Pubdate: Tue, 22 Apr 2003
Source: ABC News (US Web)
Copyright: 2003 ABC News


Q&A: Psychologist Jeffrey Schaler

Dr. Jeffrey Schaler

If you're addicted to something, whose fault is it?

As ABCNEWS' John Stossel reports, "don't blame the addict" is the message 
we often hear from treatment facilities.

But psychologist Jeffrey Schaler says we're stronger than we think, and 
that overeating, smoking and other so-called addictions are things we can 
choose to control.

"Addiction is a behavior and all behaviors are choices," says Schaler, 
author of the book Addiction Is a Choice.

Schaler joined a live discussion with our viewers on Tuesday, April 22. The 
transcript follows.

Is Addiction Just a Matter of Choice?


Welcome to our live chat with Dr. Jeffrey Schaler, a psychologist and 
author of the book, Addiction Is a Choice.

Irene Soble asks:

How do you define a disease? How does addiction to a drug such as alcohol 
or heroin compare to diseases such as adult onset diabetes or heart 
disease? Many of our chronic diseases are caused by multiple factors 
including lifestyle choices, diet, exercise, etc. Why is one a disease and 
the other not when choices play a major role in the development of both?

Dr. Jeffrey Schaler

Let's slow down just a bit. Let's be careful not to confuse the cause of 
the disease with the disease itself.

For example, smoking is a behavior that may cause lung cancer. Drinking 
excessive amounts of alcohol is a behavior that may cause cirrhosis of the 
liver. The causes are behaviors in these two cases. The diseases are 
different from the causes. A disease, according to the standard textbooks 
on pathology, refers to a physiological lesion.

Another way that we can look at this is to see that diseases are something 
that are present in the cadaver at autopsy. Behaviors are something that 
living people do. Diseases are something that people have.

Smoking and drinking, like addiction, are not found in standard textbooks 
on pathology because they are not diseases -- they're behaviors. While we 
are always able to control the behaviors that lead to diseases, diseases 
are something we cannot control by choice; they are involuntary.

Tom George writes:

It seems to me there is a difference between different addictions. Heroin 
addicts go through very real and painful withdrawal symptoms when they give 
up heroin. But if I give up my nightly bowl of ice cream, I may whine and 
feel sorry for myself, but other than that I do not suffer ill affects. 
Would it be better to reserve the term "addiction" for cases where there 
are serious withdrawal symptoms?

Dr. Jeffrey Schaler

This is a good question. Let's consider love as an addiction. When you end 
a love relationship, you often may experience terrible withdrawal symptoms; 
these may include insomnia, great emotional distress and gastrointestinal 
problems. The person may become so despondent that they commit suicide.

Here we have an example of a person addicted to a love relationship. There 
is nothing that the person is physiologically addicted to. Yet the 
withdrawal symptoms, or the ending of the addiction, is very painful and 

Many people would consider the pain associated with the breaking off of a 
love relationship far greater than the pain associated with heroin 
withdrawal. Many heroin users report that the ending of their use of heroin 
was no worse than a bad case of the flu.

In order to achieve anything good for ourselves, we have to struggle in 
life. Giving up drugs is no exception. Changing behaviors and breaking 
habits is often difficult. If you look back on your life, every decision 
you made to better yourself included some experience of discomfort.

We accept this as a matter of fact in life; the giving up of drugs is no 
exception. Dr. Stanton Peele and Archie Brodsky have written about this 
extensively in their book about addiction to love.

What we know for a fact is that many people give up heroin despite painful 
withdrawal symptoms. Every drug has an effect on the body and the effects 
may vary by the person's constitution and by the chemical properties of the 
drug. Many people experience very few painful withdrawal symptoms. There is 
no evidence to support the idea that the withdrawal symptoms, in and of 
themselves, cause the person to continue to use the drugs in an addictive 

Leigh writes:

I think blame is the least important thing here! The important thing is to 
get over the habit. I've gotten over some addictions with help and some on 
my own -- it's horrible either way, and no matter what, you're bound to 
blame yourself. Chastising the addict, however, claiming that they are to 
blame and that it was their intention to ruin their life, is not the 
confidence-building tool that the person will need to get back on their 
feet and turn it around. There are genetic predispositions, psychiatric, 
psychologic, medical, and socio-economic reasons for impulse control 
issues. I really don't think anyone wants this for themselves, truly. 'Give 
me a break' John Stossel; this is a sensitive issue that you are treating 
very insensitively.

