I’ve been posting on the interrelationship between character disturbance and substance use. And last week’s article (see: Disturbed Characters and Substance abuse – Part 2), presented two very different scenarios: one in which a person of fairly good character succumbed to the temptation to use after experiencing trauma, began “self-medicating” her pain with substance use, descended the slippery slope into addiction, and became a much different person as a result (uncharacteristically venting much anger that had been long suppressed); and another in which a person who by nature was quite aggressive and respected few boundaries or limits, used to the point that any controls he was normally able to impose upon himself completely broke down, which eventually cost him family and career. The examples illustrated how different how different the relational dynamics can be when folks who are mostly “neurotic” as opposed to primarily character disturbed abuse substances and also how different the response to intervention typically is for these two groups.
A person’s use pattern and prospects for “recovery” are always heavily influenced by their personality dynamics, which is why it’s so essential for character issues to be taken into account in treatment. I’ve known folks who weren’t full-blown psychopaths but who nonetheless had marked predatory aggressive personality characteristics and who, in advance of their daring and nefarious schemes, would purposefully “liquor up” (hence, the term: “liquid courage”) or get high on cocaine to fuel feelings of invincibility and quash what little inhibition they might otherwise have. And while their use patterns mostly fell into the category of “abuse,” their repeated use of their substances of choice sometimes led to true addiction. I’ve also encountered individuals whose dominant character features were of the narcissistic variety – folks who were overly self-confident to start with, cared little about the welfare of others, considered themselves “special,” and harbored a disturbing sense of entitlement, often acting as though the rules and caveats that apply to most people simply didn’t apply to them. One individual who was a rampant poly-substance abuser and who also happened to be quite wealthy and socially particularly stands out in my memory. A “sensation-seeker” since his teen years, he had no hesitation in admitting how much he enjoyed the “recreational” aspects of his drugs of choice. And he had the confidence (i.e. arrogance) to think that he had the ability to “handle” his use in ways that many of his friends whose lives had become shipwrecks because of their substance use were simply “too weak” to do. And even when he lost everything the first time (It would take several major “crashes” before he “hit rock bottom”), went through rehab and at least stopped drinking (He was never as fond of alcohol as he was of some other substances, anyway), he still clung to the belief that he could dabble in cocaine from time to time and use various other substances without consequence. It would be many years (and cost him and his family hundreds of thousands of dollars) before he could find room in his heart for the “I can’t” component of the First Step of A.A. and N.A. And it would take years of counseling before he came to any meaningful terms with the idea of a “higher power” to govern his life.
In Character Disturbance, I mention that on balance, the “ambivalent” personality types (i.e. the passive-ambivalent or “obsessive-compulsive” type and the active-ambivalent or “passive-aggressive” type) tend to be more “neurotic” than character disturbed (Please note that, as I go to great length to explain in In Sheep’s Clothing, the “passive-aggressive” type mentioned here is a very different personality than the covert-aggressive or “manipulative” type). And interestingly, these more neurotic folks also tend to be fairly addiction prone. They struggle with a lot of anxiety, tend to use substances primarily to relieve that anxiety, and often end up “getting hooked.” Fortunately, such folks also among those who tend to do quite well in recovery programs, especially those based on the 12-step model. And they tend to apply the principles they in treatment not only to maintain their sobriety but also to develop in character.
Not too far in the future, I’ll be posting another series exploring the special challenges posed to rehabilitation and recovery programs when it comes to the character-impaired. Genuine addictions are tough to treat. And they’re even harder to treat when the addict is also character impaired. While even the most otherwise healthy individual who struggles with addiction can experience both setbacks and relapses in their recovery, the dynamics are very different for disturbed characters who chronically abuse or are in fact addicted. And how the different dynamics are both recognized and attended to in treatment makes all the difference. So stay tuned for more on this topic.
Sunday’s Character Matters will again be a live program, so I’ll be happy to take your calls. And most of the hour will be “open topic,” so feel free to discuss whatever is on your mind.