The Persistent Myth of Moderation…


Moderation (noun): the avoidance of excess or extremes. The quality of being moderate. Restraint. Temperance.


I grew up in a predominantly White, predominantly Christian suburb outside of Ann Arbor. Moderation is a familiar notion… moderation for breakfast, lunch, and dinner. Moderation in all things. I was brought up to believe that moderating our behavior, our assertions, our appearance is expected. Correct. Appropriate.


As a kid, my mother categorized everything in our life as “appropriate” or “inappropriate.” She’s also a therapist.


As an adult, I identify as an artist and a feminist. I fancy myself a freethinker. I emphasize authenticity and expression in my work and my relationships. But “temperance” is still one of my favorite words, I think it’s compelling. Caution. Restraint.



Moderation: The avoidance of excess or extremes

Last week I wrote a piece about fostering change. Personal and individualized action. The responsibility that lies there. I wrote about the importance of trusting ourselves, not looking outside ourselves for permission. The pendulum changes direction this week (everything in balance, Namaste).


Folks experience addiction in different ways, enact addiction in different ways… so it makes sense we approach recovery in different ways. We’re all a bit different from one another; we’re the byproducts of our environments, experiences, biology. Person 1 perceives the same events/objects differently than Person 2. For this reason, we can never assume we truly understand or can conceptualize the experience of another.


Some folks approach recovery through the lens of moderation. These individuals may identify as “Highly Functioning Alcoholics.” HFAs defy the stereotype of a person with a substance use disorder. Because they hold down a job, an education, maintain a home, hold power.


To me, this presents a problem that is two-fold:

  1. Our conception of “who is a person with an SUD” is still widely skewed. Read more about that here.
  • This type of framework, that of a highly functioning person behaving badly, makes me uncomfortable. How are we defining “highly functioning?” And in which domains are they performing?

How well do you need to function to be “high functioning?” And to whom do you appear “high functioning?”




Waking up the HFA

I spoke with my colleague and Sanford’s marketing director, Marilyn Spiller, about moderation. In addition to running the  Sanford blog, Marilyn has a personal blog which chronicles her triumphs and struggles as a person in recovery. Marilyn is strong in her recovery. She is strong in her convictions. Knowledgeable about the field in which she works. She also shares my affinity for good coffee.


Marilyn had this to say about moderation in recovery:

Jess A Highly Functioning Alcoholic, or HFA, is able to maintain their employment, relationships with friends and family, a mortgage, etc amidst their addiction. How do you define a “highly functioning addict”?

Marilyn No such animal. These folks are defying the stereotype. They may perceive themselves to be “high functioning…” I can assure you, you cannot effectively hide an addiction. If you were to ask their boss, their colleagues, their children, their spouse… they’re behaving alcoholically with greater resources.

J How do these resources play into the equation? How do resources help individuals struggling with substance use?

M Resources… success… perceived success… they provide the individual with an excuse, a way to avoid. This can lead to denial. And denial can lead the individual to accept their behavior. As is often the case, money allows people to behave badly without a proper call-out..

J When is moderation an effective option for someone attempting to control their substance use?

M A person with an alcohol use disorder is someone who continues to drink alcohol despite it’s negative impact on their life. If you are drinking alcoholically, regardless of when or how that takes place, you aren’t functioning healthily. Addiction is a chronic, progressive disease… you’re playing with fire… and what’s the point? If you’re concerned about your drinking, why attempt to “moderate?” Why keep the behavior active in your life?


Not too much… But just enough.

As addicts, can we ever truly moderate? Isn’t that the crux of the disease of addiction, an inability to moderate? How did we get here in the first place? And how do we establish moderation that isn’t context-specific? What does moderation look like? 1 cocktail? 3 beers? No liquor? Drinks on the weekend? Drinks after 8:00 PM?


Is this moderation, or is this something different? How do we behave around our “moderated” substances? Do we spend our off-time thinking, planning, dreaming about our “moderated” 8:00 PM glass of wine? Are we perched in front of the clock at 7:59, glass in hand, desperate and flushed? And is this behavior worthy of “recovery?” Is this recovery? How do I know I’m controlling my substance… and at what point is my substance controlling me? Dictating my schedule? My reactions?


Hooked on a feeling

Again, I come from a place of temperance. So perhaps I’m too strict in my constitutions of recovery and mental wellness. But as a counselor dealing with substance use disorders, I worry about the role of secrecy in moderation management, and the lack of accountability. The role of convenience and the absence of surrender.


Perhaps there’s a balance within “moderation,” a word that already denotes balance. Maybe moderation is a device that both limits us and imparts wisdom.


But when is it not enough? At what point does moderation become ineffective? I’m concerned that perceived moderation may keep us sick, keep us stuck, and keep us blind to our transgressions.






Author Jess Kimmel has always had a passion for art and when she discovered art therapy it just made sense. Jess is an Art Therapist who serves as Clinical Manager, Sanford House at Cherry Street for Women. Jess has a B.S in Psychology and an M.S. in Art Therapy. Art therapy allows her creativity to shine through her work and she thrives on seeing the confidence grow in the individuals she works with at Sanford Behavioral Health. Jess is from Hartland, Michigan and currently lives in Grand Rapids.