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 Post subject: The disease debate
PostPosted: Wed Oct 07, 2015 11:39 am 
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Joined: Fri Oct 31, 2014 11:17 pm
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Here is a message I sent Coach Boundless recently, who wanted it to be shared on the community forum so it could be discussed in public.

--

I'm taking a class on Addiction and Recovery right now and we're currently on the disease or not disease debate. My own opinion has been strongly influenced by discussions I've had with you on this site, so I would like to have you weigh in again, if possible.

First of all, is there a distinction to be made between what is practical for the person in recovery, and what is objectively true? I know this gets into more of a philosophical discussion...as I think it was Hume who argued that being justified in one's belief is (ethically, and perhaps in other ways too) more important than being correct. And there are many who would argue there can be no objective truth, no certainty about anything...hopefully without going down that rabbit hole, I still wonder about the distinction. Is it that seeing addiction as a disease, or "the beast" -- or as some functional entity in the brain that robs the individual of control, because that's what the term means, right? :? -- is objectively incorrect, or just impractical for the individual in recovery? Does this question of mine make sense?

On the one hand, I totally agree with you that seeing addiction as "insert intimidating image here" can lead to problems. It may lead to the belief that there is something inherently wrong with the individual who has an addiction...that there would be a sense of permanency...that the individual would always have to struggle to keep that "thing" under control. It may lead the individual to fear losing control of this thing, where he might then develop a kind of learned helplessness or self-fulfilling prophecy, in which he believes that an urge activates a part of him that is more powerful than his own will. It might also, for the particularly insincere individual, serve as a wonderful excuse to continue engaging in the behavior..."hey, it's my disease, it's not me...I can't help it...chuckle chuckle". It might promote a dependency on recovery programs and self help fellowships, which keep the individual living in fear, which reinforces the individual's mistaken belief that he is "powerless" over the "thing". And on and on. I get that. And how unhelpful that is. So on a practical level, I have no hesitancy in completely embracing the argument that addiction is NOT a disease, or a mysterious beast, or an evil genius.

But there are also things that make me struggle to come to terms with this. In reading a lot of the neuroscience behind porn addiction, there are clear indications that the prefrontal cortex can become inhibited by excessive porn use and masturbation, which activates more primitive areas in the brain that play a role in impulsive decisions/pursuit of instant gratification (I think?). I understand that in many cases, it is not very practical for the person in recovery to consider the complex interactions of neurons in the brain to understand what is going on with him, what he needs to do, etc. But is this always the case? Do we just reject that part of things entirely? How can we reduce clear, physical processes to emotional immaturity and a lack of understanding of how to effectively manage emotions?

Consider my most recent source of anxiety:
When I ejaculate too frequently (more than once or twice in a week span), I experience very pronounced negative symptoms, typically taking the form of social anxiety, depression, and anxiety. This may or may not be explained by my feelings about my own sexuality, which most likely are not very good..but if it's more rooted in my belief system, you'd think these problems would show up after every ejaculation. Yet they clearly do not. Only when it happens at a certain frequency. And it turns out, there seems to be something going on in the brain with that. There is a reported "chaser effect" that many recovering porn addicts experience following sexual intercourse, which is marked by significantly increased cravings for pornography and masturbation. As I have been having sex more frequently with my girlfriend, this has been happening to me. But here I am, far more emotionally mature than I was year ago, having more of an understanding of my emotions, more tools to manage them, and yet today I have found myself feeling very insecure and unstable in my foundation. The urges I have experienced today have been very difficult to silence...they have not just been for porn, but also I find sexual fantasies arising as I see attractive women in public, and I have trouble redirecting my attention. And then all the anxiety pours in...that I must somehow be back where I was a year ago, that I'm no good, etc, all the frustrating self-defeating thoughts that accompany most of my emotionally unstable moments. Anyway, back to my point, isn't it helpful to pay heed to whatever insights the objective, biological perspective has to offer here? How else do I come to terms with these kind of things?

I find it difficult to reconcile these conflicting viewpoints...in my addiction and recovery class, we are studying Ken Wilber's Integral Theory, which regards the objective analysis of brain function and observable behavior (Individual, Exterior) as equally as important as the subjective experience of the individual in question (Individual, Interior), which in turn is equally as important as the intersubjective, socio-cultural perspective (Collective, Interior), etc.

Is there a way, in this health based recovery that we are striving to enact at Recovery Nation, to utilize the insights from all perspectives, or is that not the most practical approach, in your opinion?

Aren't there varying degrees of addiction? Someone who experiences withdrawal from caffeine addiction is likely to suffer less than someone withdrawing from methamphetamine addiction, right? But what if, hypothetically, both individuals are exactly equal in their emotional immaturity? Both are similarly undeveloped in their emotion management skills. Then how do we explain why it's harder for one to recover than for the other, without talking about addiction in terms that contradict what you've expressed about addiction? (That there is no "addiction" per se)

What does the term "disease" even mean? What does it mean to "lose control"? What does it mean to have or not have a choice?

Is there a distinction to be made between an individual's capacity to choose before engaging in the ritual/behavior, and the capacity to choose once the ritual as begun? Does the alcoholic have the same ability to choose after two drinks as he did sober? Does the porn addict have the same ability to choose after beginning to watch a porn clip as he did before opening his computer? What does it mean for there to be a "point of no return", and how should that inform our understanding of addiction?

Are all addictions created equal? How do we distinguish between a person who abuses a drug or behavior to cope with a lack of emotional management skills, and a person who compulsively uses a drug or behavior even with the proper set of skills to do otherwise?

What about the theory that there are different kinds of alcoholics? Quoted from wikipedia:

"Alpha alcoholism: the earliest stage of the disease, manifesting the purely psychological continual dependence on the effects of alcohol to relieve bodily or emotional pain. This is the "problem drinker", whose drinking creates social and personal problems. Whilst there are significant social and personal problems, these people can stop if they really want to; thus, argued Jellinek, they have not lost control, and as a consequence, do not have a "disease".
Beta alcoholism: polyneuropathy, or cirrhosis of the liver from alcohol without physical or psychological dependence. These are the heavy drinkers that drink a lot, almost every day. They do not have physical addiction and do not suffer withdrawal symptoms. This group do not have a "disease".
Gamma alcoholism: involving acquired tissue tolerance, physical dependence, and loss of control. This is the AA alcoholic, who is very much out of control, and does, by Jellinek's classification, have a "disease".[13]
Delta alcoholism: as in Gamma alcoholism, but with inability to abstain, instead of loss of control.
Epsilon alcoholism: the most advanced stage of the disease, manifesting as dipsomania, or periodic alcoholism."

