Hello people. This is not a post but a request. I just got the go-ahead from my agent to begin work on a new book. Here’s the plan —
Three or four intimate biographies, of people who have had serious struggles with drugs and/or alcohol, who have become addicted, by one definition or another, and who have tried and perhaps succeeded in recovering — even if it didn’t last for good. These life stories will be the backbone of the book. I plan to connect each story to one of the major outlooks, or camps, that try to understand how addiction works: the disease camp, the “choice” camp, and the “self-medication” model, all which have some power to describe addiction, but none of which explains it completely successfully — in my view. I will use science (neuroscience and psychological science, maybe genetics, maybe treatment and prevention science) to take a deeper look at what’s going on in each of these addiction journeys, and I’ll pull it all together with an approach and an explanation that I think works the best.
I need volunteers! I have already talked to a few of you in some detail about your life stories, but I need to talk to others. Would you consider letting me write the story of your life? Of course, you don’t have to tell me everything. I don’t want to “reveal” what you don’t want to be revealed. But I do need detail. I need to know what it’s been like, what it has felt like, where you have been, where you are now, and where you think you’re going. Most of all, I need to know the facts and the feelings as only you can describe them.
Most if not all interviewing would be done via Skype or phone — at my expense of course.
I do NOT have to use your name. That’s a choice you can make, but it is not at all necessary or even very useful for the book I’m planning. Pseudonyms will be fine. And, I hope it goes without saying, I would never reveal your name, or any details attached to your name, to anyone, in any circumstances, without your express (and written) permission. I’m still a clinical psychologist (one of my hats) and I’m still bound by professional ethics. Not to mention personal ethics.
Please consider this request, and if you’d like to talk with me about it, drop me a line. It’s best to use the “contact” form that is embedded in this website. Just click on the Contact tab at the top of this page.
Thanks for any replies, suggestions, or questions,
–Marc
Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis’s The Biology of Desire effectively refutes the medical view of addiction as a brain disease. A bracing and informative corrective to the muddle that now characterizes public and professional discourse on this topic.” —Gabor Maté, M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
I have a very detailed of my account of my struggles with heroin/etc.
It’s kind of long, but if you give me an email address i can send it as an attachment.
It really is an incredible story.
Sorry for the delay. I’m still catching up with my readers. But please use the Contact form, which is on a separate page of this website. There’s a link straight to it at the top of this page.
I appreciate your offer — incredible stories R Us… Best maybe to send me a summary version, and then let me digest it along with others, then get back to you.
I walked into my first A.A meeting at 22 , after years of sobriety followed by years of drunkenness followed by years of sobriety followed by years of drunkenness the biggest regret I have was walking into a AA meeting at 22 . I would love to be involved .
Hi Donnie,
Please send me an email…easiest way is by clicking on the Contact link at the top of this page. Then we can talk about it.
Thanks,
Marc
Sounds like a very interesting book !
Looking forward to it .
Thanks! Me too! Still waiting for the rest of the coalescing to happen…..when things click into place…I hope.
Hi Marc — You asked me about this when we got together in Toronto on March11th and I’m still in if you can still use me. My feelings are the same as then; I am not so much interested in my terribly long and rich story of severe addictions — spanning decades, loss of financial security, family and health — as I am in my really interesting recovery — alive and mysterious, heart-warming, spiritually and creatively challenging (and that’s just what’s happening today).
I have lots already written, as you might’ve guessed, but we could proceed with a blank page in front of us, too; whatever you like.
fond regards,
John
Hi John! Of course I remember our meeting and our discussion. I haven’t changed my thoughts about your story. Glad you haven’t either. This is so weird. I feel like I’m selling raffle tickets. But the long and the short of it is that I need about three stories that will complement each other while representing really diverse aspects of the addiction world…. Your story is indeed unique. I love it. But let’s wait till I get back to Holland, when I can start to sort through some of these “offers”…then I’ll get back in touch with you.
I feel truly honoured that you and others are trusting me with their life stories. What greater gift could anyone give?
We can correspond about this further by email, but my return email to your “comment” was rejected…address didn’t exist or something. So please send the correct address in another email.
Very best,
Marc
Hi Marc
Addiction is the most difficult word to define. Physical dependence, psychological dependence, a habit that does one harm? All the above or some? I can only speak of myself. I drank from 15 to 26 on a daily basis. Rehab at 26. No grog for 20 years. However, on and off during this period of academic and career ‘success,’ ‘growth’ and ‘community standing’, I imbibed a plethora of pills and potions. Both legal and illicit. Comforted in the belief I was in control. As none had managed to gain the ferocious hold on me that the alcohol once had. From time to time I would become fond of a substance and accordingly make room for it in my ‘successful’ ‘sober’ life. Blissfully unaware that I was sacrificing the enjoyment of normal activities I had grown to enjoy during the last 2 decades of alcohol abstinence. I felt so secure I was merely using the substance for a brief holiday from life, my hardships, responsibilities etc. The truth was I never really sobered up. I just played the parts I needed to play to maintain the illusion. For my own sake and those around me. As a child, I was raised without an appropriate male role model. I was left scant of principles and ethics that left me inadequate to living life on life’s terms. Sure I knew right from wrong. I didn’t ‘hurt’ people, rob, bash, or insult. Well, not often enough for me to consider myself aggressive and dishonest by nature. I ratified any anti social behaviour as a mere reaction to the circumstances at the time. Even justified some behaviour, which in retrospect highlights how unethical I was. I believe most men cannot function on feelings alone and live anything that resembles a ‘normal’ existence. Only recently have I incorporated principles and ethics into my life. They are the new regulators of my behaviour, not my feelings. However, putting into practice principles and ethics to dictate my behaviour and ignore my ‘feelings on a matter or issue (as opposed to mimicking them in union with the authority my academic qualifications and work place status gave, clever shortcuts and outright lies) was difficult and foreign. For 20 years I thought I was doing OK. If I quit a job. I would justify the decision. If I chose not to mow the lawn or pay a tax, again I would justify the decision with righteous indignation. But this is a whole new ball game. I have to be an adult. Not a middle aged teenager with excellent, well honed manipulative skills (that despite their self serving purpose for implementing, some strategic grand feat of manipulation ie turning a dismissal into an illegal act and compensated, still amaze me at times). I was living a life that was anything but righteous or responsible. Paradoxically, I was convinced I was a man who was put here to right the wrongs of society, the policy makers, and the employers. The reality was anyone who interfered with my whimsical approach, who dared confront me with a consequence or rebuke me, was taken to task with the compassion and precision of a sociopath.
