Ask ten different people, and you’ll get ten different answers. Even within the recovery field, the way addiction is defined and the corresponding approach to treatment differs depending on who you ask.
Today, as a warm-up for this week’s article, I’d like to suggest a quick thought experiment, adapted from a talk Dr. Bob Weathers presented in Orange County, California. When he described the process in this week’s podcast episode, I recognized its genius as a teaching tool (thank you, Dr. Bob), and I’m eager to share it with you.
This exercise will only take a few minutes of your time. To get the most out of it, I suggest that you genuinelyengage with the process.
************************************ 1) Take a moment to center yourself and become fully present. Do a quick meditation if you like, or just take a few mindful breaths, but take a moment to turn down the volume on the monkey mind and engage, instead, from a place of compassion and openness. 2) Grab a sheet of paper and pen, and split the paper into four boxes by drawing a line down the vertical center and across the horizontal center. 3) In the upper-right hand box, answer the question: “How would a doctor define addiction?” 4) In the upper-left hand box, answer the question: “How would a psychologist define addiction?” 5) In the lower-left hand box, answer the question: “How would a friend or family member define addiction? 6) In the lower-right hand box, answer the question: “How would a courtroom judge define addiction?” 7) Now, turn the sheet of paper over, and explore for a few minutes: “How would you define addiction?” ************************************* Each of our hypothetical people above -- the doctor, the psychologist, the family member, and the judge – answered the question differently because their professions, their education, their experience, and their interest in the outcome are different. Because they’re each approaching the question of “what is addiction” from a different angle, their conclusions will reflect their unique perspectives.
Doctors and medical professionals, for example, may tell you that genetics and biochemistry cause addiction. A psychologist might tell you that addiction is a behavioral coping strategy linked with a root causal trauma. A judge may tell you the laws on drugs and alcohol and the consequences for breaking them. Our friends, families, and loved ones might tell us that addiction is a pattern of disconnection and deceitful behavior.
Each of them believes that their definition is the right one. And the more invested one is in the “correctness” of their answer, the more vigorously they’ll cling to that belief. So, which one is it? What’s the correct definition of addiction?
If you did the exercise above, you stepped into each of the roles and saw the correctness of each definition from each role’s perspective. Can all four definitions be correct? Integral Recovery views both addiction and the path to recovery through four different lenses, known in Ken Wilber’s Integral Theory as the “four quadrants of the AQAL map”. The doctor sees addiction through the lens of the individual exterior (upper-right) quadrant. The psychologist defines addiction through the individual interior (upper-left) quadrant. Friends and loved ones see addiction through the relational, collective interior (lower-left) quadrant, and a courtroom judge sees addiction through the systemic, collective exterior (lower-right) quadrant.
According to Integral Theory, not only are all these definitions correct, but we must include each to understand addiction and develop a successful plan for recovery. Without addressing each of the four quadrants, treatment is partial, incomplete, and leaves clients with a high probability of relapse.
But for those who are invested in their perspective, either through academic training, personal philosophy, career necessity, or relational experience, each of the other perspectives is somehow suspect. And the more certain one is, the more likely they are to dismiss other perspectives as unsubstantiated “opinion”. And yet, each of these “opinions” deals with an aspect of addiction and of recovery that is very real indeed. Saying that addiction is a medical problem doesn’t resolve our psychological traumas, our repair our ruptured relationships. Nor does it fix the societal-systemic issues like lack of opportunity, lack of education, and lack of social support that create the conditions for addiction to appear. And yet, addiction is a medical issue. The Integral Recovery model includes each quadrant’s definition of addiction by saying “yes, and…”.
Clinging to the certainty that any one paradigm is the only right one is killing us. Let’s not mince words. Addiction is a matter of life and death, and it causes incredible suffering. The work being done in each of the four quadrants, by different professionals, is necessary and important. By synthesizing and including the findings and approaches of each discipline, we can finally add to the existing models of recovery to address the complexity of addiction through a comprehensive and life-changing AQAL approach.
But this requires the willingness to open our minds and embrace other perspectives; to see things differently than we’ve been trained to. It can be challenging to let go of our certainty about the exclusivity of our long-held views, but every time we allow ourselves to add another perspective to our understanding, we’re allowing ourselves to evolve.
