Author: Marc

Not to be confused with the 12 steps, but read on.

Two posts ago I said I’d suggest practical applications for some of Jordan Peterson’s self-help recommendations, as they might apply to people struggling with addiction. I hesitate to put Peterson’s name in the title of this post, as there has been such a fantastic degree of controversy surrounding this man.

Many thousands have thanked him for live-saving advice, women as well as men. Many love him, I’d say for good reasons. And many hate him. Despite my admiration for most of Peterson’s proposals, I also find myself turned off by some of the things he says in public. These seem careless, absent-minded, maybe provocative, sometimes angry, but certainly not intended to harm vulnerable individuals. But again, I want to avoid the political shit storm. It just doesn’t interest me as much as the content of Peterson’s proposals and their capacity to help those in need.

The first recommendation I want to explore is the theme of taking small, manageable steps out of addiction. To paraphrase from my previous post:

People in addiction often want to make a massive change in their lives, but the change is so massive that it overwhelms their capacity for self-direction. So they fail, again and again.

As noted previously, Peterson’s approach to the problem comes to the surface in this talk, about 33 minutes in:

You need a goal, but we don’t want your distance from the goal to crush you…Set a high aim, but differentiate it down so you know what the next step is. And then make the next step difficult enough so that you have to push yourself past where you are, but also provide yourself with a reasonable probability of success.

Nothing particularly new about this idea? Except that Peterson urges a balance between idealized progress and the capacity to succeed even minimally. People in addiction know the price of repeated failures. Each time we set a goal (e.g., never again, not tonight, not this weekend, not shooting it, stopping after two drinks, sticking to wine) and fail to follow through, there’s a dash of salt in the already-gaping wound to our self-respect. More evidence for that critical inner voice (which I’ll get to next post) and confirmation of the belief that we’ll never succeed or we’re not worth the effort (and pain) of repeated attempts.

These outcomes are both familiar and devastating. When I was taking drugs, each and every time I promised myself to stop — and didn’t — deepened the pit of hopelessness and self-contempt. Stopping was just too difficult…at first. “Never again” felt like being cast on the shore of a desert island, naked, alone, and lacking the one source of safety I could have brought with me.

Little steps — cutting down, controlled use — will be far more manageable for most people in active addiction. Call it harm reduction, if you like, because it certainly reduces harm. But, as Peterson emphasizes, this isn’t a rationale for falling short of complete success. Getting your life exactly where you want it to be is possible, in fact necessary, but it might not be possible this week. So, he advises, be really practical, identify a goal that’s in reach. And make sure you stick to it. If your house is a veritable pig sty, set yourself the goal of gathering the laundry off the bedroom floor — just that — and tomorrow you’ll feel capable of tackling the sock drawer.

One of my clients is a man I’ll call Jason, a sixty-plus year-old who lives in a large European city, having left his home in the U.S. more than twenty years ago. We have a psychotherapy session usually once a week via live chat on the net. Jason would  score a gram of heroin almost every Friday afternoon, because the weekend stretching out ahead of him felt like a wasteland of boredom and loneliness. When he got home from work Friday he’d get high. Then he’d use the rest on Saturday. There might be enough for a small hit on Sunday, but by then things were already looking pretty grim. Every Monday came the crashing depression of going without, compounded by exhaustion (not sleeping well) and savage self-recrimination. This generally went on until Wednesday morning.

The habit was entrenched. He did this every week. The emotional vulnerability, combined with habit strength, sunk him every Friday. So we set a goal that he felt he could manage. This week, just this week, he was to make a plan to go out with a friend on Friday evening. I helped by calling him Friday morning to make sure he was on track. By Friday at dinnertime his dealer was off duty. All he had to do was to make it till then.

We did not try to resolve whether he would use later that weekend, or the following week. He’d cross that bridge when he came to it. (The one-day-at-a-time idea is certainly familiar in the 12-step world, though it comes with spring-loaded rebuke for failing.)

