Poverty of Spirit
People who have a serious mental illness such as schizophrenia or bipolar disorder have a much higher prevalence of substance abuse. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 25.7% of adults with serious mental illnesses have substance abuse problems. They are 70 percent more likely to abuse substances than the general population according to the National Institute of Health.
According to a video I watched of a presentation by Canadian psychology researcher Dr. Bruce Alexander, addiction is caused by dislocation – a loss in life’s meaning because of loss of cultural identity and support. People who are diagnosed with a serious mental illness often lose their sense of meaning. It’s a traumatic experience. People who experience dislocation try to fill the void with some kind of substitute that becomes a compulsive behavior. Alexander rejects the disease model because it supposedly doesn’t address psychosocial integration. The disease model posits that addiction has a genetic component and that consumption over time alters the brain. Addiction is incurable but can be managed. Treatment can work. This view comes from science. Although my experience with 12 step programs has enabled me to achieve psychosocial integration, I believe the avalanche of studies that support the theory that addiction is a disease. I don’t believe Alexander’s view provides a full picture because pleasurable activities release dopamine, a spike in the neurotransmitter causes a feeling of pleasure. I see how my mental illness dislocated me and how I finally became reintegrated socially through a twelve step fellowship and the treatment I received for my bipolar disorder. A multitude of studies show there’s a strong genetic component to addiction. Addiction is probably caused by both biochemical and psychosocial forces. It’s the same “nature vs. nurture” debate. The dislocation hypothesis of addiction does address part of the problem, but the other piece of the puzzle has a biological basis as well. It’s not either or, but both.
According to a paper by Alexander, the globalization of the free market economy has led to dislocation on a mass scale and has sparked an avalanche of addiction. I’m blogging about this because I think the dislocation theory has some merit, but the bulk Alexander’s claims that the definition of addiction is too narrow and vague and his assertion that that anything can be addictive is even more vague and imprecise. Where is the quantitative analysis of his hypothesis? With so many different kinds of addiction that he claims exist it’s not possible to provide a standard measure. Alexander claims addiction is a “poverty of spirit.” Twelve step programs address this issue. Most people who have recovered from addiction through a twelve step program also subscribe to the disease model of addiction. I think Dr. Alexander’s claim that anything can be addicting trivializes the suffering that occurs with addiction to alcohol and some drugs. I’m blogging about this because I think Alexander’s ideas might interest some people even though some of his assertions are beyond the scope of this blog. The video I mentioned above is worth watching because some of it addresses some of the reasons why some mentally ill people might abuse substances.