What do you think of this? Is this bullshit? Or are there varying degrees of dependence/loss of control? What implications does this have for our understanding of addiction? Again, what does it mean to lose control? Does that represent some mistaken belief that the drug or behavior = survival, which implies that we can potentially change this cognitively? Or is there actually an inability to make the right decision? What does that mean?

I also wonder if we should be making distinctions between various developmental stages of recovery, and how our conception of addiction should change as our own recovery process develops. For me when I first started my recovery, I would have been shocked and outraged to hear things such as "there is no addiction, it's simply emotional immaturity"...but now I am much more interested in viewing addiction that way. But for someone who feels as though they have lost control, hearing it being referred to as a disease might provide some solace. Knowing that hypofrontality (where the frontal cortex becomes inhibited) actually happens might provide a sense of relief for an individual who would otherwise be at pains to explain why he continues acting the way he does. I guess what I'm getting at here touches on what I asked in the beginning...what is practical vs. what is true. In the disease debate, which part are we trying to answer? We know that there are brain changes that occur in addiction which make decision making more difficult. This clearly has more of an effect on us in the early stages of recovery, as we work to rewire the brain, form new behavioral patterns, connect more with our values, (notice I'm trying to reconcile the biological and the subjective here), understand our emotions better, etc... in these early stages, hypofrontality and other neurological phenomena seem very real, and very important to understand. But as we put distance between ourselves and our addictive behavior, our brains get a chance to begin to heal. It then becomes much easier to endorse the view that addiction is nothing but emotional immaturity, because now we've created enough space for ourselves to begin to replace the addictive behavior with healthy behaviors. But for someone who is withdrawing from their DOC in the first week of abstinence, should we still be so quick to reject the disease/brain science viewpoint?

The common argument that if you put a gun to the head of an alcoholic and tell him you'll kill him if he drinks the drink in front of him, and he chooses not to, so therefore there is no disease, it is a matter of choice, how legitimate is that argument? Does that focus too much on behavior, and not enough on what's going on in the mind?

I imagine there are more contradictions and issues to look at on both sides of this debate, but I think the gist of my own inner conflict in trying to come to terms with this has been brought to light. This topic causes me a lot of anxiety. If addiction truly is a disease, what does that mean? If it is not a disease, what does that mean? How should that change our approach to recovery? I think this also envelopes a lot of other relevant debates about recovery, like the flaws of the 12 step process, the concept of calling oneself an "addict", the question of genetic predisposition to addiction, how we talk about mental health in general, etc.

Please weigh in.


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 Post subject: Re: The disease debate
PostPosted: Fri Oct 09, 2015 7:15 am 
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Joined: Sat Feb 09, 2008 3:55 pm
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I think Wikipedia has something with stages. I would be able to take that and accept it, though I think ultimately there is one thing know as alcoholism with these phases or stages, or perhaps realms. I do know addiction is a highly complex thing, with as many different pathologies or manifestations as there are people who are addicted. I might even go so far as to accept that addiction itself is the disease or disorder (I am not trying to be ambiguous) and alcohol or sex, or pornography as the expression which develops into its own classification. With that said, I think there are 'aggravators' which bridge the social and genetic aspects of addiction. Some of those would include familial conditioning, childhood trauma, Complex PTSD, or even harmful socialization and environmental stimuli.


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 Post subject: Re: The disease debate
PostPosted: Fri Oct 09, 2015 9:33 am 
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Joined: Mon Feb 11, 2013 7:13 am
Posts: 687
Coach Sandlewood, was just going to post in mentor forum that I wish you'd post more as MeepMeep referenced an awesome post from you. You really help me get the recovering in relationship perspective and the developmental stuff.

Roadtorecovery,
Can't resist a good meaning of life (recovery) debate:). Pulled me in:) May not be what you are asking for but helped me to give it some thought. I have limited time i want to spend on this so please forgive and skim the parts that don't make sense.

First it would be easy to say you are complicating things, but when you are in a class it is counter productive "to keep it simple". If you were just talking about your own recovery process I might be prone to mention that:).

Also for me this kind of deep thinking creates imbalance, So I plan for it. I think about what I will do after to become centered again, go do laundry, breath, maybe do yoga, relax, ect.

I think you should post this on the mentors forum. To me this raises questions on many core values, sub conscious values, views of reality, ect. I think it would be really helpful in that forum to make more conscious why we are doing what we are doing in assisting others. And we can discuss, argue:) without detracting from people trying to lay a foundation of saving their lives. And as you ask later "should we view recovery as different stages, processes ect." I'd say yes. This philosophical debate seems to me to be a luxury for those that have laid a foundation, can recognize when we are off balance, have internalized our values, ect, done the workshop. But in the spirt of this format of discussion... It can be argued it has value to be addressed early on:). Also I have found the partners often have more highly developed formal thought processes, have really thought through these issues, unlike many of us adhd recovers who start a thought then jump to something else., then impulsively go do something:). You may find assistance there also.

You may be asking the origin of addiction which I am not sure anyone is able to resolve, hence all the debate and a class that raises the questions. So again it is probably the process of questioning that is important and not the result or finding the right answer, as there probably is not one.

Quote:
First of all, is there a distinction to be made between what is practical for the person in recovery, and what is objectively true?


I wonder this all the time. I most often go with the practical, a developmental view, baby steps. But then I wonder sometimes if we are deluded, on the wrong path will these baby steps just lead us to an unhelpful place? Like taking the wrong fork in the road?

I
Quote:
know this gets into more of a philosophical discussion...as I think it was Hume who argued that being justified in one's belief is (ethically, and perhaps in other ways too) more important than being correct.

Could you say more on this? Wondered this also.

Quote:
And there are many who would argue there can be no objective truth.