Having an Alpha personality was a bonus. My motto was if you can’t join them, beat them. Beat them I did. Again, armed with a righteous and litigious attitude. I would/could and did decipher policies or Industrial law to battle my usually less informed or prepared adversary and make them pay for having the impudence to question my behaviour or practice. Took CEO’s of Community agencies to VCAT, and never lost. ‘Shot them with their own bullets’. Well, the bullets that regulated them. I thought I was a clever, strong and ‘so’ well principled man. A man’s man, willing to sacrifice his job for ‘justice’. The truth was I wanted out of that job and maintain my charismatic, fearless reputation during the exit. It’s amazing how one can be so clever that they fool even themselves. To avoid living a life devoid of true success and happiness I need regulation to save me from myself. I need to adhere to society’s conventions, such as regular 9 – 5 work. Do the things I don’t particularly like. Not allow my ‘feelings’ to dictate my actions. That includes falling into the use of pills potions to ‘relax’. I am now acutely aware I only use them to escape what I know to be true and permit my mind to dispel with principles and in turn justify the dereliction of the responsibilities and behaviour of a true adult with self deception.
Sadly, I am not Robinson Crusoe here. I have had plenty of like minded company over the last 2 decades whom concurred with my behaviour my rationales’, false and deluded as they were. Many of whom were, and still are people of influence; well to do in society’s eyes. As they were so dissimilar to my old bar fly buddies from my drinking days. I valued their support and validation. So through my pious, pretentious and often drug effected eyes, they served to solidify and allowed me continue to write the rules I felt society should adhere to. Mine of course. So fostered was I by those ‘intelligent’, ‘worthy’ people. I had no compunction holding others accountable by means of manipulation or legal technicalities for merely having the courage to try and correct my behaviour.
I have only just sobered up. Now I’m growing up. Thanks for reading.. Mick
Note to Michael.
Hi Michael. Thanks for a very interesting and soul searching post. In particular your description of the ‘not quite’ addiction to pill and potions, following your giving up booze.
Your main point //Only recently have I incorporated principles and ethics into my life. They are the new regulators of my behaviour, not my feelings. However, putting into practice principles and ethics to dictate my behaviour and ignore my ‘feelings on a matter or issue// intrigued me, as it involves an issue that’s been around (among addicts & in the addiction/recovery field) for some time. Is there necessarily a moral component to recovery? When one says ‘yes’ to this, one is saying (I think) that there was (has been) a moral failing, specifically in starting and continuing the behavior. This is a prime component of AA and related approaches.
There is obviously some truth to it, though of course some of the moral failings are consequent on the addiction–e.g. lying and stealing (for some cases). So to say, the person *becomes* a liar and a thief*, and he or she wasn’t that, before.
A purely medical approach, of course, in treating the ‘disease of addiction’ is NOT going to talk to the person about immoral or unprincipled choices.
I’m raising these matters because of an area I’m uncomfortably familiar with, namely sexual compulsions (do these amount to an addiction, according to your or Marc’s definitions?). There are some problems with so called ‘behavioral addictions’; it’s not so simple as giving up or ‘saying no’ to a substance. And the simple taking a substance (a whiskey, say) may not affect anyone else, or if it does, may not harm them (though the alcoholic pattern of living, does of course cause harm.). Sexual compulsions at first or second hand often do involve others. So, without going on about these things, it seems like a moral or ‘principled’ approach may well be especially important. Those parts of our minds that rationalize seem to have a problem with this, of course, and come up with variants of ‘just one little drink can’t hurt’, the classic alcoholic’s thought.
Thanks for the post. I think it takes particular courage to admit to being unprincipled, and even more to doing something about it.
Best,
nik, my first thought is that yes, there definitely is a moral / ethical degeneration that occurs with addiction … All the ‘drivers’ within a person turn towards one thing: the next fix. Thus come the lies, the evasions, the harm done …
Marc’s written a lot of thoughts about impulse control and how it breaks down in addiction …
It does take huge courage to admit to unprincipled behaviour, to acknowledge the harm we have done … and to surmount the shame, to *dare* to act differently when everything in us and in the people closest to us says ‘Yeah, right — *Sure* you’re going to change…’ — This is a huge leap, and a time of great vulnerability. Think of courage as shame’s antidote …
Jaliya, yes, no question about ‘moral degeneration’ as marking the more rampant addictions. But isn’t the question of wrong moral choices in pre addiction and early onset stage, a separate one?
Mightn’t the ‘moral degeneration’ of late stage addicts be a side effect? And if something’s a side effect, you don’t treat it (like the red spots of measles) as such, but deal with the underlying condition.
AA essentially says, pre existing character or spiritual defects lead one into alcoholism. This is what I’m unsure of. I’m sure of course that the person, *possibly* from familial abuse, had weaknesses and vulnerabilities; was given to foolish or short sighted choices, etc. One might say these are like the choices of a small child in front of a chocolate cake, which is supposed to be eaten, only later, at a sib’s birthday party– and in such case, *not moralize about them??
The word ‘moral’ is a loaded one, isn’t it … nik, you ask such excellent questions; they demand thought —
Marc suggests in his book that there is an intrinsic vulnerability in the human brain to addiction … and my thinking about the devolution in moral/ethical behaviour is that it is another symptom of the injury being done to the brain …
Like you, I feel unsure about AA’s belief about how addictions come about … queasy, actually. There’s more than enough shame already in a person who is addicted … and if there is a ‘defect’ already in place (playing ‘devil’s advocate’ here), why bother even trying to repair the damage? –> the language makes me think of a religious doctrine known as ‘original sin’ …
Marc’s writing has been so helpful to me because of how clearly he describes brain science … He writes without judgment, of himself or anyone else … and all this conversation in the blog, all these questions being asked … Our understanding of addiction can only evolve from here 🙂
Jaliya, Your posts are always sparkling with insight and warmth. See below, where I also get into the issue or morality — whether and why we need it when fighting to stay in control, and how, as you say, it tends to leak out with injury to the brain. It’s funny: while that phrase contradicts the facts (as I see them) about the brain and addiction, it captures the flavour of it just so. This seems a mini-version of the sway of the disease model, the way it attracts and compels us, despite its seeming inaccuracies.
