She lives under a bridge with hundreds of other junkies. Once beloved by her six grandchildren, she now shuns them in favor of squalor and heroin.
I’ve never been well or happy for a long period of time. So when I do feel like I am doing well, I’m afraid because it’s not a feeling I’m familiar with and it scares me. When I do become clean, I’ve got to become a new person because I’ve been this other person for so long.¹
The familiar, even when miserable, can be preferred to the good. It seems the brief high outweighs the misery and any possible good that could come with sobriety. Whatever the reasons, the good—growing relationships, better health, work, warm shelter, a decent meal—is not always perceived as good. You would think that an escape from abject misery would be a strong reason to change, but it is not. There is a pull toward the status quo in addicts—the familiar beats good.
But this is not unique to addicts.
What about people who seem to sabotage anything good by being cantankerous with a boss or accusing a friend? Or children who prefer an abusive parent to someone who is genuinely kind and patient? Why do we so often duplicate our past, even when our past was atrocious? Maybe shame drives some people back to the miserable—worthless people deserve the worst. Maybe guilt—you get what you deserve. In fact, the pull of the status quo affects most of us. To borrow an observation from C. S. Lewis, we prefer our familiar mud puddles to the offer of a holiday at the beach. We are, indeed, a curious people.
All this reminds us of some basic AA insights: we are not reasonable people, so don’t expect reason to change us. We need something or someone much stronger than ourselves if we are to be transformed.
Bad consequences are not sufficient in themselves to change us, insight alone is not able to change us, the offer of heaven itself is not sufficient to change us. We instinctively regress to the familiar. Only the Spirit can revive our moribund souls.
So, in the name of Jesus, we come to him, who is the light, the life and our very sanity, and we invite others to come. He holds out his hands and invites even the most contrary among us (Romans 10:21). He never refuses those who come to him (James 4:8).
We come to him with a slightly keener sense that among the threats to spiritual vitality is that we do not always think the good is that good. Vigilance is the order of the day. So we pray: “Jesus, help. Help me not to regress to the familiar. Help me to see the good.”
¹ From an article in the Philadelphia Inquirer, by Sam Wood and Stephanie Farr, “A Heroin Hellscape,” Sunday, February 19, 2017, A18.
Addictions continue their upward swing. Given that we live during a time when self-control is not yet prized, our cultural strategy with hardships is to medicate them away rather than stand in the midst of them. And the possibilities for medicating hardships are always increasing. To sexual obsessions, add illegal drugs, then prescription narcotics, then computer games, and there are more to come. With this in mind, the church has a perennial project: to draw out fresh insights from Scripture on modern addictions, and move toward those who are enslaved by them.
Many of these insights exist within biblical teaching on idolatry, which has both voluntary and involuntary aspects to it. Human beings both purposefully indulge their desires—we sin because we like it—and we are dominated by those desires. We are both in-control and out-of-control. Within these two poles are dozens of important biblical themes. Here are just two.
All addicts lie. As idolaters they forge an alliance with the anti-god and his crumbling empire, and lying is one expression of this alliance. It is a case of like father, like son. “When he [Satan] lies, he speaks out of his own character, for he is a liar and the father of lies” (John 8:44). For addicts, this deception is not only what they speak, it is also what they believe. They also have been lied to and believe those lies—lies from family, friends and Satan himself.
If you want to help addicts, you will create a culture that delights in openness and honesty. Be someone with whom they can speak without fear of self-righteous judgment. Invite them to speak this new language of truthfulness, in which they speak honestly and aim to know the Truth—who is the antidote to all idolatry.
Addicts are complicated. Though they have an idolatrous commitment to their desires, there is usually more happening. Many addicts have been rejected and treated as nothing by those who claimed to love them, and live with a deep sense of shame. Without any way to escape it, they use addiction to avoid it.
If they were not dominated by shame before they began their addiction, they certainly will be after. When you live for something that is ultimately worthless, you feel worthless. When you live for neither God nor people, you will hurt others and degrade yourself. Then the cycle continues—addiction leads to shameful consequences, which leads to more devoted addiction.
So, if we are to help, we watch the life of Jesus. He was born into shame and his people are outcasts. Watch him eat with the shamed and touch the shamed. Watch him identify with them so they can identify by faith with him. At every point, we expect Jesus to turn away and not be sullied by the shamed. Instead, he always invites, always surprises, and offers a connection to himself in which we are given cleansing, covering and belonging. As we follow the story, our roles begin to change. No longer is there an addict and a helper. Now we are two people who are seeing beautiful realities that will take the rest of our lives to understand.
