One of the confusing things about addiction is that a person can sincerely want to stop using a substance and, sometimes only minutes later, begin constructing a perfectly reasonable argument for using it again.

Both can be true.

Someone may understand what their drinking or drug use is costing them. They may be frightened by it, embarrassed by it, tired of it, and genuinely want their life to change.

And they may still want to use.

That contradiction isn’t incidental to addiction. Often, it’s right in the middle of it.

“I Know, But…”

Years ago, Jack Trimpey, the founder of Rational Recovery, emphasized the role of ambivalence in addiction. His model isn’t the only way addiction is understood or treated, but the observation has always struck me as useful: a person may want to stop and simultaneously want to preserve the possibility of using again.

You can hear this in the familiar rhythm of the conversation:

I know I drink too much, but…

I really should stop smoking, except…

Marijuana is becoming a problem, although…

Everything before the but may be completely sincere.

So is some of what comes after it.

This is one reason simply explaining to someone why they should stop often accomplishes very little. They may already know.

In fact, they may have a better list than you do.

The Peanut Butter Test

I once worked with someone who was concerned about his marijuana use.

He gave me several significant reasons he thought he should stop. But each time we approached that conclusion, he painstakingly circled back and found a plausible reason to continue.

When I pointed this out, he could see it.

Briefly.

Then the conversation wandered somewhere safer.

The following week I told him I wanted his opinion about something another person had supposedly discussed with me.

I essentially repeated his argument from the previous session, except I substituted peanut butter for marijuana and health concerns for addiction.

The imaginary person loved peanut butter. He had reasons for continuing to eat it. Unfortunately, it was also causing problems.

“Do you think he should stop eating peanut butter?”

“Yes,” he said, without much consideration.

Interesting.

The reasoning wasn’t particularly difficult when he had nothing invested in the answer.

Marijuana was different.

Knowing Isn’t Choosing

This distinction matters.

People struggling with addiction aren’t necessarily failing to understand cause and effect.

Sometimes they understand it quite well.

The difficulty is that understanding something and acting on it are different processes.

A person may recognize:

When I drink, these things happen.

And also think:

Maybe tonight will be different.

Or:

After the week I’ve had, I deserve it.

Or:

I’ll stop after this weekend.

Or simply:

I know. But I still want to.

That last sentence may actually be the most useful one.

Because now we’re no longer pretending the problem is insufficient information.

We’re talking about the conflict itself.

Don’t Argue Harder Than the Person You’re Trying to Help

When someone we care about is drinking or using drugs destructively, the temptation is to make the case more forcefully.

We gather evidence.

We point out consequences.

We remind them what happened last time.

We tell them what they’re doing to themselves, their work, their marriage, or their children.

Sometimes those conversations are necessary.

But there’s a peculiar danger in arguing too hard: the other person may end up arguing the other side.

You say why they should stop.

They explain why things aren’t quite that bad.

You produce more evidence.

They produce exceptions.

Before long, you’re making the argument for sobriety while the person who came in worried about their drinking is making the argument for drinking.

That’s probably not the division of labor we were hoping for.

Sometimes the more useful approach is to become curious about both sides.

What do you like about using?

What does it do for you?

What worries you about it?

What happens when you try not to use?

What would you miss if you stopped?

And what might become possible if you did?

The point isn’t to trick someone into the correct answer.

It’s to make the conflict visible enough that they can hear themselves having it.

Addiction Usually Has a Job

Substances rarely remain important simply because someone has failed to learn that they’re unhealthy.

They do something.

Alcohol may quiet anxiety.

Marijuana may make boredom more tolerable.

A stimulant may create energy or confidence.

Using may provide relief, ritual, social connection, escape, pleasure, or simply a reliable way of changing how one feels.

Understanding that doesn’t excuse harmful behavior.

It helps explain why consequences alone may not produce change.

If you take away the substance, the job it was doing is still there.

And somebody—or something—eventually has to show up for work.

“That’s Just the Disease Talking”

Years ago I worked with a man who became sober after having a dream.

In the dream, he woke up in a flop house surrounded by people who were clearly down and out. He immediately began explaining that he didn’t belong there. He’d accidentally had too much to drink the night before. Circumstances had gotten away from him. This wasn’t really who he was.

He recognized himself offering explanations he’d used many times before.

An older bearded man listened to him and finally said:

“That’s just the disease talking.”

The man continued explaining.

Again:

“That’s just the disease talking.”

Eventually something shifted.

The next morning he sat for a long time thinking about the dream.

What mattered wasn’t whether addiction literally had a voice or whether disease was the perfect word for his experience.

For the first time, he had created some distance between himself and the argument for drinking.

He could hear the argument without automatically accepting it.

He still had to choose what to do.

But now he could recognize that the thought I should drink was a thought—not an instruction.

The Light Bulb Still Has to Want to Change

There’s an old therapist joke:

Question: How many therapists does it take to change a light bulb?

Answer: The light bulb has to want to change.

Annoying, but true.

You cannot want sobriety badly enough for another person.

You can care. You can establish boundaries. You can stop protecting someone from consequences. You can offer treatment, support, information and company.

But eventually the person using has to participate in the choice.

That doesn’t mean addiction is simply a matter of willpower.

It means that treatment ultimately requires some participation from the person whose behavior is changing.

And ambivalence doesn’t mean that participation is absent.

Sometimes ambivalence is exactly where it begins.

The Part That Wants Something Different

People often seek help because both sides have become difficult to ignore.

They want to use.

And they don’t want to keep living this way.

That’s uncomfortable, but it also means something important has already happened.

There’s now another voice in the room.

Maybe it says:

I’m tired of this.

This isn’t working anymore.

I’m scared.

I want my relationship back.

I don’t want to need this.

I wonder what my life would be like without it.

That side doesn’t necessarily arrive with certainty.

It may disappear for a while and return.

It may be followed five minutes later by an extremely persuasive argument involving why tonight doesn’t count.

But it exists.

And rather than trying to beat the addicted person in an argument, treatment can help make enough room for that part to speak.

Change doesn’t always begin with conviction.

Sometimes it begins with the uncomfortable recognition that you want two incompatible things.

And then, gradually, deciding which one you want to build a life around.