I struggled all my life with my mom and i's view of reality and when I learned about this concept, one day we were in an argument and it became clear. Both of us we "right" (and probably wrong) from our own interpretation of reality, what we were saying and experiencing was absolutely true for us. It was a light bulb moment that freed me of trying to convince her of my reality.

--
Quote:
is objectively incorrect, or just impractical for the individual in recovery? Does this question of mine make sense?


Makes total sense, love to hear how your thinking is progressing on this one.

So as far as practical versus objective truth. I have solved this for myself in a few ways. I really like the dialetical thinking, both/and not either or. I use the statement on recovery nation all the time, "we are all doing the best we can AND we can do better." Both are true and both are not true. I see this operating on our boards. I think it is beneficial if some are bringing awareness to truth, ultimate reality, ect and equally beneficial to have people working on the practical side of things. The concept I think you are familiar with absolute and relative boddihiccata helped me here also.

Quote:
So on a practical level, I have no hesitancy in completely embracing the argument that addiction is NOT a disease.....
But there are also things that make me struggle to come to terms with this. In reading a lot of the neuroscience behind porn addiction....
Do we just reject that part of things entirely?
How can we reduce clear, physical processes to emotional immaturity and a lack of understanding of how to effectively manage emotions?


I think they all interrelate, the messed up biological processes many of us are born with (disease?), make us vulnerable to high emotional states, then find immature coping strategies because we are immature, they work, we stick with them, then they cause us not to resolve or even look at existential issues, ignoring existential issues messes with our practical lives, which effects our biology. Goes round and round. So I guess I take an ecological, holistic view of things, everything is interrelated and effects everything else. Most helpful to address all areas we can.

Quote:
And then all the anxiety pours in...that I must somehow be back where I was a year ago, that I'm no good, etc, all the frustrating self-defeating thoughts that accompany most of my emotionally unstable moments. Anyway, isn't it helpful to pay heed to whatever insights the objective, biological perspective has to offer here?


For me the biological explanations help reduce some of the shame and give me some compassion for myself. I have pretty severe symptoms of ptsd at times, so now I say to myself this is just adrenaline, fight or flight kicking in how can I most quickly regain balance? food, rest, medation, mindfulness, yoga. So again the solutions all blend together. When I can see the "truth" get perspective, it helps reduce the biological symptoms. Then I can do more practical things to regain more balance.

I studied child development years ago and they discuss how every six months kids go into a "regression" basically because they need to integrate all they have learned. I see most of us going through this too, hence the need for a very developed internal monitoring system.

I
Quote:
find it difficult to reconcile these conflicting viewpoints...

I think most of do, then we make a decision, take an opinion, just to be done with the anxiety. Seems many of the worlds troubles stem from this inability to hold conflicting viewpoints, from poverty, to domestic violence and war.

Quote:
in my addiction and recovery class, we are studying Ken Wilber's Integral Theory, which regards the objective analysis of brain function and observable behavior (Individual, Exterior) as equally as important as the subjective experience of the individual in question (Individual, Interior), which in turn is equally as important as the intersubjective, socio-cultural perspective (Collective, Interior), etc.

I had a friend that went to Melborne,Australia and wrote his phd thesis on it, the four quadrants, trying to integrate all those philospohies, he is no simple thinker! Now that I remember him this may be close to what I think as far as recovering goes. biological, practical, spiritual, environment, interpersonal, all important. And maybe different "phases" moments in recover some are more relevant, in the forefront than others. they all are important and don't need to negate each other. Like you said:

Quote:
Is there a way, in this health based recovery that we are striving to enact at Recovery Nation, to utilize the insights from all perspectives, or is that not the most practical approach, in your opinion?


I
Quote:
also wonder if we should be making distinctions between various developmental stages of recovery, and how our conception of addiction should change as our own recovery process develops. For me when I first started my recovery, I would have been shocked and outraged to hear things such as "there is no addiction, it's simply emotional immaturity"...but now I am much more interested in viewing addiction that way. But for someone who feels as though they have lost control, hearing it being referred to as a disease might provide some solace. Knowing that hypofrontality (where the frontal cortex becomes inhibited) actually happens might provide a sense of relief for an individual who would otherwise be at pains to explain why he continues acting the way he does. I guess what I'm getting at here touches on what I asked in the beginning...what is practical vs. what is true. In the disease debate, which part are we trying to answer? We know that there are brain changes that occur in addiction which make decision making more difficult. This clearly has more of an effect on us in the early stages of recovery, as we work to rewire the brain, form new behavioral patterns, connect more with our values, (notice I'm
.

This is pretty much how I view this and I believe jon in the workshop addressed it this way also. He talks about brain chemistry in the beginning and the benefit of antideppresants in some cases, (biological) After the torture of the exposure to the philosophic question of our existance (vision) he switches to action plans (practical). In supplemental lessons he raises the issue of God, ect.

I
Quote:
imagine there are more contradictions and issues to look at on both sides of this debate, but I think the gist of my own inner conflict in trying to come to terms with this has been brought to light. This topic causes me a lot of anxiety.....


That's what school is for to cause cognitive dissonance, which raises anxiety, the key for me is to try and let the anxiety be there and not make a quick decision to reduce the anxiety. Easier said then done, but key to health! Good fortune to you on this undertaking yeeks!

_________________
"When everything else is stripped away the essential is reveled." B.K.S. Iyengar


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 Post subject: Re: The disease debate
PostPosted: Fri Oct 09, 2015 9:36 am 
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Timeforrecovery sorry about wrong name! I like to make lots of mistakes keeps me humble!

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"When everything else is stripped away the essential is reveled." B.K.S. Iyengar


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 Post subject: Re: The disease debate
PostPosted: Fri Oct 09, 2015 3:52 pm 
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Joined: Tue Oct 22, 2013 12:47 pm
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timeforrecovery1169,

Firstly, I know one thread which touches this subject ... The discussion took place on the partner's forum and you can find it here viewtopic.php?f=22&t=23362

timeforrecovery1169 wrote:
Is it that seeing addiction as a disease, or "the beast" -- or as some functional entity in the brain that robs the individual of control, because that's what the term means, right? -- is objectively incorrect, or just impractical for the individual in recovery?

