Tiger Woods will be in the starting field for the Masters golf tournament in two days after months of treatment for what some describe as sexual addiction. Like many before, and no doubt countless yet to come, he got caught engaging in socially disfavored behavior only to announce shortly afterward that he had a “problem” and was seeking treatment.
But, 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.
There is a sense in which addiction 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.
So, on Thursday, at the Augusta National Golf Course, another fallen hero will walk down the fairway taking his first steps to public redemption. He won’t be a self absorbed, rich superstar athlete who fooled around on the side. He’ll be latest in a long line of those recovering from an illness that compelled them to engage in destructive behavior. And most of us will forgive him. And if he falls again, we’ll know why.
Cross posted at Elijah’s Sweete Spot. COMMENTS/DISCUSSION welcome at Disqus™ enabled Thread One.
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.