As I shift more into being a writer and less an active researcher, I also find that the language itself starts to morph: words become vehicles for insight rather than building blocks of logic.
Beautiful phrase, that ‘words become vehicles for insight’ …
Re: injury to the brain … I see injury as something different from illness (and now comes the challenge to discern exactly what that difference is) … When substance use degenerates into substance abuse, injury becomes evident … the substance itself is the vehicle of injury over time … I believe that illness is, in part, an eventual, inevitable (?) consequence of overwhelm — whether it be by ingested substance, by unhealed injury, or by other detours of disaster —
Nik, You said just what I was trying to say (see below) in response to Jaliya. You say chocolate cake, I say marshmallows. But where could you ever draw the line, between the innocent flaws of the “child” in the grip of temptation and the moral degeneration of the late-stage addict?
It seems that individual personality traits are just variants of human traits, including attraction to pleasure or relief, and the internal battleground where that attraction is held in check. That’s my problem: there must be a line, or zone, or demarcation point, or a jumping-off point. Addicts do really horrible things, well beyond the desperate lunge for a marshmallow. But where the hell do you draw the line?
Thanks, Jaliya, for saying the rest of what I meant to say (should have said? see below). The dissipation of will, or self-control, and of any sort of superordinate value system, all go together with ego fatigue. What George Ainslie beautifully described as the Breakdown of Will (in a book with that name). When the dACC can’t take the strain, because it’s been working too hard for too long, ON-LINE, trying to control that barrage of impulses with an ever-dwindling supply of GABA, it gives up its hold on principles as well as practices, ethics as well actions.
But do we condemn the self-serving “id” that rises in its place? We are certainly tempted to. Freud might have tried to avoid laying blame, but there is a potent stream of moralism flowing through his writings. Freud, the Victorian, guilt-ridden Jew, who saw with such clarity the conflict in all of us. Even he had to bow his head to a Higher Power — the Superego. (would he have benefited from a Viennese chapter of Coke-heads Anonymous?) His writings, brilliant as they were, amount to a dressed up story of how guilt is unavoidable.
So, let’s take the other tack. Let’s remember that the ORIGINAL SIN of giving into our impulses, and paving it over with fakery, goes back, not to infant sexuality or any other inherent aberration, but to the tortured little kids in Mischel’s Marshmallow Test! (http://www.youtube.com/watch?v=QX_oy9614HQ)
Hello Mick and Nik. Does the rhyme give you extra points? You don’t need any. What a heart-rending couplet of — what should I call them? — disclosures? Both of you are dealing with the MORAL aspects of addiction and self-deception in great depth. Mick says: ” [I] Even justified some behaviour, which in retrospect highlights how unethical I was.” Which is the introduction to a detailed disclosure of ongoing dishonesty toward self and others.
I’m not sure what you see as the most unethical facet of your past life. I don’t think it’s the harm you caused others, or even the self-deception, which you seem to feel was foolish and immature more than anything else. Rather, it seems to be the duplicity or fraudulence of parading one set of values for others to see and living by a completely different set of values — or none at all.
It was like that for me too. Although I didn’t use my “fake” values to deliberately defeat others. It sounds like you may have done just that, but it also sounds like that sort of domination is built into your line of work. So you were partly a “victim” of context. I stole drugs from medical centers at night, and then went to work as a psychologist-in-training by day. I felt so utterly fake. Look at me, The Psychologist. I can help you examine yourself and find what’s really there. I can EVALUATE you. That was the crux of it. To assume the privilege and prestige to evaluate others’ psychological health, to sign my name at the end of the assessment report as though it actually signified some sort of authority, when in fact I could not look at my face in the mirror, couldn’t look at the face of my wife, whom I lied to weekly, almost daily…when I was so hopelessly out of control that I had in fact given up on evaluating myself. Yup, pretty heinous, wouldn’t you agree?
And yet, and yet…the ferocity with which you condemn yourself — your former self — I wonder if it’s necessary. That ferocity strikes me as some cleansed version of the moral crusader….still a crusader? You sound like indeed you are taking full responsibility, finally. Which indeed IS a foundation of growing up. And I love the way you talk about principles and values as a means of self-regulation. I don’t think I’ve ever heard it said so powerfully and transparently. So….I congratulate you.
But as you continue to grow through this phase of relentless self-examination and almost brutal self-honesty, I imagine you will also start to forgive the person you were. After all, that person did not intend to be that person. And that person now grows into this person — the present you — so he is not all bad. Just very stuck, aggressively lashing back, with defensive aggression, using your rationalization and justification skills and outright deluding of self and others…as a shield…to protect the helplessness within you.
Nik, you continue with the theme of a “moral failing” but you examine it in a slightly different way. You note that this is the basis of the AA approach, and you also note that a purely medical model does away with the entire notion. Can one fail morally in catching a disease? This question is sometimes asked with regard to lung cancer following years of smoking, or syphilis following years of you know what. Shouldn’t you have known better? Shouldn’t you have acted better? But no, by virtue of being completely helpless when ravaged by a disease, your case is dismissed. You’re off the hook.
Then you go on to tell us briefly of your sexual compulsions, but here your moral lens is focused almost entirely on harm to others. Here, I think you depart from Mick, at least in terms of emphasis, but then you rejoin him when you imply that a “moral or principled” approach is a worthwhile and productive solution.
On the weekend, I took my young sons into a very old cathedral in Maastricht. We were just sight-seeing, not worshipping. But the boys were delighted when I bought them each a candle to light, to add to the cluster of candles placed by….a cluster of sinners? My boys were not sinners (at least not in my eyes!) and we are not Christian. Yet there was a palpable sense of dignity and devotion in that moment — which they felt, and which I assume was felt, and much more finely evaluated, by the others in the church. The Church had certainly perfected the accoutrements of abiding by an architecture of values, honed through the years: a stone floor made smooth by the shuffling of generations.
Morality, moral principles, were invented by humans to control their behaviour. They work. If they didn’t, they’d have faded out a long time ago. I think you should indeed use these powerful tools if they are working for you. But be a little bit leery of the immense force of CONDEMNATION that can go with them. I would like to believe, in fact I usually do believe, that we can use morality and moral principles to control our actions without the looming threat of self-condemnation. And this is based on a different but related axiom: do no harm — not even to yourself, and not even in retrospect, through excessive guilt and regret. Forgiving yourself and caring for others…these are not so very different.