Why must it be this or that? I think that calling it a disease or a beast, personalising it ... is both impractical AND objectively incorrect. It's impractical because it induces the idea of a battle against your own nature which is doomed to fail from the start and the individual is condemned to a life long Sisyphean task, there is no way it can be done ... It is also objectively incorrect because it pertains to learnt behaviour and undeveloped life vision and skills.

timeforrecovery1169 wrote:
But there are also things that make me struggle to come to terms with this. In reading a lot of the neuroscience behind porn addiction, there are clear indications that the prefrontal cortex can become inhibited by excessive porn use and masturbation, which activates more primitive areas in the brain that play a role in impulsive decisions/pursuit of instant gratification (I think?).

For me it's crystal clear that the physical and the emotional are sides of the same coin. One influences the other and viceversa. Extreme coldness in my body makes me sad, depressed, uneasy, uncomfortable, impatient, etc. while sheer terror or shock might give me a heart attack. I've been through anxiety and panic attacks which translated into a claw-like sharp pain in my chest or one time my body went numb ... first the arms then the legs for seconds on end, it felt like my body was being drained of blood ... For me it is clear that high pitched emotion may alter/affect our bodies/organs. Therefore, I strongly believe that there are modifications in the brain as a result of addiction but I don't see that as a life sentence. New links can be established, new associations made and stimulated.

timeforrecovery1169 wrote:
I understand that in many cases, it is not very practical for the person in recovery to consider the complex interactions of neurons in the brain to understand what is going on with him, what he needs to do, etc. But is this always the case? Do we just reject that part of things entirely?

We do not reject anything, we just don't encourage someone in early recovery to get caught up in theories and explanations which would not serve him/her any good at this stage. They need to keep the momentum and build on it, we all know how difficult it is to get going and keep a good rythm. The person wants to fix the perceived problem. There is a way to fix it. And this way does not go through neurological explanations, it goes through building a life vision and practicing value-based decision making in a way which rebuilds identity and associates positive emotions to one's values. For those who are interested to learn more, as long as it does not impede their recovery for the very reasons you were mentioning, it should make a good learning experience. But people can rebuild themselves and their lives without the additional complication. I believe that simple is better in this case. Unless, of course, you do not have a professional interest in the subject, like yourself :)

timeforrecovery1169 wrote:
And it turns out, there seems to be something going on in the brain with that. There is a reported "chaser effect" that many recovering porn addicts experience following sexual intercourse, which is marked by significantly increased cravings for pornography and masturbation. As I have been having sex more frequently with my girlfriend, this has been happening to me.

Everything happens in the brain. Not just the urges. Even your perceptions, your core beliefs, your world view, your self-image, your values, connecting with your values, etc. I've also experienced this "chaser effect" now and again, but I see it coming more from my difficulty in experiencing intimacy with another person ... coupled with having a fresh memory of sexual intercourse and the usual stress/tiredness ... It's like the times after having had intercourse, the memory of the pleasure lingers on for a while and I would want that without the added complication of engaging with someone else (read as ... without the anxiety, pressure, fear, struggle) There is a familiar, comforting feel to it but redirecting the thoughts towards the after-effects and consequences, usually creates the desired effect and it goes as it came, with minimum level of anxiety.

I would also advise taking a look at the way things play out when you are with your partner, if you allow yourself to have sexual fantasies (even if the object is her or not), if your stimulation comes from your mind through visual channels or if it is sensory based. In my own case, I had to monitor what went on in my head during intercourse and I tried (and succeeded) to give up fantasyzing while relying on the sensations in the body. Even if my problem was not watching porn as such, I had a problem with getting the sexual drive exclusively through visuals stored in my head, which is pretty close.

timeforrecovery1169 wrote:
Is there a way, in this health based recovery that we are striving to enact at Recovery Nation, to utilize the insights from all perspectives, or is that not the most practical approach, in your opinion?

Indeed, it is not the most practical, nor it is neccesary. Even so, many people find the concept presented somewhat difficult to comprehend and even more difficult to implement in their own life. What would be the point or the benefit of additional, seemingly conflicting information easily misinterpreted and misunderstood? Everyone is encouraged to read anything else they can and adopt any viewpoints that work for them ... practically. Only the individual can decide what works for himself/herself. RN is not an exhaustive approach to addiction and I don't think this was the intended purpose. RN is just something that works, something that guides and sustains change.

timeforrecovery1169 wrote:
Then how do we explain why it's harder for one to recover than for the other, without talking about addiction in terms that contradict what you've expressed about addiction? (That there is no "addiction" per se)

I do believe that addiction is "personal" as we are all unique and our circumstances are also unique. It's a mix of inumerable factors and experiences which shapes our identity, our life vision, our core beliefs, our connection to our values. I believe that for some it is more difficult to come up with an inspiring life vision, for some there is not enough of the right motivation, some are utterly terrified of dealing with the negative emotions they were trying to numb. I still remember the sheer terror I used to experience. It tried to take over at times since joining RN but now I lean on my vision and my goals for my life, it really has a soothing and motivating effect. It's not a walk in the park but I've never experienced that insane despair and terror ever since I started doing the lessons and making sense of myself and my life.

timeforrecovery1169 wrote:
What does it mean to have or not have a choice?

In my experience, I did not have a choice when I did not think of the alternative. In a certain situation, I was only "able" to think and act in one way, and not because I was mentally deficient but because the excitement of going ahead with it and the need to make myself feel better overtook other things I could have thought of. There was no choice because there was no process of weighting, no alternative to choose from. It was an automatic process of doing what I felt like doing and the costs never registered then, only later, much much later. Add to this a total ignorance of my own values and a lack of self-identity and awareness.

timeforrecovery1169 wrote:
But for someone who is withdrawing from their DOC in the first week of abstinence, should we still be so quick to reject the disease/brain science viewpoint?

