Addiction is a disease?

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See, I thought this as well, that handling the original problem would prevent the "addiction". But, if you read the 12 steps (of any of the Anonymous groups), they make it seem that the problem is the alcohol, coke, etc... I don't know if I agree with these 12 steps.

craig

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This is not entirely true. The First Step of AA reads "I am powerless over Alcohol", reflecting the fact that the original 12 steps were written in the 1930s, a time before the disease concept had been fully realized in the treatment of addiction when medicine and society viewed chemical dependency as a moral defecency, . About 20 years after the steps were originally written they were adapted to the treatment of drug addiction by members of AA who were attempting to create a new fellowship that would become Narcotics Annonymous. In this adaptation, the first step reads "We are powerless over addiction..."; NA seeks to treat the disease of addiction, not the dependency upon a specific substance. Identification as an addict in reference to membership in the NA fellowship is all encompasing and does not differentiate between substances.

Greetings,

Thank you for the replies to my perspective on labels of 'mental illness' and 'addictive diseases.' First of all, let me respond to a poster who replied:

"Yes, crazy people are just stubborn. Do you really believe this crap? Here's a question for you - why do you think people make those bad decisions?"


The poster starts off with a personal attack, completely irrelevant to the truth value of my premises. Whether or not my idea seems counterintuitive, unexpected, socially unacceptable, incredible, silly, contrary to popular opinion does not matter. Ironically, he/she professes that people afflicted with 'mental illness' or 'addictive illness' have real diseases then he refers to them as 'crazy?' I wouldn't call somebody with cancer or diabetes 'bizarre or zany.' I wonder why he would chose this socially stigmatizing description for helpless victims of "true diseases."

Ok, now you ask me why people make bad decisions. First of all, what you consider 'bad' will hinge on your value system as to what constitutes 'bad.' Lets assume 'bad' means resulting in undesireable consequences. Here is my basic answer. People make bad decisions because people are inherently flawed creatures prone to doing stupid things. More specificially, people's behaviors are a function of their beliefs about things. For example, lets assume I believe that I must have the approval of everybody I meet. Let assume you indicate you don't approve of me and my goofy ideas regarding "mental illness." What is the likely result? I will likely have a negative cognitive-emotive consequence in light of my belief about needing universal approval.

You see, I believe people and things do not disturb us; rather we disturb ourselves by believing they CAN disturb us. I belief we needlessly disturb ourselves (often in very severe ways) by allowing inflexible and irrational ideologies to guide our thinking. You are not depressed because you lost your job; you are depressed because you believe losing your job is all-important.

"And another question - have you ever known a person with a serious mental illness? I mean severe psychotic/anxiety/dissociative disorders, OCD and schizophrenia and the like. And have you ever been close to someone with a relatively "minor" mental illness?

I'll be the first to admit the line can be hard to draw, and the DSM is a rather poor piece of work. I also think treatment recommendations have a tendency to be drug-heavy and questionable. But no such thing as mental illness? That's absurd."




BTW, I will risk subjecting myself to the psychoanalytic fallacy and confess I have been diagnosed with a 'mental illness.' Specifically, panic disorder, OCD, Aspergar's disorder and bipolar disorder. In my early twenties I was involuntarily committed and have met hundreds of people with both brain diseases and problems in living.

I used to buy into the medical model of mental illness and felt like a hopeless victim of brain chemistry disequilibrium. It was very empowering when I stumbled upon Rational Emotive Behavioral Psychology. REBT enabled me to appreciate the role my goofy and rigid ideologies played in perpetuating my own self-defeating behaviors and irrational ideas (which many call 'mental illness').

I personally think labels of mental illness are not helpful for most people. Many people become the personification of their 'disease' and capitulate, assuming a victim role. Also, labels of mental illness are stigmatizing and hurt people in terms of employment, education, social advancement, and consitutional rights. Generally, I don't think people are served well by these labels.

