Yet many times this pre-addictive status itself may be an abnormal one, in fact a condition of dampened or diminished mood and pleasure-capacity that may be a precursor of the florid addictive disease that later breaks out as a consequence of the addict’s often unwitting efforts to repair his pre-addictive condition by means of drugs or other behaviors that make him feel better. For in the last analysis, addiction is nothing but a miscarried and often tragic attempt on the part of an individual who does not feel good to feel better.
The newly abstinent and recovering addict therefore is frequently in a kind of hedonic "double jeopardy." For the discontinuation of an addiction always involves "payback time" as the individual’s own internal regulatory systems struggle to get back on line; and the addict’s "normal" pre-addictive state may itself have been significantly impaired – in fact, one of the reasons he was ensnared in the addictive cycle to begin with.
The exact causes of the future addict’s pre-existing abnormal hedonic state –a state of not feeling good- are seldom known with any precision. Most likely a combination of "Nature"(the inborn physical constitution) and "Nurture"(environmental and life experiences beginning at birth) are responsible.
The interaction between Nature and Nurture can be subtle and bi-directional: an infant that was born with a hedonically compromised nervous system may be unusually fussy or less emotionally responsive than average, behavioral qualities that in turn may elicit differing responses from its caretakers and, when older, peers. An almost infinite series of combinations and permutations is possible depending upon individual factors and circumstances. Simple answers in this complex area are frequently misleading.
In fact, thanks to the peculiar emphasis of much traditional thinking about mental health upon origins rather than remedies, even the questions themselves are frequently beside the point. Not "where did this difficulty originally come from?" but "how can it be changed for the better?" is the more pragmatic and usually the more productive question to ask in regard to human beings and their vicissitudes. For in addiction, perhaps more than in any other area of abnormal human behavior, insight is not enough. At best, insight provides a pretext and an inspiration to proceed with the actual behavioral changes required for recovery from addiction. But insight is not really required, at least in the beginning.
All that is usually required for recovery to commence is willingness to perform the necessary work – even if that willingness is partial, incomplete or coerced. As long as the work gets done, the recovery has a chance to begin. In the optimum case both insight and motivation develop later on - as a consequence of the original, frequently grudging spadework of early recovery. "Begin recovery first," the motto here might be, "and ask questions afterwards." Failure to acquire the motivation for sustained recovery and at least a minimum amount of insight may of course predispose the individual to later relapse after a promising beginning. But first there must be a beginning, however it is brought about. And at this stage of things, one method seems to be about as good as another – though those that are most dramatic, painful and undeniable, as well as those with still imminent and even more dreadful consequences if the addiction continues seem to yield the most initial impetus and momentum to the early recovery process.
Although abstinence from the addictive substance or process is the sine qua non of a lasting recovery from addiction, experience with addicted individuals shows plainly that abstinence alone is often not enough. For although a certain number of addicted people do succeed by simply giving up their addiction, a large number do not. What happens to them is reminiscent of Mark Twain’s famous remark about smoking: "It’s easy to quit – I’ve done it a hundred times!" Such individuals stop their addictive behavior, hold on by their fingernails for a while, and then relapse – sometimes with extra added momentum from the negative energy of their "deprivation." This familiar addictive cycle causes shame, guilt, despair, disgust, hopelessness and helplessness both in the addict and those who are affected by his addiction.
Sustained recovery from a well-established addictive disorder requires a major realignment of the psyche away from the artificial, unnatural and over-specialized dependence upon a substance or process for hedonic management, and towards a more natural, environmentally-attuned and above all flexible responsivity to internal and external stimuli. Instead of manipulating his mood and feeling state by the artificial means of chemicals that are completely unrelated to what is actually going on within and around the individual, the recovering addict gradually and often painfully learns to operate on his own resources. And because his own resources are many times inadequate for satisfactory mood and hedonic control, he must also acquire new methods of cultivating good feelings and avoiding bad ones.
The fellowship, interpersonal and social learning, and the spiritual and cognitive resources of 12 Step and other recovery programs can be of enormous assistance in helping the recovering addict to learn such new coping strategies. A kind of Catch-22 frequently develops here, however: many addicts are so impaired in their capacity to take care of themselves and manage their moods in a healthy fashion that even participating in an interpersonal recovery program may initially be beyond their resources. Thus it is often quite a challenge and stress for them merely to begin regular attendance at helpful support meetings – and many people who might benefit substantially from such meetings simply avoid them, offering as excuses for doing so a variety of familiar and predictable rationalizations. The characteristic addictive response is along the lines of "I’d rather do it by myself," an attitude that itself signals what is usually a longstanding difficulty in recognizing the need for help and in being able to request and accept it when it is in the best interest of the individual to do so.