What happens to doctors when they become addicted?
One way of understanding what happens to doctors when they become addicted is to think about their relationships. These will include loved ones, close friends and colleagues, the relationship with the substance or behaviour that they have become addicted to and, last but not least, their relationship with the self.
People generally don't set out to be addicts and they certainly don't manage to achieve it overnight. You could say that it takes practice; lots of it. Alcohol, drugs, sex, food, exercise etc can provide pleasure that, for most people, enhances their life. However, when these experiences move in the direction of substance misuse and other compulsive and addictive behaviours they can take on a different meaning. The desire to change the way they feel starts to dominate and control their lives, producing negative consequences and they discover that "you can have too much of a good thing".
We know that life can be difficult, challenging, unfair and stressful. What addiction is offering is a "short-cut" to feeling in control. It promises that insecurities, inadequacies, anxieties and fears can be overcome and that the responsibilities and burdens of everyday life will melt away. This is extremely seductive; but it is not real. It is a fantasy and finding out the truth can be a long and extremely painful process for all concerned.
For the addicted person there is a narrowing of focus in how they experience the world, where the addictive relationship becomes most important. It becomes the template for all the relationships they have. This has two very powerful effects; other people are seen as objects that can be manipulated to serve the addict's goal (of not feeling bad) and the addict feels bad (ashamed) about treating others (who don't like being treated as objects) in this way. This kind of dependence is a very powerful self-perpetuating cycle.
Loved ones, friends and work-colleagues will begin to notice changes in the addict's attitude and behaviour. These may include secrecy, dishonesty, a withdrawal from intimacy, absence from the home, absence from the workplace, angry outbursts, depression and defensiveness. They are trying to prove to themselves (and others) that they are in control whilst defending themselves against overwhelming evidence that they are not in control. There is a kind of twisted logic to this for the addict but from the outside it looks and feels crazy. This generally leaves addicts and their loved ones feeling isolated, frightened, angry and ashamed.
Facing up to this is hard enough for any addict, but it may be particularly difficult for doctors, who are the people who others turn to for help. They are generally looked up to by others and acknowledging and owning up to a loss of control can be challenging. Their substance misuse may start as a coping mechanism but develops into something all consuming.
What happens to doctors when they recover?
Recovery is about regaining one's life, free from addiction. It starts with the process of asking for help, facing up to reality, recognising the lie of addiction and taking responsibility for changing. Like addiction it takes practice; it needs to be reinforced on a daily basis for it to build into something solid that can be relied upon. For those with a severe dependence a structured day- treatment or residential treatment programme may be required. Recovery has the best chance when it involves other recovering people. It is not a solitary endeavour. Openly sharing with others does not always come easily to the professional who is meant to cope and be a model of contained self-sufficiency. But without it only isolation waits - a sure route back to addiction. Recovery is not only available to addicts but also to those affected by and caught up in another's addiction.
Treatment and Care Director
Action on Addiction
0845 126 4130
Charity Reg. No. 11 17988 Company Reg. No. 05947481