The “functional” addict

One of my favorite things to talk about with patients is their perspectives on functional alcoholism or addiction — whether in their own selves, their parents, or others in authority such as bosses, or the President. I ask with a curious mind, what is the definition of functional? Most people define functional as the ability to keep a job, show up at work, and even succeed professionally. Sometimes people mention the ability to show up at home or for social events. This is one way people defend themselves against the pain of acknowledging what they missed out on — the subtle, or not so subtle,  cravings of their soul for nourishment that were left unmet.

Never has a patient answered me by defining functional as “being consistently emotionally and spiritually available.” The impact of active addiction on the soul and on emotional well-being is usually not considered.

We now have research from neurobiology on the impact of active addiction on our higher level cognitive functioning; animals that are “addicted” show a transfer of behavioral control from more highly evolved cortex of their brains to the dorsal striatum (less developed, reptilian brain). Scientists believe we will find the same in addicted humans.

We might consider what all of this means for us as a nation — we who chose a President who may be dependent on nicotine. Could he be an even better leader, think with a sharper mind, feel with a stronger soul, and breathe with clearer lungs without the cigarette?

Most people I know with addictive disorders are highly talented, creative and special people. Some are perfectionists, many are overachievers. The sad fact for every “functional” addict is that we will never know what his or her true potential is. In recovery, this potential does have the potential to be realized.