Do We Really Always Fall Off the Wagon?

There is no Kraken, an expert says.

Posted Oct 30, 2015

Fotos593/Shutterstock
Source: Fotos593/Shutterstock

There are numerous examples in popular culture of a person in recovery or struggling with addiction relapsing when the going gets tough—or even a little bumpy. Often in television or film, there’s a shot of a person staring longingly at a bottle, pill, or other “poison” of choice. In that make-or-break moment, the person reaches for it either in resignation or defiance. The temptation proves overwhelming. At the end of the day, his willpower peters out like an engine running out of gas.

It is true that many people struggling with addiction relapse or slip. But while it is not uncommon, it is also not inevitable.

It is also true that popular culture depictions are scripted, acted, or simply make-believe. This holds true for so-called “reality television” as well. They are not real. But yet, in another sense, the images and the messages are very real: Popular culture representations do not just describe reality; they shape it. Further, popular culture molds people’s expectations or understandings of what is normal.

This is why it is important to pay attention to those relapse scenarios.

What looks “normal” for people struggling with addiction, and even those with long-term sobriety, is that we harbor our own secret Kraken. The Kraken is a Norwegian mythological sea monster that, when motionless, looks like a placid island. However, it strikes quickly, capsizing a ship by wrapping its many arms around the hull. The Kraken strikes without warning and wreaks complete devastation.

Pop culture depictions of relapse follow the Kraken script. Our addictions may be dormant—we may even have the appearance of stability and solidity like that placid island. But something is going to come along in our daily life—losing a loved one, being jilted by a partner, getting fired from work, or being told by a parent that we do really have an evil twin—and the Kraken strikes. We immediately wrap ourselves around our bottles, pills, or other addictive behaviors and capsize into a full-blown relapse in which we quickly land back at “rock bottom"—another favorite narrative move in pop culture.

The trajectory of a slip—usually a one-time, isolated use followed by a renewed commitment to sobriety—or a relapse—usually longer use that may return a person to earlier levels of use—is very different from what we see in pop culture. There’s no quick-striking Kraken, but rather a sequence of choices, decisions, and actions made by a person over time.

According to the American Society of Addiction Medicine (ASAM), slips and relapses involve:

  • Reactivation of denial: "It wasn’t so bad"; "It was a long time ago."
  • Progressive isolation or defensiveness: Separating from others who may offer a corrective view.
  • Creation or building of a crisis to justify symptom progression: Circumstances are conspiring against me; a perfect storm is brewing
  • Immobilization: Getting stuck.
  • Confusion and overreaction: Trip switches are more easily flipped.
  • Depression: Melancholy along with low self-esteem.
  • Loss of control over behavior: Too many other things feel unwieldy.
  • Recognition of that loss of control: "I can’t control this, so why control that?"
  • Use: It feels like only or best solution (done in resignation or rebellion).

The last step—the actual use—may seem sudden but is part of a longer chain stretching behind. The earlier links in the chain aren’t as exciting a story as the use link. 

The full-blown relapse also is an exciting story arc for pop culture representations, especially when a character lands back at “rock bottom.” The initial attempts to rise up from bottom are good for ratings, too.

But day-to-day living in recovery, and carefully attending to one’s sobriety? Not so much.

The Kraken approach to relapse reinforces a view that a great weakness of will or impulsivity lurks within the heart of every addict, no matter how long we have been sober and no matter how great the alterations we’ve made in our lives. This presumed weakness of will defines us; it caused our addictions in the first place and will inevitably cause our relapses.

This is a very old and established (and incorrect) view of addiction that is alive and well in contemporary pop culture.

For some recent examples of Kraken relapse, see U.S. television show Elementary and the U.S. version of House of Cards. The show Nurse Jackie provides an interesting counter-example, which is a matter for another time.

Source

Darius Rastegar and Michael Fingerhood, The American Society of Addiction Medicine Handbook of Addiction Medicine (Oxford: Oxford University Press) 2015.