Hi Guys
Just want to qualify the rationale behind incorporating principles. For years, Psychologist and psychiatrist have agreed that early childhood trauma affects ones adult life and indeed ability to cope with or succeed in ones goals. Like many, I was told at an early age I was no good, had a bad nature and was just like my father (whom my mother likened to Satan) Not the negative enforcement a child should be subjected to. So by my teen years. The ‘programming’ from my parents’, mother especially was running full speed. An older man whom spotted me as a victim introduced me to alcohol. Got me drunk and sexually abused me. That was, at the time the final proof I was no good. I could not see a future for myself. At all. The booze was for me at that point the magic bullet. I felt good. Found others who drank as I did. Ran with a rough crew. In the back of my mind, I knew I was not like them and had no desire to cause problems for society with my behaviour. However when the alcohol was added to my body. I felt confident, at ease, a rebel without a clue. Live for the day. The only thoughts of future success and happiness were present when I was intoxicated. I did not belong in that world; however, I was certain I did not have the capability to cross over into mainstream society. Catch 22. By 26, I was burnt out. I would have seizures from alcohol withdrawal. There was no relief just constant anxiety. Suicide was out of the question, as I believed I was such a bad person I would go straight to hell. Therefore, I went to detox and then rehab. Rehab was almost like being part of an order of monks. It was easy to be honest, kind. Especially given I could relate to my fellow ‘monks’ tales of self-destruction. I felt like I was not the only one who had been so bad. Further, I was made aware that with the majority of bad things I did there was a barrel of booze in my system. This was an AA, Abstinence based program. I realise there are many schools of thought on this as an effective or helpful model for recovery. Having said that I have yet to see an alcohol become a social drinker. I have witnessed ppl with 5 10 20 yeras sobriety pick up a drink and within weeks are all but destroyed. I don’t plan to risk the return to that misery for a few beers.. It has been my experience that addicts are in search of one thing. Peace of mind. The ability to sit in a lounge chair and not have the brain in overdrive..Worse still ruminating upon their past misdeeds. I have discovered there are two types of self-esteem. That of which is innate. (most addicts lack) and that provided by validation from others.
My greatest achievements were when I worked with a team of people who knew nothing of my past, accepted, and liked me for myself. That seemed to stop the software program ‘ Michael is no good’ from running.
However when alone for protracted periods. The worst was becoming self employed, that external validation ceased and the old negative self-belief system re booted. Intellectually I know what was said to me during my childhood was a lie. Who made them the expert? Hitler was a bad person, am I as bad as he was? Or is having a bad nature an analogue sliding scale? No matter what I still self sabotage and have taken professional jobs that caused such a conflict within my head that I would walk around during lunch in my suit in terror that someone would realise I was a fake. Fortunately, I realised that society is not made up of perfect people and can now operate and push myself beyond the glass ceiling bestowed upon me as a child. Maintaining that self-belief and resolve is the hard part.
I agree that the AA model is one that motivates one to change via their guilt from the past and GOD ‘as they understand him” That to me was a ticket to create my own God who was more progressive. Not so concerned about sleeping around or ‘white lies’..That was for the simple folk 5000 years ago. Not surprisingly, my bible became thinner and ended up as a pamphlet that said, As long as you’re not hurting anyone. It’s all cool. I do not believe one can work with shame. Guilt however gives you the result of an action (for those with a conscience) therefore is a good motivator to avoid repeating the behaviour. I was not regulate as a child as from my mother’s perspective no point. . Born bad, will die bad. I refute those comments that scarred my spirit and continue to work on removing the software from my head that says otherwise. Any suggestions are most welcome..Thanks Michael
Heh… Well, it’s small potatoes in terms of substance sexiness, but I did kick smoking in January. 😀 And you know I’m always up for an excuse to gab with you. 🙂
Congratulations, Sir! Does this mean no more fresh air, or can we find other excuses to step outside? I’d love to gab more. Send me an email and let me know how you’re doing….beside having improved your aroma.
Smoking is NO SMALL POTATOES !!! CONGRATULATIONS !!
Well all I can say is: I sure do want to see this proposal 🙂 I’m not sure that all these camps are necessarily mutually exclusive. What IS the ‘choice camp’? The ‘just say no’ model? Well that’s great for the people it works for…. Like I’ve always said about Lamaze breathing for ‘easing’ childbirth: Well it works right up until it hurts too much
The ‘disease’ model infiltrates the language of 12-step recovery but it is, in that context, really a metaphor. The language pre-dates most of the scientific research. Worth looking into what it meant when originally ‘coined’ . Not sure whether it was by Bill W. and Dr. Bob in the Oxford Group and early AA or whether they were already drawing from something else, but it sure didn’t mean then what it means now. Seems like those seeking to improve treatment for addicts and alcoholics picked up on metaphorical/spiritual language and tried to prove it true biologically/genetically/scientifically– at least that’s my cavalier hypothesis. I always resonate with the definition of it I heard from someone in recovery: meaning not disease as in malaria or diabetes but rather the psychological state of “dis-ease’, an essential uncomfortability with one’s self in the world, or with the slow humdrum of life on life’s terms, social anxiety plus a seeming inability to be peaceful and happy with the simple pleasures other people seem to find peace and happiness in, which substances initially work to soothe. That is what ‘dis-ease’ means to me, and the scientific ‘model’ of it came later.
xo
Hi Lisa! You’re quite right that the disease concept came well before all the attempts to fine-tune the definition, hold it up to the light of “science” and win the political controversy, the warring definitional debates, each with its own set of implications. I was just reading Art Pepper’s “Straight Life” — what a horribly scary story, about heroin addiction among jazz musicians in the early fifties. At that time, addiction was considered no more or less than an evil, almost satanic influence, that crept insidiously into people’s lives and took over their souls. Surely the “disease” idea provided a welcome relief from that terrible branding.
You’ll see by my subsequent posts (especially the one published on June 8th) that I’ve changed my tune about the definitional wars. I now agree with you that these models are not necessarily mutually exclusive. But maybe that’s because each is a different lens on the same thing — the runaway growth of a learning process. I’ve even started to think that these metaphors provide very useful perspectives that a “purely scientific” account cannot. Well, isn’t that what metaphors are for? To provide perspectives that aren’t obvious?