These, of course, are only two of many hopeful things that can attract someone caught in addiction to Jesus. Scripture is crammed with much more.
Counselors spend much of their time in the details of people’s lives, so they often think about matters of public policy because they have seen its effects on particular people. In the case of recreational marijuana, I am just beginning to see these effects, so I expect that more observations will amend my policy thoughts. But there are some things that are clear.
What do we do with this? By its very nature, marijuana doesn’t call attention to itself. It is mellow more than hyper and aggressive, so it is unlikely to ever receive a prominent place on the church’s agenda. Yet all youth leaders must provide a place for this discussion, and pastors will have to decide if and how to speak of recreational marijuana use in states where it is legal.
Addictions: Rewriting an Addict’s Story by Ed Welch explains the inner-world of addictions and the interplay of tests, temptations and sin in the life of an addict. Ed offers a beautiful story of God’s redemption through Christ and how our own stories can be re-written by the power of what Christ has done for us. Included with the audio is a notebook that can be used as a reference while you listen and for reflection later. Also consider Ed Welch’s book, Addictions—A Banquet in the Grave: Finding Hope in the Power of the Gospel.
“Need to Know:” Given the information age in which we live, many of you will be able to relate to this article. With candor and wit, Matt Mitchell invites us into the dynamics of his information addiction. His story just may help you understand some of the dynamics at play in your own life—and in the lives of others to whom you minister.
So many things in life seem relatively straightforward on our first pass. Later we discover that there is more to it. For example, at first, all deciduous trees seem to look alike—tall and leafy. Gradually though, our eyes can tell the difference between oaks, maples, poplar and ash. Finer discriminations come over time. We could also do the same with fear, anger, bipolar . . . almost any category. And we can do it with addictions.
On our first pass, addictions are lusts. They are out-of-control desires that usually hurt the addict and anyone else who is close by. But if we spend enough time with addicts we might notice subgroups within addictions, and though lust applies to them all, there are other biblical approaches that could be even more suitable.
I’ll identify four subgroups.
1. The hurt, fearful, or shamed addict. These are well known and most common. Addiction covers pain, guilt, shame, fear—stuff that just hurts. If we miss these reasons we will be unhelpful.
2. The angry addict. These drink and drug at others. They have enduring anger at certain people and the addiction is aimed at them. You won’t hear a sentence or two without some expression of judgment, sarcasm, or cynicism. Sometimes these angry addicts are also hurt and fearful; sometimes they are just plain angry. They are scary, not so much because they might hurt you, though they certainly can lash out at family and friends, but because anger is so delicious and satisfying to the angry person. For these addicts, anger becomes part of the addiction.
3. The bored addict. These are difficult. We can understand the desire to numb pain, and we are familiar with anger, but life is certainly not boring. And though we can easily summon some respect and empathy for those who are thrown by the pain of life, boredom has more in common with the spoiled brat. For the bored, addiction is a way to feel more alive and above the ordinariness of daily life. Anger and entitlement might not be too far away.
4. The “what happened?” addict. These moved into addiction by way of naive experimentation or simply because friends were doing it. But, for some reason, they seemed to like it more than most, so they did it again, and again, and, at some point, the addiction owned them. And the whole thing is a bit of a blur. The reality is that some people like the experience of being high or altered more than others. Is there biology involved? Probably.
There are dozens of other reasons for addictions. I am not suggesting that these are even the top four. I do think, however, that a growing taxonomy such as this can help us understand people more clearly and enable us to counsel them with the truth that is most relevant to their addiction.
The DSM V has arrived, and the world is largely unchanged. The new iteration opts for the status quo, which is what happens when you have to please those with competing agendas. If you are looking for something more dramatic you will have to wait another decade for the DSM VI.
For biblical counselors, an overarching principle still applies: psychiatric diagnoses can open our eyes to see real human struggles, and these same diagnoses can distract us from Scripture’s insights and spiritual causes or contributions.
With this in mind, I’ll dive into DSM V and grab one of the new diagnoses—hoarding.
What is hoarding?
