“I’m Not That Bad, I’m Not Like Those Other People.”

I Don’t Belong Here

Frequently when I get a new client that I hear a variation of “I’m not like that.” I treat a lot of high functioning persons who have substance use disorders, high functioning persons who misuse, overuse, abuse or are addicted to substances. Rarely do they identify as “addicts” or “alcoholics.” ** If they have been in a treatment setting or attended Alcoholics Anonymous (AA), they often observe “I am not that bad, I am not like those other people.”

This is a complicated statement. One of the ways in which a brain that has a hyper-response to psycho-active substances protects the pathway to use is to select and sort information that supports the preferred conclusion. What I mean by this is that a brain seeking substances will find reasons to drink or use rather than reasons to stop. As such, that brain will see patterns of use that normalize a higher level of use, will see people who use/drink like they do, will sit and listen to an hour long AA meeting and discard the shares that are like their story, and retain the stories that are quite different from their story.

I have literally had clients who came from the very same AA meeting and describe the same meeting completely differently. “The meeting was all about God” and “They never even mentioned God” or “They all had been divorced and bad bottoms, I never had that” and “I drank to the point of blacking out, they never had it that bad.” This has happened more than once.

I see the “I’m different” defense mechanism come up relative to industry frequently. “I drink because I’m in oil and gas” is common because I live in the Houston metropolitan area. But I also hear the same thing from construction professionals, engineers, medical professionals, educators, law enforcement… you get the idea.

Substance abuse exists on a continuum. There is misuse, overuse, problematic use, binge use, abuse, and dependency. 

I have written before about what is normal drinking?

I have also written a blog post of 3 unlikely alcoholics.

My recent blog post on Why You Can’t Think Your Way Into Not Drinking can help explain what’s going on inside your brain.

If you’d like to talk to me about if you have a problem and how to treat it in a private setting and with a custom treatment plan, contact me.

* The proper term is “person with an alcohol use disorder” or “person with a substance use disorder.” However, that is not what people are wondering or googling. I am keeping my discussion of the topics to the person-first language of person with a AUD or SUD but when it comes to the thoughts, searches, or other material that individuals might be thinking or interact with, as well as some older research, older terms may be used. No disrespect is meant.

**Person-centered language note: As a leading clinician in substance use disorder assessment, treatment, and recovery, I am committed to elevating the language around mental health and substance use disorder. This means I will use “alcohol use disorder” rather than “alcoholic.” It means I will use “person with a substance use disorder” rather than “addict.” I minimize my use of the term addiction because it carries stigma, often people have their own relationship with the word accompanied with misinformation. I use the term recurrence or return to use rather than relapse. However, it’s important that people searching for help get connected with services that benefit them. In this regard, people are not searching “am I a person with a substance use disorder?” They are searching “am I an addict?” They do not search, “can a high functioning person have an alcohol use disorder?” They search “am I a high functioning alcoholic.” They don’t search “treatment for people who have a recurrence” but do search “how do I stop being a chronic relapser?” As such, I want to affirm people with substance use disorders with my care, which includes language but I also need to structure my business in a way that google searches find my material.