerless over just alcohol, but now peanut butter has me in its grip.”) 

The notion that people are powerless over the focus of their addiction is also terribly demoralizing. Addictions are neither more nor less than compulsions, psychological behaviors most people have to some degree. That fact has been a great relief to people with addictions who have been made to feel different and less than the rest of humanity. But if you buy the idea that you are powerless over the chemical in a bottle (or the peanut butter on the shelf or the offshore gambling website) then you are deprived of this honest relief. Instead, you must admit your worst fear: you are in fact different and certainly less capable than everyone around you who is able to drink with impunity. 

“We admitted we were powerless over alcohol” is, of course, Step One of Alcoholics Anonymous. 12-step programs have been statistically shown to have a 5-10% success rate. Step One isn’t the only reason for this, but it is clearly a part of the problem.

Lance Dodes, M.D., is an assistant clinical professor of psychiatry at Harvard Medical School.

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