A dangerous infatuation

We all live in a celebrity culture, and celebrity addiction increasingly has become vital to it. It would be no exaggeration to say that millions of people who have never seen a Britney Spears video or a Lindsay Lohan movie are nevertheless familiar with their histories of chemical dependency, erratic behavior, legal trouble, reclusive treatment and widely publicized relapses. Indeed, the mass media now depict addiction as almost central to the lives of the rich and famous. Further sensationalizing chemical dependency, under the guise of documentary, are popular TV series such as “Celebrity Rehab With Dr. Drew” and “Sober House.”

For most Americans, the hype surrounding celebrity addiction is little more than a distraction in a difficult economic time. As evidenced by widespread Internet chatter, many certainly find it titillating. Perhaps more maturely, others simply look away. Yet overall, this growing phenomenon carries with it a particular burden for addiction professionals. And as one based in Los Angeles with many clients in the entertainment industry, I often find myself at “ground zero” in this regard.

In this article, I'd like to share my observations on how celebrity addiction culture affects our work as addiction professionals, and recommend how to respond most effectively. For whether we're located in New York or Minneapolis, Miami or Seattle, we're all intimately affected.

What celebrity culture teaches

As treatment professionals, we're committed to helping our clients identify their adaptive and maladaptive behaviors, understand the consequences for both, and learn self-responsibility. In this regard, whether explicitly or not, we're emulating the authoritative parenting style first delineated by Diana Baumrind in her influential approach to family dynamics.1 She contrasted the authoritative style with the authoritarian (obedience-oriented/punitive) and permissive (lax or indulgent) styles, both associated with weaker outcomes for fostering autonomy, self-efficacy and psychological well-being in youthful development.

Over the ensuing decades, the authoritative style has been consistently linked to better social adjustment and fewer behavioral disorders in teens and adults.2,3,4,5 In contrast, both the authoritarian and permissive parenting styles have been repeatedly tied to greater frequencies of problem behavior, including substance abuse. In a variety of ways, celebrity addiction culture undermines the authoritative approach and replaces it with essentially the permissive. It does this:

• By fostering the illusion that bad behavior is acceptable if done by talented, creative people. Tabloids, TV newscasts and films have long presented the image that drug and alcohol use are part of the “maverick” lifestyle of the creative class, including artists, musicians and actors. Such depictions have a profound effect on our society's most impressionable and vulnerable members: the young.

• Relatedly, by intimating that one can be chemically dependent and still be fabulously successful, wealthy and glamorous. This depiction makes it less likely that those with addictive problems will seek professional help at all or remain in treatment upon entering it.

• By exploiting and reinforcing stereotypes. Performing artists and screen stars are typically portrayed as beautiful “empty suits” lurching for their next high. Almost never are they depicted as complex persons with legitimate life problems shared by countless others who aren't famous or rich.

• By equating addiction treatment with what celebrities receive. In stunning Malibu facilities, the renowned are coddled and pampered. Paying fees of $40,000 to $70,000 per month, they enjoy gourmet meals prepared by star chefs and personal nutritionists, indulge in exotic spa treatments, and receive round-the-clock monitoring. Such interventions are essentially vacations and a public relations move-light years away from the real world of residential programming.

• By highlighting the “disease model” of addiction. Few humanists are ever invited to appear on TV shows featuring celebrity addiction. Instead, experts are called upon to promote the medical/genetic viewpoint, which downplays psychological factors. This emphasis is especially misguided because empirical research indicates that the entertainment industry attracts men and women with a particular personality type, craving attention and admiration.6 In a later publication, these same authors suggest that this trait cluster places such individuals at a greater risk for addiction than the general population.7

• By tacitly promulgating the downbeat message that addictions are incurable. For if even the young, beautiful and famous seemingly can't straighten themselves out despite lavish rehab, how can anyone hope to do so?

