The Recovery Hall of Mirrors:
The American "Treatment" Tragedy
by Jack Trimpey
from The Final Fix by Jack Trimpey
(©1994) Lotus Press; all rights reserved
now available as Rational Recovery: The New Cure for Substance Addiction
Here is the exciting news, Treatment is dead!
That's right, addiction treatment is dead. Those who know best, the formerly-addicted "recovering," have long known, "Therapy doesn't work." In addictions, there isn't anything to be "treated." Either you will drink or use some more or you won't. You are free to do either, treatment or no treatment. Scientific research also shows that addiction "treatment" doesn't work. People who get treatment do no better, and often do much worse, than people who don't get treatment, as measured by abstinence.
"Treatment" was never really alive in the first place. Addiction "treatment" is an illusion beneath an illusion of addictive "disease." The American-style recovery movement is a hall of mirrors.
Rational Recovery has been a pioneer in the field of addictions for nearly a decade. By remaining completely separate from the 12-step "treatment" community, RR has had the freedom to explore the nature of addiction unhampered by the biases of tradition. The result of this experimentation is a revolutionary new approach to defeating alcohol and drug dependence called Addictive Voice Recognition Technique,* or AVRT.* To get started on your AVRT adventure, let us explore the illusions in the recovery hall of mirrors.
* NOTE: AVRT, pronounced "avert," stands for Addictive Voice Recognition Technique. Addictive Voice Recognition Technique, AVRT, and "the Beast" are service marks of Rational Recovery Systems.
Illusion #1. A chemical dependence is an addiction.
We depend upon many chemicals, including oxygen. It would be odd to describe human beings as "oxygen addicts." Many people depend upon prescribed or over-the-counter drugs to lead more healthful and comfortable lives. Others use substances for the pleasureful effect they produce, i.e., caffeine and other stimulants, tobacco, sugar, fat, herbs, alcohol, marijuana, opiates, and other miscellaneous substances called "street drugs."
All substances taken in sufficient amounts, including oxygen, have negative side-effects to offset their benefits, and it is correct to say that people would not suffer a drug's side-effects if they would not use it. A "side-effect," however, is aside from a drug's primary effect, which in the context of this book is pleasure. One way to limit side-effects is to limit or prohibit people's access to the substances.
It is vitally important that consumers of a substance be educated on its side effects. People who drink too heavily, eat lots of sugar, take opiates for enjoyment, eat fatty foods, smoke cigarettes, or drink a pot of coffee or tea each morning are not necessarily addicted. If they are aware of the negative side-effects, they may freely choose a chemical dependency for reasons that are entirely personal. An addiction exists only when an individual continues to use an intoxicant against his or her own better judgement. This leads to the next illusion.
Illusion #2. The state of addiction may be objectively demonstrated.
It is not possible for one human being to know the reasons for another's behavior. It has been said, "Anything that's worth doing is worth doing in excess." Some may differ with this wisdom on philosophical grounds, but is that sufficient cause to say there is something wrong with people who are devoted to certain pleasures? If one chooses extremely risky behavior, such as rock climbing, does it help to say he or she is "addicted?"
Are skid-row drunks "addicted" to alcohol? What are we saying about those people by saying so? Perhaps it would be better to ask the individual lying in the gutter rather than to assume that he or she really wants anything more than the effect of the next drink. The inebriate may tell you that he or she is an "alcoholic," and cannot behave otherwise, but this suggests that drunkenness is a chosen lifestyle, that drinking alcohol is the most meaningful activity for that person, that the inconvenience of street life is an acceptable side-effect of the drug alcohol, and that he or she has ruled out other possibilities such as refusing to consume more alcohol.
Many such people live in low-income areas and use all of their personal and financial resources to maintain a significant blood alcohol content. They are told by the judgement of society that they are addicted, and most of them paradoxically agree. But following Illusion #1, is the assertion that addiction exists only against one's own better judgement. If we take the time, and if the inebriate is sober enough to reflect on questions, we may find that he or she sincerely wants to quit drinking, but acts otherwise. At that point, we may conclude, based on his or her subjective statement, that a state of addiction exists.
Illusion #3. Alcoholism or addiction is a "treatable disease."
There is not one tiny shred of evidence that substance addiction is, or is caused by, a disease, or that people drink because their ancestors drank. Conversely, and very importantly as you read on, addiction is not a symptom of any disease. Addiction is merely a fact -- a state of being. People who drink heavily or use drugs a lot are not necessarily included among the addicted, even though most of them may in fact be addicted. This discrepancy sets up endless illusions in the recovery hall of mirrors.
Substance addiction causes diseases such as liver disease, heart disease, neurological disease, digestive tract disease, diseases of the skin, and also aggravates a much larger number of other diseases. These are side-effects of the substance or drug. But there is no known disease that causes one to drink or use drugs for the pleasurable effects they produce.
