art, I guess. On Wednesday, I cannot resist any longer. I go out and buy the
parts to make my machine again.”
“Your electrical stimulation machine?”
“Yes,” he said sadly, only barely meeting my eyes. “The problem is when
you start, you can be in ecstasy for a very long time. It’s like being in a
trance. And it’s such a relief. I don’t think about anything else. I go twenty
hours without stopping. I go all day Wednesday and through the night. On
Thursday morning, I throw the machine parts
away in my garbage and go
back to work. On Friday morning, I take them out of the garbage again and
repair them and use all day. On Friday night, I call my sponsor, and go to a
Sexaholics Anonymous meeting on Saturday. On Sunday, I take the parts out
of the garbage and use again. And on Monday again. I want to stop but I
can’t. What should I do?”
“Pack up the machine and any spare parts,” I told him, “and put it all in the
garbage. Then take the garbage to the dump or somewhere else where it is
impossible for you to retrieve it.” He nodded understanding. “Then anytime
you get the idea or urge or craving to use, drop to your knees and pray. Just
pray. Ask God to help you, but do it from your knees. That’s important.”
I converged the mundane and the metaphysical. Nothing was too low or too
high for my consideration. Telling him to pray was breaking unwritten rules,
of course. Doctors don’t talk about God. But I believe in believing, and my
instincts told me this would
resonate for Jacob, raised Roman Catholic.
Telling him to drop to his knees was also a way to insert some physicality
into it, anything to break the mental compulsion that was compelling him to
use. Or maybe I recognized some deeper need he had to act out his
submission.
“After you’ve prayed,” I said, “then get up and call your sponsor.” He
nodded again.
“Oh, and forgive yourself, Jacob. You’re not a bad man. You’ve got
problems, just like the rest of us.”
—
Self-binding is the term to describe Jacob’s act of throwing out his machine.
It is the way we intentionally and willingly
create barriers between
ourselves and our drug of choice in order to mitigate compulsive
overconsumption. Self-binding is not primarily a matter of will, although
personal agency plays some part. Rather, self-binding openly recognizes the
limitations of will.
The key to creating effective self-binding is first to
acknowledge the loss of
voluntariness we experience when under the spell of a powerful compulsion,
and to bind ourselves while we still possess the capacity for voluntary
choice.
If we wait until we feel the compulsion to use, the reflexive pull of seeking
pleasure and/or avoiding pain is nearly impossible to resist. In the throes of
desire, there’s no deciding.
But by creating tangible barriers between ourselves and our drug of choice,
we press the pause button between desire and action.
Further, self-binding has become a modern necessity. External rules and
sanctions
like taxes on cigarettes, age restrictions on alcohol, and laws
prohibiting cocaine possession, although necessary, will never be sufficient
in a world where access to an ever-growing variety of high-dopamine goods
is practically infinite.
My patients have been telling me about their
self-binding strategies for
years. At some point I started writing them down. I repurpose strategies I
learn from patients to advise other patients, as I did with Jacob when I told
him to dispose of his machine in a remote dumpster that wouldn’t allow him
to retrieve it later.
I ask my patients, “What kinds of barriers can you put into place to make it
harder for you to get easy access to your drug of choice?” I have even used
self-binding in my own life to manage problems of compulsive
overconsumption.
Self-binding can be organized into three broad categories:
physical
strategies (space), chronological strategies (time), and categorical strategies
(meaning).
As you will see in what follows, self-binding is not fail-safe, particularly
for those with severe addictions. It too can fall prey to self-deception, bad
faith, and faulty science.
But it is a good and necessary place to start.
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