Addiction Fiction

Even good authors can make misunderstandings worse.

Posted Dec 07, 2019

Addictive behavior can look dramatic, so it's often used in stories and novels to portray people dealing with strong emotions. Here are a couple of examples from a novel I read recently:

  • "The images reappeared and the pain from them sizzled again. More painkillers were needed to dull the hurt."
  • "He had been saved in the past when he sought help for the pills and the images that had wormed into his head."

These quotes do a good job of conveying drama but they highlight some of the most common misunderstandings about addiction. Here's what I mean:

"Painkillers were needed to dull the hurt."

Most people think that addictive acts, especially using drugs, are intended to dull, mask, or run away from painful feelings. This idea is a major reason that people suffering with addictive behavior have been believed to be weak, weak-willed, or even cowardly. Nothing could be farther from the truth.

Like every other psychological symptom, addictive actions are the result of a complex function of the mind. They occur when people feel overwhelmingly helpless. Taking an action (the addictive act) reverses the feeling of helplessness, and is powerfully driven by the (normal) rage that always occurs in response to feeling overwhelmingly helpless. In addiction, however, this action is not expressed directly but in a displaced way: taking a drug, gambling, eating, and so on. And because the action is driven by this normal rage (at helplessness), it is emotionally compelled: The rage becomes a powerful urge to repeat the behavior. I've described this mechanism behind addiction earlier on this page and won't go into it further here, but you can find much more in previous posts, and complete discussions in my  books, The Heart of Addiction and Breaking Addiction.

Addiction is a complex psychological symptom. Remember that the physical aspect of drug addictions is easily treatable and not the reason for continued repetition of the behavior, even after detoxification. Since it is an active effort to reverse helplessness, the idea that it is simply a way to "dull" pain is basically backwards. This mistake arose because people thought addiction was about drugs, and they thought that because drugs dull your thinking that was their function in addiction. But nobody would say that a person who compulsively cleans his house is doing it to dull his pain, yet the psychology is the same as if he compulsively drank alcohol. Indeed, as I've pointed out before, people often switch from drug to non-drug compulsive/addictive behaviors; the fact they can substitute for each other shows that they operate the same way.

"He sought help for the pills and the images that had wormed into his head."

Here the problem is simpler. The author says there are two things that needed help: the pills and the images. But there aren't two problems. Using the pills is a compulsive (addictive) behavior whose function is to manage feelings aroused by the images. That means there is only one problem, namely whatever is the issue within this man that makes him feel overwhelmingly helpless when he sees the images.

It may seem like I'm being picky in making this distinction, but there is an important concern here.  By isolating this man's overt behavior—taking pills—as a problem in itself, the author denies the very nature of addiction. It is this error that so often leads to failed treatment.

If the man in this novel thought of his pills as the problem, he would waste time in treatment talking about them, how they work physically, and why they're bad for him, instead of talking and learning about what inside his mind led to his compulsive use of them. By describing the pills and the images as separate, the author of this book missed the nature of addiction.

Novels and stories tend to reflect the current state of knowledge, or accepted wisdom, in the culture. By reflecting these culturally accepted ideas back to us they can quietly cement them as truth, for better or worse. But the common wisdom about addiction, and how to treat it, is unfortunately terribly wrong. In reading, therefore, it's good to be aware that even great novelists can reflect the ignorance in their culture.