Power, Powerlessness and Addiction PDF
Preview Power, Powerlessness and Addiction
POWER, POWERLESSNESS AND ADDICTION Addictionexercisesenormouspoweroverallthosewhoaretouchedby it.Thisbookarguesthatpowerandpowerlessnesshavebeenneglected in addiction studies and that they are a unifying theme that brings togetherdifferentareasofresearchfromthefield,includingthedis- empowering nature of addiction; effects on family, community and theworkplace;epidemiologicalandethnographicwork;studiesofthe legalandillegalsupply;andtheoriesoftreatmentandchange.Exam- plesofalcohol,drugandgamblingaddictionareusedtodiscussthe evidencethataddictionismostdisempoweringwheresocialresources to resist it are weakest; the ways in which the dominant discourses aboutaddictivebehaviourencouragetheattributingofresponsibility for addiction to individuals and divert attention from the powerful whobenefitfromaddiction;andthewaysinwhichthevoicesofthose whoseinterestsareleastwellservedbyaddictionaresilenced. jim orford is Emeritus Professor of Clinical and Community PsychologyattheUniversityofBirmingham.Jimisalong-standing researcherandwriterintheaddictionfield.Amongsthisprevious booksaresuccessfultitlesonaddiction,notablyExcessiveAppetites:A PsychologicalViewofAddictions(stedition,;ndedition,); as well as others on community psychology, including Community Psychology: Challenges, Controversies and Emerging Consensus (). HeisoneoftheUK’sleadingaddictionresearchersandhasaninterna- tionalreputation.Inhewasawardedtheprestigiousinternational E.M. Jellinek Award for his contribution to alcohol and addiction studies. Downloaded from Cambridge Books Online on Sun Apr 10 03:04:39 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 Downloaded from Cambridge Books Online on Sun Apr 10 03:04:39 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 POWER, POWERLESSNESS AND ADDICTION JIM ORFORD Downloaded from Cambridge Books Online on Sun Apr 10 03:04:39 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 cambridge university press Cambridge,NewYork,Melbourne,Madrid,CapeTown, Singapore,Sa˜oPaulo,Delhi,MexicoCity CambridgeUniversityPress TheEdinburghBuilding,Cambridgecbru,UK PublishedintheUnitedStatesofAmericabyCambridgeUniversityPress,NewYork www.cambridge.org Informationonthistitle:www.cambridge.org/ (cid:2)c JimOrford Thispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithoutthewritten permissionofCambridgeUniversityPress. Firstpublished PrintedandboundintheUnitedKingdombyBelliandiBainiLtd AcataloguerecordforthispublicationisavailablefromtheBritishLibrary LibraryofCongressCataloguinginPublicationdata Orford,Jim. Power,powerlessnessandaddiction/JimOrford. pages cm Includesbibliographicalreferencesandindex. isbn----(hardback) .Compulsivebehavior. .Control(Psychology) I.Title. rc.o .′–dc isbn----Hardback isbn----Paperback CambridgeUniversityPresshasnoresponsibilityforthepersistenceor accuracyofURLsforexternalorthird-partyinternetwebsitesreferredto inthispublication,anddoesnotguaranteethatanycontentonsuch websitesis,orwillremain,accurateorappropriate. Downloaded from Cambridge Books Online on Sun Apr 10 03:04:39 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 IdedicatethisbooktothememoryofProfessorGriffithEdwards,who diedinSeptember2012asthebookwasjustabouttogointo production.IwouldhavelikedhimtoreaditandIwould havebeenanxioustoknowhisopinion.Hewasthesingle personofgreatestsignificanceinmycareerandwasan inspirationtomeastosomanyothers. Hewasagiantintheaddictionfield. Downloaded from Cambridge Books Online on Sun Apr 10 03:05:08 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 Downloaded from Cambridge Books Online on Sun Apr 10 03:05:08 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 Contents Preface pageix Acknowledgements xv Powerfulconnections:threeexamplesofaddiction Howaddictionerodesfreeagency Addictionsubordinatestheinterestsoffamilymembers andfriends Inequalityinthepowertoresistaddiction Powerandpowerlessnessintheaddictionsupplyindustries Reassertingcontrolandpowerintheprocessofchange andtreatment Facinguptothepowerofaddictionandthosewhobenefit fromit References Index vii Downloaded from Cambridge Books Online on Sun Apr 10 03:05:24 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 Downloaded from Cambridge Books Online on Sun Apr 10 03:05:24 BST 2016. