Hi everyone. I haven’t been writing on the blog much lately. My book was released in the UK on July 14th, and that meant shooting off articles for various publications and giving talks and interviews. So I went to London two weeks ago. It’s still there, as colourful and overwhelming as ever. Despite Englands’ majority vote to leave the European union, London is the most multiethnic city imaginable. On ever street you hear a bubbling cauldron of accents and see faces of every colour and shape. What a city!
My trip was fabulous. The first day I was interviewed by The Times, and that night I gave a talk with Johann Hari as my host and interviewer. An interesting man…complex, smart, fun, and a bit darker than expected. The next day, an interview with BBC and another with The Guardian podcast. That night I talked to nearly 400 people — the most positive audience I’ve ever had. Waves of applause and even cheers. Felt like a rock star.
But the most interesting event of my trip was meeting a man named Colin Brewer. If you google him you’ll see that he’s a wild child in British psychiatry circles. Most recently he was villainized by the media for providing 
supportive assessments for people seeking assisted suicide in a Swiss clinic. The trouble was that they didn’t have terminal diseases, and that’s a no-no. Was this man a monster? He’d gotten in touch with me by email and came to one of my talks. When he showed up at the foot of the stage, I recognized his face from the internet, and he certainly looked…unusual.
That night at my hotel I googled him more thoroughly and found that the people he’d helped obtain assisted suicide were actually in big trouble. One was 90 years old and in severe, untreatable pain. Another was in his seventies, going blind, another had motor neuron disease, and yet another had Alzheimer’s. It turned out that Colin was motivated by empathy and a firm belief in people’s right to die with dignity. He was no monster.
So I accepted his invitation to come for a visit and arrived at his home a few days later. He lives in a beautiful house in the heart of London. He showed me around the antique-laden interior with evident pride, swelling a bit when I complimented the taste and beauty of his home. And then, equipped with home-made elderberry cordials, we sat and talked.
Colin’s trouble started when he used his own instincts and methods to treat addicts, beginning in the 80s. He prescribed methadone, as did other doctors — no problem. But he would also provide a couple of months’ supply of methadone to people who travelled a great deal and could not renew their prescription daily or weekly. He also prescribed heroin for those who needed it (while this was still legal in Britain) as well as generous supplies of benzos and other drugs for those withdrawing from opiates or alcohol. He even supplied do-it-yourself detox kits to people who could not afford residential care. Another well-intentioned though dissident policy. The press branded his practice a drug supermarket and he was struck off the medical register in 2006.
Colin was indeed a renegade who made up his own rules for dealing with addicts. In fact, like Percy Menzies, who wrote a guest post for this blog several months ago, Colin enthusiastically prescribed naltrexone for opiate addicts as well as disulfiram (Antabuse) for alcoholics. He firmly believed in giving addicts a time-out, a substance-free period for resetting their circuitry — and he brought their families into the act, so that they could help encourage their addicted loved one to stick with the program until they were in safer waters. Far from someone who took his patients’ plights too lightly, he seems to have functioned as a deeply concerned caregiver, who wanted above all to give addicts the freedom to transform their own lives.
We wasted no time discussing whether addiction was a disease or not. We both saw the classic disease model as a dead-end. Rather, we talked about the power of placebos, the extent to which addiction includes placebo-like effects — namely the belief that taking something has particular benefits, when the belief creates the benefits. Colin introduced me to a study showing that even physical withdrawal symptoms can follow sudden termination of a placebo believed to be an addictive drug. Fascinating!
But the most important idea I left with was Colin’s belief that overcoming addiction is like learning a second language: reframing, retraining, and thus rewiring synaptic networks. I guess I already knew that, but here’s the new punchline. The best way to learn a second language is through total immersion: avoiding going back to your native tongue for some period of time. The reason my Dutch is still so shitty is because I speak English most of the time. That’s sometimes called “controlled use” in addiction parlance.
I’ll end with a quote from an article written by Colin and a colleague. It makes it pretty clear why total abstinence — at least for a time — is so very helpful.
Relapse-prevention is an educational process. Learning to abstain from alcohol or opiates after years of dependence involves selectively suppressing old, maladaptive habits of thought and behaviour and establishing new, adaptive ones. This process resembles foreign language learning…. ‘Immersion’, the most effective foreign language teaching method, discourages students from using their first language…requiring them to use the foreign language instead, however inexpertly.