I never stated that I believed brain disease didn't exist. Now that would be a difficult position to defend. To reiterate, I don't believe 'mental illness' literally exists. To say a mind is all is analogous to saying society is disease; an abuse of language. The mind a hypothetical construct, a concoction, an invention, a means of explanation. True disease like diabetes has a concrete referant.

JeffreyREBT 'Wherein I don't promise to make you rich without trying; or even trying very hard; I do promise to say things that will make you feel rich."

[PokerAmateur4]

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When people say addiction is a disease without a cure, do they mean this literally or is it metaphorical?

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Both. I can't speak for all addictions, but scientists believe that alcoholics have a genetic predisposition toward their addiction. Whether this makes their alcoholism inevitable from birth is not known.

What is known is that no alcoholic is ever cured of his disease. There are no ex-alcoholics, only recovering alcholics. The only solution is to abstain.

[/ QUOTE ] I didn't read past here but...
This can't be true I don't think, such a universal statement. While wise as a rule for any, can't some alchoholics drink just a few beers or what have you later in their recovery?

I apologize for offending you, that wasn't my intent. (well, maybe a little bit just to shake things up)

Personally I think the "mind" is really an abstraction of brain interactions that we can't mechanically describe (belief, memory, emotion, etc). But even if we do away with the term, I don't see how something like addiction fails to qualify as indicative of disease.

I assume a "belief" has a neurochemical existence here and that there is therefore some concrete referent. We just can't describe it in physical terms because it can only be identified through behavioral symptoms. Also many mental illnesses seem to be independent of belief - they are "brain diseases" as you say. A number of mental illnesses have also been show to have a strong biological component through twin studies, etc.

I disagree with you on certain points, but I don't think most of them are relevant to the topic. If you agree that mental illness is a problem (and not something that is just willed away magically) then I suppose whether we call it an actual "illness" is just semantic.

The thing I do take issue with is your claim that the labels don't help. It's easy to see where this is true, of course, but I think they do more good than harm. Being able to put a name on your problems can make them much less intimidating. A person who has "x disorder" knows he isn't alone, knows he can't be expected to just "buck up and deal with it," and knows that there is help out there for him. Treatment is also more efficient with categories and labels - most labels are based on strong symptomatic correlations, and while the labels themselves may not have any real accuracy, identifying those correlations seems like a clear step forward in understanding and treating the problems.

I don't think it's realistic to think that a single treatment will be effective for every problem. Do you believe that REBT is an effective cure-all? If not, how can we create alternative treatments without using labels and categories?

Greetings,

And I wasn't offended in the least. In fact, I generally choose not to let anything 'offend' me. First of all, I have read your definition of the mind. If my understanding is correct, you basically believe the mind is the brain in motion. And the reason the mind construct is important here has everything to do with volition and free will. The disease theory proponents often argue free will has been thoroughly sabotaged and annihilated by the 'disease process.' They are not referring to the kidney or the spleen as the cause of alcoholism; they are referring to the mind construct. Alcoholics Anonymous argues in their twelve steps, "Admitted we were POWERLESS over alcohol; that our lives our lives had become unmanageable." Ironically, they also hold this seemingly irrational and contradictory position that they can be 'restored to sanity' if they 'come to believe a power greater then themselves can restore them to sanity.' As you can see, they are arguing alcoholism is a problem of belief (as I argue as well, just differently). They believe the prescription for stopping chronic alcohol abuse is belief in God's ability to remove "character defects." I think AA's philosophy is hogwash. I think the prescription for stopping chronic alcohol abuse is thinking more rationally through disputing and changing irrational beliefs .

I am still trying to discover which mental illnesses are independent of belief. Isn't mental illness really just a problem of irrational belief and subsequent deviant behavior? I assume you are thinking of more severe 'mental illness' like schizophrenia. Most people call this a mental illness and I call it brain disease. And yes, there is some convincing proof that it's a serious disease. For example, schizophrenics are abnormal responders on EDA. Also, there is the enlarged fourth ventricle theory, PET scan findings, etc.