[1:00] The growing passion for Integral Recovery, and the spreading enthusiasm evident in John’s recent presentations with Adam Gorman in Albany, New York. We’re truly grateful to everyone listening to the show and everything you’re doing to spread the word. [5:52] The growing momentum that’s building in California: Dr. Bob gave six presentations in the last week, all of which were Integrally informed. [6:54] Dr. Bob’s method of explaining the four quadrants of the aqal map to people with no background in integral theory by asking how a representative from each category would define addiction. By asking participants to take a series of perspectives, we see not only the complexity of the disease, but we also realize that each of the four perspectives is valid and must be included to achieve a fuller understanding of addiction. [8:53] When the model is presented in this way, clients have moments of insight – holding perspectives and viewing addiction through different lenses can inform and improve our own understanding and our methods of treatment. [10:12] But aren’t those four views just opinions? What’s the true definition of addiction? That’s the right question, because the “true” definition of addiction must include each of these equally valid perspectives. [11:30] Many in the recovery field, though, (whether therapist, scientist, or courtroom judge) believes that they already have the definition of addiction, and that any of the other perspectives is irrelevant and misinformed. In the day of fake news, it’s hard to know who to trust, so we’re more likely to disregard as “uninformed opinion” anything that doesn’t line up with what we’ve already been taught. This is dangerous and limiting. [12:45] As such, the community of recovery professionals is where the work of perspective taking for the inclusion of “other quadrant definitions” of addiction can have the greatest impact. [13:45] But aren’t some of these perspectives, for example the way a courtroom judge or a disciplinary committee would define addiction, just superficial? In short, the answer is no. Lower-right quadrant “systems” definitions have profound consequences that dramatically impact people’s lives, and that definition is just as important and valid as medical, psychological, and relational definitions of addiction. All four quadrants impact our recovery, and if we fail to recover in any of the four quadrants, our recovery will be incomplete. [15:10] There are people out there who aren’t ready, yet, to hear that other perspectives are valid. In such cases, when challenging strongly held models of reality, the reaction can be hostile. Nevertheless, this is where the growth edge lies in recovery work. [16:20] The art of taking perspectives, forcing oneself outside of our normal ways of thinking, is the fastest way to accelerate our development. By offering the experience and the chance to see addiction and recovery in a different light, we’re opening the doors to accepting and integrating other models in a way that’s more likely to be accepted more quickly. [18:45] People in certain professions adopt the views and definitions they do because it’s their job to do so – their place in the integral model is to assume a certain role, and holding a definition of addiction that supports the role is necessary and good as part of the larger whole. [20:39] Specialization matters; it allows us to make progress. But the importance of interdisciplinary communication and abandoning our intellectual conceit to incorporate other viewpoints is essential to our continued evolution. [22:19] In the recovery world, many people do indeed have legal and financial issues that are affecting their lives, so the legal definitions and consequences surrounding recovery are just as important as the medical and psychological ones. We turn to the experts in a given field to give us the best information in the field from a given perspective. [22:49] And further, this specialization is a very good thing when we know which perspectives to adopt for which purposes. For example, if I’m looking for a cancer diagnosis, I’ll trust the doctor and the scientific model to give me the facts. The key is knowing which perspectives to engage, and when. [24:05] How do we evolve a group of listeners and move them further along the path to integral sensibility? How can we apply this in areas of our lives, no matter with whom we’re communicating? [25:25] The idea of asking people to imagine themselves in different roles and experience definitions of addiction from each of the different perspectives makes the validity of those perspectives more visceral. That’s one reason addicts can take so readily to these ideas: to the addict, the ideas aren’t just academic. We’re living them. [27:58] To many professionals, though, and to many in recovery, they’ve found “it”. And once a person is convinced, changing the mind becomes that much more difficult. It’s costly to change our definitions, ideas, and orienting philosophies when we’ve invested so much time and energy in coming to them. [28:24] Another reason clients take more readily to the Integral quadrants than many professionals will is that, in addition to life experience, those new to recovery haven’t yet found “it”, and thus, their minds are more open to inquiry and new ideas. [28:38] No matter our profession, and no matter the situation, we all have a vested interest in protecting the paradigms we’ve worked so hard to acquire. We don’t change or give them up readily, and thus, we can only open people’s minds to change by meeting them where they are. Opening the door just a crack, aiming for a one percent change, can make a difference. [30:44] In the Integral model, the “it” we’ve found is multiple, but it’s still a mental framework we’ve adopted. As such, we, too, must avoid taking on the same intellectual conceit as those we would hope to teach, as the gentle opening is often so much more effective than rigid insistence. [31:10] In the early stages of addiction, the drugs are the “it” that someone has found, and that’s exactly why it’s so hard to convince an addict who isn’t ready to stop using. [32:46] When recovery professionals, though, are convinced that “the right answer is this and only this”, great harm can be done to people who need help, especially when the “right answer” isn’t complete and doesn’t address addiction and recovery in its totality. This can leave the addict missing something important, as we must address the problem in every area. [35:18] When people in recovery hear that there’s one and only answer, and addiction and recovery can only and must be solved in that way, it can be incredibly disheartening and damaging to the addict who needs more help in a different domain. The solution and the path forward can and must resonate with what will work for us, based not only on definitions of addiction in all four quadrants, but also on our typology. People will respond differently to different modes of treatment, and recovery must address that. [36:40] The twelve step approach, though it can also be dogmatic, has largely not been hostile to the Integral Recovery movement for the important reason that Integral is not trying to do away with AA or make it wrong, but rather to add to it and complement it. Neither is AA trying to dismiss psychology or medical science, but rather to bring them all together and add to their existing models. [38:20] The eleventh step of alcoholics anonymous, for example, talks about prayer and meditation, but doesn’t go into much detail. The twelve-step model can be expanded and improved upon by bringing an integral emphasis on inner-contemplative practice to discover personal spirituality, and this is a worthwhile goal. [39:10] State-specific consciousness can make a big difference in the way we operate, so when introducing new ideas like the integral model to a group of clinicians, it might make sense to begin with, for example, a few mindfulness of the breath exercises to get everyone more grounded and open to a natural state of compassion and acceptance. Similarly, this applies to introducing challenging ideas in other areas of our lives in recovery. [40:43] However we can get people to move into a heart-centered space, we’ll find greater connection and greater acceptance when people are open to listening through their hearts rather than through their heads. When we’re open to compassion, with open hearts, we can then open our brilliant brains to a place of open-mindedness and begin to introduce a more inclusive picture of addiction, benefitting everyone out there who is suffering.
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11/17/2017, 43:30, 29.88 mb (Audio)
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