Colin Brewer & Emmanuel Streel. Substance Abuse, 2003, 24(3) 157-173.
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
It’s a great comparison. Language and substance use are both fundamental tools for coping and engaging with a complicated, scary world. Everybody has a different situation – a different language, dialect and idiolect. If I go to a place where no English is spoken, I will learn that language. If I go there for 2 weeks I will learn a lot, but any fluency will disappear shortly after returing home. If I go into rehab for 2 weeks, I will learn many tools for understanding and dealling with my addictive behavior, but no practice in context. There will be little development of my own dialect (in my own community) or idiolect (personal way I relate to the language, associations and behaviors that developed with it along the way.) I think the level at which language and addictive behaviors most resemble each other is at the level of personal control over one’s environment, and of making sense out of the world. The how and why; the pragmatic and the social uses of language. Achieving fluency takes time and practice. Communication and connection are key.
Hi Marc,
Very interesting thoughts. You could call it Positive Redirection. I know how overwhelming it felt when I heard the word “abstinence.” I thought to myself, “I have to quit drinking forever?”
Now, my choice to remain drug and alcohol free is a result of finding something that was more rewarding than my addiction to alcohol, and creating those new pathways that you talk about in your new book.
Essentially I mentally and physically redirected myself in a positive way and by having others support me in my new direction, or new “language” as you have been talking about, I was able to maintain motivation to continue my healthier lifestyle.
Positive Redirection, and Motivational Maintenance are key I think.
I think that thinking about myself and my addiction, the words “control” and “abstinence” were fightin’ words, however, if I changed my perception of what those words meant for me I became willing. And with willingness came motivation, and with motivation came complete abstinence for me because my addiction held no value anymore.
Those are very useful phrases, Jessica. I agree that the words “abstinence” and “control” are cold and authoritarian….at least they sound that way to me as well.
I like it
I believe we as humans have a right to live and a right to die when life has no value like living a bed and chair in assisted living just waiting for the inevitable in frustrating misery
We ought to have a choice as to how long we wish to put up with that .
Many physicians inspite of the social anathema will be helpful quietly in providing ways to that path for patients they know well .
As a college student I spent a semester in Berlin and was housed with a German family that spoke next to no English– talk about immersion .. I learned it fast and well and now many years later can speak it conversationally albeit rusty and if I visit Germany am back on track within a day
We at Smart Recovery have been wrestlling with the term ” abstinence” as being so permanent sounding – yet firmly believe that a period of total abstinence for a significant time is an important key to success . The problem remains what to call it ..time out doesnt do it for me
Thoughts ??
Hi, Bill
I totally agree because the abstinence isn’t what gets people to change their addictive behavior. It’s replacing the compelling, unhealthy behavior with a new healthy one. How about coming up with a unique word or neologism. “Replacemency, supplantence.” Something.
People don’t re-engage or “recover” if the compelling, addictive behavior isn’t replaced by another healthy one, in line with a person’s interests. That’s why opiate substitution like methadone or suboxone can be considered a successful recovery– not just harm reduction– if someone is able to get their life back. If they divert it or use it abusively, they haven’t changed the behavior.
Yes! I like “supplantenance”, a variant of your supplantence.
A mouthful, but I like it! Isn’t the productive morphology of the English language a beautiful thing?
Reframing time out? Everyone needs periodic time outs. A longer term time out to reframe ones life is time well spent.
MLP as far as I know is not considered effective for those still in denial
hi Terry
What’s MLP? Is that a typo for NLP (neurolinguistic programming)?
Funnily enough I’m also in Holland and I’m reading about “addiction” from a Dutch perspective. The central library in the Hague is extremely well equipped on many subject matters including substance use. I spend as much time on Dales dictionaries as anything else but I really enjoy spending a few hours a day improving language and understanding of substance use. Everything boils down to drug set and setting for me. This is not as simple a message to get across to policy makers though. Empathy comes through attempting to understand as much as possible by accessing practical experience and swotting on theory.
The Dutch word for addiction is “verslaving” — right? Which means slavery or enslavement. The Dutch are masters of practicality, and it sounds like you are immersed in that very thing…. Not sure if you are getting more practical being on Dutch soil, but there is something in the air here that helps me see things more clearly.
I thought controlled use was simply non-addictive use, like the way most people drink alcohol (or other substances). I didn’t know it was limited to addicts?
