The untimely passing of Audrey Conn (formerly Kishline), who took her own life last month, prompts some troubling questions about why our culture promotes fear of “addicts” who attempt moderation.
Conn founded the Moderation Management program in 1994, wishing to start a group that did not differentiate between an “alcoholic” and a problem drinker. Yet after media scrutiny and questions about her motives, she eventually changed to believing there was such a difference. In January 2000 she declared that moderation wasn’t the best goal for her, and that she would instead begin attending abstinence-based programs including Alcoholics Anonymous and SMART Recovery. In March of that year, she crashed her car after driving the wrong way down a highway in Washington state while three times over the drunk driving limit, killing a man and his 12-year-old daughter.
Media condemnation ensued, and the National Council on Alcohol and Drug Dependence (NCADD) pronounced it “a harsh lesson for all of society, especially those individuals who collude with the media to continually question abstinence-based treatment.” Conn served three and a half years in prison.
Many people feel a need to confront the “denial” of people like Conn (even though at the time of her crash, she was attempting abstinence, not moderation), to make them “see the light.”
Yet evidence ranging from the recent NESARC study back to the work of the Sobells in the early ‘70s indicates that moderation isn’t just possible, but often probable. People who drank problematically in college, for example, frequently find that family fulfillment and career opportunities lead them down a long-term path of reduced, safer drinking—we all know people whose lives fit such patterns.
Extreme binge drinking in college is often regarded indulgently. But for people who have instead been labeled, at any point in life, with the diagnostic moniker of “alcoholic,” “addict” or “chemically dependent,” a moderation outcome is often not seen as permissible. Our culture finds it necessary to confront and sometimes even ridicule diagnosed people like Audrey Conn who try moderation. Why is this?
I believe that when diagnosed people show themselves capable of moderation, it blurs the line we draw between “normal” and addicted, between society and the marginalized. And this frightens a lot of people who need to see themselves as “normal.”
A clear delineation between “addict” and “normie” can be comforting. I’m not one of them, we tell ourselves, so I must be fine. Blurred, nuanced differences in behavior, on the other hand, pose a worrying question: Is what I’m doing OK?
In this way, the “addict” concept is a representation of society’s own denial—the idea of the diseased and abnormal addict shields most of us from having to explore our own relationships with addictive behaviors.
The French philosopher and social researcher René Girard posited that the scapegoat is the end result of a cultural “mimesis,” or imitation, of what is considered “good” (or desirable). What others show us is “good,” becomes “good” to us. Yet if we all went for the same thing, violence would break out and community survival would be threatened. To explain why everyone cannot have the “good,” society creates the scapegoat, refocusing its members’ hostility against one another onto something or someone else. And the “addict”—incarcerated in huge numbers, blamed for crime, the spread of disease, constant lying and much more—is certainly one kind of scapegoat in our society.
This is not to say that addiction does not exist and cause great harm, or is simply a matter of insufficient willpower. It is, however, something we all get caught up in. You find something (or, sometimes, someone) that makes you feel instantly better, and you want that feeling again. So you repeat whatever it is you did before, again and again and again. But is this really a disease? Something only a few people are capable of? Addictive behaviors manifest themselves in our lives as a response to something that we all face: an existence that often feels overwhelming and absurd.
The belief in an all-or-nothing version of addiction is a crutch that allows us to feel like we can deal with our world, that we can control things that deep down we know we have no control over. Just as we dehumanize people who commit terrible crimes, despite evidence that they’re more like the rest of us than we think, to avoid having to place ourselves in the same category as them, we also carry on marginalizing, separating “addicts” from the rest of us.
DSM-5, the 2013 edition of the psychiatrists’ bible, has finally come to regard substance use disorders as existing on a spectrum, with a range of different levels of severity. But wider society is still not ready for the truth that there is no definitive difference between “addicts” and everyone else, that addiction is just an extreme form of normality.
Until that changes, our attempts to help people who are experiencing addiction will remain fraught with difficulty. And many more people like Audrey Conn will feel our anger for denying us our crutch.
