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Are Addicts Truly Powerless?

Sunday 05th April
If their habits don't reflect their desires, we might do better to recognise an addict's powerlessness
| Associate Lecturer in Philosophy at University of York

addiction

Addiction is often connected with the idea of powerlessness, compulsion, or having one’s agency ‘hijacked’. That idea shows up, for example, in the first of Alcoholics Anonymous’s 12 steps: 1.    We admitted we were powerless over alcohol - that our lives had become unmanageable.AA is an incredibly popular organization. Organizations that take the ...

Addiction is often connected with the idea of powerlessness, compulsion, or having one’s agency ‘hijacked’. That idea shows up, for example, in the first of Alcoholics Anonymous’s 12 steps:

1.    We admitted we were powerless over alcohol - that our lives had become unmanageable.

AA is an incredibly popular organization. Organizations that take the same approach to addiction, but focus on different objects of addiction – e.g. narcotics, food, sex – are also globally successful. So, the idea that addiction involves powerlessness has resonated with a vast number of people who have first-hand experience of addiction. It deserves to be taken seriously. Should we also take it literally? Well, that depends on working out what it would mean to take it literally. And that turns out not to be obvious.

It might help to focus on this question to have an example in view. Susan is an alcoholic who is having some early success in being abstinent and is slowly putting her life back together. She has constructed a daily routine designed to minimize stressors and triggers for her drinking. Now along comes something to trip her up, the delayed fall-out of her unmanageable past – e.g. a debt or an affair that has just been discovered. The thought of drinking, which has perhaps been a regular unwelcome but fleeting visitor, now impresses itself on her with incredible tenacity. She runs through the script she has developed for this kind of scenario. She takes some deep breaths. She rehearses her reasons not to drink. She contemplates ringing her sponsor, knowing that they will likely offer to come round and escort her to a meeting. At a certain point, she nevertheless succumbs. She drinks. In what sense, if any, was she powerless over alcohol?

Here is a first suggestion. Alcoholics like Susan are powerless over alcohol in the sense that they can’t cause themselves to stop desiring alcohol, simply by deciding that they would be better off not having that desire. If they had that power, staying sober would be much easier than it actually is. This though doesn’t distinguish an alcoholic’s desire for alcohol from anyone’s desire for anything. I might have a mild craving for eating meat this evening. I can’t get rid of that craving, simply by deciding that I’d be better off without it. If I could, making healthy and environmentally sound eating decisions would be much easier than it actually as.

___

"Might alcoholics be powerless in the sense that their drinking is merely the result of habit, and doesn’t reflect what they actually want to do?"

___


A very different suggestion is that addicts are powerless not because they don’t get to choose what desires they have – no one does that – but because their actions are caused by habit, rather than by desire.  To get a sense of what the relevant notion of habit comes to, imagine that you have recently changed where you live. A junction that has been a left turn on your way home for the longest time is now a right-turn. Approaching the junction with your mind on auto-pilot, you turn left. Your turning left is not a mere reflex, like the movement your knee makes when knocked with a hammer. Your turn left is purposive behavior, directed by a habit acquired and reinforced over many previous drives home. But, arguably, your habit isn’t a kind of desire. You don’t turn left rather than right, because you want to turn left more than you want to turn right. In this case, habit usurps the role in directing your movements that desire would otherwise play. Might addiction be similar? Might alcoholics be powerless in the sense that their drinking is merely the result of habit, and doesn’t reflect what they actually want to do?

