Addiction and Self Esteem


Self-esteem, I can’t give somebody else self-esteem. It can’t be done but I can show how it is achieved. Self-esteem comes from relationships. John Donne said, “No man is an island.” But in our addiction we isolate ourselves. We put ourselves on self-imposed items. We put a room fence around it. “You can’t hurt me. I’m going to do what I want to do and you cannot interfere with that. It is my right.” Well, right it may be but you finish up in a pretty lonely place, isolated from other people but has no self-esteem when the world is becoming progressively lonelier and lonelier and lonelier.

We necessarily involve ourselves with other people and that’s exactly what John Donne meant when he said, “No man is an island.”  We need to interrelate with others if we’re going to get our own self-esteem. It isn’t just a question of who we’re going to take out to supper or who we’re going to work with.

Our own self-esteem will depend upon our behaviour towards other people. If I am kind, understanding, sympathetic, generous, I will have friends that is not rocket science. It’s what John Cleese would call “the bleeding obvious.” It’s obvious. If I am unpleasant, angry, resentful, mean, nitpicking, I will not have any friends. Again, it’s the  bleeding obvious.

The first, I will feel good about myself. The second, I will feel bad about myself. Again, that’s not rocket science.

If we want to improve our self-esteem, we have to focus upon our relationships with other people and be the people we really can be, because addiction gets in the way of that and actually prevents us being the people we really can be. It dominates us. It makes us in to the very people we hate and therefore we have no self-esteem.

Addiction is primarily an illness of self-esteem. We cannot live with ourselves. We despise ourselves for very good reasons because we don’t like our behaviour. We try to justify it. We try to explain it. We try to manipulate things so that it looks okay. We always say, “I haven’t done this.” To which the counselors answer, “Yeah, you haven’t done it yet.”

We’re always moving the boundary. “I don’t drink in the morning. I’ve never been arrested. I don’t use drugs.” They’re all “not yets” We’re all trying to justify ourselves as we slide further down the slope so that we get ourselves into progressive more trouble and rationalize it.  “Well at least I don’t do that.” And our self-esteem slips down and slips down and slips down.

What happens is that our behaviour and our self-esteem work together. When our behaviour slips, our self-esteem slips. When our behaviour slips again, our self-esteem slips again. And therefore what we have to do is to adjust our values, so that when our behaviour slips, our values slip. We get a new sense of values so that we can adjust our self-esteem. When our behaviour slips again and our values slip again, that’s addiction. We can’t use the opposite.

We establish a new set of values, a new sense of self-esteem. It’s hard. It’s hard. It’s hard. To try to get our behavior to match the new set of values, the new self-esteem.  This is hard. It’s the hardest things I’ve ever done in my life and I’ve done some hard things. You don’t survive British private school in a hurry. What our patients do here is very hard, is very, it’s very difficult. Try to get a new system of values, a new level of self-esteem.

A patient said to me earlier today, “I’m a devout Christian. I’ve been a devout Christian since the age of four. I do not tell lies.” His self-esteem is based upon that. The sad thing is that his insight into his behavior is totally at variants with what his wife says and what his children say.  But this is very important, he is not telling a lie when he says,” I only drink three glasses of wine a day.” He is telling his truth.  He is not telling a lie. His whole self-esteem is tied up in that.  He does not tell lies. He is telling the truth. The sad thing is that his truth is wrong.

This is not my hand. It’s not in front of my face. He can’t see it. That is the nature of the illness. That’s the nature of the psychopathology of denial that we can’t see. He has to preserve his self-esteem by any means that he can, otherwise what’s the alternative? He would see himself as evil. Well I don’t. I see himself who’s not being very well.

We see this commonly, everyday. The basic psychopathology of addiction is denial. We don’t see that we’ve got it and therefore we don’t feel that we need treatment for it. “I don’t take insulin. Why didn’t I take insulin? Because I haven’t got diabetes.” And he’s saying equally. “I don’t need to call myself an alcoholic because I’m not. I only drink three glasses of wine a day. I’m a devout Christian. I don’t tell lies.”

You see what we’re up against? How do you help somebody who doesn’t believe they’ve got a problem? If he’s not diabetic, you don’t need to give him insulin. He’s not alcoholic; he doesn’t need to be here. But we have to get the evidence from the families and from other people to see what the truth really is and hopefully we can help him to see that.

He’s got no problem with self-esteem, so the problem is the psychopathology of denial and this is difficult. I respect every one of our patients who comes to tackle his or her own denial.