A metaphor for addiction is that of a person digging themselves into a hole; while their original intent may have been harmless (e.g., have fun, experiment, group/peer pressure, etc.), if digging continues, eventually the person begins to experience problems. Research shows that most people who begin using (digging) at some point decide to stop on their own, and for all the usual reasons – don’t like feeling impaired, doesn’t support their goals, causes unwanted problems, etc. Using this metaphor I want to illustrate three levels of digging for those who don’t stop:
- Level-1 (mild to moderate use disorder): hole is waist or chest deep; person still has significant agency and can climb out with moderate struggle. While free of the use disorder, the person may need to address whatever issues caused them to use to the point of problematic consequences.
- Level-2 (severe use disorder and dependency): hole is just above the top of the person’s head; they can still reach up and grab the edge, but it’s clearly more difficult and the person experiences desperation. Some agency may still be present but is greatly diminished; the person can, with significant effort (and possibly some help), extricate themselves and become free. This person too may need to address deeper issues which caused and sustained the use disorder.
- Level-3 (full addiction – no longer just a use disorder): the person has dug themselves into a hole so deep it’s now well above their head, and they can no longer reach the top to try and escape. More than desperation, they now experience despair, knowing full-well they’re trapped and can’t escape without help. Worse, no matter how hard they try, they also can’t stop digging. This is the complete loss of agency to stop the digging regardless how extreme the consequences.
This article explores the idea of Level-3 powerlessness, examining arguments both for and against. This Level-3 condition of complete loss of agency is hotly debated within the addiction and recovery communities; there are strong voices on both sides of the debate, each absolutely convinced they’re right. I’ll do my best to set aside my personal experience and opinions and provide an objective comparison of the two sides of the debate. Click the graphic below to access the article (PDF).
