Don’t add trouble on top of trouble

It’s common for people suffering with an addiction to tell others, or even themselves, “I promise I’ll stop (my addictive behavior)” or, “I commit to stopping.” This isn’t surprising, since having an addiction generally means feeling out of control and leads people to the idea that they should finally take a stand to regain control of their lives. Those around them are also often desperate to hear precisely this commitment from them. And people with addictions commonly feel guilt for causing distress to family and friends and want to reassure them, even when they aren’t actually clear whether they can keep that commitment. In fact, folks suffering with addictions may know perfectly well that they aren’t telling the truth when they promise to stop, but feel it’s best to avoid a useless fight. Besides, they may hope that, even though they’ll continue the behavior, they can keep it a secret.

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dr-lance-dodesDr. Lance Dodes has been the Director of the substance abuse treatment unit at Harvard’s McLean Hospital. He also served as the Director of the Alcoholism Treatment Unit at Spaulding Rehabilitation Hospital. He recently retired as an assistant clinical professor of psychiatry at the Harvard Medical School. Dr. Lance annually chairs the discussion group “The Psychology of Addiction” at the fall meeting of the American Psychoanalytic Association.

Editor: Arman Ahmed


But in almost every case, making a promise to stop is a recipe for harm. With any action driven by a powerful psychological need, such as every compulsion or addiction, promises and commitments to stop nearly always fail. Then, very bad things happen.  Those who made the promise feel worse about themselves. Their loved ones feel worse about them, seeing them as untrustworthy, or even unloving (“If he loved me, he would keep his promise”). Everybody becomes angry with the person who “broke his word,” and even more tragic, everybody becomes more discouraged.

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This can lead to more impossible-to-keep promises, or to precipitous and poorly-thought-through changes in treatment plans, such as suddenly pulling people out of otherwise good outpatient therapy, or sending them away to expensive and nearly always useless rehabilitation treatments (“He can’t be trusted so he needs to be locked up”).

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