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Dependence Versus Self-Determination

There is a road, no simple highway
Between the dawn and the dark of night
And if you go no one may follow
That path is for your steps alone

- The Greatful Dead

Addictive Disorders are notoriously difficult to treat because of the high relapse rate. While in treatment, patients typically comply with the treatment regime and are able to resist the pull of the incentive. The limitations of this strategy show up after treatment is complete and the external supports provided by the program are no longer available. When success is due to external sources of control, relapse is the most common outcome of treatment.

The alternative to passively receiving treatment is developing the power of your will. But willpower is a controversial topic.  Most everyone caught in an addictive trap has tried what they call willpower  —  "white knuckling it" — without success. As a result of their repeated failures, they conclude that they have no willpower. The idea that they are powerless rings true to them, because despite their best efforts and sincerest vows, they relapse again and again.

In fact, some people are powerless over their impulses and are best served by turning responsibility for outcome over to an external source of control. For others, the disease model does more harm than good. Your first, and possibly most important, task is to choose a strategy to get yourself out of your addictive trap and prevent relapse.

The Disease Model Vs Bio-Psycho-Social Model

In North America, the vast majority of treatment programs for addictive disorders are based on the 12-Steps of Alcoholics Anonymous.  According to this view, incentive use disorders are diseases. Treatment emphasizes admitting powerlessness over the illness, complying with a plan developed by treatment providers, and adopting the norms and values of a new social group—the support or self-help group—in order to achieve total abstinence, which is the only acceptable outcome goal. The victim of the disease is responsible for neither the cause nor the resolution of the problem.

The Bio-Psycho-Social Model: True, you are not responsible for falling into your addictive trap—you had no control of your genes, conditioning history, and the social world in which you live.  However, now that you are an adult you are responsible for acting in accord with your interests and principles despite the cause-and-effect principles that define the path of least resistance. Rather than encourage you to accept powerlessness over a disease, this approach encourages the opposite strategy: Namely, to develop the skills and faculties that enhance the power of your will.

Which is the best approach for you?

As is the case whenever you have to choose, there are two types of errors you can make. Consider the hypothesis "You have the disease of addiction over which you are powerless":

  1. Type I Error: Rejecting the hypothesis when it is, in fact, true. Some individuals who have developed a pathological relationship with an incentive have lost, or never possessed, the capability to over-ride their impulses. They will always require an external source of control to protect them from relapse. For these individuals to believe they can exercise their will during crises of stress and temptation is a grave error.

  2. Type II Error: Accepting the hypothesis when it is, in fact, false. If you have the personality traits and cognitive abilities required to exercise your will, fatalistic acceptance of the belief that you have a disease over which you are powerless can do more harm than good.

    • It is better to learn to fish on your own than to be fed by an external agent, because if you are fed, you will not be prepared to respond adaptively the next time you are hungry. However, when you learn how to achieve the desired outcome on your own, the change is irreversible. Likewise, if you depend on an external agent to prevent relapse, the next time you are in a high-risk situation you may not be prepared to handle it.

    • The loss of control that is often observed as people with Incentive Use Disorders go through rounds of treatment can be viewed as an iatrogenic condition in that it is a direct result of adhering to a treatment strategy of turning responsibility for change over to an external source of control.

{Take the Treatment Matching Self-Test to get some data on which approach is best matched with your personal attributes.}

Researching the Subjective Realm

Western education is primarily focused on the cause-and-effect principles that operate in the objective world. However, understanding addictive traps requires an appreciation of the cause-and-effect principles that operate in the subjective world. When you can see how a mechanical trap  — e.g., a mousetrap — works, you are not vulnerable to it. This course will guide you through a range of thought experiments, trance-formational protocols, and other invitations to explore and manipulate experiential phenomena. By following it you will become familiar. and learn to manipulate the cause-and-effect principles that operate in your subjective world. Developing the skills and faculties to work with these principles is the irreversible change required to master an addictive trap. contribute to your addictive trap and developing the skill to manipulate them will free yourself from it.

To do the course-work that will enable you to manipulate subjective phenomena such as motivation and emotion you have to appreciate the difference between objective and subjective reality. Addictive traps are maintained by illusions. The foundation of them all is the idea that "Seeing is believing." Understanding why it is an error is the key to freeing yourself from the self-sabotaging patterns of addiction.

 

Optical Illusions Illustrate the limitations of Perception > >
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