Maintaining Active Addiction

Maintaining active addiction necessitates a set of defensive maneuvers to evade the natural corrective consequences of cognitive, behavioral, and ethical dissonance as the disease progresses. Addiction is especially insidious in how it convinces those of us who suffer from it that we do not have it. Those who become addicted almost always believe they can control their using, even in the face of blatant evidence to the contrary. Defense mechanisms are psychological processes that operate unconsciously to help us cope with aspects of reality that are too painful or threatening to acknowledge. They are normal and universal features of the human mind that protect us from the awareness of thoughts, feelings, and facts that are uncomfortable or painful. Defense mechanisms provide shelter from the storm of distressing situations with which we cannot cope. The use of defense mechanisms is natural and adaptive, and everyone uses them throughout life. Some means of protection from painful thoughts and experiences is important in order to remain mentally and emotionally healthy and functional—too much psychological pain is unhealthy, plain and simple. Defense mechanisms become unhealthy when their use causes problems. They can become overused, effectively overprotecting us from reality to the point where we become disconnected from it. When this happens, our defenses can enable all sorts of self-defeating and destructive behaviors, addiction being a prime example. It is part of human nature to avoid painful truths, and it is part of the nature of active addiction that painful truths abound. Sometimes these truths lurk just beneath the surface of awareness. We may have a sense or know on some level that “something” is wrong, perhaps terribly wrong, but it is too damn painful to concede consciously. These truths are kept at bay through a combination of the defenses of denial, minimizing, rationalizing, and avoidance. These phenomena help to protect addicts from mental and emotional pain related to their addiction and provide fuel for continuing to use even as the negative consequences continue to mount. In keeping addicts from being able to accurately see many of the problems that are obvious to others, these defense mechanisms create cognitive distortions and blind spots, similar to that space in a driver’s field of vision somewhere between what’s visible in either the rearview or the side view mirror. Often, it’s what we can’t see that poses the greatest danger. Denial is perhaps the most well-known and common defense mechanism. It is an unconscious rejection of unacceptable feelings, needs, thoughts, or external reality factors. A situation that threatens emotional safety or sense of self is simply not perceived. People in denial seem to ignore distressing facts and discard information that contradicts what they need to believe, like an addict in active addiction who refuses to admit that he or she has a problem because this reality creates too much anxiety, stress, or pain. Denial keeps people from accurately seeing the full impact of their actions on their lives—it is too uncomfortable, too painful for them to admit to and accept. Denial is often confused with dishonesty and the labyrinth of lies that active addiction ordinarily spawns, but the unconscious process of denial and overt dishonesty are two very different things. With conscious, deliberate dishonesty the individual remains aware of the difference between his or her own claims and the actual truth of the matter. Someone in denial, on the other hand, genuinely believes his or her own deceptions and distortions, and accordingly regards the divergent opinions of others as false, viewing their efforts to convince him or her otherwise as misguided at best and malicious at worst. “You’re a drug addict, and you need to do something about it.” “I’m not a drug addict, I’m responsible for over thirty behavioral health and substance abuse treatment programs and twenty therapists. I help drug addicts.” Minimizing is a scaled down (sort of a minor league) form of denial. Instead of negating the existence of a painful reality altogether, minimizing is an unconscious decreasing or lessening of the severity of such a situation/ event. It makes painful thoughts, emotions, behaviors, and situations more comfortable/less threatening than they really are. It’s extremely common for addicts to minimize or under report how much they use, how often they use, and even what substances they use—I sure as hell did. Rationalization is the effort to justify behaviors, feelings, thoughts, or desires that are unacceptable, thereby creating false but credible justifications. When one’s actual motivations are not socially or publicly acceptable, rationalization operates by substituting more appropriate motives. For example, an addict admits to using daily, but only because his or her partner is nagging him or her, or that he or she is in pain, or that he or she is under great stress at work. My most frequent rationalizations involved the last two of these. In addition to being in continuous pain, the enormity of my job responsibilities created a ton of stress. This line of thought was unintentionally encouraged by one of my doctors who wrote in an assessment that without the aid of opioid pain meds, I might not be able to work full-time. That’s what I’m talking about! Avoidance is the unwillingness to encounter situations, people, or activities because they create anxiety, stress, or pain. It may also involve finding ways not to discuss or even think about distressing topics. Usually, it takes the form of removing oneself physically from a situation—such as not going home to face an angry partner, staying home from work to elude the boss, or avoiding places where someone to whom money is owed is likely to be. Intellectualization is the unconscious controlling of emotions or impulses through excessive thinking about them rather than actually experiencing them. It uses logic and intellect to remain dispassionate, and consists of treating an emotionally charged situation in a detached or emotionally tamped-down way. This blog post is an excerpt from Some Assembly Required – A Balanced Approach to Recovery from Addiction and Chronic Pain by By Dan Mager, MSW; Published by Central Recovery Press (CRP).