Or maybe I misunderstood what you’re saying.
Very interesting article, either way.
Matty, my understanding of controlled use is just use that one can control….but control isn’t an on-off switch. So addicts can often limit themselves to use at certain times, certain amounts, certain methods…without losing the attraction, cravings and other cognitive and emotional features that might identify them (to themselves or others) as “addicts.” Often that’s the best way when abstinence just isn’t working.
In the language analogy, my use of English (my addiction) is barely controlled. I break into English as soon as I get cues from people I’m talking to in Dutch that say Give it up, bud. Your Dutch sucks. So I say to myself, ok, why keep on trying? And I say the magic words: Mach ik engels spreken? (May I speak English?) and I’m off on another binge.
If I were to abstain from English completely, I’d suffer for a while, no doubt. But I’d learn Dutch a hell of a lot faster.
A percentage of people recall the addiction/recovery scenario differently.
Here is a different take on the Language Analogy. (in this analogy, the NEW TRANSLATOR DEVICE will be analogous to an ADDICTION.)
The New Translator Device made the finding of words and communication seem effortless. It became preferred, desired, and used all the time.
However, you discover you are dependent on it. Life without it was appearing to be too difficult without the new translator, and you began using it for everything.
Efforts to control or limit the new translator proved ineffective, and periods of abstaining from using it seemed like un-natural breaks from its daily need and use.
A sense of helpless dependence set in, but also some valuable and substantial REALIZATIONS were occurring too.
You realized that your traditional and natural abilities to translate had become eclipsed by this New Translator Device.
The New Translator Device was interrupting the natural “rapport” you originally had with yourself and life itself.
The struggle against it was traumatic and the outcome unknown, but the struggle produced other meaningful and valued realizations.
For many people, the re-discovered freedom itself changed ones perception of the results New Translator Device offered.
Some people end up choosing to not use the new translator at all… some choose to use it moderately…some tried re-using it and find they do not prefer the translations anymore… some feel the new translator will always be a draw and join supports groups that feel the same way, etc.
The Main points of this analogy are:
1) The new translator, (the addiction) was a NEW thing to a person’s life, so living without it is un-burdening yourself of something “new”.
2) It was the new translator, (or the addiction) that required the maintenance.
3) Choosing to not use the new translator is not due to weakness, it is because of the history one has had with it, much like the history one has an ex-spouse, lover, old school, town, career, etc.
Carlton, This is a really thought-provoking analogy, quite delightfully brilliant. I get a definite sense that your analogy targets a certain worldwide organization with a distinctly “automatic” approach to transforming one’s addiction into…what exactly?…into a lifelong relationship with the new translator device. A substitute addiction. I wonder if methadone maintenance can be viewed the same way. I’ll have to think about this some more, but thanks for such a creative perspective on the “middle ground” between addiction and freedom.
Marc, many thanks for your reply and valuable thoughts on this Analogy.
Perhaps Analogies would best illustrate the new “DILECTION” model of Addiction and Recovery.
I sent a summery of this new model to the main players in the non-disease model camp; Stanton Peele, Maia Szalavitz, Tom Horvath, and posted it on this BLOG in the February post:
The Disease Model of Addiction…Not again?! ,
but not being versed in the Academic Vernacular, there has been no responses… it may not be clearly worded?
If so, perhaps analogies are the way to go.
The new model is still being shaped and developed, so feedback like this is invaluable and appreciated.
Thanks again, Carlton
BTW- In this new model, a “substitute addiction” would be seen as : “considering things you are naturally attracted too”.
Carlton, can you send another link to your model in a reply to the present post? I did not have time to look at the comment last February, but perhaps I can now.
We academic types can become allergic to new models, because sometimes it seems that everyone’s got their own model…and that may be the problem. Also nobody has time to read anything, so succinct is best.
Best to say what your model offers that others don’t, right at the top. What gap does it fill? That will help attract people’s interest. Also, smaller models sometimes work better than larger ones. If I told you I had a model of human thought vs. a model of, say, internal dialogue, which would you choose?
Marc, yes, here is a copy of the brief summery of the DILECTION MODEL.
It is a work in progress, so any suggestions or discussions here on the blog would be deeply appreciated.
Currently, Addiction and Recovery are defined as opposites in constant battle.
