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wundayatta's avatar

Why are addicts their addiction while the mentally ill are not their disorder?

Asked by wundayatta (58586points) February 23rd, 2010

When I say, “I’m bipolar,” people often respond by saying, “you are not your disease.” I see people say the same to folks with cancer.

However, at twelve step meetings, everyone introduces themselves by saying, “I’m [name], and I’m an alcoholic [drug addict/sex and love addict, etc.]” It’s the same language that makes people say “you are not your disorder.” However, I haven’t heard people say, “you are not your addiction.”

I suppose people could say it and I just haven’t noticed. But the language of twelve step programs clearly identifies individuals with their addiction.

So, is it true that addicts are their addiction? If so, why are addicts their addiction while the mentally ill are not their disorder? If not, what’s with the twelve step language?

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17 Answers

KatawaGrey's avatar

I think it’s because addicts choose to take that first step. You did not choose to be bipolar but the heroin addict chose to put the needle in his/her arm the first time. They may not have chosen to be addicted but they willingly set themselves on that path.

I also think it’s a political correctness thing. Let’s face it, some people are their diseases but no one’s going to say that. If your bipolar disorder consumes your life and ruins your relationships and environment, then, yes, I think you are your disease. However, if you keep it in check by whatever means, then, no, I don’t think you are your disease.

stump's avatar

I think it is because in the 12 step thinking, you have to accept that your addiction will always be with you. A disease or disorder can be cured or corrected, but you are an addict because something inherent in you makes you more likely to become dependent on something self-destructive. If you are an addict, you have to change your behavior for the rest of your life, and always remember that you could slip back into the self-destructive behavior. You are never cured.
I think that is the 12 step philosophy, but I am not an expert.

marinelife's avatar

It dates from the 1930s. There are a number of issues with 12-Step programs, but people cling to them, unchanged, because they have helped some people.

wundayatta's avatar

@stump and @KatawaGrey I think those are really good points. It makes me wonder, though, about the idea that an addiction can not be corrected. I’m no expert, of course, so I hope I’m not being too ignorant. Still, it seems to me that addictions are often mental illnesses on their own, or they are comorbid with other mental illnesses. I.e., a lot of bipolar people are also addicted to one drug or another.

It seems to me that if you treat the underlying source of pain, then the need for the “medication” that the substance supplies is no longer there, and, once you break the dependence on the drug, you should no longer be tempted to use it. In a way, what you call “the first step,” @KatawaGrey, can also be seen as the first step towards recovery from something else—usually mental pain from either brain chemistry or environmental conditions. It’s not an effective step, but it may be all people know about.

Trillian's avatar

I think we waste way too much time on semantics. The person with bipolar disorder and the addict both have choices to make in the pursuit of treatment and living a more healthy life. The bipolar person choosing to get off his/her medications does so knowing on some level that he/she will go back to the destructive behaviours just like the addict who chooses to fall off the wagon that one time is reverting back to that particular pattern of behaviour that is ultimately self destructive.
Maybe there should be support groups for bipolar people. It might help them to stay with their own course of treatment.
Then, rather than listening to lay-people like myself who have no real knowledge other than what I hear on Oprah, the persons with whatever disorder is out there can be trained to listen to their doctors and professionals for definitions and guidance and to ignore well meaning people who say things like “You’re not your condition.”
I think that the problem with this kind of thinking and reasoning is that ultimately people think it is bad to have a mental condition like bipolar. Mental health bears a stigma, so we hasten to reassure people that it’s ok, it’s not their fault, etc. So on some level, we’ve internalized that mental health problems are somehow lessening of a person. Once we can get past this line of though and just deal with the mechanics of an addiction, or a bipolar disorder the way we deal with the mechanics of any other disease or condition, we’ll all be better off.

Just_Justine's avatar

Admitting you have something drives you to the pharmacy to collect your medication. Admitting you lie all the time means you are becoming honest. To be honest is to accept. To accept is to take steps to stop it. Or to take other steps to assist yourself in recovering from that which you have admitted to. I could say “I have bipolar” or “I am bipolar”. The latter is in the primary reasoning stage when you are assimilating what has just happened, often useful in resistance or reminding. However, if you were your alcoholism you would still be drunk right now (as an e.g.) so you realise you have it but you are not it.

escapedone7's avatar

I just think the language developed for the twelve step was written before the concept of political correctness came on the scene.

Perhaps part of the reason they do this is because accepting you need help or have a problem is an important step in the recovery process. I imagine someone goes through a period of denial before they accept the fact they need help. Standing up and admitting there’s a problem may be a breakthrough after a stage of denial. So perhaps this is meant to foster growth in that way. Saying “I have an addiction” would probably have the same effect though. I’ve never been through the 12 steps so I am not sure.