Compulsive hoarding is a category that has gathered momentum, especially by way of reality shows. It was once tucked away as a variation of obsessive-compulsive disorder and obsessive-compulsive personality disorder. Now it stands on its own. The description includes:
(1) persistent difficulty with discarding possessions,
(2) discarding these items is distressing, and
(3) decluttering is the result of third party interventions.
In other words, hoarders will not ask for help; their children and other family members will be the ones who sound the alarm. Since hoarders have their reasons, expect that they will not be enthusiastic about an all-paid weekend getaway while the church descends on the junk-strewn and contaminated home with the world’s largest dumpster.
Notice the commonness
How should we think about this? One place to start is by briefly considering how this problem is not either/or, but it is more/less. Some fit the category more, some less. When we locate ourselves on the hoarding continuum, we gain patience. Most of us let some things accumulate somewhere. (The cautions to this approach? Don’t minimize the difficulty hoarders experience. Don’t expect that “let’s get rid of ten things a day for the next month,” which might be appropriate advice for you, will help them).
When we stretch the diagnosis, we can imagine that hoarders are motivated in part by practical matters and sentiment. For example, you never know when you will need that broken lamp, those ten-year-old moving boxes, and those unread books. Maybe you will lose weight and be able to fit into those old clothes, so why spend money on a new skinny wardrobe when you can keep the clothes from two decades ago and be retro-cool? And sentiment has no end. “Those elementary school drawings are priceless.”
Now extend this thought further to: “anything that is my possession is a part of me.” For the person who hoards, these are not just objects heaped up in chaotic piles. Each item has significance. Now we can begin to imagine how the thought of parting with any object is met with visceral pain.
What is important?
From understanding, we move toward help. The challenge with helping hoarders is that they don’t want help and, if you can actually talk with them, they are rarely insightful.
“Could the place use a good cleaning?” you ask gently.
“No, not now.” End of story.
You could try an old fashioned visit to the home. The first time I talked with children of a hoarder, they described the hoarder’s home, but it was almost impossible to take their description seriously—until they produced some pictures. The first showed the exterior. The house was actually bowed from the weight of the hoarded stuff. Then they showed a picture of the inside. There was one narrow canyon surrounded by mountains of debris—mostly trash and garbage. Now I understood.
Assume that the hoarder will not discard anything. If anything is to go, the family will have to do it. You can help the family be patient and gracious during the clean-out process. (Note: The family should call the local police before making plans because they will be moving possessions that belong to another person.)
If you have the opportunity to talk to the hoarder, look for a way into the person’s life. Hoarding will probably not be a fruitful route. When in doubt, aim to know, enjoy and bring Jesus to the person. Evangelism and the knowledge of Jesus Christ is more important than changes in hoarding.
The DSM V will help you to see hoarding, but it might blind you as well. It’s not just about throwing things away. The rescue and encouragement of a person’s soul is the most obvious way to the deepest form of help.
I should have seen it coming.
I should have invested in storage units.
Some problems are universal. You can find schizophrenia and depression in every culture. Hoarding, however, is uniquely Western, and it is getting worse. We see houses misshapen under the weight of debris and hear warnings such as Spent: Memoirs of a Shopping Addict that try to scare us away from the path of accumulating.
There are aspects of it that are in all of us. For example, I WANT runs deep in every heart. Desires morph into needs. We must keep up with the Joneses. We prefer our silos full. But the obsessive accumulating that has been getting more attention recently also needs an advertising-driven culture of abundance. Without these conditions, storage units go bankrupt.
On the surface, the solution is simple: throw the stuff out or give it to the local thrift store. If you can’t do that, leave town for the weekend and let your friends clean house. But the solution is only simple in the same way that the solution to every problem is simple: stop drinking, love your spouse, forgive as you have been forgiven, fear God and keep his commandments, and …throw out your extra stuff. But, it’s not simple when it’s your problem.
So, how should we think about this?
Find the Normal in the Abnormal. Key to understanding and helping hoarders is to find it in yourself. The more unusual the problem, the more critical this step is. And it should be easy for most of us. What have I bought in the last week that I don’t need? What is in my closet that I can’t wear now, but . . . if I lose 10 pounds…? Maybe my grandkids will want these 1960’s pictures from National Geographic. If they don’t, what about their kids? I’m sure they will want them to spruce up a junior high paper too thin on information. Those National Geographics might give them that A in a class, which might put them in a position for a college scholarship.