Of course, not everyone exposed to celebrity addiction becomes more likely to develop a chemical dependency, shun necessary intervention, or drop out of treatment. Rather, from my clinical experience, those individuals who lacked authoritative parenting while growing up are precisely those most vulnerable to the mass media's message as presented by the above examples.

Enough about you: the problem of narcissism

It's impossible to discuss the impact of celebrity addiction culture on our work without touching on narcissism. For decades, mental health theorists have associated entertainment stars with the narcissistic personality. Such writings have come mainly from two psychoanalytic thinkers, Heinz Kohut and Otto Kernberg. Both based their influential formulations on the seminal work of Sigmund Freud, who viewed narcissism as self-love coupled with fragile self-esteem, fear of failure and other factors. According to the DSM-IV, narcissism is a personality disorder marked by an exaggerated sense of self-importance and uniqueness, an unreasonable sense of entitlement, a craving for admiration, exploitative tendencies toward others, and arrogance.

Many mental health professionals today believe that narcissism is increasing, especially among youth. This notion received dramatic empirical support in a cross-temporal study showing that almost two-thirds of recent college students are above the average narcissism score of those who attended college between 1979 and 1985.8 But what makes some of us narcissistic? How and when does it happen? Relatively little is known about the roots of narcissism, but most children show narcissistic features until about age 7 or 8, and then develop a more realistic view of self. Based on recent findings, the exceptions appear to be those raised by either inattentive or overly admiring parents.9 As these investigators poetically suggested, “Perhaps narcissistic individuals learned early in life to put themselves on a pedestal either to live up to parental expectations or to compensate for a lack of parental warmth.”

Addiction on the pedestal

The evidence is strong that parents lacking the authoritative style are more likely to foster substance abuse, as well as narcissism, in their offspring. Indeed, some theorists have argued that basically all addictions are problems of narcissism-a view I've come to share.10 But is there also a link between narcissism and chemical dependency and celebrity culture? The answer is an unequivocal yes, for empirical research found that celebrities scored significantly higher on a scale of narcissism than the general population6,7, and years of experience in the entertainment industry were not associated with higher levels of narcissism, suggesting that those entering the field were already higher than the norm.

What this means for our field is clear. Celebrity culture is essentially a narcissistic culture, and inevitably, celebrity addiction reflects that reality. The men and women on the pedestal got there in part because of their intense need for admiration, praise and exhibitionist success. But no amount of audience applause can fill an inner void-and so, the addictive process begins. In my own experience, when successful entertainment industry clients finally understand that I will treat them exactly like everyone else, some of that narcissism may diminish, and real work can begin (see Sidebar: Five mistakes to avoid with celebrity clients).

Most addiction professionals, of course, rarely treat celebrities. Yet, as I have tried to emphasize, celebrity addiction culture negatively affects us all. Here are some suggestions for helping your clients combat its destructive influence so that they remain committed to recovery:

• At the outset, recognize your narcissistic clients, for they are most likely to identify with addictive celebrities and resist treatment. (See Sidebar: Narcissism quiz) for several initial diagnostic questions that are a modification of those seen in standardized assessments.)

• Encourage your clients to take the Celebrity Attitude Scale (CAS) to determine the extent to which they are influenced by celebrities. This influence might be maintaining addictive behaviors by increasing anxiety and depression.

• During session, ask your clients to list the values of celebrity culture, such as fame, wealth and good looks. Then ask them to list on a separate page their own values about what is important in life. Such values as kindness, friendship, loyalty, charitableness and courage will often be mentioned. Elicit discussion on this contrast. This activity is especially useful with young people, individually and in groups.

• Keep a file of recent news articles on celebrities who are experiencing problems with addiction; online and print magazines are excellent sources. Ask your clients to choose a celebrity and read a related article. In the next session, initiate discussion through questions such as: How does this article make you feel about yourself-better or worse? Why? Does it make you more likely to change your own behavior, or more complacent?