The most popular and deterministic model portrays Addiction as a disease and Recovery as maintaining a constant resistance to the disease.
The DILECTION Model is radically different.
The DILECTION Model of Addiction considers Love to be the initial origin of Addiction.
Therefore, the absence of love, or loss of Love (for the addiction) describes Recovery.
Addiction and Recovery are thus re-framed and presented as two ends of a spectrum; just as “Being in Love” and “Being out of love” are part a spectrum, and not separate things.
Terms like cure, eradicate, conquer, etc, are not applicable.
This is not a deterministic model, but a stochastic model due the inexact nature and science of Love.
This accounts for the many perplexing aspects of Addiction, such as Spontaneous Remission, etc.
This model fits with the inedible shifts and complexities that occur during a persons life.
This over-arching model can also account for all the beliefs and models of addiction and recovery (including the Disease model).
It opens the door for re-thinking re-framing things like :
control, abstinence, sobriety, triggers, strength, commitment, choice, relapse, slips, biologic/environmental factors, treatment programs, support groups, self-empowerment,
and many other aspects of the Addiction/Recovery spectrum.
This new model allows people to relate, comprehend and understand in a realistic way, what they are experiencing.
The realization that you no longer need to do anything about the addiction, is a indicator of recovery.
To conclude, This model opens a door for the discovery and exploration of new and effective ways to help people who experience addiction.
D. Carlton Bright 2016
The idea of controlled use is an interesting one – and indeed studies of ‘controlled drinking’ in ‘alcoholics’ were the some of the first to seriously challenge the diease model some 40 years ago.
Sadly it all still seems so binary to me – ‘addicts’ or ‘non-addicts’, ‘alcoholics’ or ‘normal drinkers’.. ‘contolled use’ or ‘loss of control’.. As such the language metaphor is good as it makes the wider complexity of many varied often subtle factors at play more obvious. Of course learning a new language is easiest immersed in that environment..
At the same time, ‘controlled use’ is still a potenitally worthwhile concept on a number of levels, if we consider it with various nunaces. Myself I have both failed and succeeded in ‘controlled drinking’, but having succeeded in it I don’t like the term. If I am actively ‘controlling’ my drinking, it *sounds* like I am doing so despite the presence of some level of ‘addiction’, when in fact I would consider it was time to return to abstinence if dependence had indeed re-emerged. That was the deal I made with myself before attempting it again.
For the record – and to match it to the metaphor – my failed ‘controlled drinking’ attempt was at a period when I still had a life and social circule structured around heavy drinking. Controlling it (or learning a different language) in this context was extremely difficult. Abstaining for many years allowed me to reset my life towards an environment far more conducive to learning a new language.. friends, responsibilities etc. Years later ‘controlled drinking’ was possible, albeit slightly underwhelming. Nice to compliment a meal but not the great joy I’d subsequently fetish-ized it as..
I think as Marc often emphasises though, overcoming addiction requires determination. So does learning a new language.
HI James. These are great points. Indeed, the context for “controlled use” can change massively with time and context. And once you get really good at it, new circle of friends included, then you are finally past being any kind of addict, so the meaning of the phrase breaks down.
To continue the language metaphor, I’m in a dastardly situation. My “drinking partners” are my wife, who only speaks English, and my kids, who switch to English as soon as they see me coming. In fact I’ve been known to yell at them: No Dutch, please! English speaker here! Which is like saying get the booze out, the alcoholic has arrived! I could trade in my wife and kids for a new family — a Dutch family — and then I’d be able build up my abstinence or jump all the way into it. And then maybe I’d still be able to speak English on occasion, maybe on weekends. Or I’d let myself watch American movies without subtitles. (Kind of like watching Trainspotting if you’re a former heroin addict — I guess. I’ve avoided it so far.)
But I happen to like my present family, so I suppose I’m doomed to remain an addict. English can be an ugly business, but at least it doesn’t kill you.
Sorry to have missed your talk, Marc! Would have cheered you on from the stalls 😉 Colin sounds a very wise and brave man. I know my heroin addicted brother did well on methadone, back at home with my mother, and working full time, for 11 years. His environment, friends and hobbies changed (he walked a lot and London was an occasional treat, where he probably did do other drugs.)
He was only ever stable when in a loving, caring relationship. That taught me a lot about addiction. Too much of Western medicine is concerned with diagnosis and drugs, rather than exploring people’s wider social and mental contexts. But, things are slowly changing, as Portugal’s policy on decriminalising drugs is showing.