I don't equate the brain modifications as a result of addiction with the notion of having some sort of mental disease. Immediate gratification is about emotional immaturity. This is very clear to me as I'm raising two kids who are (hopefully) in the process of ingraining values and learning how to weigh their choices through the filter of the long-term consequences. They engage daily in countless and repeated activities which grossly violate most of the commonly accepted values, doing whatever pleases them in that very moment with all the accompanying minimising, blame shifting, lying, hiding, cheating, selfishness, occasional agression, etc. If it weren't for the boundaries, rules and the balance that we as parents are enforcing upon them, they would surely be already addicted to pretty much anything from watching TV to food and playing. Imagine they never get past this stage and they never develop self-control based on personal values, vision and a sense of "who I want to be"... the result would be quite a disaster but I'm pretty sure they are not diseased, just immature. Granted, an adult behaving like this is something which stands out, but with kids it is pretty much accepted as more or less the standard ...

timeforrecovery1169 wrote:
The common argument that if you put a gun to the head of an alcoholic and tell him you'll kill him if he drinks the drink in front of him, and he chooses not to, so therefore there is no disease, it is a matter of choice, how legitimate is that argument?

I believe that many if not most people with life threatening addictions such as drugs, alcohol, smoking, when faced with the choice of quiting versus dying, will choose dying in the long run. And not because they are powerless over their behaviour but because they do not have the vision and the skills to change their behaviour. Granted, one could say they might be powerless because they don't have the skills (vision, awareness, understanding) and IMO it would be an accurate statement to make ... but they would not be powerless because there is some kind of disease running rampant in their brain :).

Be well,
Ursula

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 Post subject: Re: The disease debate
PostPosted: Mon Oct 12, 2015 1:40 am 
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To me, addiction can never be a "disease". The 12 Step Program labels addiction a disease but it's also a program that was created in the 1930's which is well before humanity discovered great deal of psychological understanding through research. It's a program that has had a very positive effect in many peoples lives but the idea that we all have a disease and are permanently addicts for the rest of our lives just doesn't jive with my core beliefs and it's not what Jon taught here at RN either.

"Disease" has the connotation that one has been born with or inexplicably contracted some sort of illness. And in the 12 Step Program that disease also has no cure, just ways to deal with the effects as best you can. That seems remove all power of recovery from the individual and it seems like you're just destined for a life of struggle.

What Jon taught, on the other hand, is that addiction isn't some strange disease you contracted walking down the street one day, but the effect of years of poor emotional awareness, no values management, and emotional immaturity. So in a sense addiction is not a disease, but rather a symptom of an individual's inability to manage one's emotions through healthy/normal means. And if you try to label "poor emotion management" as a "disease" it suddenly becomes much clearer that it isn't an actual disease because it's clearly something that we have control over. And as someone who has gone through the RN Workshop and has been living a healthy, addiction-free life for over 8 years, I can personally vouch for the idea that we do have control over our emotions it just takes a lot of hard work and dedication to create healthy habits that other healthy people naturally developed through their lives but I just missed the boat with them due to my upbringing.

So just to reiterate addiction is not a disease but rather a symptom of poor emotion and values management. That understanding is why RN is, for me personally, light years beyond other programs that have you treating the symptom rather than the actual root cause of your addiction.


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 Post subject: Re: The disease debate
PostPosted: Mon Oct 12, 2015 1:10 pm 
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Ah, so many good thoughts here! I want to add some, but I am going away for a week starting tomorrow so am very busy, but I will contribute when I return, because I think this is a really important discussion! :g:

Boundless

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 Post subject: Re: The disease debate
PostPosted: Fri Oct 16, 2015 1:00 pm 
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For me addiction is nothing else but emotional immaturity.
It's like we have never grow up from behaviors which are more assosiated with children. We feel bad, lonely and we need to fix it straight away. Our hurt child inside is speaking through. We need immediately feel better.....and we can only do it with mind altering substances or behaviors. To fix our loneliness/emptiness inside through values takes time and quite often we don't even have these values to hold, on that's why in this workshop the subject of values is so important.
It could be something in our gens passed through generations like my parents were both addicted to different things. Even if this is the case then it's not activated automatically, it has to be triggered by something. I don't think I was born with my addiction, my addiction it's a result of my upbringing. I went through a childhood trauma which coused my emotional immaturity. My addiction it's a way to cope with every day struggles.
It also serves to recreate the emotions I felt as a child. My childhood was never stable but full of ups and downs. I would be very supprise to see a person addicted to sex or relationships/codependent who had healthy childhood.
And our behavior, the way we react and cope is changing "connections" in our brain. When we recover our "old brain connections are replaced by new ones". It's like a learning process. Addiction serves as distraction from ourselves, our pain and the only way to avoid quickly is to make oneself high with "whatever".

Addiction it's a coping mechanism, unhealthy one, which can be replaced with the one based on Values and delayed gratification.

About acting out:
So even if you act out or feel like acting out.....we are not perfect. Does recovery means that we are never going to act out again?

And then where is a distinction between "normal behavior" and acting out? Is someone who masturbate to porn once in a 6 months and not feeling awful about it still addicted?
There are some grey areas here. But I suppose only the person in question knows/feel this in the guts whether the particular behavior is addictive.

I am still acting out (6 months in recovery) it's less and different but still. And I feel shame and guilt afterwards which I am trying to change. Because having these feelings is setting everything out for the next ritual, and even improves the overall stimulation from acting out. This is what Jon mentioned in one of the lessons. And it makes sense.The thing is that after we act out we need to forgive ourselves and it doesn't mean that we are not progressing in recovery. And we need to forgive ourselves because otherwise we are going to sabotage our own recovery. I have a chaotic way of writing, and English is not my mother language but I hope that what I wrotr here make sense :))


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 Post subject: Re: The disease debate
PostPosted: Tue Oct 20, 2015 11:16 am 
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Joined: Fri Oct 31, 2014 11:17 pm
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Thank you all for the thoughtful replies.

I am starting to see that although there is a kind of unity that we all share in as being a part of recovery nation and engaging with its vision, some of us interpret its message (and addiction in general) in very different ways.

I hear some say
Quote:
addiction is a highly complex thing
while others say
Quote:
addiction is nothing else but emotional immaturity
. Can it be both simple and complex at the same time? :pe:

As I believe it was stated in the lessons, and many people would nod their heads to, it is pretty rare to see an individual with an addiction who did not suffer from some kind of childhood trauma. So, someone with a fluffy, sheltered upbringing who lives a healthy life but who might have had grandparents who were raging drug addicts, how should that inform our interpretation of the genetic aspects of addiction? That they did in fact have "addict" genes that simply remained dormant as they were not triggered by their environment? I don't know how valid that claim is...and I suppose it doesn't really matter in the end, I just feel the need to pick the concept of "addiction" apart relentlessly, even though knowing the answers to these questions would not necessarily lead to an easier recovery process. I would say, though, that referring to genetics in explaining addiction should be scrutinized pretty thoroughly, as that kind of a view can lead to a feeling of powerlessness, which, despite the term's indispensability in the 12 step program, I find to be a significant road block to healthy recovery.

