Getting off drugs, or learning to stop drinking, is very often easier than staying off them. As Mark Twain remarked about tobacco, quitting was easy—he’d done it dozens of times. Relapse, the biological imperative, will have its way with most of those abstaining for the first time. Addiction is a psychological disorder with strongly cued behavioral components, whatever its dimensions as a biochemically-based disease.
The three-headed dragon is a metaphor first popularized by alternative therapists at the Haight Ashbury Free Medical Clinic in San Francisco. The first head of the dragon is physical. Addiction is a chronic illness requiring a lifetime of attention. The second head is psychological. Addiction is a disorder with mental, emotional, and behavioral components. And the third head of the dragon is spiritual. Addiction is an existential state, experienced in isolation from others.
Addicts speak of “chasing the dragon” in an effort to catch the high that they used to achieve so easily. It is also drug slang for the use of small metal pipes to catch and inhale the wisps of smoke from a pile of burning opium, crack, or speed. We can picture the dragon chasing his own tail, snapping at it with all three hungry mouths, in an endless escalation of tolerance and need.
“Because of the unique reaction that the genetically addiction-prone individual experiences to his drug of choice, he or she programs his or her belief system with the deep conviction that the substance is ‘good,’” writes Richard Seymour of the Haight Ashbury Clinic. “This is where self-help becomes intrinsic to recovery. Unless one deals with the third head, unless one changes the belief system and effects a turning-about in the deepest seat of consciousness, there is no recovery.” The “X” factor in recovery, for many people, turns out to be a form of inner self-awareness; something that includes the attributes of will power and determination yet transcends them through a form of surrender.
And speaking of changing one’s belief system, experience has shown that it is a spectacularly bad idea to sit around and do nothing but stare at the wall during the early phase of recovery. Psychologist Mihaly Csikszentmihalyi argues, in The Evolving Self, that when attention wanders, and goal-directed action wanes, the majority of thoughts that come to mind tend to be depressive or sad. (This does not necessarily apply to formal methods of meditation, which cannot be described as states marked by wandering attention.) The reason that the mind turns to negative thoughts under such conditions, he writes, is that such pessimism may be evolutionarily adaptive. “The mind turns to negative possibilities as a compass needle turns to the magnetic pole, because this is the best way, on the average, to anticipate dangerous situations.” In the case of recovering addicts, this anticipation of dangerous situations is known as craving. The next step is often drug-seeking behavior, followed by relapse.
For a highly motivated addict with a stable social life, a safe and effective medication to combat craving might be all that is needed. For many others, however, attention to the other two heads of the dragon is going to be necessary. An addict’s ability to experience pleasure in the normal way has been biochemically impaired. It takes time for the addict’s disordered pleasure system to begin returning to normal, just as it takes time for the physical damage of cigarette smoking to partially repair itself. Alternative therapists are fond of referring to recovery as a process, with an emphasis on the importance of time. Medication of any disease, even if successful, does not treat the continuing need for healing. It is now well understood that mood and outlook can have an effect on healing. Positive emotional states can be beneficial to the maintenance of good health. Thoughtful physicians make the distinction between a disease and an illness. A disease is a chemically identifiable pathological process. An illness, by contrast, is the disease and all that surrounds it—the sociological environment, and the individual psychology of the patient who experiences the disease.
Where does the everyday self go during active cycles addiction? It is not a simple case of amnesia, or sleepwalking. It is more like a waking trance, or autohypnosis. Psychologically, it is a state of dissociation. For addicts, the three-headed dragon is both a part of them and not a part of them. It is integral to who they are, yet it is estranged from their core selves. When activated, the cycle of addiction lead men and women away from their genuine natures. Their sense of self becomes impaired through the processes of intoxication, denial, neuroadaption, withdrawal, and craving. This impaired sense of self causes behavior that is baldly contradictory to their core beliefs and values. Honest men and women will lie and steal in order to get drugs.
Webster’s Unabridged Dictionary defines dissociation, rather vaguely, as “the splitting off of certain mental processes from the main body of consciousness, with varying degrees of autonomy resulting.” Recall that in the case of state-dependent memory, if you give a rat a mind-altering drug, and teach him to run a maze, the rat will perform this maze task more efficiently in subsequent runs if it is under the influence of the same drug. How autonomous were you, consciousness-wise, the last time you got drunk and parked your car somewhere you couldn’t remember?
