by Yosef Cornfeld
Addiction is a major subject of problem behavior in today’s society. While the primary concept of “addictions” is centered on the chronic, compulsive use of certain psychoactive drugs such as opiates (heroin, morphine), the concept has be used by association to apply to non-drug behavior, such as overeating, gambling, compulsive sex, etc. Associated with the concept of addiction is that it is compulsive behavior over which the “addict” has no control. This addict is an attempt to understand the concept, deconstruct it, and suggest some narrative ways to put the “addict” more in control.
In Torah sources there is no clear, unequivocal mention of psychoactive, addictive drugs that we know of today, such as opium, cannabis or cocaine. The one psychoactive substance that is discussed in the Bible and Rabbinical writings is wine. On this there is a mixed review. Used properly, wine is very good: “Wine gladdens a man’s heart.” (Psalms 104, 15) The sages instituted a special blessing for wine: “…Who creates the fruit of the vine.” Many holy occasions, such as Shabbat, Holidays, weddings, etc. are sanctified with a cup of wine. However when it is misused it can cause great harm and disgrace to the drinker. Examples are the case of Noah where his getting drunk caused his son Canaan to abuse him(Genesis 9:21) and Lot, where his daughters got him drunk so that he would engage in illicit sex with them. (Genesis 19:32-38) Indeed the Sages us Lot as the example of unbridled drunkenness with the disparaging term: “the drunkenness of Lot.”
The Talmud discusses the pros and cons of wine. One example is:
So Rav Kahana says’ “If he merits [drinks wine properly] he will become. wise, if he does not merit[drinks too much] he will become a poor beggar.” Rava has a similar exegesis on the verse “Wine gladdens a man’s heart.” (Psalms 104, 15) “If he merits the drinking will make him happy, if he doesn’t merit it will lay him waste.” (Sanhedrin 70a) So we see that wine can be a very good thing, but using too much of this good thing turns into a bad thing. But the concept of “addiction” to drugs and alcohol as it is known in today’s world is not evident in the writings of the Sages.
The classic usage of the term “addiction” is derived from the effects of chronic opiate use. This is because that with chronic use the opiates generally cause certain effects in the body “physical addiction”. One quality of physical addiction is called “tolerance”. This is the process whereby using the drug over time causes the body gets used to the drug and the user needs to ingest more of it to achieve the same effect. Another quality of physical addiction is “dependency” by which over time the body becomes dependent on the drug. A person who has developed a “dependency”, when he ceasing using the drug will experience the physical distress of “withdrawal”. Different drugs exhibit these qualities of physical addiction in different ways.
As difficult as a physical addiction can be to get over, what can be even harder is the “psychological addiction”. This can be seen in addicts who go through the process of detoxifying from the drug and have no physical symptoms. Nevertheless they often go back to the same pattern of use and abuse. This is because they fall back into their old patterns of using the drug to solve their emotional problems.
In today’s thinking about alcoholism and drug addiction there are two schools of thought. One view is the “disease model” whereby the alcoholic and addict it thought to suffer from a disease whereby he has no controlled over his compulsive use. This is the prevailing view of most of the medical establishment of the Alcoholics Anonymous movement. Reasons given for this view are that it removes the guilt from the addict and that it brings the addict within the treatment of the medical establishment. However, much research and experiments have been carried out to determine if the alcoholic and addict really have no control, and in almost every case the studies have found that under the right conditions they indeed do have control over their substance abuse. Another argument against this view is that it turns a free will act of ingesting alcohol or drugs into an unavoidable compulsion.
The other view is of addiction is known as the “sin model”, whereby the addict is harming himself in the long run by indulging in the instant pleasure of the drug or drink. But rather than using this model to berate and blame the addict, it can be used as a way for him to accept responsibility and repent his actions.
One way that narrative therapy enables the client to overcome guilt and blame is by externalizing the problem. In the case of addiction, one of the most useful aspects of the problem to concentrate on is the craving or the urge to use the drug. The client can be asked about what the craving is telling him, when and under what circumstances it comes to him, what it wants from his life, it’s strategies and tactics. The client can be encouraged to give this craving his own name, whether it’s the “Yetzer Hara”, “addictive thinking”, or whatever resonates for him.
In almost all cases the person has had times in the past where he did not give in to the urge to use. The client is encouraged to come up with some of these “unique outcomes” where he was able in the past to talk back to, ignore, or otherwise overcome the problem saturated story of the craving inducing him to use the drug. By strengthening these unique outcomes and building on them, we help the client to avoid giving into these cravings in the future.
Drug abuse and addiction starts out as an attempt to solve some kind of life problem, whether it’s sadness, boredom, a desire to be happier. In the therapy we try to explore what some of these issues were in the “problem saturated story” and explore other ways of solving these life issues. Also helpful is building up positive things in the client’s life, such as finding meaningful life work, proper diet, exercise, friendships, etc. Group support is very helpful, and where appropriate referring to or forming support groups can be a useful adjunct to the therapy.
Rabbi Yosef Cornfeld is on staff at the Narrative Therapy Institute. Questions and comments on the above summary are welcomed. He can be reached at 052-4500068, email: email@example.com.