Reaction to Cummings on Addiction

Cummings (December 1979) is to be vigorously applauded for bringing to light the seriousness of the drug and alcohol addiction problem and the inability of traditional psychotherapy to deal with this problem effectively. Those of us who work daily with addicted people hold most of Cummings's statements to be self-evident, but we suffer frequent frustration at the apparent unwillingness of other psychologists to listen to and consider these ideas. That Cummings has bravely stated his views in our official journal and lent his prominent name to them does much to reduce my sense of separation from my profession and my chagrin at not being taken seriously in a matter that I know to be profoundly serious. Unfortunately, I see in Cummings's article an assumption (or set of assumptions) that I regard as unfortunate, both for psychologists who work in addiction and for our clients/patients. He betrays his attitude by devoting only a short paragraph to Alcoholics Anonymous (AA) and speaking in a way that dismisses AA as not worthy of serious consideration in the treatment of addictions (i.e., "I respect AA, but . . ."). Though Cummings confesses that he, like many of us, used to treat addiction "in the traditional, ineffective fashion," until he was apparently enlightened, I suggest that he needs further enlightenment, in this case about AA and the need to recognize its value. Cummings seems to believe that AA's sole value is that it "turns a destructive rescue game . . . into a positive rescue game" (p. 1126). I submit that AA has far greater value than this and is, in fact, the source of most of the ideas that he presents under the label "psychological model of addiction." In addition, AA can be a great resource in helping us to make our treatment interventions more effective and durable, as well as in contributing significantly to their cost-effectiveness. The crucial element in Cummings's model of addiction is the idea that "addiction is not merely popping something into one's mouth but a constellation of behaviors that constitute a way of life" (pp. 1121-1122). Addicts, then, are people who must give up their destructive, addiction-supporting games (or traits) and develop new, constructive ways of living. Compare these ideas with some quotations of AA's cofounder, Bill W. (1967):