Still, some of their value does come from their divergence. I’ve been fascinated for quite a while by the fundamental disparity between the “disease” and “choice” models. The “choice people” are not so dumb as to provide “Just say no!” as the answer. That sounds like the pet creation of some advertising agency hired by the DEA for its most recent version of the War on Drugs. The best glimpse into the “choice” model is in Gene Heyman’s book, Addiction: A Disorder of Choice. Here’s the link: http://geneheyman.com/books.htm
I took issue with Heyman in a little scholarly warfare. I wrote a critical essay review of his book, which was published in Perspectives on Psychological Science in 2011. In the concluding paragraph, I say:
“Based on the temporal properties of dopamine-induced craving and the neural changes that result from repeated dopamine enhancement, addiction and abstention are not choices made freely and flexibly.” I then go on to argue that this doesn’t make addiction a “disease” either.
My overall claim in this piece is that you just can’t ignore the brain when you’re talking about addiction, even if you do focus on its more deliberate, conscious aspects. And that’s because processes of desire, goal pursuit, and self-control are NOT simple. They’re not simple at the best of times. CHOICE isn’t simple at the best of times. My wife and I seem to get into arguments most easily when deciding which route to take when driving from town A to town B. Choice is NEVER unbiased. There are always proclivities, histories, associations, hidden motives, bound up in WHETHER to do one thing or the other. And if the choice involves getting high, then these factors are strongly coloured by emotion, which can be accurately explained only by linking psychology with neuroscience.
So, anyway, for me it is important to consider the brain no matter which model you prefer. Thus, I see neuroscience as necessary in order to map out the terrain in detail. But then again, I’m a neuroscientist.
I like science in general. I think it helps us understand ourselves and our world. Yes, it comes later than the metaphors; I think that’s always the case. Science comes along after “obvious” interpretations (e.g., the world is flat, men are smarter than women) run their course. We look up and say: that seems right but it’s not. Addiction isn’t about good and evil, or illness and health; it’s about how biological tissue creates and constrains thought, feeling and behaviour, especially when we try to acquire something we seem to need so badly.
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Just want to qualify the rationale behind incorporating principles. For years, Psychologist and psychiatrist have agreed that early childhood trauma affects ones adult life and indeed ability to cope with or succeed in ones goals. Like many, I was told at an early age I was no good, had a bad nature and was just like my father (whom my mother likened to Satan) Not the negative enforcement a child should be subjected to. So by my teen years. The ‘programming’ from my parents’, mother especially was running full speed. An older man whom spotted me as a victim introduced me to alcohol. Got me drunk and sexually abused me. That was, at the time the final proof I was no good. I could not see a future for myself. At all. The booze was for me at that point the magic bullet. I felt good. Found others who drank as I did. Ran with a rough crew. In the back of my mind, I knew I was not like them and had no desire to cause problems for society with my behaviour. However when the alcohol was added to my body. I felt confident, at ease, a rebel without a clue. Live for the day. The only thoughts of future success and happiness were present only when I was intoxicated. I did not belong in that world; however, I was certain I did not have the capability to cross over into mainstream society. Catch 22. By 26, I was burnt out. I would have seizures from alcohol withdrawal. There was no relief just constant anxiety. Suicide was out of the question, as I believed I was such a bad person I would go straight to hell. Therefore, I went to detox and then rehab. Rehab was almost like being part of an order of monks. It was easy to be honest, kind. Especially given I could relate to my fellow ‘monks’ tales of self-destruction. I felt like I was not the only one who had been so bad. Further, I was made aware that with the majority of bad things I did there was a barrel of booze in my system. This was an AA, Abstinence based program. I realise there are many schools of thought on this as an effective or helpful model for recovery. Having said that I have yet to see an alcohol become a social drinker. I have witnessed ppl with 5 10 20 yeras sobriety pick up a drink and within weeks are all but destroyed. I don’t plan to risk the return to that misery for a few beers.. It has been my experience that addicts are in search of one thing. Peace of mind. The ability to sit in a lounge chair and not have the brain in overdrive..Worse still ruminating upon their past misdeeds. I have discovered there are two types of self-esteem. That of which is innate. (most addicts lack) and that provided by validation from others.
My greatest achievements were when I worked with a team of people who knew nothing of my past, accepted, and liked me for myself. That seemed to stop the software program ‘ Michael is no good’ from running.
However when alone for protracted periods. The worst was becoming self employed, that external validation ceased and the old negative self-belief system re booted. Intellectually I know what was said to me during my childhood was a lie. Who made them the expert? Hitler was a bad person, am I as bad as he was? Or is having a bad nature an analogue sliding scale? No matter what I still self sabotage and have taken professional jobs that caused such a conflict within my head that I would walk around during lunch in my suit in terror that someone would realise I was a fake. Fortunately, I realised that society is not made up of perfect people and can now operate and push myself beyond the glass ceiling bestowed upon me as a child. Maintaining that self-belief and resolve is the hard part.
I agree that the AA model is one that motivates one to change via their guilt from the past and GOD ‘as they understand him” That to me was a ticket to create my own God who was more progressive. Not so concerned about sleeping around or ‘white lies’..That was for the simple folk 5000 yeras ago. Not surprisingly, my bible became thinner and ended up as a pamphlet that said, As long as you’re not hurting anyone. It’s all cool. I do not believe one can work with shame. Guilt however gives you the result of an action (for those with a conscience) therefore is a good motivator to avoid repeating the behaviour. I was not regulate as a child as from my mother’s perspective no point. . Born bad, will die bad. I refute those comments that scarred my spirit and continue to work on removing the software from my head that says otherwise. Any suggestions are most welcome..Thanks Michael
Id be interested in talking
hi
5, nearly 6 months in recovery from painkiller addiction. Still dealing with the underlying issues which lead to the addiction so still very raw. Very successful and not the kind of person that anybody would expect to have an addiction. I’m interested.
Nobody’s exempt. And you exemplify why the “kind of person” argument isn’t useful. Good luck. You can do it! By the time I was six months clean, the rest was relatively painless. But you know how much more pain you’re going to feel if you start again. Nobody’s exempt.
I am extremely interested in speaking with you. Addicted since 1992. While I have functioned at high levels for most of my addiction, I have been unable to stay clean for more than six weeks.
jacqueline,
That’s a fine post, and gets to the heart of the problem. High level functioning or islands of it, does exist for some labelled (or self labelled) “addicts”, though of course the shrinks and AA persons say this is not possible.
