Lyric discussion by yelliee 

Cover art for Drilled a Wire Through My Cheek lyrics by Blue October

It's obviously an addiction to a harmful behavior:

"And where crying isn’t secret It’s the art of how we grieve"

-taking pain and escaping through behavior... drugs, sex, whatever.

"And when the hurt comes there’s an argument A fight to save a smile"

-not a split personality, but a war waged against himself to quit or continue his addiction.

"And where confidence is found Attached to wires on a sleeve" -although he may find solace, there are strings attached to the way he copes.