It’s not uncommon for people in early recovery to question their level of personal responsibility for their addiction. The medical model, which is the basis for 12 step programs, reflects the belief that factors such as genetics and adverse life experiences relieve us of responsibility for causing our addiction. Once it becomes clear that an addiction is present, however, all accountability for dealing with it falls squarely on the addict.
Critics of the 12-step model of recovery sometimes believe that the steps relieve the addict of responsibility by saying that he or she has a “disease.” However, despite any causal factors, the addict is ultimately responsible for his or her behavior, and simply stating “I am powerless” in no way releases the addict from taking ownership of his or her actions.
That said, some factors can complicate the role of personal responsibility when symptoms of addiction are present. Bipolar disorder, for example, can create a manic state in which people act out in a hypersexual manner. This behavior can mimic sex addiction, but the underlying cause is very different. In other cases, people may carry a genetic predisposition to addiction, something that becomes clear with careful reflection of one’s family tree. Or there may be cultural concerns in which greater use of alcohol, other drugs, or acting out sexually is condoned. Gay men are often cited as an example of a subculture in which addictive behaviors are tolerated to a greater extent than in the larger society. And with the opioid epidemic, we are seeing the damage that can be caused when physicians prescribe drugs that are highly addictive.
Despite these complicating factors, addicts always remain responsible for their behavior. Below I have listed three factors linked to an addict taking personal responsibility in dealing with his or her addiction.
- Awareness: Denial is a significant factor that can delay full acceptance of responsibility for one’s addiction. Breaking through denial is an essential step. In treatment, the first phase is all about breaking through denial and looking for inconsistencies in the ‘stories’ the addict is telling himself or herself. Such awareness includes developing a realistic view of addictive behaviors without rationalizing, becoming the victim, or succumbing to other defenses. It also includes acceptance of personal factors that may have increased the addict’s risk for the development of addiction, such as genetic predisposition or unaddressed childhood trauma. It is this awareness and acceptance that keeps the addict in a state of responsibility.
- Understanding the Cycle of Addiction: Every addict ultimately falls into the same basic cycle of addiction and must recognize his or her personal expression of this pattern: disturbing thoughts, uncomfortable emotions, acting out, and ultimately the shame and remorse that follow. This is the basic cycle for all addicts, both substance and behavioral. Knowing the specific signs and symptoms of one’s own cycle is vital. Taking steps to counteract disturbing triggers or cues at any point in the cycle ultimately augments personal responsibility.
- Support: One of the most important things any recovering person can do is to build a robust social support network. We know that connection is a critical force for recovery. It can protect the addict from his or her rationalizing thoughts or feelings and provides a means by which reality testing can occur. It’s important for the addict to have trusted people in his or her life who will provide honest feedback on what they are observing. And the benefits of support go both ways. While it’s important to receive it, it’s also very healing to provide it for others.