This goal was in range. It was possible. And he succeeded. Saturday happened to be a sunny day and he spent it well. By Sunday there was no intense longing. Tomorrow would be a workday. Work organized Jason’s life. He wouldn’t feel tempted to use again until next Friday.

A good start.

Obviously this isn’t rocket science. But it is powerful. Jason felt good about himself. By Sunday, and through the week, his mood was brighter than it had been in months. And he had the beginnings of a defense, a bulwark, against the self-denigrating voice that made him feel like shit most of the time.

As Peterson recognizes, as any good psychologist practicing CBT ought to know, small changes build momentum, allowing for a lot more progress than can be envisioned from Square One.

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Check out this cute Medium post showing how small changes to bad habits can generate a chain reaction. Just as good habits lead to the strengthening of additional good habits, indulging in addictive acts leads to more addictive acts. It’s that simple.

I find it impossible to reflect on these cognitive calculations without considering the internal dialogue. See next post.

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By the way, here is a positive and constructive website/blog from a recovered heroin addict — now a neuroscientist. No, not a cousin.

I want to talk about the feeling of emptiness so many of us experience (sometimes as depression) and our sense that substances (i.e., drugs, alcohol) can fill that void. Why is this conceptual sinkhole so universal…and so relentless? Can it be overcome? If not, it seems we’re doomed to live our lives between two crappy alternatives: emptiness and addiction.

I know I said my next two posts would try to apply some of Peterson’s suggestions to strategies for moving beyond addiction. But that can wait another week. I need a break from writing and thinking about Peterson. The comments on my last two posts were mostly polarized — people either loved or hated Jordan Peterson. I wasn’t completely surprised. Peterson is nothing if not controversial. But political arguments gets tiring. So I’ll take a week off to write about something different.

Ever hear of Metaphors We Live By? That’s the title of a book by Lakoff & Johnson (2003) — and a powerful idea they’ve been pursuing since at least the early 80s. The idea is that metaphors are not just comparisons we make to clarify concepts; metaphors are actually the basic organizing structure of our cognition. In other words, we think in metaphors. We use metaphors to make sense, not just of unusual or novel ideas but of everything.

Think of everyday concepts like, say, arguments. We tend to think of an argument as a war, with a winner and a loser, and a certain amount of damage. The war metaphor gives the concept “argument” its meaning. It’s not a matter of listening or sharing; it’s something you either win or lose. How do we conceptualize “communication”? Often as a conduit, a tube connecting speaker and listener. If you see communication as a conduit, then your main concern is sending a message down the tube and having it received at the other end. A failure in communication is seen as an obstruction or break in the tube. But if our metaphor for communication were different, say a pool of water encompassing speaker and listener, then we’d view communication failures in a completely different way. Maybe as a drought.

Because metaphors have (a limited number of) attributes or features, they get us to see things in certain ways and prevent us from seeing things in other ways. And of course all this is unconscious — under the hood.

I often think of addiction as a thought problem (as do many others). But what if, instead of seeing addiction as a cognitive bias, we see it as the result of an unconscious metaphor with a powerful attribute that holds us prisoner (another metaphor: addict as prisoner).

When we think of ourselves as “empty” or “lacking”, we are using a universal metaphor lifted from everyday life: the metaphor of the container. My self is a container. Containers have one prominent attribute: degree of fullness. Containers are either very full or partly full or partly empty or very empty. See the point? The only other attribute that comes to mind is “leakiness”. If you suffer from anxiety rather than depression, this may strike a chord.

So you wake up in the morning and you feel empty. You say to yourself: shit, I feel so empty. I’d really like to feel more full. So I will take a drug or a drink to fill myself up. Maybe not right now but soon. I really dislike this sense of emptiness so I will put something into my self to fill it up. If you’ve ever been in addiction you know exactly what I mean. Yet the reason we feel “empty” in the first place — rather than, say, uninvolved, or emotional, or out of sorts — is because of the container metaphor. Empty containers need to be filled up.

