Jeffrey A. Schaler, Ph.D.

28 New Therapist 8, July/August 2000
Dorpspruit, South Africa.


"Jeffrey Schaler's new book Addiction is a Choice is not going to make him a lot of friends for him among the legions of those who make their money "treating" addiction. If you're looking for a new line on addiction, this is a compelling way to wipe the slate and with a new paradigm."

28 New Therapist 8, July/August 2000

Title: Addiction is a choice
Author: Jeffrey A. Schaler
Publisher: Open Court
ISBN:0 8126 9404 X

Choosing a new line on addiction

By Susan Spencer

Jeffrey Schaler, a psychologist who has worked extensively in the field of addiction, will be ruffling some feathers and making a few fresh enemies with his new book, Addiction is a Choice . In this extremely refreshing book he challenges widely held beliefs about addiction, chiefly that addiction is a disease and that moderation does not work. He believes that people exercise their own choice and free will when taking various drugs. He also gives treatment providers a thorough working over, likening Alcoholics Anonymous to a religious cult. Arguments are presented in an accessible step by step way with ideas supported by numerous references -many by his colleague and friend Thomas Szasz, a leading figure in the anti-psychiatry movement.

At times ,the book reads like an Erin Brokovich saga. For instance, Schaler refers to a project undertaken in the U.S.A. in 1995,entitled Match (Matching Alcoholism Treatment to Client Heterogeneity)using some $35 million of tax money. The results which emerged were not in keeping with expectations. As a result, great efforts were made to conceal the results and to discredit anyone who published them.

Schaler expands our view of addiction by stripping down all the superstructure the establishment view of addiction has built up over the decades, drawing a simple distinction between virtues as good addictions and vices as bad addictions. He says that a "positive addiction enhances the values we hold dear ", while a negative addiction "pulls our life apart ".

"Positive addictions," he argues, "may include alcohol, work, and love. Negative addictions may also include alcohol, work, and love "(p.5).In other words people can be addicted to almost anything that they choose. When the effect of this addiction is constructive it is construed as a virtue and, by contrast, when its effect is negative, then it is thought of as a vice. "Addictions are as diverse as peoples ' values."

Schaler emphasises that not all drug users become addicted. Contrary to popular anti- drug propaganda,"if you deny the fact that people can use drugs like heroin, cocaine, marijuana, alcohol, and tobacco responsibly you 'll never comprehend the true meaning of addiction and you'll never be able to help people with the problems-in-living that lead to drug use " (p.129).

Schaler is predictably and stridently critical of the disease model of addiction. He maintains that when we talk about addiction as a disease, rather than a choice, then the individual no longer feels in control. "People use legal and illegal drugs like Prozac and heroin to avoid coping with their lives. The reasons people avoid coping with their lives may be judged good or bad …Addiction is not a disease...Addiction is a choice," he argues (p.120).

More importantly for the therapist population, though, this book forces practitioners to look more closely at why rehabilitation treatment is so notoriously unsuccessful, and why clients being treated for addiction are frequently resistant to change. Schaler looks closely at the idea that treatment for addiction can be found through turning one 's life over to a "higher power "as advocated by Alcoholics Anonymous (AA).For AA members, the locus of control must of necessity be external to the individual.

Schaler argues that if clients were encouraged to take more personal responsibility for their behaviour, and to moderate their intake, then they would feel more empowered and more able to control their use of whatever substance they are struggling with.

Schaler advocates the use of moderation as opposed to complete abstention. He says that when one encourages clients to believe that they are powerless and that complete abstention is necessary, one risks paving the way to maintaining the addiction. He argues that treatment programs for addiction which encourage people to believe that they are not able to moderate their intake of drugs tend to become a self fulfilling prophecy.

Schaler draws attention to the obvious link between drug use (recreational and psychopharmacological)and personal difficulties in the user 's life. "People who rely on prozac or heroin are deadening themselves, as a way of avoiding the effort and resolve required to face life 's problems "(p.145).For this reason Schaler argues that the most effective treatment, is in addressing these underlying problems or conflicts.

Addiction is a Choice, is a most compelling and easy read. It 's ideas and arguments are hard to refute. I began the book with a distinct leaning towards the idea that alcoholism is a disease, that Alcoholics Anonymous (AA)was the obvious form of treatment, and that moderation, as opposed to complete abstention for alcoholics was not possible. Having made my way through Schaler's lucid, if a little vociferously put, arguments, however, I was beginning to believe that I had held the view all along that alcoholism (addiction)is a choice and not a disease, and that moderation is a logical and promising outcome for those wanting to kick the habit.

This is an excellent resource for people working in the field of addiction and, for that matter, for all therapists and their clients, regardless of whether they agree with Schaler 's assertions or not -principally because it shakes up quite fundamental ideas about agency, locus of control and choice in the addictions field.

In the words of Schaler: "You hold your life in your own hands. What you do with it is your choice " (p.146).

28 New Therapist 8,July/August 2000