Adversity is a seductive invitation to self-pity. Cancer, like other unwelcomed challenges experienced in my life, provided such an invitation. But adversities provide opportunities as well as pitfalls. None of us escape adversities in our lives, but there really is something to the old saw, “When life gives you lemons, make lemonade.” Cancer was far more than an assault on my cells; it was a test of my character. Cancer provided invaluable lessons regarding my personal vulnerability and my need for better self-care—lessons of great import to someone both other-directed and action-oriented. The loss of bladder control in the weeks after my surgery forced me to once again confront limitation and powerlessness and brought humility and humiliation in equal measure—also valuable experiences for those of us fixated on controlling our own daily destinies. My need to rely on others, particularly my wife, forced me from the role of caring for others to the role of being cared for. I was forced to abandon efforts to bend life to my will and accept the limitations that cancer and healing imposed. And yet paradoxically, in that experience of acceptance, I found a way to transfer self-pity into something of great value.
For years I had been advocating that addiction in its most severe forms be recognized as a chronic disorder and treated on par with such chronic conditions as cancer, diabetes, asthma, and heart disease. My arguments were drawn from my studies of addiction and models of disease management for chronic illnesses. My writings on these topics were exercises in observation and thinking. What my cancer and its treatment provided to me was a far deeper and more profound understanding of the differences between cancer treatment and addiction treatment.
Recognizing this opportunity, I turned my cancer treatment experience into something of a research project with me as the sole subject. The result was a paper suggesting a number of ways that addiction treatment could be improved by incorporating dimensions that were standard practice in cancer treatment. I used my experience with cancer treatment as a source of deep meditation about how differently we treat cancer and addiction. If we really believed addiction was a chronic disorder on par with cancer (and other chronic primary health disorders), we would provide every person seeking assistance:
- Clear and consistent communications regarding the intrapersonal, interpersonal, and environmental factors that contribute to the development of a substance use disorder.
- An assessment process that is comprehensive, transparent, and continual.
- Objective data upon which a substance use disorder (SUD) diagnosis is based with normative data for comparison to the general population and to other patients being treated for SUDs.
- Objective information on the severity (stage) of the SUD.
- Objective information on treatment options matched to the type and severity of the SUD.
- A declaration of potential professional/institutional biases related to diagnosis and treatment recommendations.
- A menu of treatment options before making a final decision on the course of treatment.
- Access to the experiential knowledge of former patients who have experienced a variety of SUD treatments and who represent diverse pathways and styles of long-term recovery management.
- Personalized refinements in treatment-based assessment data and individual responses to initial treatment.
- At least five years of monitoring and support following completion of primary treatment.
- Assertive re-intervention and recovery re-stabilization in response to any signs of clinical deterioration.
- A long-term, person- and family-centered recovery support relationship based on mutual respect that is free of contempt or condescension.
It really is that simple. If we believe that addiction in its most severe forms is a chronic disorder, then let’s treat it like we really believe it. We don’t get to pick all the cards we are dealt in life, but we can choose how we play them. Adversity can be transformed into achievement; the call to self-pity can be shunned and transformed into a call to service. Adversity is a call for both self-assertion and self-transcendence. Are there cards of injury or sorrow you have been dealt that could be turned into instruments of self-learning and service to others? Wouldn’t playing the cards this way be better than the alternatives?