• Assign your clients to watch at least two TV programs that deal with addiction, whether drama or reality show. Then, in session, elicit discussion through questions such as: Did you find these programs entertaining? If so, how? Did these motivate you to change your behaviors, or did they present a downbeat and discouraging message? If you could write your own script for a drama or reality show involving addictions, what would it be?

By all indications, celebrity addiction culture will be staying with us for some time to come. Its misleading, sensationalist depiction of chemical dependency, and treatment, undeniably complicates our work. It is therefore vital that we have the right perspective and tools for guiding clients effectively. As a counselor at “ground zero” in this domain, I know it can be done.

References

1. Baumrind D. Effects of authoritative parental control on child behavior. Child Devel 1966; 37:887-907.
2. Adalbjarnardottir S, Hafsteinsson LG. Adolescents’ perceived parenting styles and their substance abuse: concurrent and longitudinal analyses. J Research Adolesc 2001; 11:401-23.
3. Chassin L, Presson C, Rose J, et al. Parental smoking cessation and adolescent smoking. J Pediatr Psychol 2002; 27:485-96.
4. Kandel DB. Parenting styles, drug use, and children's adjustment in families of young adults. J Marriage Family 1990:52:183-96.
5. Smith DC, Hall JA. Parenting style and adolescent clinical severity: findings from two substance abuse treatment studies. J Soc Work Prac Addictions 2008; 8:440-63.
6. Young SM, Pinsky D. Narcissism and celebrity. J Res Pers 2006; 40:463-71.
7. Pinsky D, Young SM. The Mirror Effect: How Celebrity Narcissism is Seducing America. New York City:Harper; 2009.
8. Twenge JM, Konrath S, Foster JD, et al. Egos inflating over time: a cross-generational temporal meta-analysis of the narcissistic personality. J Pers 2008; 76:875-902.
9. Thomaes S, Stegge H, Bushman BJ, et al. Development and validation of the childhood narcissism scale. J Pers Assess 2008; 90:382-91.
10. Forrest G. Alcoholism, Narcissism, and Psychopathology. Northvale, N.J.:Jason Aronson; 1994.

Sidebar

Five mistakes to avoid with celebrity clients

1. Don't think you really know the person by their media coverage. Most likely you have only a well-produced image.

2. Maintain your objectivity. If you respond as the person's fan or critic, you're biased from the outset.

3. Avoid frivolity. If they're seeking help, then help. Don't expect to be entertained.

4. Allow extra time to build trust and rapport. These are very guarded people to begin with.

5. Watch out for countertransference. Celebrities are accustomed to getting their way, especially through charisma. You're not there to satisfy your need for popularity or respect, but to be an effective caregiver.

Sidebar

Narcissism quiz

Researchers have devised several narcissism scales, but none is as yet authoritative. Below are six self-report questions based on the dimensions of entitlement, exhibitionism and grandiosity. This sampling can assist in gathering information about the client, but is not meant to replace a standardized assessment in a 40-question forced answer format (an example of this can be found at https://psychcentral.com/quizzes/narcissistic.htm).

Your client is to answer the questions below on a 5-point scale: 5=strongly agree; 4=agree; 3=not sure or neutral; 2=disagree; 1=strongly disagree. Questions such as these are not raised until some degree of trust and rapport have been established with the client, and the client is not aware of why he/she is being asked the questions.

1. I deserve a lot of praise.

2. I feel entitled to special treatment compared to others.

3. I love being the center of attention.

4. “Showing off” to others gives me pleasure.

5. I know I'm a remarkable person.

6. Many people secretly envy me.

Scores can range from 6 to 30. Many young people today are pursuing their need for attention and relevancy in any way they can and would likely answer these questions honestly. A score of 20 to 24 suggests narcissistic tendencies, and a score of 25 and higher suggests a narcissistic personality. As people get older they tend toward less honesty and, if they have narcissistic traits, will generally deny the more obvious traits-a narcissistic trait in itself.