Disease and Destiny or Choice and Responsibility?
He chose us in him before the foundation of the world, that we should be holy and blameless before him. In love he predestined us for adoption to himself as sons through Jesus Christ, according to the purpose of his will . . . Ephesians 3:4-5
My first addiction counselor told me my addiction was a disease. It’s just like cancer. I didn’t really believe him, but the idea was attractive, because what I heard was – None of this is your fault. The disease model, to me, meant that I was destined for addiction and that I couldn’t be blamed. The problem with this interpretation was that I was also helpless to do anything about it. I was a victim of circumstance, simply along for the ride. Taken to the extreme, my disease controlled my future, and I really had no choice in the matter. This isn’t really what the counselor said, but it’s what I heard. To me, the ideas of disease and personal responsibility were opposites. Both couldn’t be true. It had to be one or the other.
In his opening words to the Ephesians, Paul introduced the theological equivalent of this concept of destiny versus responsibility. In it, he said that we were chosen by God before the Earth was made. In my black or white thinking, if I’m predestined by God to be his child, then there’s not much I can do about it. I’m relieved of all personal responsibility, and I can just sit back and let God’s plan pay out. It’s an attractive idea, because in it, I don’t have to do anything.
Paul however, had previously – an on many occasions – demanded that we do. We’re told to walk with, live in, and keep in step with the Spirit (Galatians 5:16-25). We’re told to put to death the old life (Colossians 3:5). He demanded that we work out our own salvation with fear and trembling (Phi 2:12). In Paul’s mind, the idea of destiny and responsibility were not mutually exclusive. We were chosen by God, yet somehow, we still have choice and we’re still responsible for our actions. Both things are true.
So, I’ve come to accept the disease model of addiction. I certainly do have addictive predispositions that others don’t have. I have, however, rejected that idea that I can do nothing about my addiction. Like diabetes, I may have little choice if I get it, but I have tremendous responsibility to address it – or suffer the consequences. Both things can be true. I can have a predisposition for a thing, and I can be held responsible for dealing with it. It’s not one or the other. I may have a disease, but that doesn’t mean I’m just a victim. There’s always a choice.