Forty per cent of people with asthma, diabetes and blood pressure do what the doctor suggests, sixty per cent do not. We say with their diabetes, you are going to get cataracts. You’re going to get arterial disease resulting in heart attacks or gangrene. You are going to have all sorts of medical problems unless you treat your diabetes in the way that we suggest, with your insulin and with your diet and so on. Sixty per cent don’t do it.
The same with asthma, sixty per cent of patients do not follow the recommendations that we give to them. Same with high blood pressure, we say, “You’re going to have heart attacks. You’re going to have strokes.” Sixty per cent do not follow the advice that doctors give them.
Now that isn’t really denial, it’s just belligerence. By and large, none of us want to have rules made for us. We don’t want to do things that other people tell us. Well I’m like that. I don’t like being ordered what to do by the Department of Health or by the Healthcare Commission or by the commission for this that and the other. There’s so many government agencies, I don’t like governments. I like doing the things my way where all of us individualist in that respect. We don’t like being told what to do.
That is perfectly healthy but the denial of addiction is very unhealthy. It is the basic psychopathology of the illness we genuinely don’t see what’s happening to us and that’s very frightening.
Addiction frightens me more than any other illness because of that. How do you treat somebody for diabetes if he hasn’t got diabetes? You can see the problem. He hasn’t got diabetes. He doesn’t need treatment for diabetes. Well that is exactly the attitude that an addict will have. “I’m not an addict. I don’t need treatment.” Now, everybody else knows that he or she is an addict and does need treatment but the individual doesn’t. He swears absolutely, black and blue, “I do not have a problem.”
What I want to explain to you is this when an addict says, I am not an addict. I have not drunk. I have not used drugs. I do not have an eating disorder or whatever, he or she is telling the truth. You see how dangerous that is? The truth is wrong; we all know that except him or her. “I’m not an addict.” They’re telling the truth. Isn’t that frightening? How on earth do you get past that?
If somebody says, “I’m not diabetic.” You can say, “Well look this is your blood sugar. We can repeat it again if you want.” You can produce evidence. Now if somebody has addiction problems, again you can produce evidence but you produce it from other people.
When companies ask me how to find out who the addicts are in their employment, you know, cause they can tell, should we do this urine test or should we do random blood test or whatever. I say, “No, go to your personnel department and you will see who your addicts are.” Because you’ll see there’s a high incidence of minor illness. There’s a very poor work record in terms of turning up at the right time. The staff would say, “He’s lovely but I can’t work with him. He’s so unreliable.” The clients say, “He’s great but he doesn’t deliver. I got to run my business and he’s not there. He doesn’t actually deliver the thing at the time that he said he would.”
So if you look at the accumulative evidence, you will see who your addicts are. You can see them in your personnel file. Simply at home you don’t have to go looking for funny envelops or burnt spoons or funny pipes or whatever, just look at the behavior.
If he’s not turning up, if his school record has gone absolutely plummeting, if his friends are all wearing dark glasses, you can see the consequences of the behaviour. If the only music he wants is heavy metal, you can see that he’s becoming more comfortable in that environment rather than the environment you might want.
So we can diagnose from where the elephant has been even if we don’t see the elephant. Nobody but an elephant could have caused that amount of damage .So we could do that but the individual will still say, “But I’m not an addict. I don’t have a problem. I don’t need to work on this because I don’t have a problem.” frightening.
In my experience there is only one thing that turns us around and bear in mind I’m a doctor. Pain. Pain, it’s the only thing that turns us around. I turned around when my wife was sitting in front of a divorce lawyer. I had no idea why she was there but I was in pain I didn’t want to lose her. So I turned around. I said, “Okay, what do I need to do?” I didn’t think I need to do anything but at least it turned me around.
Now, I’m not suggesting that we should cause pain. I’m not saying that. I’m saying we should leave people in the pain that they create. Don’t bail them out. Don’t pay the bills. Don’t tell lies to the employer. Don’t soothe down the upset girlfriend. Don’t do anything that relieves the pain.
As I said, bear in mind I’m a doctor. This is the opposite of what you’d expect a doctor to say. I’m trained to relieve pain. I’m trained to comfort people. I’m trained to look after people, to care for them, to be considerate. Well I am considerate for addicts. I am saying, leave them in the pain because that’s the only way they’re going to get better. They need to see their own pain.
If they won’t listen to you, then say, “I can’t live in this relationship. I can’t go on with this relationship.” And that’s what my wife said to me and it turned me around because I had to look at it, because I was in too much pain. That may be sometimes the only way of doing it.
Give us the consequences of our behaviour. Don’t give us opinions, give us the consequences of our behaviour and then there’s a chance of us turning around.