Joe was a young man in his late 20s who was having life adjustment problems. He had tried several times to set a positive direction for his life but, for one reason or another, he felt he was a total failure. To combat feelings of loneliness and failure, Joe began to abuse alcohol on a regular basis. One day his drinking was especially bad and he began acting crazy and out-of-control. Someone reported Joe to the police, they arrested him, and a judge ordered a mental examination. The psychiatrist decided he needed to be on medication, so Joe was required to go to a residential treatment center where he was given medication. When I first met Joe he was sitting on a couch with his head bowed and his eyes barely opened. I tried to get him to talk but he would only say a few words. The effects of the powerful brain drugs he had been given kept him in a zombie-like state.
Over the course of the next several weeks, I tried to get Joe to open up and establish eye contact with people. I also encouraged him to talk about his life in an attempt to discover what led to his current situation. In our conversations, I learned that Joe felt helpless to make changes in his life, so he was just going along with whatever people told him. I recognized that before Joe could ever function normally again, he needed to overcome his feelings of helplessness and get off the medication. His original psychotic episode was likely due to his alcohol abuse rather than schizophrenia or some other psychotic disorder. These symptoms usually disappear soon after a person stops using drugs or alcohol. Unfortunately for Joe, he was diagnosed with a psychotic disorder and was put on powerful brain drugs.
It is easy to get lost in the mental health system and once a person is diagnosed and starts taking medication it can be a long time before anyone ever reexamines his condition. In Joe’s case, I was the first counselor to spend more than just a few minutes with him.
Joe is a good example of someone who has experienced failure and disappointment in life and has reacted to it by giving up. He was now allowing addiction, people, and events to control his life and he appeared to be in a state of helplessness. My counseling goals were to help him overcome the negative effects of the medication so he could communicate better, change his helpless state of mind, stop his alcohol abuse, and help him discover new values and goals for his life. I became convinced that Joe’s delusions and hallucinations resulted from his alcohol abuse and that the correct diagnosis according to the DSM-IV should be Substance-Induced Psychotic Disorder. This diagnosis did not warrant the powerful brain drugs he had been given, and even if he had some form of schizophrenia, these drugs may not be necessary for recovery anyway (Breggin, 1991, 1998).
Joe’s problem is that he has given up on fighting for himself and he no longer believes he has the power the shape his future. Joe’s helpless attitude is characteristic of many who are addicted. Sometimes this is because of repeated failed attempts to stop an addiction, or it is because of what others have told them about their own powerlessness. The belief in powerlessness is often reinforced by friends, family, medical doctors, and others who treat the addiction. Unless this belief is changed, it is unlikely they will ever change their behavior.
What if it is the case that the failure of people to recover from addiction is because of the false belief they have about themselves and their environments? What if these false beliefs arise from mistaken inferences they make about the power of drugs and their past failures to stop their addictions? When people hold pessimistic beliefs about controlling certain behaviors they enjoy, they can easily develop a helpless and hopeless view toward recovery. Instead, what if people could change pessimistic beliefs by acquiring new skills that allow them to gain personal control over addiction?
The work of Martin Seligman (1998) suggests there are two important concepts that can explain why some people become helpless and quit trying to change their behaviors. These concepts are learned helplessness and explanatory style. Learned helplessness is “the giving-up reaction, the quitting response that follows from the belief that whatever you do doesn’t matter.” Explanatory style is “the manner in which you habitually explain to yourself why events happen” (15). Both of these concepts are closely related, and if people want to change learned helplessness, they must change the way they explain the bad events of their lives.
Seligman discovered that if dogs were put in cages where they experienced unavoidable shock, they would soon quit trying to escape. Later, when the dogs were given the opportunity to escape, they would still endure the shock and not try to escape. It seems they had learned to remain in a state of helplessness. When the dogs had some control over escaping a shock they would not learn helplessness and continue to try and escape, but when the shock was inescapable, they would give up. Seligman applied this research to humans and found that helpless animals act like helpless humans. When people experience negative events and become convinced they have little or no control over these events, they give up trying. In humans, a key element in developing learned helplessness is explanatory style; that is, the way people explain to themselves why negative events happen. If people have a negative explanatory style they tend to get depressed and become helpless. If they have a positive explanatory style, they tend to be less depressed and more energetic in solving their problems.
The way people explain things to themselves determines how helpless or how energized they become when they encounter negative events. Seligman describes a negative explanatory style as one that is personal (It is my fault), permanent (It is always going to be like this), and pervasive (It is going to undermine every other aspect of life) (76).
To illustrate, if Bill asks Ann for a date and she says no, he might personalize the rejection by thinking, “There is something wrong with me.” He can make the rejection permanent by believing, “I am never going to have a girlfriend.” Finally, he may allow the rejection of one woman to extend to all other women by saying, “Women hate me.” In this example, Bill has the three Ps of a negative explanatory style. He has explained a negative event in terms that are personal, permanent, and pervasive.
Seligman’s work in this area represents a major contribution to understanding depression. He developed a questionnaire that reveals when a person has a negative explanatory style and found that depressed people consistently explain bad events negatively, which he argues is the core of depressed thinking (58). Seligman also found that cognitive therapy could change the explanatory style of many depressed people from negative to positive, and “the more expertly it was delivered, the more thorough the change to optimism” (81). What this shows is that when people change the way they think, they can determine whether they become depressed or stay depressed.
Although Seligman’s work focuses mostly on depression, his ideas can also be applied to addiction. In fact, I would argue that depression is like addiction in that it begins with the way we think about problems of living. If we are pessimists, we tend to give up and become depressed. Those who are pessimistic and depressed are more likely to engage in addictions because they are unhappy with the way they view themselves. Addiction is a way for people to distract themselves from their strong negative feelings by providing either an escape or a temporary way to feel differently. Soon, they begin to falsely believe they are unable to deal with unpleasant events and negative feelings unless they engage in their addictions.
There are some interesting parallels between addiction and depression. The cognitive approach to depression suggests that if we change our thinking we can change the way we feel, whereas the medical community often views depression as a chemical or biological problem that is to be treated with drugs. Likewise, addiction is often viewed as a disease, or a biological response that is automatic and beyond one’s control rather than a cognitive choice that one makes.
J B Myers