To clarify, Theadog, my question about whether we should pursue objective truth or mere justification of belief is really to highlight that the two are not necessarily synonymous. There are those who need THE answers, even if they shatter all the beliefs they have held until that point. And their belief system is always shaky, as they always have to entertain the possibility that they are objectively wrong in their approach. There are others who want what works for them, what stabilizes them, what is consistent with their intuition, regardless of whether or not the claims hold up to science. I think in academic philosophy there is a deep skepticism of the very idea that one could know anything with absolute certainty. And so does it even mean anything at all to be going after the "objective truth"? I think these larger questions just further complicate what is already proving to be a complicated subject.

Quote:
I really like the dialetical thinking, both/and not either or


I think this gets at a part of the resolution here. And I think this is what the integral theory approach attempts to do; include both, rather than reduce one to the other. My question is, does this serve a practical function for the person in recovery? If so, what? If not, does that then mean that there is no value in continuing to think of this in terms of both/and? Where do we draw the line between general inquiry for informational purposes, and inquiry for the purposes of making things easier for ourselves? This is a question that I'm not sure how to answer for myself. I often think about things too obsessively/abstractly to separate what's important to think about from what's not..

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I think it is beneficial if some are bringing awareness to truth, ultimate reality, ect and equally beneficial to have people working on the practical side of things.


Again, I think you are highlighting an important insight, Theadog. The practical and the absolute do not need to be enemies. But often they are made to be seen that way.

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the messed up biological processes many of us are born with (disease?), make us vulnerable to high emotional states


But this is where I find a problem. Is this really true? Is it biological? If that's the case, doesn't that set us up to see ourselves as "uniquely defective"? Just what Jon says in an early lesson is a toxic view to have of oneself in recovery...that something in one's biology makes them "not normal" or "damaged". This is the heart of why the genetics argument is so unsettling to me...particularly because there seems to be no total consensus as to whether or not it is scientifically valid...but also the implications for how we see ourselves.

Quote:
then find immature coping strategies because we are immature, they work, we stick with them, then they cause us not to resolve or even look at existential issues, ignoring existential issues messes with our practical lives, which effects our biology. Goes round and round. So I guess I take an ecological, holistic view of things, everything is interrelated and effects everything else. Most helpful to address all areas we can.


I think I see what you're saying here. But still, I wonder if we should really be seeing the "messed up" biological processes as the first cause here. Does the cycle have a beginning? Is it important for it to have a beginning?

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For me the biological explanations help reduce some of the shame and give me some compassion for myself.


This is a great example of where the biological view has value...the trouble I have is incorporating that into the rest of my emotional life. Not everything has such obvious biological underpinnings, though arguably all of our emotional experiences have some biological correlate...

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then we make a decision, take an opinion, just to be done with the anxiety. Seems many of the worlds troubles stem from this inability to hold conflicting viewpoints, from poverty, to domestic violence and war.


This is a great point and I think this touches on a core part of why I posted this. I feel a kind of cognitive dissonance when there are these kind of conflicting viewpoints in my own mind, and it's not easy for me to choose to end the cycle of anxiety by choosing a specific way to look at it, at the exclusion of all else. It's as though I expect my mind to have no confines...I must assimilate all information, and become a super brain! :no:

Quote:
biological, practical, spiritual, environment, interpersonal, all important. And maybe different "phases" moments in recover some are more relevant, in the forefront than others


This is another important part of what I'm inquiring about. Are there certain developmental stages in recovery where one view is best? Where it is consistent with what we consider to be the objective truth, while also being practical in ways that it isn't in later stages?

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This is pretty much how I view this and I believe jon in the workshop addressed it this way also. He talks about brain chemistry in the beginning and the benefit of antideppresants in some cases, (biological) After the torture of the exposure to the philosophic question of our existance (vision) he switches to action plans (practical). In supplemental lessons he raises the issue of God, ect.


Where do you find this in the workshop? I haven't read his writings on this.

Will be posting additional replies later today.


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 Post subject: Re: The disease debate
PostPosted: Tue Oct 20, 2015 1:36 pm 
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Joined: Fri Oct 31, 2014 11:17 pm
Posts: 188
Quote:
It is also objectively incorrect because it pertains to learnt behaviour and undeveloped life vision and skills.


Ursula, could you expand on this? What exactly is it that makes it objectively incorrect? What does this statement of yours mean?

Quote:
I strongly believe that there are modifications in the brain as a result of addiction but I don't see that as a life sentence.


I think this is an important part of what I'm trying to come to terms with...that it is ok to view the biological result of addiction as legitimate, but that this does not entail permanent damage. I think it's important to recognize the damage being temporary, as I often feel when I hear someone using the term "disease" that they are expecting it to be with the person for the rest of their life, in an endless fight against oneself. That it could be completely reversed (ie the brain changes like hypofrontality return to normal states, and the old wiring for compulsive rituals is overwritten with new, healthy connections) would, I think, challenge the essential meaning of the term "disease" as it is used in this context. "Disease" is not as ominous of a word, and doesn't provoke as much anxiety for me, if I see it as a temporary thing. I think where I have a lot of problems is when disease refers to an in-born biological defect that must be managed for one's entire life.

Quote:
I believe that simple is better in this case. Unless, of course, you do not have a professional interest in the subject, like yourself :)


I'm starting to wonder if this is the right time for all this inquiry or if I might be able to view things with less urgency and less I NEED ANSWERS when I am further in my recovery process. I guess I'll see how things play out. I thought my choice to take an Addiction and Recovery class at school would confirm my insights I learned here, not cause my anxiety levels to skyrocket! (the fact that any of this causes me anxiety is also something that I think requires some reflection!)

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Even if my problem was not watching porn as such, I had a problem with getting the sexual drive exclusively through visuals stored in my head, which is pretty close.


