By Jeff Vircoe
In the darker years of my addiction, there were times that I would come to.
No, not wake up. Come to – out of a blackout.
My first thought was usually, “I did it again.”
Like clockwork, the next sound stampeding through my fragile skull, like hooves clattering on rain-soaked cobblestones, was the Four Horsemen of Bill Wilson’s apocalypse: Terror. Bewilderment. Frustration. Despair.
All those inexplicable decisions from the previous night or weeks (because binges can go that long) would invariably lead me to the familiar place of, “How and why did I do that again?” It was as if the power of choice had been ripped from my hands. And it had been like that almost from the day I started drinking and drugging at 13.
So when we study the essential symptoms of addiction – and in particular the nine key aspects of what the Edgewood Health Network clinicians believe lay at the core of this illness – Emotional Compulsion is one of the most profound.
I should know better. But I drank. I just got out of jail. But I used. I knew I shouldn’t hang with her. But I did and now I’m in trouble. Why do I always do that?
Fear. Anger. Sadness. Joy. Disgust. Trust. Anticipation. Surprise.
When Robert Plutchik (1927-2006) came up with his list of what he deemed to be the eight primary emotions, the professor emeritus at the Albert Einstein College of Medicine presented the feelings that humans experience as a first response to a situation. He then went on to present eight defense mechanisms, such as when you feel X, you probably respond with Y. It has nothing to do with addiction, of course, and it all seems pretty logical. But the deeper down the rabbit hole you go on the topic of emotions, the more you find psychologists, philosophers and scientists of all kinds pontificating, debating and theorizing on the how’s and whys of emotion just as they have for centuries. They still don’t have a concrete definition. For example, Dictionary.com serves up a healthy 46 synonyms for the word “emotional”.
Charles Darwin studied them and wrote The Expression of Emotions in Man and Animals in 1872. He looked at everything from blushing to raised eyebrows, from shame and shyness to modesty and disgust. The great Scottish philosopher David Hume also studied human nature and the correlation between emotion and logic, and famously proclaimed that feelings ranked higher than intellect in motivating actions. “Reason is, and ought only to be, the slave of the passions.”
In 2014, Harvard University, University of California (Riverside), Claremont McKenna College and Carnegie Mellon University students put out a 45-page paper called Emotion and Decision Making. In it they explained how many psychological scientists now assume that “emotions are the dominant driver of most meaningful decisions in life.”
“Decisions serve as the conduit through which emotions guide everyday attempts at avoiding negative feelings (e.g., guilt, fear, regret) and increasing positive feelings (e.g., pride, happiness, love), even when we lack awareness of these processes. And once the outcomes of our decisions materialize, we often feel new emotions (e.g., elation, surprise, and regret). Put succinctly, emotion and decision making go hand in hand.”
Most would agree that the ability to read and respond to our emotions is a good thing. Yet, experts on the matter like Dr. Robert Cialdini, who wrote the 1984 bestseller Influence: The Psychology of Persuasion, says most people don’t seem to get that.
“People’s ability to understand the factors that affect their behavior is surprisingly poor,”
Other doctors agree wholeheartedly that reacting from a place of emotional baggage is hardly utilizing free will.
“Almost any human being, when overwhelmed by stress or powerful emotions, will act or react not from intention but from mechanisms that are set off deep in the brain, rather than being generated in the conscious and volitional segments of the cortex. When acting from a driven or triggered state, we are not free,” says Gabor Maté in his best-selling book In the Realm of Hungry Ghosts.
Simply put, if your emotional makeup was sound, if you were able to appropriately regulate your emotional moments, you simply would not need to be irrational about your choices. You could feel your feelings, then step back and reassess. Maybe ask for a second opinion before acting out. You would have the power, the decision making strength, the will to back out before taking actions laden with harmful consequences. Young or old, men or women, emotions can trigger humans into all kinds of decisions.
And then there are the addicts.
For them, emotional compulsivity means that, no matter how well-intentioned former U.S. First Lady Nancy Reagan’s advice for beating addiction, you don’t have that choice to “just say no.” No addict in active addiction does. Being triggered means something very different.
For an addict, failure to regulate and reflect rather than react to emotional swings can lead to all kinds of irrational decisions. To drink when they did not intend to. To act out. To cause harm.
Looking at the nine essential symptoms of addiction, as ascertained by renowned experts like the late Robert McAuliffe and his wife Mary Bosen McAuliffe, one quickly sees from what addicts suffer which most people don’t.
The pair spent three decades together helping addicts in the U.S., compiling into a book the traits which define the essence of chemical dependency. In their 2007 effort The Essentials of Chemical Dependency: Toward a Unified Theory of Addiction, the McAuliffes describe in great, gory detail the following nine components of the disease which they and Edgewood clinical staff believe to be present in every addict: Physical, Obsession, Low Self-Image, Rigid Negative Attitudes, Delusion, Powerlessness, Rigid Defense Systems, Psychological Dependency and Emotional Compulsion.