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139540971 Cambridge Books Online © Cambridge University Press, 2016 Preface Thisbookisexploratory.Thereisnosinglebodyofknowledgecorrespond- ing to power, powerlessness and addiction; I have had to make it up as I went along. The idea for this book merges two streams of thought which havedominatedmycareerinpsychology.Oneofthoseisaddictionstudies wherepowerisscarcelyeverexplicitlyreferredto.Theotheriscommunity psychology,forwhichpowerandpowerlessnessarecentralconcepts.Writ- ingthisbookhas,therefore,servedapersonalpurposeinunitingthetwo halvesofmyprofessionallifewhichmightotherwiseremaindisconnected. I might go further and argue that in order to explore the relationship between power and addiction it is necessary to bring together theory and research arising from different scientific traditions: on the one hand the biomedical,publichealthandepidemiologicalandontheotherthesocial sciences. The former have dominated addiction studies while the latter have played a much lesser role. One feature of my earlier book on addic- tion, Excessive Appetites (Orford ), which left me dissatisfied was its emphasis on the individual and its relative lack of attention to the social. Thepresentbookisapartialattempttoputthatright. Althoughpowerisrarelymentionedwhenaddictionisdiscussed,ithad longoccurredtomethatpowerandpowerlessnesswereneverfarbelowthe surfaceand,onceyouwerelookingforthem,theyoftenappeared.Thevery concept of dependence, often used as a synonym for addiction, implies a lossofpower.Indeed,acknowledgingone’spowerlessnessisconsideredby Alcoholics Anonymous and other -step groups to be a requirement for recovery.Theexperienceoffamilymembersandotherscloselyaffectedby otherpeople’saddictions–somethingthatmycolleaguesandIhavemadea specialstudyof–canwellbethoughtofasanexperienceofpowerlessness. Once the focus moves beyond the individual and the family to consider thecomplexnetworkofconnectionsinvolvedinthesupply,legalorillicit, of substances and activities to which people become addicted, then the exercise of power and the creation and exploitation of the powerless are ix Downloaded from Cambridge Books Online on Sun Apr 10 03:05:35 BST 2016. http://dx.doi.org/10.1017/CBO9781139540971.001 Cambridge Books Online © Cambridge University Press, 2016 x Preface impossible to avoid. All those manifestations of power, overt or hidden, malignantorbenign,andothers,arediscussedinthechapterswhichfollow. Indefenceoftheword‘addiction’ Terminology in this field is itself controversial. I use the common term ‘addiction’throughoutthisbookalthoughItrytoavoidasmuchaspossi- bleusingtermsappliedtoindividualpeople,suchas‘addict’or‘alcoholic’, labelswhichhavebeenassociatedwithstigmaandwhichcancarrypejora- tiveconnotations.Ihavealsotriedtoavoidanumberoftermswhichhave become popular in official circles and which appear to be less pejorative butwhichinfactservetoreinforcethefocusofresponsibilityforaddiction ontotheindividualwhoexperiencesitatfirsthand,intheprocessshifting thefocusofresponsibilityawayfromeveryoneelsewhoisconnectedwith addictioninsomeway.Theexpressions‘drugmisuse(r)’and‘drugabuse(r)’ aresuchterms.Similarintheirimplicationsarethenow-populartermssuch as‘sensibledrinking’and‘responsiblegambling’withtheirclearlyimplied opposites – drinking which is not sensible and irresponsible gambling. Other terms such as ‘drug dependence’, ‘problem drinking’ or ‘excessive appetites’, are alternatives, each with their own slightly different take on the matter. In this book I fall back on the word ‘addiction’ because it is onethatisbothinwidepublicuseandiscommoncurrencyintheexpert literatureonthesubjectaswell.Formypurposesitisalsoagoodvehiclefor introducingthethemeofpowerandpowerlessness,asIhopewillbecome clear later. ‘Addiction’ does, however, carry a number of dangers. It can easilybetakentoimplyadefinableillness,distinctivelydifferentfromnor- malexperience,andmostlikelyexplicableultimatelyintermsofbiological vulnerability,probablyinvolvingsomegeneticpredispositionandpossibly brainabnormalities.Inmyviewtheoppositeofallthoseistrue.Addiction is best thought of as a process; at any one time it is represented in the populationintermsofacontinuum(severalcontinuainfact),withmany morepeoplemildlyormoderatelyaddictedthanseverelyso;anditscauses are legion, probably involving many genes which interact with numerous environmental factors in complex ways which vary by time and place. I hopeitwillnotbethoughtthat,byusingtheexpression‘addiction’,Iam tryingtoover-simplifywhatisinfactaverycomplicatedsubject. I need also to make a point about the diversity of addiction and to explain why I have concentrated on three forms of addiction, to alcohol, drugs and gambling. They constitute, for me, the ‘big three’, with many features in common. Each involves an activity which is indulged in, or Downloaded from Cambridge Books Online on Sun Apr 10 03:05:35 BST 2016. http://dx.doi.org/10.1017/CBO9781139540971.001 Cambridge Books Online © Cambridge University Press, 2016
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