The problem with the comparison emerges when we ask what happens if during your drive home something happens to make you leave auto-pilot and actually think about where you need to be. So long as that happens before you’ve reached the junction, you have no difficulty at all in overriding the habit of a life-time and turning right. That is why it isn’t natural to think of the habit as a kind of desire – if it were, you would feel conflicted in this case in a way in which in fact you do not. Habit surely plays some role in addiction. The default response of an alcoholic to a stressful situation might be to start making a beeline towards the drinks cupboard. To arrest this process, simply coming out of auto-pilot might be enough. To the extent that it is enough, the use of alcohol is simply habitual. But Susan’s case, which seemed typical enough, is not like this. Her mind is not on auto-pilot. She is intensely focused on the fact that she faces a choice, and on the negative consequences of drinking. Nevertheless she drinks. For most alcoholics, the alcoholic ‘habit’ does involve a repeating pattern of intense desires for alcohol.

There is a third idea about how to understand the idea of powerlessness that I think is more plausible than the two we’ve so far looked at. Addictive action isn’t psychologically distinctive, but it is morally distinctive. This is the cash-value of the first step’s talk of powerlessness.

Consider the following case. I am ordered to kill a dog by someone who is threatening me with a gun. I don’t want to kill the dog. I don’t want to be shot either. I want to avoid being shot more than I want to not kill the dog, so I do kill it. Later, when asked to account for my actions, I say that I was ‘powerless’ to not kill the dog. In saying this, I don’t imply that there was anything psychologically distinctive about my action – e.g. that it was caused by a habit rather than a desire (if I really did have such a cruel habit, it wouldn’t be a point in my favor). I do imply that I had a strong excuse. We expect people not to harm animals gratuitously. But there are limits on what can reasonably be expected in this area. People also have a right to protect themselves against credible threats. In this case, that right excuses my killing the dog. A court of law would regard my killing the dog as ‘involuntary’.

Is the case of addiction anything like this? Susan doesn’t want the negative impact on other peoples’ lives that her having a drink most likely will have. She also wants to drink. At least at a critical moment, her stronger desire is the desire to drink. So she does drink. Unmanageability ensues. Later, she is accused of gross selfishness, perhaps by a loved one. She claims that, at the time, she was ‘powerless’ over alcohol.

___

"Some addicts lose everything. This is sad. But it is also what makes it reasonable to think that addicts really are, in a morally relevant sense, powerless."

___



This is always going to be a contentious card to play. We’ve seen that to suggest that her drinking isn’t something for which she has any moral responsibility at all – e.g. because she didn’t choose to have the desire to drink, or because she didn’t really desire to drink but merely acted out of habit – would be to overplay the card. And interestingly that doesn’t seem to be what the 12 steps programs have in mind, since the fourth and fifth steps imply that addicts must be held accountable for their actions:

4.    We made a searching and fearless moral inventory of ourselves.
5.    We admitted to God, to ourselves and to another human being the exact nature of our wrongs.

The most plausible reading of Susan’s powerlessness claim is as a plea for understanding: she had some at least some excuse for what she did (even if not as absolute an excuse as a gun to the head). One thing that makes the force of the excuse difficult to assess is that it involves her inner life. In the shooting the dog case, everything is out in the open. My interest in not being shot is obvious. What is the basis for Susan’s ‘interest’ in drinking? Perhaps it has something to do with the intolerable unpleasantness of her mental state, experienced sober. As such, it involves something that is much harder for other people to gauge. This makes bogus claims of powerlessness more likely. E.g. I might claim that I am powerless not to eat meat – that asking me to go vegetarian tonight is simply asking too much of me. But there is a way of subjecting such claims to scrutiny. Has my pursuit of the thing over which I claim to be powerless led me to harm not just other people’s interests but also my own? In the case of most addicts, the answer is that their addiction has cost them. Some addicts lose everything. This is sad. But it is also what makes it reasonable to think that addicts really are, in a morally relevant sense, powerless. The damage they do to their own interests gives the lie to the idea that they are just unusually indifferent to the impact their choices have on other people.


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Alain Savard on 15/04/2018 9:36pm

With 5 to 10% sucess rate for AA, this is greatly controversial but interesting read.
BOOKS
The Interview: Does AA fail addicts?
http://www.macleans.ca/society/health/does-alcoholics-anonymous-fail-addicts/

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