Addiction to alcohol or drugs is a state of hyper-hedonism, a devotion to pleasure produced by the substance, and ultimately becomes a condition of chemically-enhanced stupidity. No disease, no "treatment."
Illusion #4. People who are addicted need "treatment."
Says who, and for what? Don't all substances have negative side-effects? Isn't an addiction the willful pursuit of chemically-influenced pleasure against one's own better judgement? An addicted person may need treatment for serious side-effects of the substance, but how may one's desire for pleasure be "treated"?
Doesn't the preamble to the U.S. Constitution guarantee " ... the pursuit of happiness"? Were the Founding Fathers, most mourning the loss of loved ones in the Revolutionary War, concerned about the cost of freedom? As a concept, the "treatment" of desire not only clashes with uniquely American concepts of freedom, but also places a shroud of social oppression on large segments of society, our chemically dependent and addicted masses.
Self-intoxication is a fundamental freedom. After all, whose life is it? The ugly results of self-intoxication are the cost of that freedom.
If I drink every minute of every day, am I not making a choice to do so? If I am free to do this, am I not free to stop it? If I can think of no good reason to stop drinking, why should I stop? If I am willing to go to jail, why shouldn't I smoke crack? Remember, addiction is intoxicating oneself against one's own better judgement. If my best judgement is to drink alcohol and accept the risks involved, how can I be "addicted" or otherwise diagnosed? Who will render this opinion, and what's in it for them?
Addiction begins not with intoxication, but with awareness of pain and a desire for a better way of life. It continues with a sense of ambivalence, being "of two minds," and it ends with reclaiming one's self from the grip of pleasure.
Illusion #5. Addiction runs a course counter to a person's wishes, and if not "treated," progresses toward death. (Substitute "malignant tumor" to sense [the irony of] the illusion.)
Drinking or drugging by an addicted person is willful behavior that reflects the addicted person's sincerest desires. He or she may also desire to avoid the consequences of the addiction, but the behavior, nevertheless, is chosen in spite of the risks involved. Addicted people are not victims of any predisposition, malady, disease, or inherited deficiency. Instead, they are facing the same responsibilities as any other citizen but making consistently poor decisions in dealing with them.
Additions may result in death from acute intoxication, from diseases caused by addiction, or from dangerous behavior resulting from impaired judgement. But the consequences of addiction, even death, are best attributed to the individual rather than to circumstance at birth. The state of being addicted is a fact; facts may change, but they are not progressive!
Illusion #6. One cannot independently quit an addiction because it is a symptom of something of which one has little awareness, and over which one has no direct control.
Only about a third of all people who stop their addictions get help of any kind. Stopping an addiction is not as difficult as most people make it out to be; the struggle is shortly over. Staying stopped is also easy, because sobriety is self-reinforcing. People who get "treatment" do less well than people who get better on their own. When people take personal responsibility to quit their addictions, they get better regardless of how serious or long standing the addiction.
Many veterans of the Viet Nam conflict returned to the United States addicted to heroin, but upon resuming civilian life, 90% of them quit using altogether without getting "treatment." (Sixty-four percent had used narcotics before entering the military.)* Some say they had "spontaneous remission" from the disease of addiction, but we may more realistically conclude that their better judgement took over when it was no longer appropriate to self-intoxicate.
* NOTE: Robbins, L.N., et al, Drug Use by U.S. Enlisted Men in Viet Nam: A Followup of Their Return Home, American Journal of Epidemiology, 99(1974):235-249
The term "denial," among other things, is the idea that addicted people are pathetic dumbbells who cannot figure out that they are drinking or drugging themselves into trouble. It is used to describe people who do not know why are addicted. No such persons exist, for addiction is known only to the addicted person. Remember, addiction is drinking or drugging against one's own better judgement, not against someone else's judgements.
The American Society for Addiction Medicine is an enclave of physicians whose chemical dependencies brought them before the judgement of others, others who told them they were addicted. To save their careers, the doctors fled into "treatment," asserting that "denial" is a cardinal symptom of the disease of alcoholism. Thus, the disease-model "treatment community" perceives that all chemically dependent people are addicted and don't know it, and that their presumed ignorance is a symptom of a disease for which they are not personally responsible. (They forget so soon that they knew all along exactly what they were doing during their years of inappropriate drug use.) This illusion, above all others, has brought us the American "treatment" tragedy in which substance abusers and chemically dependent people who are exercising the fundamental freedom to intoxicate themselves are coerced into "treatment" programs that forcefully impose a belief system which makes recovery from addiction impossible.