I think it’s important to build on those islands, not seek to undermine or submerge them. What I’m referring to is the issue of ‘hitting bottom’ as well as that of ‘underlying global character defect.’ I just don’t think there always is such a defect; I don’t think it’s necessary to say, “these islands–or even continents like Australia–are illusory
I think too that persons like yourself deserve immense credit; there is no need or justification for saying, “you’ll wake up to the truth about yourself,” i.e. suggesting that progress in better living depends on some global self-indictment.
Thanks for that post and its stimulating ideas.
Jacqueline, we can communicate via this blog, or else you can reach me by sending a note through the Contact field, linked at the top of this page. You’ve been at it for a long time. It might seem a strange question, but why do you want to quit?
Hello,
Great blog and I look forward to reading your book. I’m a 50-year old female recovering addict who has variously been addicted to alcohol, cocaine, marijuana, and ativan. I was clean and sober from 1988-1994 and have only recently gotten out from under again, but I’m sure this is the last time. Like Donnie Mac, I feel that in the long run my involvement with AA was detrimental to not only my recovery but my mental health.
I do believe addiction is a disease much comparable to diabetes. One can be born with it or a strong propensity for it, or one can drink or use themselves into it. It makes sense to me, but I also know other things make sense for others and it’s not necessary to believe any certain way to get free.
I intend to spend the rest of my life doing whatever I can to assure that when people are ready to get sober, there are more choices of recovery models than AA.
I also write a blog and you’re going on my blogroll. Thanks!
Hi Angela,
Nice post. Just to further the discussion. You said,
//I do believe addiction is a disease much comparable to diabetes. One can be born with it or a strong propensity for it, or one can drink or use themselves into it. It makes sense to me, but I also know other things make sense for others and it’s not necessary to believe any certain way to get free.//
It occurs to me that if ‘addiction’ (e.g. to alcohol) is analogous to diabetes as, in some way, ‘a disease’ then the moral approach would seem to be misguided. True some (potential) diabetics ate poorly and brought on the disease. But would we say their choice was *immoral*? Perhaps misguided,
or even foolish. One might say the choice was ‘ultimately self harming,’ and maybe *that’s* immoral? I don’t know. I don’t think we’d use the term Michael, above, applied to himself “unprincipled,” though it may have been without much forethought.
This seems to be crucial in the discussion of 12-Step programs and their ilk. Their basis is alleged immorality; [moral] defects of character, lack of spiritual principles, etc. I think there’s something to the approach, but I see matters as complex. And it’s certainly clear, as some posters have indicated or illustrated that the feeling “I’ve done something wrong; to be ashamed of” is a double edged sword, at the extremes leading either to resolute recovery or suicide (perhaps in the form of even greater abuse of the substance).
Thank YOU, Angela. I’ve been hearing a lot of negative feelings about AA lately. Since I never went myself, I can’t judge it from the inside, but it seems as harmful for some people as it does helpful for others.
I very much agree that addictions grow differently, feel different, and lend themselves to resolution differently, depending on people’s character, their environment, and their compilation of experience — all of which show up as differences in neural structure and neurotransmitter activity…
If you wish to share your blog address, please go ahead and send it. Sounds like it might be pretty relevant to what’s happening here.
Hello Angela , would love to read your blog . could you send me a link ?
i have 2.5 years clean off heroin. my addiction started in my 20s after graduating college with a degree in english. i went to a rehab, got out, used opiates again for ~ 2 months then quit for ~ 12 years, only opiates, not cannibus or alcohol. in that twelve years i obtained a degree in physics, went to graduate school for optics then got a job in aerospace that was really rewarding. three years into it i started to use again. i can’t exactly explain why. i spent 3 years out there, almost lost everything. in 2009 started subs and going to NA.
Hi Kim, This is a sad story, but not that unusual. It’s hard to explain why people suddenly start using again, especially when life is going well. This is one of the most perplexing questions.
My hunch is that a) the aversiveness appraisal goes down with time and b) there is something that reminds us of the original loneliness that got us using in the first place. So….then we feel “why not?” and the rest is history, as they say.
Good luck, and thanks for sharing.
I’d be very interested in talking to you about the self-medicating model of addiction. i have a long history, beginning at 12, using first alcohol and then drugs to damp down trauma, which kept repeating itself until i went into therapy.
yes therapy!
i do not subscribe to an across the board demand to attend AA or use their steps, although very lifesaving to so many. i have some views on the AA model and trauma survivors.
marie
Nik,
I don’t think addiction is due to moral failing although it does cause us to act against our values. I think AA works very well for a specific personality type – the type that Bill Wilson and Dr. Bob apparently were and I think it works less well or not at all for other personality types. I’ve had long involvement with a secular organization for sobriety so I personally know a lot of people who have gotten sober with no higher power and no steps. As for myself, I’m using Charlotte Kasl’s 16-step model because it fits with my worldview and my personality type. Oh, and I don’t drink or use no matter what. Thanks for your comment.
Angela,
That’s great to hear and I was moved to look up the 16 steps. They seem like a welcome revision and elaboration of the 12, and deal with what a number of people have noted as a problem, *besides* the God or higher power problem: excessive negativity (focusing on and delving into shame, guilt, and character defect) and apparent lack of attention to building self worth.
I think that in recovery, those who’ve succeeded have found a positive focus and self worth, and this *can* happen in 12 step programs; maybe indeed it’s a way healthy living happens in those programs (and their derivatives, like Minnesota) *despite* these programs! This is not unlike the ‘therapy’ problem. Depending on the person and her therapy, I think it’s fair to suggest that some people have ‘gotten better’ or past their problems; learned to live better *despite* their therapy.
That’s a very good point. Since we know that spontaneous recovery is quite common, then why shouldn’t it occur independently of any form of therapy. It could be helped or hindered by the focus of the therapy, and its “match” as you two have discussed. But if you happened to get clean anyway, and you happened to be in therapy, there’s little doubt that the therapist (especially AA!) would take credit for it.
That’s sort of like superstitious conditioning. You step on an ant, it starts to rain, and from then on you figure that ants and rain are linked.
I am interested, and would love to speak with you, if you yourself are interested. My route was prescription opiates for medical reasons, which led very quickly to me being thrown into the entire 12 step treatment industry. Oddly enough, I started using them more and ended up in sort of a war between the 12 step folks and the neurologists who were trying to treat me (I’d had a dreadful nerve injury in my face). Luckily, I the nerve injury healed, but I didn’t get better myself from the addiction until I took the reins completely and cast myself out, as it were. I was in terrible shape, one of the worst case scenarios that is talked about (despite not having progressed to other drugs), yet once I took control I’ve had not so much as a single craving. I’ve even been prescribed my former DOC once, and it didn’t phase me. I think I did the exact opposite of everything I was told “in recovery”, and somehow ended up a very happy, clean and successful person!
