A couple of weeks ago (16th August, on BBC3; “Russell Brand: From Addiction to Recovery”), Russell Brand launched a hard-hitting attack on conventional approaches to drug addiction: first, he lambasted the view of right wing tabloid commentators who favour the view that addicts recklessly and freely abuse drugs, and could as easily choose differently. And second he castigated, even more passionately, the medical establishment that accepts the apparent inability of addicts to desist voluntarily, and compounds the felony by prescribing medically sanctioned (but perhaps equally, if not more, addictive) substitute drugs.
Brand believes, and he is hardly alone in this, that individuals should not be blamed for their addiction, but that theirs is a lifestyle that can be transformed. The alternative – harm reduction via the use of medically authorised drugs – he regards as a dreary, unremitting failure of nerve that leaves addicts psychologically no better, and maybe worse off.
His version of the disease of addiction – echoing that of 12-step based treatments – suggests that choice is, indeed, important, in fact is fundamental, to recovery. However, his preferred alternative route is not offered to clients in routine medical practice. Providing a residential context in which an extended abstinent way of life is elicited that enables clients to explore potential for reformation, is expensive, and available only to those who can afford to pay for it. Ironically, as Russell Brand reminded us, those compulsorily detained in Her Majesty’s prisons may have this privilege offered to them cost free. And reconviction rates after discharge are significantly lowered in those taking advantage of the offer – indicating that the financial costs of this treatment may pay substantial economic dividends in the longer term.
We know that lives can frequently be transformed when the residential alternative is appropriately offered and taken up. But even so, individuals’ resistance to personal reform is frequently intense, even amongst those offered the best of circumstances in which to achieve change. And we know that of the many who may start attending meetings of the 12-step based Anonymous Fellowships only a minority succeed in achieving their goals. So why is it so difficult for addicts to face the imperative of making and maintaining the decision to recover?
One common view is that there is an overriding emotional craving, or seemingly irresistible desire for a substance that cannot be resisted without a supreme exertion of will-power. An alternative view might be that addicts have a huge armoury of what they perceive as irresistible reasons for maintaining their addictions. There is a universal human tendency for self-justification. We all justify the decisions we have made, and the ways in which we have sometimes felt impelled to behave. And given the degradation and harmful consequences that addiction brings in its wake, the psychological need to justify the behaviour is particularly strong. Moreover, addiction is frequently embedded in a distinctive, highly valued, and, to the addict, indispensable way of being, which, as Brand indicated in his TV programme, can be strongly defended.
Can we more precisely identify the cognitive mechanism whereby this apparently perverse way of being is created? A recent article by a group of social psychologists develops the case for a particular form of reasoning as a plausible basis for promoting addictive behaviours. Briefly, the authors (1) report a laboratory experiment, in which the researchers showed that people who believe they have worked harder than they were contracted to do are more likely to stuff themselves with delicious cake when given the opportunity than are those who have worked equally hard, but without being inadvertently misled. The effort expended, and the need for sustenance was equal in the two groups, but the initially misled group apparently felt “self-licensed” to indulge.
The authors suggest that the process of self-licensing can be of great importance in both the initiation and maintenance of “hedonistic” behaviours generally, and this view is consistent with what we know of the self-justificatory reasoning strategies that addicts adopt in defending their behaviour, and of their indifference to the havoc frequently caused not only to themselves but to their relatives and friends.
I think the concept of self-licensing is an effective way of characterising what is loosely described as the “addictive personality”. It suggests an acquired form of reasoning that arises in justification of the excessive behaviours that have become so personally valuable. It aptly depicts the psychological dynamic that is crucial in maintaining addictive behaviours, whatever the biochemical or interpersonal needs that make these behaviours so fulfilling. By the process of self-licensing, addiction becomes a morally defensible way of life, and it is not readily relinquished. But at least, as Russell Brand pleaded before a governmental committee of enquiry, we should promote the most effective ways of getting beneath this reasoned defensive armoury in those who both need, and seek assistance.
Professor Geoffrey Stephenson