For me personally, I don't struggle with this much anymore. There may be fleeting moments when my partner's particular clothing choice reminds me of a porn scene I'd once watched. But when I engage with her sexually, those kind of images and mental landscapes recede. I wouldn't act sexually toward her with any conflicting perceptions of who she was to me in that moment. In previous relationships I struggled a lot with viewing my partners as objects, in this current relationship there is none of that, which is partly what makes the negative after effects more frustrating. But anyway, recently I've tried pushing the boundaries a little while letting go of any hope of controlling the outcome in terms of my anxiety levels, all the while keeping in mind that I always have control of my behavior, and things were not as bad. So I may find a solution to this problem with sexual intercourse through my own process of letting go and challenging my limiting beliefs.

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In my experience, I did not have a choice when I did not think of the alternative.


I like this interpretation of not having a choice. It's not actually not having a choice in the absolute sense, but you did not have a choice at that time because you had not learned what you've now learned. With that new understanding, there is always a choice. It's kinda weird how that works!

Quote:
I don't equate the brain modifications as a result of addiction with the notion of having some sort of mental disease. Immediate gratification is about emotional immaturity. This is very clear to me as I'm raising two kids


I think this point of yours is pretty enlightening and it helps explain a big part of why I posted this. In my class, there was a documentary that attempted to defend the "disease" position, and it said something about the brain equating the drug or behavior with physical survival. This I see as more than anything a lack of awareness/emotional immaturity. I think your example about your kids proves that point well. And in my own experience, it's easy to see. What still has me wondering is if someone develops all the emotional maturity, the awareness, the sense of self and values, etc, and then STILL ends up in addiction. If you or another of the mentors who clearly knows the fundamentals of recovery were to go smoke meth every day for a month straight, are you saying you would not become addicted because you already developed the skills necessary to overcome addiction? I guess that's where I'm still stuck. Is it just emotionally immature people who have addiction?

Quote:
So just to reiterate addiction is not a disease but rather a symptom of poor emotion and values management. That understanding is why RN is, for me personally, light years beyond other programs that have you treating the symptom rather than the actual root cause of your addiction.


I agree with you Coach Robert. Just to be clear, I'm not making this post because I believe it's a disease. I simply don't know how to completely explain away the explanations that "disease" advocates suggest. And that causes me lots of anxiety. If I were in a twelve step program seeing my addiction as a disease that needs to be rigorously "managed" for the rest of my life, I'd be in a much worse place than I am now with Recovery Nation. So I too believe RN is lightyears ahead of most other approaches, but I have trouble defending that in terms that specifically address all the brain changes/biological elements of addiction.

Hoping to get replies from you guys. I'll soon read the post that you dropped at the top, Ursula.


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 Post subject: Re: The disease debate
PostPosted: Wed Oct 21, 2015 2:39 am 
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Joined: Tue Oct 22, 2013 12:47 pm
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Hi TFR,
timeforrecovery1169 wrote:
Ursula, could you expand on this? What exactly is it that makes it objectively incorrect? What does this statement of yours mean?

What I meant is this: I felt that by how the issue has been set out (i.e. addiction as disease is objectively incorrect or just impractical) kind of implies that addiction is a disease (or at the very best we have no idea what it is) but we try to hide it or sweeten it as being about emotional immaturity to allow people have some sort of hope and still try to do something about it. It seems to me that using OR in this context implies that if you accept that it is impractical (which everyone would probably agree), then it cannot also be objectively incorrect, they exclude each other. In my opinion that is not the case, it is both impractical and objectively incorrect (without getting into the discussion of reality being objective or subjective). This has been my experience. I am now aware of my terrors and of my need to escape, to run, to numb and I try to cope otherwise, even if just keeping awareness and bearing with it. It really sucks being scared most of the time but I hope it is temporary, until I will build some self-confidence about my ability to handle life's challenges. I call that growing up, not recovery.

Strictly what I ment by "It is also objectively incorrect because it pertains to learnt behaviour and undeveloped life vision and skills.": I know that when I was 5 (in kindergarten) I first experienced how someone's attention towards me felt ... it was exhilarating, giving me a lot of power, made me feel so so indescribably good, so so very special. The boy was my age and he would put all the toys at my feet, not letting anyone else play with them in case I want them. I had to fight with him to let other kids also play but even in that it made me feel good, like I was some kind of princess who can choose the fate of her subjects. I was someone special. At home? I don't remember being hugged, talked to, cared for, carressed, held, protected, or anyone ever asking me what I want to be when I grow up, trying to instill some sort of dreams and vision. My sister would always abuse me mentally and physically, making me feel worthless in anything I did or said. No wonder this went on for years and I developed some sort of obsession around certain boys. It didn't have to be shared. I survived from age 6 to age 12 or 13 by being obsessed with a boy in my class. I can tell you what clothes he would wear, how his face looked like, what he did, but I can't tell you about my everyday life in the house with my parents (nothing much anyways, never went out of the house) or what I was learning in school (and mind you, I was always first in my class). My mind was always preoccupied with him. After him there were others and so on to this day. No vision, no other ideas developed or pursued ... only marginally, when not having a choice and having to survive or having to do good in school because otherwise it would have created too much anxiety but not knowing why I even study or what I will do with it once it's over. This is how I have survived. I switched to the only thing that would give me some comfort and I would live mostly in my fantasy world in my head. Everything else faded, never given much thought. It just took over without me knowing what is going on. What was I supposed to know when I was 5? I just acted on what made me feel good and banked on that as much as I could. I strongly believe that in other circumstances where I would have the love and attention from my parents I would not have had to look for it from others. Also, if they knew how to instill a vision about my life, about what you can do in life or the things worth pursuing, encouraging me to have dreams and find a way to make them happen, I would not be here today. So, to cut it short, I see addiction or better said my addiction as emotional immaturity, lack of life vision and skills. But until I did not see it in this light, it was a terrible drive, an unspeakable force to which I felt helpless and exposed. I knew it's no match for me and I would succomb to it, even knowingly at some point. I thought this is who I am, too passionate and that is a very special gift I am wiling to make to someone else who would just be willing to love me back the same. Mind you, I speak more of my love addiction but also the porn component is not too far fetched. Even in porn and fantasies there is that feel good around power, about other people worshiping you or your bodily parts ... talk about self-objectification ... it's the same feel good I experienced when I was 5 when that little boy treated me like the queen ... pretty messed up ...

