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Editorial Comment 10/27/2020: Moral Posture in Addiction Treatment
Below, Jim Wahlberg (older brother to the Calvin Klein underwear idol, ”Don’t call me Marky!” Wahlberg), describes his and his son’s experiences of addiction and of recovery. In reading it, I was drawn to parallels between his arguably more-famous brother and those on either side of the national debate on “rights”: The more junior Wahlberg has himself gone through changes, evolutions in opinion and commitments, in the days since he led a boy band. People’s views may soften with education, experience, and development of character; and sometimes we discover that it is our views which want softening.
Unfortunately, and for the moment tending in the opposite direction, conversations about gun access, intentional termination of pregnancy (ITOP), immigration and assisted suicide have gone from contentious to adversarial to combative. Expressed by many journalists as the outcome of politically-motivated polarization, topics on which civil disagreement was once possible have become progressively incendiary. This is of course nothing new. The American Civil War was an outcome of irreconcilability of dichotomous views, views which either side held as morally clear and inarguable. One side had to be right, right?
Wrong. Which is of course why we include motivational interviewing among the skillsets of the addiction medicine trainees. We encounter the same dichotomous thinking in trying to bring our patients around to a viewpoint that is supposed to be therapeutic, but which to them is antagonistic. “You can’t take away my right to drink” is a hardened, even adamantine position to face when trying to get the patient to consider that a life without alcohol might ultimately be a happier one. Both adversaries must identify some common ground upon which each may place a foot.
Which dictates the opening question of the conversation: “Please tell me what it is that alcohol [substance] does for you?”
Editor-in-Chief: Dr. William Haning, MD, DFAPA, DFASAM