This is indeed a fascinating story. A little different from most, but that’s what makes it most interesting. Please do send me an email. Use the “contact” link on this website. And then we could talk about your story in more detail.
At this point, I thank you for sharing it with our readers. It’s helpful to know all the odd combinations and trajectories that recovery can assume.
Marc,
I’d be interested in speaking with you. I’ve struggled on and off with alcohol. My biggest beef with the rehab system was forcing people into AA without ever addressing underlying psychological issues.
I was also raised in an LDS household (Mormon). The similarities between AA and Mormonism, which I rejected, are shocking.
There’s a prophet, Bill W. and Joseph Smith. Both groups have their own add-on to the bible, The Big Book and the Book of Mormon. Both men claim to have had divine experiences they need to share with mankind. And they both had an eye for the ladies.
These similarities were just one reason I struggled with AA and its moralistic take on addiction. That and I’ve seen way harder core drunks than myself return to moderation, but this point is denied by any mainstream addiction types.
Anyway, that’s a bit of my story. Thanks for your honesty. I’ll be picking up your book this week.
Cheers,
Steve E>
I’ve come to think that each person’s path out of addiction is as singular as his/her path into it … A gift I have received from the AA model is one seemingly small lifesaver –> the phrase, “One Day at a Time.” Sometimes it’s one minute … one thought … one breath at a time. I’ve been learning to incorporate that phrase, giving my brain and mind new habits, new options …
I wonder about carving out new habits (because we are, as the saying goes, creatures of habit) … Perhaps some of our healing comes in ‘resetting the autopilot’ — working to recalibrate our instinctive reactivity, one step at a time. It really is daily work …
Moderation … someone once said to me with a small, bittersweet smile, ‘Moderation in all things, yes … and for some, moderation means *none*.’
Re: the massive success of AA — how was it that this particular model “stuck” so firmly into the culture and the time that it emerged from?
You’ve contributed two very interesting phrases. What’s most amazing to me is that people often take what they need from whatever therapy they’re engaged in. But isn’t that like life, after all?
Hi Steve. We’ve gotten a lot of negative comments about AA on this blog, so I’m not too surprised by your experience. But you sure do cast in in a new light. Very informative!
I’ve never thought too much about the religiosity of AA, but it makes sense. It’s hard to assume a single “right” course without a religious slant, and it’s hard to be religious unless you do assume a single “right” course. Unless maybe you’re a Buddhist or Hindu. Anyway…it sure does make sense now. Thanks for your insight. .
Steve , I had a friend who was heavily involved in he Jehovah Witness church , he to said the similarity between that and A.A were astounding .
Hi Mark my name is Kerryn ans I am 38 well 39 on Sunday. I have always wanted to tell my story but could never find the words. As you can imagine its a long story lasting almost 26 years now, but I will give you the short version of events rather than going into detail.
When I was 12 cigarettes
When I was 13 marajuana
When I was 14 steal mums serapax and accidently overdosed
When I was 15 amphetamines and 3 months in started IVing it
left home
When I was 16 I hitch hiked from “Victoria Australia to the Queensland Gold Coast alone where I became a prostitute being young made alot of money. But as I couldn’t get speed I soon turned to IVing heroin. After 8months I decided to hitch back to Vic.
The truck driver I thought seemed a nice old fella and he had his 14yo son with him. On the way back in the wilderness somewhere he pulled over in the dark. At first I thought nothing of it and then he told his son to wait by the back tyre until he called him. After I watched him get out of the truck I turned to look at the driver and he had a big knife, he held it to my throat and raped me. Afterwards we all pretended nothing happened. The next day he said he wanted to call into his house. It was somewhere in NSW in the middle of nowhere. He kept me there for 3 days in a cat and mouse game that had me wondering the whole time if he was going to murder me. I made him think I was his friend and liked him and eventually talked him into letting me go.
At 17 I was drugged by bikers and when I woke found I was in someones bedroom with 8 guys who had obviously had sex with me.
After that I went home and told my mum I had been raped and she said I deserved it. After that I hit the speed big time and always the marajuana too
At 19 drug rehad and caved in hours after release and contiued until I was 23 40kgs and very tired and depressed. I quit the speed and kept my marajuana. During those years I worked at a few Melbourne brothels and hid my drug use well. They were classy places and to be honest I enjoyed the job most of the time. I was detatched where there is any feeling with sex anyway after the rape.
I always enjoyed the company of men and was as curious about sex as I was drugs. I went to high rise motels for sex parties with up to 15 other people and lots of drugs were there too.
After I quit I started to study agriculture and have worked on lots of farms mustering cattle with horses and general farm stock hand work
At 26 gave the pot away
I am now married to a farmer and agricultural contract since 2002 who has never used any drug except acohol in his life.
When I got pregnant found out I had hepc
2008 7mths treatment ribivirn and interfuron and personally suffered horrendous headaches. I then began Oxynorm and oxycontin addction that spun out of control and before I knew it was taking 80mg of oxycontin and 160 to 200 mgs of oxynorm and of course my pot..
I have been also on antidepressants valium temazapam phenergan restavit panadine forte on and off for years last year I had a oxy relapse again and the last 6 weeks started doing meth snorting. I know I got to stop before I slide again and I cant afford to again. I have spoken to my gp about attending a phyciatric ward. My husband doesnt know about the meth and I cant tell him at the moment. He can’t understand why I relapse and I guess neither did I.
My husband heard you being interviewed on the abc last week here in Australia and told me about your book which I intend to purchase. I think I have some damage. Before I was 14 I did very well at school and in Grade 5 started advanced maths and I found school easy and boring. And believe it or not managed to pass year 12 during all those crazy years.
When I went back at 23 I found the classroom situation alot harder. Just consentrating for long periods was difficult. My mind drifts off and I get sleepy. My memory is not the same especially short term. I get alot of migraines in the last 10 years. And I am sensitive to loud noise and bright light. I have suffered terrible depression and been suicidal. I have seen countless psychologists and phychiatrists. One in particular when I was 23 saved me by letting me unlease all the pain of my teenage years.
My parents, and husband take it so personally when I relapse that I hate telling them. They all dont understand how I could use again after all these years and risk my young family. I don;t understand it either.