Okay, I haven’t rented a storage space yet, but I get the point. We are in this one together. Whatever a hoarder finds in his or her heart, I will find in my own. And whatever helps me with my unwillingness to throw out old magazines, will most likely help someone whose problem is more extreme.
What does hoarding say about us? It tells us that we are irrational people, but at the same time, we know that the heart has its reasons. We have a purpose in our hoarding. Listen and you might discover its logic.
A side note. Hoarding is an opportunity for Scripture to demonstrate its breadth. One way to use Scripture is to look up verses in a concordance that directly address the problem. This method won’t help us with hoarding. A second way is to merge the core of the problem with key themes in Scripture. In this case, greed and fear are obvious themes. They might apply to some hoarders, but won’t apply to most of them or will apply to them only in part. A third way is to bring out your basic doctrine of the person and see the hoarder as an embodied soul (a.k.a. heart) who is influenced by the world. This is the way I am using Scripture to think about hoarding.
So what might influence the heart of the hoarder to keep everything in the “save” pile?
Some hoarders have no words to describe the tension they feel when there is a threat that something could be discarded. Can we find some words that can get them (and us) started?
What does the King say? The New Testament describes life with Jesus as King. That life, of course, is usually the opposite of how we normally think and live. In the Kingdom we live by faith in Jesus, from start to finish. For hoarders, the task is to consider how their basic beliefs would be transformed if they really knew the King, both his presence and power. For example, in light of the Kingdom, possible wrong decisions about what we discard are exposed as legalistic. Whereas Jesus draws our attention to the more important matters of love and mercy, hoarding focuses on non-essential matters. It hopes to master one realm of our world apart from faith.
Certainly, there is much more to say, and we will need to say much more because this problem is on the rise (…and those National Geographics are still in my basement). Hoarding resides at the confluence of the human heart and influences that include unprecedented amounts of goods received through inheritance, items that no longer work because they were created to be disposable, higher incomes, cheaper goods (dollar stores and the age of plastic) and a culture of sophisticated and saturated marketing. What a perfect opportunity to learn more of the Truth.
Counseling and Physiology Class: Post 7 (Neurobiology of Addiction (or, A Good Thing Gone Bad))
In the first chapter of the American Society of Addiction Medicine’s textbook on addictions, Alan Leshner says this: “The brain of someone addicted to drugs is a changed brain; it is qualitatively different from that of a normal person in fundamental ways, including gene expression, glucose [sugar] utilization, and responsiveness to environmental cues.” Now, as Christians, what should we think of this? Our temptation is to go to one of two extremes. One extreme is to allow the medical research to shape our understanding of addictions in such a way that the physical aspects of the problem completely overshadow the spiritual aspects. The other extreme is to bury our head in the sand about the research being done on additions and to assert that addictions is only a spiritual (sin) issue that must be conquered with self control.
Addiction is a spiritual problem and it is a body (or brain based) problem. As Ed Welch says, addiction is a problem of disordered worship. And it is a brain based issue. Did you ever consider that not all patterns of sin involve the body/brain in the same way? For example, people don’t get high from gossiping or lying. And nobody develops a physical dependence on grumbling and then experiences withdrawal symptoms when he/she stops! There is something different about drug abuse that “hooks” the body in some way and we need to take that bodily component seriously if we are going to minister in a compassionate, truthful, and realistic way to those struggling with substance abuse.
It seems that alcohol and drugs of abuse hijack normal pathways in the brain associated with desire and pleasure. When you eat a sumptuous meal, listen to your favorite relaxing music, or engage in sexual activity leading to orgasm, your brain releases the neurotransmitter dopamine. It’s an elegant system and right in line with the psalmist’s declaration that we are fearfully and wonderfully made (Ps. 139:14). But drugs of abuse usurp the role of our brain’s natural neurotransmitter systems and lead to a much more explosive (and pleasurable) release of dopamine. Over time, it is hypothesized that the balance of dopamine changes, so that despite more frequent and higher amounts of the drug, there is less effect because the overall supply of dopamine decreases over time. And even with abstinence, it may take over a year to restore the natural balance.
What are a few counseling implications from this research?
As we have seen in this series of posts, attention to both the spiritual and bodily aspects of our personhood is essential for wise ministry. How have you seen this to be true with an addicted individual? Where have you seen imbalanced approaches that end up being detrimental to strugglers?