Dissociation may be part of the way consciousness itself adapts to chronic drug use. Richard S. Sandor, a thoughtful Los Angeles physician, helped to clarify many of these issues in an excellent essay in Parabola magazine:
…the inability to satisfy a physical craving or psychological compulsion will produce all kinds of unusual behavior, but this is true for natural drives and appetites as well as for created ones. What might one not do to avoid starvation? Such behavior alone cannot be used as evidence for a pathological personality type. The failure to recognize this point has led to a considerable amount of confusing retrospective research--deducing a personality type after the addiction had developed. But in fact, a dependence on a substance or activity condemned by society as illegal or immoral leads the addict to act in antisocial ways; and this is the case far more often than that drug addiction results from an antisocial personality type.
Secondly, Sandor points to the inability of prevailing behavioral models to produce a comprehensive framework for effective treatment. “None of the current treatment methods based upon the positivist scientific paradigm—be it psychodynamics (Freud, et al.) or behavioral (Pavlov, Watson, Skinner)—has demonstrated any particular superiority in the treatment of the ‘addictive disorders,’” he writes. “Many psychoanalysts readily admit the uselessness of that method for treating addicted individuals (the patient is regarded as being ‘unanalyzable’).”
Thirdly, says Sandor, “It appears that the most successful means of overcoming serious physical addiction is abstinence—very often supported by participation in one of the twelve-step groups based on the Alcoholics Anonymous model.... The basis of recovery from addiction in these nonprofessional programs is unashamedly spiritual.”
The problem for the addict, as Sandor realizes, is not so much the matter of quitting, as it is the matter of not starting again. The resolve to quit is often present, but the resolve not to start again can be interfered with in a variety of ways. All addictions, Sandor argues, more closely resemble “the whole host of automatisms that we accept as an entirely normal aspect of human behavior than to some monstrous and inexplicable aberration.” Bicycle riding is a good example of an automatism, because once learned, “…it no longer requires the subjective effort of attention; more importantly, once learned, it cannot be forgotten. It is as though the organism says to itself, ‘Riding this thing could be dangerous! It’s much too important to trust that Sandor will pay close attention to it.’”
So what does the mind do? It creates a new state called bicycle riding:
Number one priority in this state (after breathing and a few other things, of course) will be maintaining balance. In much the same way, the organism recognizes that mind- and mood-altering chemicals disturb the equilibrium of functions and are therefore potentially dangerous. In response, it may form a new state in which the ability to function is restored, but in which a new set of priorities exerts an automatic influence. Just as one’s only hope of not riding the bicycle again (if for some reason that is important) is to never again get on one, once a particular addictive state has developed, there is no longer any such things as “one” (drink, hit, fix, roll, etc.). Addicts begin again when they forget this fact (if indeed they have ever learned it) and/or when they become unable to accept the suffering that life brings and choose to escape it without delay. Addictions can be transcended--not eliminated.
Sandor ultimately concluded that “The only modern Western psychologies that can aid us in our search to become truly human are, like AA, frankly spiritual or transformational in nature (e.g., those of Gurdjieff, Jung, Frankl).” Sandor compares the addictive state to a form of hypnosis accompanied by posthypnotic amnesia. This automatism, this subsequent amnesia about the drugged “I” on the part of the sober “I,” is highly reminiscent of the consequences produced by state-dependent memory:
A hypnotized subject is instructed to imagine that helium-filled balloons are tied to his wrist; slowly the wrist lifts off the arm of the chair. The subject smiles and says, ‘It’s doing it by itself!’ The ‘I’ that lifts the arm is unrecognized (not remembered) by the ‘I’ that imagines the balloons.... One part denies knowledge of what another part does. A cocaine addict, abstinent for a year, sees a small pile of spilled baking soda on a bathroom counter and experiences an overwhelming desire to use the drug again. Who wishes to get high? Who does not?
“Interestingly,” Sandor says, “this type of amnesia is very similar to that seen in the multiple personality disorder (see Jekyll and Hyde), in which one entire ‘personality’ seems to be unaware of the existence of another. Even more interesting is the fact that confabulation, rationalization, and outright denial are also prominent features of the addictive disorders.” Dissociation, then, can occur without the intervention of anything as dramatic as hypnosis. The common quality is automaticity, the experience of “it doing it by itself.”