Helping addicts recover is a family and community responsibility. No condemning, just accepting and helping. Very challenging for most though in our aggressive, blaming cultures….
Neuroscience is also VERY helpful in assisting in understanding our unconscious beliefs and habits too. Healing from all addictions is a HOLISTIC, daily practice, no doubt about it.
I agree with every word, Annette. So would Johann Hari, who uses the Portugal example frequently in his book and in his talks. Adding the neuroscience is like building a solid basement under a home in which love and acceptance are the occupants. Since we’re in a metaphorical spell, maybe we could say that understanding how the furnace works helps you when you need to change the temperature in the rest of the house.
Wish you’d been there too!
Comparing recovery from addiction with learning a language is quite useful, especially if you think that recovery is mostly just another addiction, which I do. I found I could practice total immersion, speaking the language of recovery with great fluency, and then at will, maybe a long time later, I could return to my native tongue–which was wrapped around a crack pipe. If all we’re talking about is reducing the harms of hard drugs maybe that’s fine– just don’t go back there–but if you believe, as I do, that addictions to power, money, and shopping are destroying the world, than I think we need to use our experience of getting beyond recovery, beyond language entirely, to the truer transformative freedom of a real cure.
Novalis said all diseases are musical and all cures are musical. Transform the medical model into the musical model and take another look at addiction, why don’t we?
John, are you being more complex and obscure than usual or am I just getting dumber with age? If I understand you (which I doubt), then getting beyond recovery would be (in Colin’s metaphor) getting beyond language. But we need language.
Stepping out of the metaphor, I’d say we need competition, anxiety, and greed — I mean we don’t need them but they are us, so we can’t get away from them. In which case, let’s try to narrow financial inequality, environmentally destructive practices, and remind each other that ostentation is ugly. But what you are advocating sounds like it would require removal of the brain stem.
Perhaps occasionally a little bit too autopoietic, but certainly not complex and obscure, not me, eh.
Einstein said that you can’t solve a problem at the same level of consciousness in which the problem was created, and that’s all I’m saying. Addictions and recovery are two languages, or two dialects, maybe even two idiolects, but within the same level of consciousness, and this problem of getting through addictions needs an understanding that leapfrogs them both. Language, necessary as it is, is always being leapfrogged by the human spirit, in the progress of cultural evolution.
And I would never advocate removing a brain stem. I love brain stems, always have. We can’t make music without them, or dance, or play leapfrogging.
Abstinence is one of the most heated and contentious term in the treatment of addictive disorders. For people like us who work in the trenches, ‘abstinence’ is achieved when the patient stops using the offending drug. This occurs when the patient stops drinking; stops using heroin or other illegal or illegally obtained drugs. The common pathway to abstinence from alcohol is attending AA meetings. Many patients will substitute the alcohol with smoking, excessive coffee, sugary foods etc. and this is acceptable and is considered ‘recovery’. The treatment of opioids addiction, especially heroin has taken a different pathway. The most commonly used and effective medications to get patient off heroin are prescribed opioids – methadone and buprenorphine. Most patient do well on these meds and should be considered ‘abstinent’. Many of these patients may need to be on these meds for years.Sadly, there are groups that fiercely contest this and insist that true abstinence and recovery is not achieved unless the patient is off all drugs including those prescribed by a physician. Why the controversy? Because methadone and buprenorphine are abusable drugs and have to be carefully administered and controlled. The argument is that one opioid is being substituted by another opioid and this is not true abstinence and recovery, even if the patient has achieved normalcy. There is a third drug naltrexone, which is a non-opioid that protects detoxed heroin addicts from relapsing. This medication is opposed on two fronts. The methadone and buprenorphine advocates insist that naltrexone is not as effective because of high relapse rates when the drug is discontinued. This also happens with methadone and buprenorphine. The abstinence folks insists that being on naltrexone is not true abstinence.
The three medications approved by the FDA to treat alcoholism are non-addicting and non-abusable. The first and the oldest, disulfiram, better known by the trade name Antabuse, makes a patient vomit if alcohol is ingested. It was viewed as a form of punishment rather than treatment. It is still used in selective patients who have a strong motivation to stop. It effective in select patients.