“Chemically dependent emotional compulsion is essentially an intense, uncontrollable, and largely subconscious emotional impulse or urge, caused by a person’s committed drug relationship, to ingest mood-altering chemicals abusively and to experience their rewards. It is caused directly by the dependent’s personal love relationship to drugs and is initiated (along with the relationship itself) by his or her commitment to getting high on drugs. It is an integral element in the essential pathology of chemical dependency,” according to the McAuliffes.
In a 21 page chapter on the matter, the McAuliffes detail and document the ways and means of this condition.
“It is so deep that it operates beneath the conscious psychological or physical craving that dependents, and other persons as well, sometimes experience. And it asserts itself out of nowhere without preplanning or forethought, with no conscious decision or choice. At one moment a dependent is not taking drugs and a moment later he is. The urge strikes and the action follows at once. If confronted about it, dependents will often admit that they had no intention of taking drugs – they just did it for no reason at all. Paradoxically, these same dependents will staunchly maintain that they can ‘take it or leave it,’ that they are handling their drugs with control.”
Despite sincere promises of abstinence, as Bill Wilson promised to his wife, Lois, in the family bible, the addict uses. Most people reading this who have battled the illness know the swearing off phases all too well. It is a cunning, baffling truth which experts like Maté and the McAuliffes, nor the addicts themselves from Wilson in the 1930s to Edgewood patients in the new millennium who live it, cannot adequately explain. Emotions unresolved can lead to earthquakes of carnage.
“Intuitively, it seems clear that because of their peculiar physiological strength, emotions and addictive cravings can short circuit choice or at least distort the rationality of choice,” says Jon Elster, a Norwegian-born social-political theorist professor at Columbia University, in his 1999 book and lecture series Strong Feelings: Emotion, Addiction and Human Behavior.
Getting one’s mind around the terminology and elements of Emotional Compulsion can be mind numbing. As new scientific and neuro research arrives, definitions change, counter arguments and theories spring up from all corners of the globe. One scientist thinks it’s this. A psychiatrist swears by another angle. But there are some basic facts to chew on.
In a broad sense, a compulsion is a repetitive, ritualistic behavior carried out by a person without rational motivation. These compulsive actions offer temporary relief from anxiety, as with OCD. But when it comes to addiction, emotional compulsive behavior is more about rewards, not necessarily anxiety, although opioid users do have particular anxiety about withdrawl. Addictions are all about the use and re-use of substances and/or behaviors which then lead to harmful consequences.
Whether acting out of fear of withdrawal or in search of a reward, addicts bypass the logical reasons as to why they shouldn’t use today. They get triggered by an emotional memory or situation and they do whatever it takes to shift out of that place – fast.
So getting a handle on our emotions is a critical stage of human psychological growth, and especially for addicts.
“Most of our suffering is avoidable,” says Peter Michaelson, a Michigan-based psychotherapist, one of the key voices behind whywesuffer.com. “Unless explored and understood, these emotions produce inner conflict, suffering, and self-defeat,” he says.
“Our unresolved emotions have to be identified. An addictive person can be struggling with feelings of being deprived, refused, controlled, helpless, rejected, betrayed, abandoned, criticized, hated, and so on. Even when the addictive person is not actually being, say, refused or controlled, this individual is unconsciously determined to experience events and situations through these unresolved, negative emotions,” says Michaelson, who clearly doesn’t see emotional compulsion as incurable at all.
“With the right knowledge or with in-depth therapy, a particular individual can identify, based on his or her childhood experiences, those negative emotions that push his buttons,” he says.
“Once the negative emotions are identified, the individual becomes aware of how determined he or she has been to continue to experience those unresolved negative emotions in the different situations of everyday life.”
And that’s where treatment centers and programs like those offered at Edgewood come in. A big part of the treatment experience at Edgewood is about helping addicts find those buttons, experience those emotions, those feelings.
Elizabeth Loudon is Edgewood’s clinical director. She has also been a counselor there for over 15 years. She explains how dealing with emotions or feelings is one of the toughest aspects of the rehab experience for most people.
“It’s hugely difficult. You have to imagine that, when people come into treatment, they are in those fight, flight or freeze aspects and they don’t know what their feelings are. If they actually accessed them, if they accessed the pain or the shame – well, that’s really hard to go through,” says Loudon.