Personally I view addiction as a psychological problem like any other. I don’t believe a person is their addiction.

CMaz's avatar

That is semantics. It is the same thing.

All leads back to the mental.

Shuttle128's avatar

Well, there really is a difference in how people see addiction and how people see mental illness. Overall it all stems from things that a person cannot control: genetic predisposition or physical condition. I think identifying yourself with a condition, regardless of which it is, promotes rebound problems. When you fall back to saying “I cannot control my desires” it doesn’t allow the necessary feedback that promotes better behavior. When one has the mindset of “I am not my disease” they can self-correct much more easily.

Simone_De_Beauvoir's avatar

I don’t agree. I think many people do treat people with mental illness like they’re their disease.

YARNLADY's avatar

@Trillian there are support groups for people with bipolar disorders. They range from group therapy to chat to Q & A to 12-step type groups.

phoebusg's avatar

You are also not your condition. You suffer from addiction, alcoholism for example. The intention behind “I’m X” is for purpose of acceptance of the condition. But if it’s so close that it is one’s identity – isn’t it harder to get rid of?

I am A, and I have B. vs I am B.
If you are A and have B, you can also not have B. Thus B is possible to overcome.
Or at least, diminish/put under control. You are still A. Instead of thinking you will always be B.

But then again, are you even A – in the first place? ;)
Thus labels are temporary, as your awareness moves, so should your label(s).

Trillian's avatar

@YARNLADY As I was typing that, I thought; “I bet I’ll find out that there are, indeed, support groups out there.” That’s good, I think it’s a positive thing.
As an aside, I meant to tell you that I didn’t feel like I was glorifying rapine and murder by talking like a pirate, and I don’t think the others did either. We were just having some fun with the syntax and grammar!

YARNLADY's avatar

@Trillian I suppose that is safer than doing ‘hillbilly’ or ‘Okie’ which usually manages to be offensive to someone

Trillian's avatar

@YARNLADY Yer prabbleee raht abahhht thayut!~

wundayatta's avatar

Yup, there are bipolar support groups all over the place. There’s a web site that will help you find one in your area. Mine is very helpful. I look forward to the meetings with much anticipation. I was disappointed that the last one was cancelled due to snow. It is a wonderful thing to be surrounded by people who understand.

Meetings are run in all kinds of ways. My meeting does “care and share” but that’s about all the jargon there is. We talk when we want to, but everyone has a chance to speak at each meeting. Usually there is what the 12-step folk call “cross-talk” at the meeting. Personally, I prefer that, but then I know how to control things when people start offering “shoulds” without having been asked for them.

Judging from what I’ve heard and the one meeting I’ve attended, 12-step groups have many more rituals and stricter adherence to customs developed a while back. I know that rituals are important, because they bind people together and make them feel a part of something. Since I didn’t know the rituals, I felt quite apart. And even if I had known them, the fact that they remind me of religious rituals makes me feel apart.

It was a beginners meeting, so the focus really is on the traditions and commentary on the traditions. However they do use techniques that are also used for brainwashing. As people here have mentioned, they break down your resistance to some degree and then rebuild it in a shape that fits with the tradition. I would not go so far as to say it is a cult. In the particular group I went to, there is a big fuss made about equality (no leaders), and anonymity, and what that allows you to do (and anyone who has been here for more than a month knows how strongly I feel about anonymity).

Believe it or not, I didn’t take an opportunity to speak. What was a big problem for me was starting my saying, “my name is Wundayatta and I am a sex and love addict.” I don’t know if I am. I don’t know what the definition of such an addiction is. I know I’m not a sex addict. I know that my psychiatrist, going by the DSM IV, doesn’t know what hypersexuality is.

In my research yesterday, I found out that the “love” part of the addiction (the only part that seems relevant to me) was added as an afterthought in order to make it more palatable for a church to rent them space. I found out that the concept arose from the meetings, and was taken up by and popularized by therapists. It wasn’t a problem identified by research, nor did anyone really think it was a problem until a couple of AA folk decided it was one. I found out that there is no one definition of this kind of addiction, and that the formulation of the definitions seems to be primarily based on social norms. I don’t know this yet, but I can’t imagine that the treatment has been proven effective by research, nor do I imagine there is one standard definition of health in this area.

Well, I’m interested in other people’s experience. It’s also a bit off-putting that the research shows 12-step “treatments” do no better than no treatment at all. I’m not going to go to a stampede of meetings at first, as they suggest (another brainwashing technique), but I will keep going mostly to get what I think the meetings really offer—a chance to be with other people who understand. However, I am pretty sure that even if I went for years, I would never feel the kind of connection to the group that is supposed to be engendered by those rituals.

Anyway, people. Thanks for your help on this topic.

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