Dr. Jeffrey Schaler

I would like to differentiate between viewing addiction as a moral and 
ethical issue, and making a moralistic judgment about a person who uses drugs.

When we say a person chooses to engage in addictive behavior, we are not 
passing judgment on that person insofar as they are a good or bad person; 
what we mean to say is that they engage in certain behaviors for reasons 
that are important to them. These reasons may be psychological, social, 
emotional, cultural and existential.

Saying that a person is not in control of his or her behavior impresses me 
as decidedly disrespectful of their humanness. People do things and behave 
in certain ways for reasons; they are not things that are caused by 
chemicals or brains.

There is plenty of evidence to show that genes have everything to do with 
our physiological makeup, but that's very different from saying genes cause 
us to behave in certain ways. After all, we are all genetically programmed 
to die, but that does not mean that life is a disease.

I firmly believe that in order to be free, a person must accept 
responsibility for his or her behaviors. A myth perpetuated by people who 
believe addiction is a disease, is that you can be free if you just say a 
disease or gene made me do it.

My view on why people use illegal drugs and legal drugs and psychoactive 
prescription drugs is that they want to change the metaphorical lens of 
perception; in other words, they want to change the way they view 
themselves and the world.

In order to understand why someone continues to use these drugs, we must 
take a look at what it is existentially that the person wants to avoid 
dealing with.

A mistake in many of our addiction policies today is to focus solely on the 
availability of the drug, the chemical properties of the drug, and the 
physiology of the person. As long as we focus on those factors instead of 
the existential factors, we will never resolve the key issues.

The research consistently shows the best explanations for drug use have to 
do with the values of a person, their mind set and the environment they 
live in. People often use drugs in a self-destructive manner as a way of 
avoiding coping with some experience in life.

What they may need to do is muster up the courage to face some difficult 
facts about themselves and their existential predicament. When they do 
that, they are unlikely to rely on drugs as a way of coping with life.

Kate asks:

What about people who have multiple "addictions" or lose one and start another?

Dr. Jeffrey Schaler

As Professor Bruce Alexander at Simon Fraser University has written, there 
are positive and negative addictions, neither of which have anything to do 
with not being able to control one's behavior.

Positive addictions are activities we engage in that enhance our sense of 
well-being; negative addictions are activities we engage in that detract 
from our sense of well-being.

What we call a positive or negative addiction is something that varies from 
person to person. The population of people we call addicts is a 
heterogeneous one, not a homogeneous one. In other words, people use drugs 
in different ways, for different reasons, with different results. No two 
people are identical.

The fact that people may transfer their addiction from one activity or 
substance to another is nothing particularly unusual. Hopefully, people 
will transfer their negative addictions to positive ones. People engage in 
multiple negative and positive addictions all the time.

All addiction really means is that you are moving towards something, you 
are saying "yes" to something, you are consenting or are devoted to some 
erson or activity.

The idea or meaning of addiction as devotion dates back hundreds and 
hundreds of years. The idea that addiction means you can't control your 
behavior came out of the alcohol temperance movement in the early part of 
the 20th century.

The idea of addiction as involuntary is not only illogical but has been 
consistently disproved in scientific experiments. There is no such thing as 
an involuntary behavior.

These experiments are well documented in my book Addiction is a Choice and 
in numerous writings by my friend and colleague Stanton Peele.


Dr. Schaler, do you have any final thoughts?

Dr. Jeffrey Schaler

I think it's important to remember that what we call addiction is not the 
symptom of a weak will but the expression of what I call an iron will.

In other words, it's not that the person can't change his or her behavior; 
we need to recognize that what they do is continue to engage in a 
self-destructive behavior at any cost for reasons that are important to them.

The people we call "drug addicts" are not weak, but strong. What we need to 
recognize is that they themselves are the higher power.


Thanks to Dr. Jeffery Schaler, and all those who joined this chat session. 
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MAP posted-by: Beth