About the brain modifications being reversible ... I had no problem accepting that as I already knew about the liver being able to regenerate. For me it makes sense that as we learn and grow, our brain also evolves or imprints our experiences. And as I strongly believe that addiction is nothing else but learnt habit, it goes without saying that one should be able to learn new things which rewrite the previous information. I mean, this is pretty much how we evolve, gaining new knowledge and applying it to whatever it is that we can apply it to.

timeforrecovery1169 wrote:
I thought my choice to take an Addiction and Recovery class at school would confirm my insights I learned here, not cause my anxiety levels to skyrocket! (the fact that any of this causes me anxiety is also something that I think requires some reflection!)

You are learning and making sense of things. That can only happen in your own time and on your own terms. It is only then that it will be fully ingrained, it will turn into conviction and you would use it to guide your own life and decisions. So, take your time and inquire as much as you want. By all means, a bit of self-reflection is necessary, as always. Never stop questioning yourself. I think there is more potential value in asking yourself what this all means to you. Everything boils down to ourselves ultimately.

timeforrecovery1169 wrote:
It's not actually not having a choice in the absolute sense, but you did not have a choice at that time because you had not learned what you've now learned. With that new understanding, there is always a choice. It's kinda weird how that works!

Yes, it is pretty weird. You do have a choice but you don't actually because you don't know that. It's like the house is burning with you inside and you run for the cellar because this is where you always hide and it makes you feel safe but there are no ways out and you burn. You could have headed for the door and gotten out of there but you never think that is an option, never crosses your mind. To other people (and to you later on after you find out you could have used the door) it all seems so irrational. Why in the world would a full grown person do something that stupid but you know you did not have a choice because you never thought or believed that you could actually use the door instead. So, you do have a choice only in as much as you believe that you do and you genuinly want to exercise your option.

timeforrecovery1169 wrote:
If you or another of the mentors who clearly knows the fundamentals of recovery were to go smoke meth every day for a month straight, are you saying you would not become addicted because you already developed the skills necessary to overcome addiction?

I don't know about meth ... I only tried on marijuana two times, the second one it made me vomit my guts out so we parted ways forever. I also had a period of drinking steadily for a few months every day (coincidentally or not this is when I violated my values the worst and ended up hating myself for life). I smoked and that was not easy to give up when I had nothing else to lean on ... It was an easy way of regulating emotions, of finding relief but when I found something else to replace it I had no problem giving it up. Drinking coffee is for a higher level of energy. Like now I have exams so I started drinking again. After the exams or maybe even before that I will give it up again. I know I'm looking at a few days (2 weeks tops) of excruciating headache and very low energy but I know I can live through and it will come to an end. First of all, why would someone be smoking meth for a whole month if they have a balanced life and they are enjoying living in reality? That is the question. To experiment, sure, it could happen but I don't think you would then go back and do it every day afterwards if it doesn't provide something more that you need .... i.e. escaping your problems, forgetting your worries, departing reality. And that in itself means you do not have the skills or the emotional maturity to handle life. I'm sure people experience physical withdrawal symptoms after a month but if they can remember their life before, goals, dream, what they are here for, they would want to get back to it. It would still be a process of getting back to your values, to your vision and building from there what it is that you want. Maybe medical assistance would be required for the physical symptoms as I imagine substance addiction has more harmful effects on the body but otherwise I don't see much difference.

Hope it helps,
Ursula

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"A wholehearted attention feels like the nurturing presence that I always wished I had in a parent. Now I am free to be there for myself in a way that I assumed I needed from someone else." Tara Bennett-Goleman, Emotional Alchemy


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 Post subject: Re: The disease debate
PostPosted: Wed Oct 21, 2015 6:20 pm 
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A great thread with many pertinent and well made points
so at the risk of raising controversy
I ask
does it matter?
It just a label
what matters is recovery
that statement invites the question recovery from what , addiction, a disease, an illness, a habit , a defect , an illusion or delusion , a characteristic

What matters is recovering and discovering an identity and lifestyle that you can be openly and honestly be proud of at all times and the irrefutable refusal to use
I was / am an addict as an excuse or reason to fail in the rebirth of the new and very worthwhile real you

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Remember recovery is more than abstinence
Every transition begins with an ending
Do not confuse happiness with seeking pleasure
stay healthy keep safe
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 Post subject: Re: The disease debate
PostPosted: Wed Oct 21, 2015 11:22 pm 
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Kenzo:

:g: :g: :g: :g: :g: :g: :g: :g: :g: :g:


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 Post subject: Re: The disease debate
PostPosted: Thu Oct 22, 2015 10:31 pm 
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Joined: Fri Oct 31, 2014 11:17 pm
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Coach Kenzo,

I think this debate matters more for people who see addiction as a disease, because there's often a fear of losing control which accompanies that belief, which would make recovery a lot harder than it needs to be. I think Jon mentioned somewhere in the workshop that those who fear their addictions and view them as a disease can still recover, sure, but they often don't feel very safe in their recovery. So in the interest of helping everyone develop the most practical view of addiction as possible, I think the debate is relevant. Aside from that, I am uncharacteristically inquisitive about every little thing, so it may serve me on a personal level more than it serves most people in recovery. I certainly don't need to answer this question to recover. But my recovery will be a lot more comfortable if I can put away for good the part of me that is afraid of the "thing". The fact that a part of me still identifies with that, or at least feels anxiety when this question is raised, is part of why this question remains important to me. I do hear your point though, when it comes down to the nitty gritty work of recovery, what works for an individual is what's important, the labels are not.


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 Post subject: Re: The disease debate
PostPosted: Fri Oct 23, 2015 5:49 pm 
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Joined: Thu Apr 29, 2010 8:07 pm
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TfR
Quote:
I think this debate matters I think the debate is relevant. this question remains important to me.

I never suggested otherwise
all debate is healthy and encouraged
I said
Quote:
A great thread with many pertinent and well made points


this forum is here to ask questions use it
my point was that this forum is a part of a process and that process is life changing recovery

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Remember recovery is more than abstinence
Every transition begins with an ending
Do not confuse happiness with seeking pleasure
stay healthy keep safe
Coach Kenzo


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