Identity: Am I Really and Addict (Alcoholic)?
By John Steinberg, MD – Medical Director, The Bergand Group
In a previous newsletter article, I outlined the five principles embodied in the twelve steps of the self-help programs. The next several newsletters will examine each one of these principles in greater detail. It is fitting that with the holidays approaching, the principle to be examined in this article is that embodied by Step One, Step, Two, and Step Three: Identity.
Every person has core identities that make up our sense of self. These core identities have broad implications; they affect how we behave, how we interact, how we see ourselves, what we do, and who we are. Each “core identity” has, as well, certain implications regarding our limitations and the boundaries within which we can craft and maintain healthy, comfortable, successful lives. While there are, for some, less than simple issues in recognizing core identities such as gender or ethnicity, for many, if not most, these would constitute relatively unambiguous core identities for most of us.
Some examples are in order at this point. Each of us identifies as a certain gender. This gender identification affects whom we are drawn to and what role we play in our most intimate relationships. Our citizenship is a core identity. No US citizen would feel deprived if denied the right to vote in Belgium, or feel inadequate if unable to speak Albanian. We tend to identify with certain socioeconomic groups as individuals within those groups. Though it may seem contrived, we also have our core identity is a member of our species, Homo sapiens. Knowing that we are mammals, we do not feel burdened by the fact that we must sleep at times. Nor, do most of us bemoan the fact that we cannot fly unaided. We accept our identities. We know our limitations. We live within them without even consciously being aware of these imposed limitations.
For some of us, there is a further “core identity,” that of having a chronic disease, such as rheumatoid arthritis, or hypertension, or insulin dependent diabetes. The latter serves as a particularly useful analogy. Every insulin dependent diabetic, as most develop this disease in childhood, is cognizant at all times of things that most of us take for granted: checking blood sugar, making conscious decisions about what to eat and when to eat, adjusting insulin dosing in accordance with meals and exercises, being aware of the symptoms of low blood sugar, etc. We could not imagine a person winding up in the hospital for a diabetic high blood sugar crisis and, upon being asked, “What happened?” having the patient respond: “I went on a cruise. I was so excited about taking the trip that I completely forgot I was a diabetic. I left my testing kit, my insulin, and all my supplies at home. I just completely forgot I was a diabetic!”
Yet, how many times do we see a person with a drug or alcohol dependency relapse in a manner that seems to imply that he or she “completely forgot” about being an alcoholic or addict. The first three steps remind us that, at our core, our substance dependency diagnosis is part of our essential identity. It, as with insulin dependent diabetes, implies certain limitations. These are three, in accordance with the steps:
- We know what’s wrong with us. The problem has a name. It’s no longer a mystery. We cannot, ever, to any degree, control our intake of drugs or alcohol or what happens when we resume use.
- Having been unable, to date, to effect a solution, we must avail ourselves of help, with the confidence that there is a way out of this predicament, a way to put our disease in remission.
- We must make the same type of daily commitment to managing our dependency disorder that a diabetic makes toward managing his or her glucose levels.
This need not cause us anxiety or worry. We need simply, having become aware of our new, core identity, to be equally aware of what this core identity implies for us, as we proceed to recover and, as it says in one of the twelve step programs, to become “useful, responsible members of society.”
As George Santayana noted, those who do not remember history are condemned to repeat it.” Those of us with substance abuse disorders who “forget” that we have them, are condemned to repeat our active addictions all over again. Relapse is part of recovery for many. It not be a part of your recovery story.
In making our identity as alcoholics or addicts part of our core, we protect ourselves from thinking we can use or drink like “normal people.” We forget our identities at our peril. As we look forward to the holiday season, we at the Bergand Group urge all of our friends and patients, our staff and colleagues, who are in recovery, to be cognizant of our core identities at all times, as recovering persons. We manage our disease to grow in recovery. We abstain from drugs and alcohol, and, as the original twelve step program assures us, in doing so, we attain “an adventure beyond our wildest dreams.” If you’re in recovery, don’t forget who and what you are. The reminders of relapse are all too painful.
Instead, enjoy the other “face of the coin,” the recovery side of our nature. It’s an opportunity not to be missed.
John R. Steinberg, MD
Medical Director, Co-Founder
The Bergand Group