The addiction/existential concussion of one person may also contribute to the existential concussion of others. Many existential concussions involve what psychologist Pauline Boss calls “ambiguous loss.”11 Boss offers two categories of ambiguous loss. The first is when a person is physically absent but psychologically present, such as a soldier missing in action and presumed dead or a child who has been kidnapped. An active addict who abandons his family may also fall into this category. He’s both there and not there, which affects the family dynamic in uncountable ways. Hoping and wishing for someone’s return or remaining furious about someone’s abandonment may become an axis around which other concerns of the family revolve.
The second type of ambiguous loss is when a person is physically present but psychologically absent, such as a person with dementia or someone suffering from significant mental illness. An active addict parent who attends primarily to his use may fall into this category. He’s both there and not there. His presence and his moods define the dynamics of his family. Everyone in the family may try to act in ways that do not draw his attention or upset him in any way. Walking on eggshells becomes the family pattern.
Ambiguous losses do not fit easily into our patterns of grief and loss. A person is either present or absent, alive or dead. One is either single, married/partnered, divorced, or widowed. Dichotomous categories are always the most rigid. Each time a person hits the rigid limits of these categories or careens back and forth between them, she may become a little more disoriented and full of more despair. Disorientation and despair cause more careening and a vicious cycle begins.
Consider the varying ways that different illnesses and the suffering of individuals and their families are regarded. In a poignant article, “Food Comfort,” Larry M. Lake describes a “tsunami of food offerings [as] an edible symbol of our community’s abundant generosity,” when his wife is diagnosed with breast cancer.12 The outpouring of concern took many forms—rides to appointments, notes and cards, and telephone calls. As crass as it sounds, his wife had the “right” sort of illness, one that people acknowledge. The family’s suffering was recognized and shared, which contributes to it being meaningful.
There is no such acknowledgment ten years later when Lake’s daughter is admitted to a psychiatric hospital with bipolar disorder following years of alcohol and drug abuse. Clearly his daughter is ill, but it isn’t the sort of illness that elicits a community’s acknowledgment. No one brings you dinner when your daughter is an addict.
A person can also experience ambiguous loss of her own person. This can be one of the most profound forms of alienation. Consider the ways that a person often recognizes—even at the same time as she denies—how she is losing parts of herself to her addiction. Commitments, values, activities, and dreams that once made her feel alive, valuable, connected, and like she was contributing to the world, start to fall by the wayside. She is still physically present, but pieces of her are now missing.
When she is no longer capable of caring for her person or has no interest in doing so, she is psychologically absent in significant ways. Addiction causes a person to lose parts of herself when she loses important relationships that have become fundamentally fused into her identity and her self-understanding. She may no longer be someone’s partner. She is no longer the best friend. She is no longer the parent who is actively engaged in her child’s life. Without these relationships that have been so life affirming, she is not able to care for her person. This is ambiguous loss.
The ambiguous loss of a person to herself does not fit neatly into our more usual and recognized categories of loss. People whose experiences of loss fall into the cracks and fissures of frameworks keep hitting jagged edges. No wonder they are concussed and find themselves on a precipice.
Are there ways to prevent existential concussions? Not even the best-padded helmet is sufficient to prevent all concussions. But we can effect changes in the conditions that contribute to existential concussions and make them less likely and less severe. One way to do this is to continue to expand our understanding and acknowledgment of types of suffering, especially those that relate to ambiguous loss. We can also work against the stigmatization of groups of people, which has happened with many types of addiction.
Recovery from addiction involves making or finding meaning that begins to orient a person in her life and the broader world. Some people will do well in a program that provides an easily recognizable framework, such as a twelve-step fellowship. Some desire different frameworks that make no reference to powerlessness or a higher power; they may incline to something more secular. Yet others will want a more explicitly faith-based model or a more therapeutic model. Some will eschew ready-made frameworks in favor of ones that are more of their own construction.
Regardless of the particular framework, people begin to orient their actions and their lives around recovery. Recovery becomes an axis around which life can turn. Recovery is a passionate commitment to living a life of self-care, self-examination, and respectful connection to others.
FROM WILLPOWER TO WILL TO POWER
WILLPOWER IS A POPULAR SUBJECT THESE DAYS. CHANNEL YOUR WILLPOWER in all the right ways, and you can transform your life. Or so it seems. In an interesting and provocative book, Willpower: Rediscovering the Greatest Human Strength, Roy Baumeister and John Tierney argue that willpower has a physical basis and functions like a muscle. Willpower can be strengthened, and it can be depleted. It is a finite resource, so one ought to expend it wisely. Glucose puts the power in willpower; when levels of glucose are low, willpower diminishes. Raise glucose levels, and willpower increases, too.13
It all seems so straightforward. If a person puts herself on the right regimen, she can build her willpower muscles so that she is totally ripped. Then she’ll be able to do anything because her reserves will be plentiful. If, along the way, she becomes savvier about where and when she expends her willpower, there is a compounding effect on her reserves.
This view of willpower raises interesting questions for addiction. Are some addictive behaviors beyond the control of willpower? Many experts in the field of addiction studies would say a full-blown or extreme addiction is beyond the pull of willpower, and the diagnosis of substance use disorder in the DSM-5 now involves a spectrum from mild to moderate use to extreme use.14
Some of the old questions about willpower will return, especially for those who are closer to the mild and slightly moderate end of the spectrum and who could pivot back toward “normal” use or abstinence. Are these “mild” addicts simply not directing their willpower in the proper way if they progress down the spectrum? Or are they not properly “willpower working out” so that they are not building strong temptation-resisting muscles while they still can? These questions raise the specter of the old familiar view that addicts are moral failures because we lack self-control to stop our destructive behaviors. We’re either impetuous and act without thinking or we know what we should do but still give in to the temptation. Either way, it will be crucial to break the link between willpower and moral failure. This is one link in a chain of reasoning that, when internalized by people struggling with addiction, may contribute to a fatalistic attitude. Why bother to stop when someone like me can never change?
Willpower is equated with self-control and saying no. The idea is that we exert willpower when we resist temptation. The temptation can be of any sort—that delicious piece of cake, the extra twenty minutes napping on the couch, surfing the web while at work, or the twelve pack