I know I use to get relief from my depression, it eases the pain in me. When I am straight I walk around like I am either dead inside or I feel a pain in me like when someone dies or your soul mate walks out on you. I only feel pleasure when I use and a life without it is unbearable.
My Hepc treatment failed and I reckon even tho I am geno type 3. I have extreme fatigue.
Theres heaps I left out and in some ways I regret it all but in another it made me who I am today and damn it I did have some awesome fun along the way.
Wow, what a story!!! I am sitting here in a minor paroxysm just imagining what you went through. There is so much I could say in reply, but perhaps nothing that would be of much help.
You sound like the epitome of addiction — psychological addiction. Like I was. I understand that that’s why you relapse, but your family doesn’t. They think it has something to do with the outside world, the world they live in. But we who’ve been there understand the connection between addiction and depression, and the tiny events that can bring it back without warning. And how little it has to do with our primary relationships, at least most of the time.
I also know what you mean about regret vs. some kind of satisfaction. It is the life you lived, there was no other, and so I think it’s sort of brave and important to not regret where you’ve been. But that doesn’t mean you can’t or won’t change it. You’ve got a lot of years left, at least we hope so. (I had Hep C too, but I got lucky, and most people live with it for a very long time). I’m wondering what would happen if you chose to be really really honest with your husband. The loneliness of not being able to talk about it can greatly augment the depression. And, if you can get past his initial reactions, you could maybe set up a sounding board that could be useful to you in a number of ways. Please give him my regards. I have fond memories of Australia.
Thanks for sharing this searing tale…and I truly do wish you good luck!
I
I have not met many people in rehabs (and I have been through 6 inpatient and 2 outpatient programs) with a story like mine. I did not become seriously addicted to the drug of my choice until I was 40 years old; although I believe I was developing an addictive personality from a very early age. I was brought up in a upper middle class home in the suburbs of Chicago. My father owned a family business (a relative of mine invented the casket lowering device and the business made other metal products used in cemeteries and we bottled embalming fluid, among other things). My father was basically an absent father who did not provide much guidance, intellectual or spiritual stimulation, or discipline of any consistent kind. He basically brought home a check and let my mother run the family. My mother was hypercritical, shaming and not real affectionate. None of us four siblings have fond and warm feelings for either of our parents. I am the youngest. I have a brother 4 years older than me, a sister 7 years older than me and another brother 10 years older. My father was a functional alcoholic and I never saw my mother drink much at all. The two older siblings took on the responsible roles in the family while my brother and I kind of did our own things. All 3 of the males have had problems with alcohol. I believe this brief sketch of my family history set the stage for my developing the addictive personality that I still battle with today.
I became addicted to sports in my youth, because I had a talent for it, and then became addicted to various forms of spirituality, philosophy, religion and theology. I am more introverted than extroverted so I found I was much more comfortable with others when I started drinking in my early teens. I always found it difficult to have healthy relationships and started getting into lots of conflicts with friends and associates. This became more pronounced as I started drinking more frequently and experimented with marijuana during my high school years.
I had a religious experience the summer after I graduated from high school and began voraciouly devouring books on philosophy, classic literature and theology. I was bound and determined to try to answer all the big questions about life. I spent the next five years studying liberal arts at a small college in Traverse City, Michigan and attending church on a regular basis. I quit alcohol and any mood altering substances for the next 20 years. I got married and had 5 kids during this time. My marriage started going bad in my mid 30’s and I started frequenting topless bars as I was driving throughout the state of MIchigan selling funeral and cemetery products for our family business. This got me drinking again, and causing guilt problems with my-ex wife and people at the church I had gotten close to. This led to my eventual divorce. I also should mention that I went back to school and got my business degree while I was selling for the family business. This took me a good 4 years to complete while working.
This is getting too long but I think anyone who is an addict can imagine the progression I went through after my divorce and then having my father die and then my two brothers and I working in a family business that already was dysfunctional to begin with. We were making good money at the time when I was going through the divorce which occured about the same time as my dad died. My two brothers and I got into serious conflicts about the business when he died which is still going on today.
This is the backround for what happened in the next 14 years where my addiction escalated out of control with other substances beside alcohol becoming the predominant drugs of choice. It was during this time that I went through the 6 in-patient programs and 2 outpatient programs. I have basically ruined my life along with the lives of my 5 kids and ex-wife. Along with the 3 relationships I have been through with other females. One got really bad that I was in for 4 years- she was a prescription drug addict herself. She tried and almost did destroy me. She knew cops, lawyers, judges, et cetera (and had lots of money to blow) and really caused a lot of havoc for everyone in my family and the family business.
Of course, this has made it difficult for my brother to trust me to hire me again at the family business and it has made it difficult for me to find a job. That is a short version of my story. I could go on about the 14 years in my addiction and having guns to my head, etc but that would take way to long to go through. To say the least, I had to learn street smarts the hard way.
Another amazing tale of woe. The number of accounts I’ve received, both on the blog and quite a few more as emails to my contact address, must now be well above 50. It makes me sad and whimsical, also honoured that people are sharing their painful stories with me and with my readers.
John, your story is particularly heart-breaking. From your family life, it’s true, you could almost see it coming. People have focused a fair bit on trauma and abuse as precursors to addiction, but having an absent father and a cold mother is also a common forerunner. Maybe we should call it neglect. Or…a striving never satisfied.
Each of these stories is different, and therefore interesting for me to read and think about. But they also have a great deal in common, obviously. Not only the tragedy and waste, pain and disappointment, but also the weird gravity exerted by addiction on so many different kinds of lives. Thanks for sharing yours.
Would certainly be interested in participating in your survey. I “believe” in the learning or habit model. After 200 AA meetings, 6 mos. 12-step residential rehab, 18 months psychiatric treatment and 18 months consultation with a licensed addiction counselor I found sobriety when I put all that behind me and discovered the learned/habitual nature of the problem. To me, it seemed simple; if I learned this drinking habit I could just simply replace it with another healthy habit. Alcohol triggers many common neurotransmitters and it has food value. Eating triggers many of the same neurotransmitters. I replaced alcohol with milk which I’ve always loved. I started smoking more which keeps the dopamine high and I avoided all stress by becoming a recluse. Now I’m beginning to try and replace the nicotine but haven’t yet found the right replacement. I’m slowly less reclusive as I’ve found once the habit is broken stress management much easier.