Use disorders: A definition for change

A good place to begin to talk about addiction is to think about what it is and how to think about disengaging from the clutch of dysfunctional behaviors; starting with definitions helps ground the discussion and make the topic clear. Starting at the beginning is a helpful process for me; it also is a useful reference technique so that when the conversation gets dense and complicated, I can always return to the beginning for reference and re-orientation. I am grateful for clear definitions.

Definition: Addiction is the compulsive use of one or more behaviors in the face of negative consequences experienced from the practice of those behaviors, which contributes to changes in brain structure and a process of progressive isolation.

Each of us lives in a body that responds to stress through physical and psychological processes, like feeling energized or overwhelmed. For some people, co-occurring mood and anxiety processes exacerbate stress and get mixed up with ineffective stress-coping mechanisms. The use of alcohol, nicotine, gambling, speed, narcotics, shopping, and sex alone or in combination are socially approved ways to relax and unwind that can cause problems when repeatedly relied upon.

Addiction is a label used to indicate that ours, or our loved ones, stress-coping habits have themselves become stress creators. When a behavior is both the cure and the problem, then an addictive process is in place.

Therefore, the real problem with substance and behavioral use for self-care is that for some people at some times using continues well after it ceases to help, which affects everyone around them. Use disorders, the professional name for addiction, happen inside a system—an essential concept for understanding the effects of use disorders on family members to talk about in the future.

So, to wrap all this up neatly, use disorders, addictions, are ways of coping with stress that have taken on a life of their own. This stress-coping model provides us a way to see use disorders as they develop, well before stopping is troublesome, and gives us a way to disrupt the process and re-create our lives. There are several new ideas here that we can return to as this blog gets fleshed out.

A quick word about language: sometimes, as when discussing addiction as a concept, it is easy to forget that the word addiction carries baggage. People-first language is a way of remembering that a person is not equal to their behavior; and that sometimes a more subtle understanding is needed. For instance, some might say a person is an “addict” or a “drunk” or whatever label seems to fit, which makes it appear as if that is all a person was, is, or ever will be. Saying that a person has a substance use disorder is different from saying that a person is a disorder.

The first allows room for identity expansion while the latter creates a situation where change is much more difficult. If we want to encourage change, then we must allow room for change. That room must be found within our understanding of an addicted person as much as they have to understand they can see themselves as more than just their addiction. Expanding concepts of identity is particularly true when we care for someone practicing, even seemingly against their will, behaviors destructive to themselves and others.

This brings up one aspect of my philosophy of change. Each of us has a shorthand way of thinking about who we are that we express in cognitive labels and behavioral habits. These labels and habits show our self-concept. The more restricted our self-concept and the less psychologically flexible we think about ourselves, the more difficult it is for us to complete the tasks of change. By opening up possibilities and practicing flexibility, our change tasks are simpler to complete because we have the brain space play with visions of a better future. So, to change one’s self-concept, we must create flexible self-labels.

A second piece of my philosophy of change is based in hope and possibility. When a vision of a personal future emerges, the journey toward that potential future is underway. Commitment to that future, coupled with persistence and accountability, yields a new identity. We begin to live our future when we understand that we hold the key to the realization of our possibilities. It is kind of scary when we are lifted from natural soil. Then, our roots begin to take nourishment, and new growth occurs. We know we have moved past our previous use disorders and related dysfunctions when we realize that we can choose the soil where we root.

The quote that headlines this post reminds me that I can only control my thoughts and actions. How I conceptualize a situation is within my control. How I respond to a situation is within my control. So that when I focus on living my possibilities, and not someone else’s, my world adjusts to my needs.

Thanks for reading. What do you think? Comment or email. If I can help you focus on your change, let me know.

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