Addiction and the use of treatment and rehabilitation to avoid ultimate responsibility for conduct is a subject I’ve taken up before. Rather than reinvent the wheel, here is some of what I raised in April of 2010 in the wake of the Tiger Woods revelations. It becomes pertinent again with the adventures of Anthony Weiner.
“… are problems like eating disorders, gambling, computer use, work, exercise, shopping, stealing and sex really susceptible of being described as addictions when taken to excess? Historically, addiction has been viewed in terms of using psychoactive substances like alcohol, tobacco or drugs that cross the blood-brain barrier once ingested and result in an alteration of the brain chemistry. But the definition is changing.
The most widely accepted medical definition of addiction is “a chronic neurological disorder [resulting in] continued use of a substance despite its detrimental effect…” Use of a substance remains part of that definition. The American Psychological Association defines compulsive disorders or psychological dependence as “impulse control disorders”, not as addictions. DSM IV TR does not use the word addiction.
There is, however, an expanded common usage of the term addiction to include psychological dependence or compulsive behaviors. DSM V, scheduled for release in 2013, is likely to expand recognized disorders, though not calling them addictions. For example, DSM IV does not recognize nymphomania or satyriasis as disorders. Proposed language for DSM V would follow the lead of the International Classification of Diseases [ICD] and recognize “hypersexual disorder”.
It is said that if you ask 100 different professionals to define addiction, you will get 100 different answers. Whatever that definition is, it fits America’s favorite story: the fallen hero and redemption. Where once problem behaviors were swept under the rug as private matters or those who were caught were ruined, today we have gone public. “I have a problem and I’m entering treatment” has become the all encompassing response to being caught in compromising situations, usually followed, after treatment, by press conferences, interviews and appearances on late night talk shows filled with contrition. Ah, the contrition must be real; s/he has been through treatment. The hero is redeemed, given a second chance…or a third or a fourth.”
[A]ddiction is too easy a rationale. No, it’s not that treatment isn’t valuable. It is. But, the public pronouncements are becoming troublesome. There’s a bit of “I’m not truly responsible, I’m sick, please forgive me, I’ll get treatment” to all of this. It doesn’t help, of course, that they wait until they’re caught to make their pronouncements and seek treatment. And, through all the contrition at the post-treatment pressers, one senses a certain self absorption. In some circles [why does Hollywood come to mind?] having a “problem” and going through treatment has become a badge of honor. I’ll tell you about my addiction/treatment if you’ll tell me about yours.”
This time, post-Weiner, Ruth Marcus of the Washington Post joins in asking the questions. From her editorial :
“…rehab has become an all-purpose laundromat for irresponsible behavior, an infuriatingly easy substitute for accepting blame and living with consequences.
Increasingly, in our Rehab Nation, the concept of sin has been replaced by the language of addiction. Shame has been supplanted by therapeutic intervention. The disease model of misbehavior dictates that there are no bad people, only damaged individuals compelled to commit harmful acts. In this scenario, personal responsibility evaporates and virtue becomes an anachronism.”
What’s your take?
Contributor, aka tidbits. Retired attorney in complex litigation, death penalty defense and constitutional law. Former Nat’l Board Chair: Alzheimer’s Association. Served on multiple political campaigns, including two for U.S. Senator Mark O. Hatfield (R-OR). Contributing author to three legal books and multiple legal publications.