Diseases, Disorders, and Self-Fulfilling Prophecies (Blog 6)

Note from the author:

This is the sixth post in my 15-part series based on Outgrowing Addiction: With Common Sense Instead of “Disease” Therapy, the book I co-authored with Dr. Stanton Peele. While the book was a collaboration, this series reflects my voice, my work, and my experience helping people move past addiction.

How Beliefs Become Reality

In my work with both kids and adults, I’ve seen one pattern repeat over and over: people live up — or down — to the story they believe about themselves.

When someone is told, “You’re a troublemaker,” they start to expect trouble from themselves. When a student hears “You’re not good at math,” they stop trying to be. And when a person hears, “You’re an addict” or “You have a lifelong disorder,” that becomes the lens they use to interpret everything they do.

This is how human learning works. We filter the world through our expectations, and then we act in ways that confirm them. That’s the self-fulfilling prophecy.

 

The Danger of a “Permanent” Diagnosis

When the addiction field leans on language like disease, disorder, or chronic condition, the intention is often good — to remove blame, reduce stigma, or get someone the help they need.

But there’s a hidden cost: these labels can quietly tell people, This is who you are now, and it’s who you’ll always be.

If you believe that, then every slip, every bad day, every moment of doubt isn’t just a setback — it’s “proof” you’ll never change.

That belief may become more limiting than the addiction itself.

 

How This Plays Out in Real Life

I once worked with a young man who’d been in and out of treatment since high school. His file was stacked with labels: oppositional defiant disorder, ADHD, substance use disorder. By the time he reached me, he could rattle off his diagnoses like a résumé.

The problem was, those labels had become his role. When teachers expected him to blow up in class, he often did. When counselors expected him to relapse, he figured he might as well.

It wasn’t until we started talking about what kind of life he wanted — instead of what kind of “disorders” he had — that he began to feel better about himself as a developing person. He enrolled in a training program, reconnected with his sister, and started imagining himself in a future he wanted to be part of.

 

Breaking the Prophecy

You can’t just rip a label off and expect instant transformation — it doesn’t work like that. But you can stop treating the label as the truth about who you are.

Instead, start asking:

• What am I capable of learning?
• What roles do I want in my relationships, work, and community?
• How would I act if I believed I could succeed?

These aren’t only feel-good questions — they’re the ones that guide and change behavior in positive ways.

 

Final Thought

The most dangerous part of the disease model isn’t just that it’s inaccurate — it’s that it can quietly convince people to live down to it.

Addiction is something you can outgrow. The label doesn’t have to be your future. And when you stop letting it define you, your life stops revolving around proving it right.

That’s when the prophecy breaks.