2A: Choice as both Cause & Effect

ABSTRACT

Addiction exposes the difficulties in a Body-Mind-Spirit model of Human Nature. When we narrowly define what we are as a Body, Mind, and Spirit conglomerate, we straight-jacket ourselves with contradictory explanations about how we make choices: as Body our choices are compelled by uncontrollable urges; as Mind we choose based on personal autonomy; as Spirit we choose only to the extent that we align ourselves with God’s will or supernatural law. When we look closer at our Selves, however, we see that Body, Mind, and Spirit are constantly changing and difficult to distinguish from each other without unsettling overlaps in function and gaps in operation. The more we examine it, the more the Body-Mind-Spirit model of Self fails to explain either addiction or recovery in a manner that moves our investigation forward. We can—and will— do much better.

WHAT CAUSES ADDICTION?

It’s not fun; it’s not sexy—but there may be no topic more important to what it means to be a human being than cause and effect. If we are to enjoy the gift of choice, then we must be able to discern the difference in outcomes when we are presented with a choice: if I do this, this will happen; if I do that, that will happen. The better we explain what addiction is, the better we should be able to understand its cause. Until we understand the cause—and base our solution on that cause—we will never know whether or not any solution to addiction we present alleviates symptoms or actually removes the source of our suffering. And when lives are at stake, this is an unacceptable uncertainty.

II. AA’S KNOWLEDGE OF THE CAUSE: The cause of alcoholism is…selfishness?…instincts run astray?

Here’s where we hit gold from casting our 4 Basic Questions into Joe-and-Charlie (Module 1A) speak: 1. Knowledge of the Problem; 2. Knowledge of the Cause; 3. Knowledge of Solution; and 4. Knowledge of the Means to Implement the Solution. The first Three Steps of the Twelve Steps of Alcoholics Anonymous were the context into which this terminology was introduced in their tapes, and the following interpretation has been parroted at AA meetings ever since:

Anyone who can count can see what’s missing: Knowledge of the Cause—not a trivial omission. It is worth repeating that that an unambiguous solution to addiction requires knowledge of its root-level cause so that we know we are not just treating symptoms. After an earnest review of the canonical Written Tradition of Alcoholics Anonymous and reflection on the Oral Tradition that I had inherited from my ~1000 benefactors in AA, The interpretive book “The Twelve Steps and Twelve Traditions”, written in 1952—13 years after Alcoholics Anonymous—contained the most direct and unambiguous reference to “cause” that I could find in the exoteric AA corpus. Here Bill Wilson posited that:

At first glance this statement did not appear to be particularly useful, nor was it clear to me how these instincts misfire in an alcoholic with different results than they do in someone who is not an alcoholic. Many Twelve-Steppers see this as a more modern, psychological update to the omnipresent and off-putting religiosity of Alcoholics Anonymous. This is a huge misinterpretation. As an inveterate watcher of TV evangelists I knew that “instincts” in this context was codeword for “appetites” and “instincts run wild in themselves” was codeword for “sins.” Alcoholics Anonymous—written in 1939, is a little more blunt about the issue:

I choose not to parse the difference in meaning between two words—”cause” and “root”—written by the same person 13 years apart. The extent to which Twelve-Steppers cling to “selfishness” as part of their alcoholic self-definition can be off-putting to anyone with a modicum of self-esteem. But if we are looking to generalize specific ideas about addiction to the general idea of human suffering, there is some precedent:

If we consider for a moment the possibility that “instincts run wild in themselves” are the underlying (proximal) cause of destructive drinking, and that self-centeredness is the root (ultimate) cause of “instincts run wild in themselves,” then we can restate a straightforward, albeit surprising, answer to our Second Basic Question: self-centeredness is the cause of the alcoholic’s destructive drinking. Obviously, there are many self-centered people who do not become addicts, but my AA benefactors have always impressed on me that what may only inconvenience a non-alcoholic will kill an alcoholic. I had always taken this to heart as an example of how different alcoholics were from non-alcoholics. Perhaps it meant just the opposite: at the core of Self we are all the same; we only differ in how that core manifests—Addiction being one of the most lethal manifestations of self-centeredness.