Chemically dependent newcomers to recovery support groups are often smugly told, "You may continue to drink, but you won't be able to enjoy it." Here, a chemically dependent person is told by others that he or she is addicted, against the group's better judgement. Later, one may experience uneasy feelings concerning continued use, but that uneasiness is not, per se, the result of going against one's own better judgement. More likely, the person feels uncomfortable as a result of going against others' judgement, especially when they are predicting, "Betcha can't have just one."
The reason to drink or not to drink is this externalized -- taken away from the chemically dependent person! This sets up an oppositional relationship between newcomer and group which continues until the person finally surrenders (snaps) under the illusion that he or she is powerless to exercise better judgement over the desire to drink or use drugs, when actually one has been exerting his own free will against the better judgement of others. The "treatment" in store is likewise externalized in sponsors, higher powers, and ancient philosophical dilemmas. "Treatment" is often a disguise for those who would deprive us of our freedom to make bad decisions. They feel justified to intervene in the lives of others, pass judgement on others' behavior, and to "treat" someone else's desire for pleasure, " ... for their own good."
Few "do-good" movements in American history have achieved such social prominence as the recovery movement, which may also be referred to as the American "treatment" tragedy. The recovery movement is only a replay of the American prohibition tragedy, but the toll in suffering, in lives, in money, and in threats to our Constitutional freedoms is much larger this time. Like a retro-virus, the "treatment" mentality has penetrated the protective membrane between church and state, resulting in the release of enormous sums of money for "treatment" that is little more than religion disguised as science, and which has the sum effect of spreading illusions that are the root cause of mass addiction.
Illusion #7. Some substances are more "addictive" than others, and some addictions are stronger than others, making them more difficult to overcome.
The Latin roots of "addict," are ad, meaning "toward" or "yes," and dict, meaning "say." People may become dependent on a wide range of substances by choosing to take them for their effects. Substances do not addict people; people do, by continuing to "say yes" against their better judgement, which says "no."
Addiction is a state of being, a fact that is neither severe, strong, nor serious. (To sense the illusion, imagine an earthquake -- moonquake? -- on the moon. Is this serious? Is it severe?) The results of addictions, however, may be devastating, but that does not mean that the addiction itself is stronger or more difficult to overcome. Interesting research by George Valiant shows that abstinence is a more common outcome among men who were most "seriously" or "severely" addicted.* Research on Rational Recovery groups by New York University Medical School showed no difference in abstinence outcome among participants who were addicted to alcohol versus cocaine. It is often said that tobacco is more addictive than heroin, and that crack is the most addictive of all. The message to those who use those "most addictive" substances is, "Now you've done it. You're hooked. There's no turning back." To any addicted person, the most serious addiction in the universe is the one he or she has; other addictions are irrelevant.
* NOTE: Vaillant, George, "The Natural History of Alcoholism," Cambridge, London, Harvard University Press, 1983
The traditional disease model of addiction views addicted people as victims of chemical culprits (Devil Rum, cunning and baffling), thus shielding addicted people from responsibility and realistic hope. We have declared war on external substances rather than upon the ignorance of addicted people. Then, ironically, we indoctrinate them further, usually at public expense, with the idea that they are not responsible to immediately, confidently, and permanently discontinue the use of substances they find harmful. The structural model of addiction finds the cause of addiction within each addicted person, and identifies human consciousness as the battlefield for each individual's war on his or her addiction.
Illusion #8. There is something inherently "wrong" with, or different about, addicted people.
If so, what is it? Is there an addictive personality? Hardly. If you will look at a group of people in "treatment," you will see enough human diversity to overwhelm any such prejudice. Addicted people have little in common except their common pleasure of self-intoxication -- and the suffering resulting from it. "Treatment" focuses on the wide spectrum of human imperfection including irrelevant issues such as character flaws, health and nutritional problems, genealogy, emotional disturbances, spiritual deficiencies, psychiatric problems, relationship problems, family conflict, and psychological maladjustment. When a sufficiently negative self-concept is identified, it is then "treated" through unwholesome introspection guided by group norms or talented "treatment specialists." This process occurs during a time of special vulnerability, when one is usually desperate from some self-induced life crisis. The tragic result is that the addicted person concludes that the life crisis happened not as a direct result of chemically-enhanced stupidity but because of deep-seated, longstanding, or inherent personal defects. An addiction treatment disorder has been created, in which the addicted person now believes that his or her substance addition is a symptom of other imperfections. This, of course, leads to the next illusion.
Illusion #9. If an addicted person becomes better adjusted, more self-accepting, more fulfilled, more emotionally mature, and happier in life, he or she will become less inclined to drink or use.
