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| Coulter's Tetrahedron of Addiction |
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Cravings (and other feelings or emotions) do affect thinking. But it goes both ways: thoughts affect cravings (and other feelings or emotions). And both of these types of things affect behavior, and are also affected by behavior. We never do a more thorough job of rationalizing a behavior than after we've engaged in it, for example.
All of these three kinds of things are affected by brain functioning, and also have some effect on brain functioning.
Thus, these four types of things all have bi-directional relationships with each other.
Where:
A = addictive behavior (or other types of behavior)
B = conscious thoughts, decisions, choices
C = cravings (or other urges, feelings, or emotions; unconscious processes)
D = brain physiology, biological functioning
And each line connecting two points represents a two-directional flow of effect.
Of course, the whole tetrahedron sits within a sphere that we could call "environment," and each point has its own set of interactions with the environment. "Environment" would include social environment (such as being surrounded by users or abstainers) as well as physical environment (such as whether there's a fifth of bourbon on the table).
People tend to think of addictive behavior (A) as being determined wholly by conscious decisions, (B). It's not at all like that; the reverse direction is probably a stronger link. It simply isn't true that we choose most of our behaviors, either for addiction or the many mundane issues like getting ourselves to exercise, or not eat so much, or stop chewing our nails. C, D, and Environment are probably much stronger influences on behavior than are conscious thought and decision-making.
Where do we place spirituality and group identity, the tools of the Fellowships? I'd categorize them with C, feelings and unconscious processes. Like cravings, they're very hard to get a theoretical or research grasp on, but they're an important part of the overall picture.
If you want to alter behavior A, you need to pay some attention to B, C, D, and Environment all. The near-universal error among clinicians, clients, family, and society is to think that B (willpower, conscious decision-making) is where the action is. But the B-to-A link is the weakest and least useful link on the chart. The weakness of the B-to-A link, the ineffectiveness of will power as a tool to alter behavior, is what Bill Wilson meant by "powerlessness" in Bill's Story. Of course, the idea of "powerlessness" has been thoroughly mangled since then.
It's time to ditch the fairy-tale idea that we simply decide what our behavior will be. Reality is far more complex and nuanced than that.
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