Whether this is true or not, we come to a rather clear causal chain for alcoholism based on a model of Body-Mind-Spirit:

This confusing theoretical discussion of Body-Mind-Spirit simply reflects real-life confusion: our Body tells us to finish that last slice of pizza; our Mind tells us that we have had enough; Spirit just feels the guilt—we are at war with ourselves. Confusion in thinking leads to confusion in behavior. Perhaps we are, ultimately, divided beings. But is Body-Mind-Spirit the right way to carve up the metaphysical turkey? In Module 1B we will see that the real division is between wanting, not wanting, and not caring, and an understanding of addiction that embraces the Self as Process of making choices explains more and offers more than any Body-Mind-Spirit model of Self could.

None of this is intended to be decisive or persuasive, but instead to suggest to both the addict and the non-addict that that, when discussing addiction, there are implicit assumptions being made that need to be examined. Few people will make a decision to change until they realize that the old way doesn’t work and they have a new way placed in front of them. So, we will summarize how well AA did answering our Second Basic Question, and then suggest a new approach that is a game-changer.

ACQUIRE & APPLY SUMMARY:

Do the Twelve Steps of Alcoholics Anonymous correctly Analyzes the Root Causes of Alcoholism and the Conditions under which those Causes are expressed?

• As the Twelve Steps give no explicit answer to question of causation, we must look to AA’s Oral Tradition which is confused and contradictory. Several competing explanations of the cause of alcoholism exist within AA, and the one we have chosen fails to move us forward.
• No distinction between addiction as a primary and secondary phenomenon which means that we do not know whether or not we are not just treating symptoms. If there is no physical phenomenon of craving, then can a problem drinker be taught to drink safely?
• Because AA assumes that alcoholism is a self-existing entity—like Body, Mind, & Spirit—no mention is made of the conditions under which alcoholism is expressed. In other words, does alcoholism change as the environment within which the alcoholic finds themselves change? Over time is alcoholism really a progressive and irreversible phenomenon? Or is it even more dangerous as a mutable phenomenon that adapts and changes to conditions? And the big question: does the cause of alcoholism, and the solution, change over time? Does the AA solution only apply to a particular group of people at a particular time and place in their lives?

REALITY TO THE RESCUE:

Choice as Cause & Effect

To move us forward in our understanding requires only that we challenge AA’s assumption that an initial ingestion of alcohol causes a physical phenomenon of craving that cannot be resisted. That an alcoholic who has taken the first drink feels an increasing pull towards a second one by no means defines Body as the motive force—we might suspect that the mental obsession continues to steam-roll with each additional drink, and it would be very difficult to distinguish such an effect from a similarly cascading physical phenomenon of craving. Given the absence of a demonstrable phenomenon of craving operating independently of a mental obsession—something that Science has yet to prove—what we may actually be observing after the first drink is not a physical phenomenon of craving at all, but an amplified mental obsession that occurs alongside a physical response to alcohol that may or may not play a supportive role:

So is the phenomenon of craving that occurs after the first drink physical, mental, both, or neither? Although trying to design & execute experiments with alcoholics to test these questions leads into questionable ethical territory, real-life scenarios indicate that these are indeed meaningful questions. At a family restaurant dinner I attended with friends one evening, one person at the table ordered a Rum-and-Coke and another—who was a three year sober Twelve-Stepper—ordered a “New” Coke. A little later the Rum-and-Coke drinker was complaining about how they must be watering the drinks, while the “New” Coke drinker was exuberant in their praise of this revolutionary Cola formula. It quickly became apparent that the waiter had mixed up the drinks. But the alcoholic who accidently ingested alcohol did not experience a phenomenon of craving. Given the one drink-one drunk mantra that pervades AA meetings, why not? Is it because one was not enough to trigger a physical response, or because there was no mental intent that preceded the drink? If not one drink, then how many drinks are needed to trigger this unproven response? AA meetings—where one drink always leads to a drunk no matter what the state of mind—are full of horror stories about the consequences of the first drink. But the real world is full of stories of alcoholics who do not go to meetings who catch themselves after the first couple of drinks and put the bottle down. Is it because attendance at AA meetings reinforces the self-fulfilling formula that one drink = one drunk?