Your original problem -- drinking or using drugs -- has been redefined as a symptom of something else, over which you are powerless. Now, you must commit to a plan for general self-improvement, at least until your insurance runs out. The long, long road to recovery loops through support groups for disease victims, inpatient detoxification, outpatient programs, and other publicly-funded formats. In none of these publicly-funded programs will "treatment" expect that you would immediately quit forever, but only for one day at a time. If your addiction were abruptly ended, how could the next meeting or "treatment" session be justified?
"Treatment" projects a set of values and beliefs, whether they are spiritual, humanistic, religious, scientific, rational, or psychological. Addiction is far too democratic to strike any philosophy or religion, and recovery is too widely distributed to favor one particular viewpoint. Whatever one believes, one can believe it drunk or sober.
"Treatment" teaches relapse by implying that you will continue to intoxicate yourself until "treatment" of the root causes finally takes effect. It is a bargain that promises a payoff -- a happier life, fewer problems, better friends, and better feelings all around -- in exchange for your loss of that precious stuff. When things go bad, the deal is off, and back to the stuff you go. But if you win the lottery or have some other windfall of good fortune, your reasons for quitting are also removed, and back to the stuff you go. If there is no change for better or worse, there is no reason to consider quitting. Your addiction exists on its own, separate from all else. It is all yours, and it will continue until you decide to end it.
There is strange comfort in getting "treatment" for your addiction because you are spared the immediate and long-term responsibility of self-discipline. When you get drunk it is called a "relapse" instead of common stupidity, and your attention is further diverted from self-discipline by increased emphasis on irrelevant matters such as inner conflicts, moral betterment, spiritual growth, relationships with others, and your failure to heed the advice of your mentors.
In spite of all the hocus pocus, you know you drink or use -- good times or bad -- because that is what you want to do. You are already "treatment-wise." Stay that way.
Once you are securely abstinent, treatment may be a very good idea. You may then get your money's worth because you will be seeking help for problems that others can help you with. You will be seeking help for the same legitimate reasons that others do.
But who's to say that you will need help with your personal problems? Having defeated a serious addiction, you may wisely conclude that you also have what it takes to tackle other problems unhampered by routine self-intoxication.
Illusion #10. There is no cure for alcoholism or drug addiction. Once an addict, always an addict.
Here we see the permanent loss of freedom that comes with "treatment." The authentic self is lost to a new self-identity as a "recovering" person, struggling endlessly against the inevitable.
There is no disease of addiction, and no "treatment," but there is certainly a cure -- a final "fix" for the problem. You are reading it. AVRT* makes your last drink your final fix, freeing you from the prison of addiction. Those who have been in "treatment" may take back their lives from recovery.
* NOTE: AVRT, pronounced "avert," stands for Addictive Voice Recognition Technique. Addictive Voice Recognition Technique, AVRT, and "the Beast" are service marks of Rational Recovery Systems.
Let me summarize the above points using the concepts of Rational Recovery:
All substances have side-effects, sometimes quite painful. Chemical dependency is a civil liberty, a benign state in which people use substances for personal reasons, including pleasure, and often in the presence of painful and harmful side-effects. An addiction exists when one continues to use a substance against one's own better judgement. Addicted people are responsible for acquiring, maintaining, and ending their addictions. It is impossible for one person to determine if another is addicted, except by asking.
"Denial" is a self-canceling concept because it obliterates the self as a viable entity in the struggle addiction. The disease model of addiction is a fiction of convenience for addicted people, for those who "treat" addictions, and for people who wish to avoid the consequences of their addictions. "Treatment" insulates addicted people from personal responsibility to change, while education places responsibility squarely on the heads of addicted people.
There is more dignity in "stupidity" than in "disease," because you may do something about stupidity. With disease comes loss of freedom. In Rational Recovery, addiction is self-admitted stupidity -- acting against your better judgement. By taking a direct hit of personal and moral responsibility, you may take dramatic, decisive action to end your addiction, and in doing so be free from addiction as well as from an oppressive "recovering" lifestyle.
A list of illusions of the recovery hall of mirrors could fill this entire book. In fact, that is what is in store for you. Rational Recovery redefines both addiction and recovery in a way that appeals to your intelligence, your individualism, and your American heritage of freedom. The Final Fix sets forth AVRT (Addictive Voice Recognition Technique) as a natural avenue to permanent abstinence that anyone can use to completely recover from addiction. It was developed by a formerly addicted person (me) based on years of experience helping addicted people.
My career is a vote for the integrity of addicted people who take responsibility for (1) acquiring, (2) maintaining, and (3) ending their substance addictions. Addiction to alcohol or drugs is not a symptom of unhappiness or some mysterious disease, nor is it a way that people cope with life's difficulties. So, quit first, and quit for good. Maybe your life will be better, and maybe it won't, but at least you'll be in a position to know what your problems really are. AVRT bets that you'll know what's best to do about them.