Health

Understanding Addictions:
Self-Medication and Self-Harm

Of the many hazards of lack of self-love, among the most serious, is behavior that harms you. Failure to take care of yourself properly, to treat yourself with compassion and love can pave the way for self-destructive actions that are life-threatening.

The use of substances that alter your consciousness, such as alcohol and drugs, is often called “self-medicating behavior.” The ‘user’ is someone who is trying to deal with psychic pain but the substances and then the addiction has the secondary effect of causing self-harm or even death. Some professionals refer to it as “slow-motion suicide,” in fact.

Addiction is an epidemic in the United States, one that has touched almost every family directly, and indirectly as well, by taking a serious toll on the economy, health-care, law enforcement, and national well-being. It’s a multi-pronged problem, whose causes are varied and complex. But while it is known that some people have a physical vulnerability to get hooked on drinking or drugs, and that some become dependent more readily than others, it is social and psychological factors that create and perpetuate conditions that have made it proliferate.

Long before the current crisis, in the 1970s, psychiatrist Heinz Kohut noticed that “self” problems, including a fragile, unstable identity, feelings of low self-worth and emptiness were more and more common. He saw that the issues and symptoms created by “self problems” were depression, isolation and self-destructive behaviors like eating disorders, alcoholism, and addictions of all kinds—drugs, gambling, sex, etc.   Since that time, all these have been on the rise, and the Internet age has ushered in a new kinds of addiction like the compulsive use of pornography, social media, web-surfing, gaming, and more.

Kohut’s self psychology offered a new way of understanding these behaviors. If you have an insecure, unstable sense of self, and do not have a source of internalized self-love, you must find ways to soothe yourself when you are anxious, stimulate yourself when you feel depressed, and fill yourself when you feel empty. Having no access to healthy self-compassion for support, you turn to these outside sources for temporary comfort. And for a little while, it works. Drinking makes you feel less anxious, more confident and more outgoing in social situations.  Drugs can provide a feeling of euphoria and comfort never known before. Compulsive eating fills emotional emptiness for a while, and other eating disorders are an attempt to control your feelings and overcome fluctuating self-esteem.

While alcoholism has been around for millenia, opioid addiction is a relatively recent phenomenon. Millions of people are prescribed painkillers every day in this country, and while some of them are in severe pain, a significant subset continue to use the drugs after the precipitating illness is resolved. They find that these drugs soothe them and make them feel good feelings they have not known before. When they don’t have access to the drugs, the bad feelings return, along with physical withdrawal symptoms. Many become addicted.

The widespread prescription of these drugs, which began in the 1990s, has created a raging epidemic of drug abuse. The hardest-hit victims of this epidemic are not the urban poor as they were during the last heroin epidemic in the 1980s, but those who live outside of big cities in depressed small towns and rural and suburban areas.

“Opioid addiction is America’s 50-state epidemic,” says The New York Times. It has swept through New England, the Mid-Atlantic states, and the Rust Belt, where the jobless poor have few prospects and obesity and diabetes are widespread. West Virginia has been devastated by the epidemic.  Joel Achenbach reports in The Washington Post:

“ . . .The citizens of these communities are often falling victim to drugs, drink and suicide, the so-called diseases of despair. These diseases do not adhere to any obvious boundaries—they’re not limited by race, gender, geography, income or education. But they’ve found a great deal of traction in places facing economic decline and social stagnation. That describes much of rural and small-town America and certainly the industrial areas of the so-called Rust Belt.”

The despair that results from social stagnation and economic decline cause feelings of unworthiness, but it is also an effect. Emotional and social isolation create self problems, which lead people to self-destructive behaviors. Lacking opportunities for healthy self-improvement like productive work, adequate money to care for a family, not to mention creative pursuits, feelings of emptiness and despair increase even more, leading to more drug abuse, more self-hatred and social decline, etc. Users also become further isolated from social support, increasing their risk and vulnerability more and more.

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