“They’ve got a defense system that pushes everything away, and rationalizes and defends it for them. So when we peel that defense system away, those feelings are there. We see people kind of ‘thawing’ – the feelings are starting to percolate, those defense mechanisms of fight, flight or freeze are starting to go away, or getting less, yet it’s still really hard. That’s why we see people bolt out of family conferences. Or in group, when their shame is being touched and they suddenly have to go to the bathroom,” she says. “We try not to shame them when they come back to group, but we will ask, ‘Did you really need to go to the bathroom or were you just leaving as an old coping style?’ Often it will be an old coping style. So, a lot of our assignments and a lot of the groups that we do here are trying to help them get at their feelings using all sorts of different ways.”
Another Edgewood clinician who is fully armed with information about emotional compulsion is counselor Debra Kine. As supervisor of the seven-member team of counselors on the Cedar unit, Kine has been delivering a one-hour lecture each month on this essential symptom for the past six years.
“It goes deeper than the feelings,” says Kine of the emotional baggage addicts store, stuff and hide. “It’s all about the feelings about the feelings. When addicts have emotions, they become so powerful that they react to the emotions. The feelings are there, but as they repress them they grow and grow into this emotion that feels like [they] can’t handle it,” she says.
“You know how, sometimes, you see those advertisements, and it’s like thumping, thumping and thumping until finally the pillow case bursts and the feathers come out? It’s like that,” Kine says.
The McAuliffes stress the dangers of unchecked emotional compulsion in addicts, and how deep underground it can run.
“It is an intense and compelling impulse. This urge arises from and is nurtured by the expectation of rewards that motivates all dependents. It is so intense that, although the expected rewards are no longer in fact obtained, the drive to achieve them remains,” they write.
A non-addict as far as we know, Dale Carnegie explained emotional people like this:
“When dealing with people, remember you are not dealing with creatures of logic, but with creatures of emotion; creatures bristling with prejudice and motivated by pride and vanity.”
Just because patients stop using once they get into treatment doesn’t mean it will all be better emotionally now, Kine explains.
“It’s really challenging for them. They’re always looking for that next thing to mood alter with. When they come into treatment, they’re like, ‘Oh my God. I can’t handle it. I’m walking around here and there’s nothing here to stimulate me. I’m always looking for something to stimulate me. Food. Flirting. Acting out. The gym. Going and trying to work up a sweat. It’s all about overdoing it. They need to get used to just sitting and being comfortable with who they are instead of always trying to react.”
“I explain to them [that] having that emotional compulsion inside of them is just feeding the addiction. It’s like them being in prison. I always say, ‘Do you want to live in prison or do you want to live in freedom?’ They all put up their hands and say they want to live in freedom, and I ask them, ‘How do you want to get out of prison?’ Then I always say, ‘Go talk about your feelings in group,’” she says with a smile.
Talking about feelings can give addicts the pause they need before acting out or reacting to a feeling versus responding appropriately.
It’s not advice which addicts alone need to face.
In the world of high finance and investment, working through emotionally volatile moments before buying or selling is a wise move. Nicole Dugan, financial analyst and Director of Global Marketing at drivewealth.com, put it this way in a recent column:
“Bringing emotions to the table when making investing decisions is just as unwise as letting yourself get emotionally attached to a single Game of Thrones character – there’s always a possibility that it won’t end well and that you’ll spend the better part of a year scouring the internet for resurrection theories.”
In closing, emotions are a fact of life for all people, addicted or not. But to addicts, spontaneous reaction to emotions is dangerous.
Mike Quarress is a counselor on Kine’s Cedar team at Edgewood. He explains how emotions and addictions are intricately linked.
“They relate in the sense that, typically, it is easy to see that addicts can’t cope well with situational-type things that bring up emotions. For non-addicts, the emotions come up, they have coping mechanisms and tools that they can utilize to work through the emotions. Addicts don’t. Their ability to emotionally regulate is highly compromised because they have used substances or process addictions as a way to act out sexually, or gambling or whatever way to regulate themselves emotionally. It’s all tied into emotions,” he says.
“If I have an inability to regulate myself emotionally then I am going to do something compulsively to compensate. I can regulate myself by using substances. I can regulate myself by gambling or acting out sexually. But there is a second piece to this. When the substance use or acting out subsides, there is the despair, the shame, the guilt, which actually then just feeds more into the injured emotional process. And those consequences [create] even more heightened situations that I can’t regulate myself emotionally about.”
“So it’s just going to keep spiraling. When I am not able to regulate myself emotionally from an emotional compulsion perspective, I don’t have clear thought process. So then my thought process is going to be irrational as opposed to rational thinking. What ends up happening from an emotional compulsion perspective is there actually isn’t any thought, it’s just act. It becomes like an automatic default system, no different than that I don’t have to tell my body to breathe. It just breathes.”
In the end, the solution is simple. Talk about your feelings. Share with a sponsor or friend. Don’t let them build up, and then you have a chance to not wake up wondering, “How did I get here again?”