Dr. Colin Brewer got into trouble by attempting to use naltrexone in a potentially risky protocol called ultra-rapid detox. Opioid patients are anesthetized and undergo rapid detox off the opioids. The intense withdrawals are not felt because of the anesthesia. The patients are then sent home on a naltrexone implant that lasts up to six months. There are clinics that still offer this controversial treatment.
Dr. Colin wrote a rather thoughtful comment last year on Marc’s website and it is an interesting read.I am not sure how I can get to the readers. Maybe Marc can help.
Our clinics have used buprenorphine, naltrexone and disulfiram very successfully by individualizing the treatment. The key is behavior modification. Replacing the unhealthy behavior with healthy behaviors. If patients can quit smoking we can certainly do an equally good job helping patients quit drugs and alcohol. My often used mantra – addiction always happens accidentally the goal is to make it incidental. This proves that addiction like smoking is not a disease but a condition or disorder and the highly resilient organ called the brain can achieve recovery.
Hi Percy. Nice synopsis. Thanks for this. I’ve found Colin’s comment from last year. It’s about 10 or 12 down on this page: https://www.memoirsofanaddictedbrain.com/connect/a-doctors-view-on-what-doctors-cant-do-for-addicts/
It’s long, but if you’ve got 20 minutes to spare, it’s exceptionally erudite: clever, comprehensive, articulate, and thoughtful. Give it a read.
I meant to add something, Percy. You don’t make it clear whether you approve of Colin’s unorthodox and “risky” detox method. Do you think it can be justified, at least in some cases?
Thanks for finding this comment Marc. The first time I read it I was so impressed that I saved it! There is no doubt that Colin was a pioneer and willing to go against established orthodoxy. He crossed the line by promoting ultra-rapid detox as a viable option. This procedure is dangerous and is not acceptable under any circumstances. Opioid detox is not life-thretening and actively involving the patient in both the detox procedure and as Colin correctly describes ‘re-education’ is critical. Sadly, as I mentioned earlier, the detractors of naltrexone found additional ammunition to denounce the product rather than the procedure.
I hope Colin continues to write and share his experience and wisdom and educate a field that is decidedly unwilling to change. Opioid Substitution Treatment cannot be the only and dominant treatment option that is killing thousands of people each year.
Thanks for clarifying, Percy. But see Colin’s defense of his various rapid detox procedures. It should appear in the next post — I hope by tomorrow.
As always really love reading these blogs. Think that ‘renegades’ like Colin Brewer are ones that really expand our knowledge and stretch our comprehension.
Have begun reading the 12 Step Buddhist by Darren Littlejohn and want to recommend it to those like myself who are drawn to both the 12 Steps and Eastern practices. Something came to me this morning as I recognize my own continuing struggle with addiction to ‘processes’ like sports on TV. These thoughts have to do with the concept of “higher power/God’, Addiction as Learning and also Addiction as Disease.
Here is my thinking. I have struggled with addictions/attachments to alcohol and food and largely overcame these but still have relapses around food and other addictive patterns that interfere with my daily life. My way out to health involved intensive work in the 12 steps/TM/Vipassana and Tony Robbins work. I still use most of these every single day of my life and realize I have no choice. (What I call “choice less choice).
I find that my addictive journey is definitely a two edged sword. It has created great misery and I have wasted time and money. But is has also led me on and necessitated intense spiritual work that I would maybe never have done otherwise. I feel that when I am vigilant and doing the work I really feel connected to a spiritual and healthy center within myself. I connect with other people quickly and really feel vital and alive. But when I don’t do the daily work and relapse I get zoned out and am not effective.
Here is my thought around this that relates to Addiction as Learning and Disease. Addictive behaviors change the brain. Perhaps to some extent these changes/rewiring are relatively permanent.
This could seem hopeless but this is the paradox of addiction. Perhaps this permanent/semi-permanent re-wiring requires that the individual find an alternative substance/practice/process to be healthy and to be connected to the best part of themselves (the living wise part most equivalent to the natural human/animal). I am 61 years old and I have found I cannot give up my spiritual daily practice or I quickly get lost in addictive processes, different brain chemicals arise and I lose my way.
So maybe this is one reason that addiction seems so much like a disease. The brain changes – to some extent it can change back or get re-wired but probably never completely. Perhaps the ones that learn to adapt to this re-wiring find the daily practices to deal with this. Perhaps also this “re-wiring” in some strange way makes them more open to connecting with a Growing Center/Higher Power.