A simple definition of the problem of alcoholism as mental obsession and phenomenon of craving has moved us away from direct, powerful, persuasive exposition and towards subtle academic argument—not a place I intended to go. We are already getting a taste of what will soon become a recurring theme in our investigation: attempting to answer a specific question about alcoholism always seemed to require asking more general questions about how human beings make choices. In this case we are facing a task no less daunting than untying the famous Body-Mind knot. What an extraordinary thing that a simple analysis of the AA Program leads us so deeply into the metaphysical woods!

Based on our challenge of the reality of a physical phenomenon of craving we can now suggest that our problem comes from trying to reconcile a static model of who we are—Body, Mind, and Spirit—with a dynamic model of choice as both cause and effect. What happens if, instead of linking Body, Mind, and Spirit as the causal vehicle, we simply link the choice to drink or not drink as the causal vehicle. We take advantage of a definition of alcoholism that has choosing to take the first drink as the EFFECT of the mental obsession, but that choice then becomes the CAUSE of the physical phenomenon of craving (See above diagram). As soon as we say that a single choice is both cause and effect we also say that any human choice is both the result of past actions and the cause of future actions. We also get closer to the Holy Grail of addiction: an explanation that allows for the existence of individual choice and the existence of a runaway force that accumulates as a series of choices are linked together. We can postulate a proliferating momentum that, because it is stored in memory, outlasts the initial effects of those choices.

Simple, elegant—almost embarrassingly obvious. With this small step, we show a new way to interpret the cascading phenomenon of craving that does not require a resolution of Body and Mind: each individual choice builds on the last to bring something new into existence that cannot be described by the simple act of making choices. Within a much larger context, we have also made a major shift in worldview from a “Substance-Causality” explanation of addiction to a “Process-Creativity” explanation of addiction. In “Substance-Causality” the world is composed of “stuff with attributes”: Body, Mind, & Spirit exist as is and each have characteristics that hint at how they will interact together. In “Process-Creativity”, the interaction itself determines the nature of the explanation. Body, Mind, & Spirit are consumed within a Creative Process of choosing.

The difficulty, of course, is that now we are looking at a Self, and an addiction, that never stops changing rather than a Self, and an addiction, that we can stop, snap a moment-in-time photograph of, and study at our leisure. A moving target requires a new set of observational skills, which we develop in later Modules. One clear advantage gained from this shift in vantage point lies in our ability to more usefully explain “Process Addictions” such as gambling as well as “Substance Addictions” such as alcoholism under the same conceptual and practical umbrella—an integration that has remained out of reach for many thinkers in this area. (The question is, will our new explanation explain more than the old? If this intrigues you, go to 1C The War within Self where the fully developed, mature “Process-Creativity” model explains EVERYTHING we observe about addiction)

“Addiction is a Choice” fails to account for the runaway property of addiction that at least appears to rob us of the freedom to choose. Addiction as the “Momentum of Choice” moves us closer to describing what we observe, and this should motivate us to look into these issues more clearly. We make choices in our own life, but we do not choose our own lives. When we do not understand how our choices link together to create their own momentum, we wake up one day wondering how we could have gotten to where we are. We live falsely in the present without realizing that the choices we make now are determining where we will be in the future.

NEXT CHOICES:

MOVE TO LEVEL B: 2. Discover Causes, Conditions, & Effects

MOVE TO STAGE 3: 3. What Ends It?

©2012 Michael V. Cossette