Let me lastly address your point that belief has a neurochemical existence and is therefore the concrete referant. Doesn't EVERYTHING have a neurochemical existence. We might assert almost all human behavior is the product of "mental illness" if we believe brain chemistry abberation is the culprit. Does your brain chemistry not deviate from its usual course when you engage in different activities? Are you then mentally ill sometimes and not at other times. What constitutes an ideal brain chemistry profile? For example, assume I lose a significantly large amount of money on a hand of poker (or win a large amount). Wouldn't my brain chemistry change from its equilibrium point and therefore be in an abberant state. Would I be temporarily mentally ill until my brain chemistry re-orients itself? Can you see where this reductionism leads?

And your point about labels. Are labels useful? Well, I assume they are used as a means of facilitating communication. The utility of the DSM-IV is that it affords behavioral health professionals a common language. Uniform language helps conduct research and acquire compensation from insurance companies. A common language would seemingly be necessary for the purposes of assessment, treatment and research of behavioral problems. I do not deny this. However, labels also can lead to negative consequences such as stigma and discrimination. Also, the labels can result in clients capitulating and assuming a victim or sick role.

Lastly, let me briefly address the efficacy of REBT and its utility in treating 'mental illness' and addictions. I don't believe I can emphasize enough the proven utility of REBT and CBT in general. The founder of REBT, Albert Ellis, pioneered cognitive behavioral therapy. The meta-analytic studies show a consistent advantage for CBT over all other forms of psychological talk therapy and even medication for most mental illness (excluding psychotic disorders) and behavioral health problems. You might have noticed the decline in popularity of psychoanalysis. This is because psychoanalysis is being replaced by electic therapy and cognitive behavioral therapy, which generally produce more desireable results in a shorter period of time.

While REBT might be useless in stopping command hallucinations it might help a schizophrenic or somebody with a psychotic disorder deal more effectively with other challenges posed by their disease. I believe REBT and CBT (cognitive behavioral therapy) will generally improve the lives of those who apply this therapeutic approach.

JeffreyREBT "Wherein I don't promise to make you rich without trying, or even trying very hard; I do promise to say things that will make you FEEL rich."

I suppose with that distinction between mental illness and brain disease, I can agree. I do think brain disease can increase the risk of addiction, however. Also sometimes it is very difficult to make that distinction.

Going by dictionary.com disease is "A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms." So I would say if your belief structure could be considered "pathological" it would qualify as an illness. Personally I would say that any set of beliefs that causes harm to an individual can be considered a disease.

I believe that people who choose to treat themselves as victims will choose to treat themselves as victims, whether or not they have a convenient label. Many of these people do use labels as excuses, but I think they would assume victims roles regardless. In my opinion they want to believe they are victims, and they will use any tools at their disposal to reinforce that belief. I don't think the label itself is actually causing harm. My view on the stigma surrounding mental illness is similar - I think the stigma was actually stronger before the labels, and now that mental illness is coming to be understood that stigma is diminishing.

With regard to CBT, I agree that it is effective, but I also think it's limited. Other approaches to treatment are also very effective, and in some cases necessary. Group therapy, medications, humanistic therapies, and even treatments like ECT have their place. Labels help determine which treatment to administer when. Even cognitive behavioral therapies aren't universal. For example, patients with borderline personality disorder don't respond all that well to REBT - but they do respond well to dialectical behavioral therapy, a different CBT which takes the specific diagnosis into account.

Addictions to things that are not physically addicting (cocaine, sex, gambling, etc.) are totally for pussies with no self control and most likely a cry for help.

Being serious,
Capo

[craig r]

So, nicotine, alcohol, heroin, and benzos are the only drugs not for "pussies"? Those who do a few bags of smack a day are not crying for help, but those who snort 3 eight balls a day are?

craig

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Addictions to things that are not physically addicting (cocaine, sex, gambling, etc.) are totally for pussies with no self control and most likely a cry for help.

Being serious,
Capo

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[Alex/Mugaaz]

Hey guys, south park covered this last Wendsday, just a heads up.

All I'm saying is that if someone is "addicted" so something NOT ADDICTIVE then they are bitches.