I have always had a problem with the concept that a physical allergy or disease is the root cause of alcoholism and chemical addictions. It does not explain the cause of chemical type addictions (including alcohol) and it absolutely doesn’t explain non-chemical ones like food addictions, compulsive gambling, compulsive sex and the like. I have observed many recovering folks who, with numerous years clean and sober, pick up non-chemical addictions. If the allergy explanation was the whole story then working the 12 Steps for one of the chemical addictions should cover all the addictions, but it doesn’t. Something is missing.

A clue to the real root cause of all addictions can be found by carefully listening in meetings of 12 Step programs to members sharing their “how it was” stories. Someplace in those shares they will usually state how, when they took that first drink, hit, sex act, gambling game win or whatever, it filled “that empty hole inside of me!” This is approximately the same rendition of that event for chemically and non-chemically addicted people. The narrative usually continues with a rendition of feelings of well being and relief, along with a new ability to do many things that heretofore they were inhibited from doing.

Everyone talks about “filling that empty hole,” but few bother to ponder what exactly that hole represents and what was not present that cause that hole. As best as I can figure out, that missing ingredient is self-esteem and usually, but not always, a lack of self-confidence.

I once had a client who, when describing his feelings when he attended his first AA meeting said, “The speaker was talking about how when he was newly recovering he had very low self-esteem. I thought to myself, ‘God, I wish I was able to have low self-esteem! Right now I have none!’”

Although the terms, self-esteem and self-confidence are usually associated with each other, and sometimes used synonymously, they have quite different meanings and functions. Self-esteem is a measure of one’s feelings of self-love and self-worth, whereas self-confidence is a measure of one’s evaluation of one’s ability to perform as task or a skill.

Although it is quite possible to develop a great degree of self-confidence without an equally high self-esteem, it is certainly a less than optimal state to be in, and in the case of very high performing people such as rock stars and high power executives, it becomes a perfect storm for the development of all sorts of addictions.

When people’s performance greatly overshadows their level of self-esteem, they are susceptible to feeling like a fraud, The accompanying internal dialog (self talk) is along the lines of, “if they only knew how much I’m messing up” or “If they discover the real me, I’m toast!” That paranoia of being “found out” can be enough to trigger a variety of coping behaviors including addictions, suicide and perfectionism.

Perfectionists are an interesting group. They have little or no self-esteem and are usually fairly high performers in what they do. Their paranoia of being found out leads them to attempt to do everything perfectly. Unfortunately, perfection is impossible to attain, so they continually fail, which creates a feedback loop that reinforces their negative self-evaluations. That in turn feeds into the obsession and another addiction is born.

Most people with low self-esteem including, unfortunately, many people in recovery, also have a similar feedback pattern. Less obvious, it appears as a habit of harsh self-criticism of their actions, their appearance and just about anything else that touches their lives. Unlike the perfectionist, they are not obsessed with rectifying their uncovered flaws. They use their harsh self-criticisms and both actual and imagined failures as proof of their negative self-evaluations. These folks rarely give themselves an even break. For them the cup is always half empty. They beat themselves up at the drop of a hat. The slightest criticism from a boss, peer, or even a client can throw them into a depressive state akin to giving up.

High school age underachievers are a good example of this. Although usually misdiagnosed as kids lacking motivation, they are very smart with very low self-esteem. Actually they have very high motivation. It takes considerable motivation for a smart kid to intentionally fail. These are young folks who think of themselves as potential failures (aka, losers) and who voluntarily take themselves out of the competition. That way they don’t risk being actual failures, and have a perfect cover story, “I could have won, but I chose not to play.” They are perfect candidates for a variety of addictions.

The value of learning self-enhancing techniques to boost self-esteem

Understanding that the lack of self-esteem is the core problem that drives people to adopt behaviors (addictions) in a futile attempt to cover up “that empty hole inside,” it stands to reason that once folks have developed great self-esteem and self-love that the empty hole will be truly and permanently filled, and the need for any addictions, chemical or otherwise, will be over.

For this reason, a major component of treatment needs to be teaching the tools that effectively promote positive self-esteem. Many of these tools are quite simply taught and through daily repetition are quite effective.

There will be noticeable improvement in the degree of self-esteem after a month of daily practice. The real payoff of learning these tools will come upon completion of the 9th Step. It is very difficult to work on self-esteem when “the real self” is viewed through lenses clouded by feelings and trauma that working The Steps will remove. As those negative feelings are eliminated, it opens up space for self-esteem to grow and, with these new self-enhancing habits firmly in place, that new self-esteem will grow automatically and exponentially!

©2015, Jason Wittman, MPS, CATC-IV, ILAADC

Note: This article first appeared as a column in the Keys to Recovery Newspaper.