Finally my thoughts on the 12 Steps/God/Higher Power. I don’t know if this healthy living part of myself I have discovered through the 12 Steps, Surrender or meditation or in some cases deep interpersonal connection – is really God or a Higher Power. But it feels good and loving and when I am in touch with it I feel extended beyond my Ego. Perhaps what we call God or Higher Power in the 12 Steps is just the same feeling that a Flower has as its blossoms open and it does what it was meant to do. Perhaps this is the Higher Power of the 12 Steps – the God as we know him. My own last name is Greenwood and I feel when I connect to this part of myself I am connected to the Living Green part of my Being reaching upward toward growth and realization.
Tim, you brought up the topic of spirituality-
One reason a percentage of people do not return to an addiction is because they become aware of other aspects of life that they were not well aware of before.
Here is an analogy, (A “house” represents a “persons life” in this analogy.)
Living within the confines of an addiction is like living in only one room of your house.
The traumatic struggle with the addiction can help force a person to venture outside the room, and have realizations that there is much more to the house, (such as discovering a spiritual side of ones-self, etc)
These realizations can make going back to living within the confines of the one room something no longer preferred or desired.
This is not a common “take” on addiction and recovery, but it can become apparent in hindsight, rather than during the struggle itself… which can go on indefinitely.
This is very beautiful, Tim. I think I know what you mean about that growing/connecting feeling.
As for brain change in addiction. We can say, in a simplistic but maybe important way, that the massive brain change that goes with massive learning — be it addiction, being in love, having children, or religious conversion, to name a few — well it’s sort of like putting a new shirt in the washer and then the dryer…and it never looks the same again. (at least my shirts don’t)…. Take a complex system and change it somewhat radically, and it will NEVER go back. As I’ve written somewhere else, based on my reading of Norman Doidge, brain elasticity works like Play-Doh, not like a rubber band. The brain never springs back to the shape it had originally. So that very act of wrenching the brain, that disruption, may be the step we have to take en route to transforming our lives more permanently.
It may also be that addiction itself requires so much self-confrontation, self-struggle, self-acceptance, that it specifically launches processes of self-actualization that might otherwise never occur.
Realize this is not on theme but feel to compel to share thoughts on Donald Trump and understanding him through Lens and Perspective of “Addiction”
Hope this is not inappropriate.
I share this because I don’t read anyone trying to understand Trump through the Lens of addiction. It seems to be very helpful. Realized I was addicted to following Trump and then it dawned on me that Donald Trump is “Unfit for Office” as Obama says because he is literally in the grips of a fierce addiction. Addiction to drama/social media/conflict/attention – etcetera. And the Media and many of those who are willing to vote for him are addicted to him and his antics. His lack of ability to stay on focus, his constant tweeting, his current self sabotage all is illustrative of this. Addicts in the grips of an addiction are clearly not fit for higher office. It is not a question of character – but rather someone who is clearly “not well”
I share this here because I think it would be good to have people who know about addiction share their insights on Donald Trump and our own addictions. Please feel free to comment or if people feel my sharing is inappropriate let me know. Just want to hear this conversation and idea being shared in the Media
Everything’s permissible here, Tim, unless it’s intended to hurt people.
Have you seen this?
https://www.youtube.com/watch?v=mNiqpBNE9ik
It’s hilarious.
Here’s some recent research I wouldn’t expect: reward circuits are silenced rather than hyperactivated with addiction. How might that work?
http://www.alphagalileo.org/ViewItem.aspx?ItemId=166704&CultureCode=en
Thanks for this, Mark. I read the synopsis you linked. We’ve known for a long time that there is desensitization of “reward circuits” with addiction…the famous blunting of striatal circuits, which probably depends on the temporary loss or desensitization of certain dopamine receptors on specific neurons.. I can’t tell whether these guys are reporting on the same phenomenon, using a different technology/approach, or whether it’s something really new. I guess I’ll have to read the source article.
But yes, in the classic model, there is also hyperactivation. That’s true regardless. The hyperactivation is in response to cues associated with the addictive activity. These are parallel processes: more activation when you smell dope or drink, but less activation to rewards more generally. I don’t think the new research disputes that in any way.
Spirituality is one of the best ways for people to overcome addiction. It gives people something to believe in that gives them the strength to keep going and stay sober.