Now let’s say this is a problem for you, or maybe someone you know. How could you help relieve the feeling of emptiness so completely that the attraction of substances would pretty much vanish? I’m trying this on myself, as an experiment, because sometimes I do feel empty. (I don’t take illegal drugs anymore, but I find it hard to resist a drink at the end of the day, to fill me up.) Well, what you could do is feel your own insides and/or touch or pat yourself (on the outside). You’ll find that you are in fact very full. Of stuff. Tissue and muscles and blood and bone, or, maybe more to the point, you are full of chemicals; neurotransmitters (including opioids!) coursing around inside your body constantly. If you are a container, you’re certainly not an empty one.

The first thing I did this morning was pat my chest and stomach: Yep, full. And the feeling of emptiness I sometimes wake up with just disappeared.

You are also full of feelings. And perhaps other qualities that I haven’t mentioned. Sensing what it’s like to be inside yourself is a pretty standard practice in mindfulness meditation. And it’s known to bring peace and contentment.

What about changing the metaphor? Would that work? The self isn’t really a container. The self is an exquisitely tuned network of nerves, neurons and their synapses. Or the mental activity that moves through them. The self is open, yet containers are (or can be) closed. So maybe we can experience the self as something like an antenna or radar dish or…I don’t know…something very uncontainerlike.

Another thought: Let’s say you can’t shake the container metaphor but you recognize that your container is open. Maybe it’s open at the top, where stuff flows in, but also at the bottom, where stuff flows out. (or in as well, if you take to the metaphor of roots) Then you are rejigging the container metaphor: the container becomes something more like a wide, rich, pipeline connecting “you” to everything else — an open passage.

I’ve often wondered why substance addictions are so tenacious, so difficult to wrench yourself out of. And why one substance tends to replace another. I’ve long believed that addiction is a problem in how we experience ourselves and the world. For now I’m just playing with ideas that might bring this abstract principle a little closer to our lives…and actually evolve into therapeutic (or mindfulness) practices.

I see that I need to supply a caveat to yesterday’s post. As expressed in no uncertain terms by the first commenter, a lot of people don’t like Peterson. The comment was “Ugh, seriously?” There’s more vituperous criticism further down, of me (for appreciating Peterson) as well as Peterson himself. When I scan down the first 15 comments or so, I see huge polarization. Some people love him; others hate him. That’s a pretty accurate reflection of the Peterson phenomenon in the larger world.

(Addendum: my review just got published. You can find it here.)

I mentioned this political maelstrom in yesterday’s post, without getting deeply into it. I guess I should go a bit further and summarize the issues as I see them. Some of Peterson’s arguments offend, and they particularly offend people on the (perhaps far) left. For example, he explains dominance hierarchies as a product of our evolution rather than the construction of an oppressive (white, male) culture. He distinguishes sex differences, which are (he claims and I certainly agree) rooted in biology and evolution, from the social construction of gender. He analyzes the personality traits associated with women and men and argues that the asymmetrical distribution of these traits (something you may have studied in Psych 101) has much to do with the gender pay gap — which is therefore not simply a result of sexism. He certainly doesn’t deny the existence of sexism, or oppression by dominant cultural forces, or the rights of transgender people. Not at all. Yet his infusion of statistically validated facts and an evolutionary perspective into the ideological battles raging (especially in the universities) about diversity, gender, social justice and so forth has alienated and angered many on the left.

The ideas I’ve just outlined don’t seem so radical to me. I’ve heard that Peterson says more controversial things about marriage and women’s roles, etc, though I haven’t read them myself. The famous pronoun war (google it) can certainly be judged from divergent viewpoints. I suppose Peterson really is a conservative in some respects. He’s definitely not trying to be politically correct. In fact a foundational plank of his philosophy is that people should say what they believe to be true, especially if they are voicing unpopular views. He staunchly elevates free speech over “sensitivity” to the feelings of others. In a response to one interviewer (and this is worth viewing if you want more insight into his politics) he said he greatly admires Rosa Parks for standing up for herself against the systemic racism of her day.

As a result of his stated positions, Peterson has been mobbed by what he terms “social justice warriors”– people who espouse extreme leftist views. There’s no doubt that he disagrees with many of their views and he’s angry at the insulting nature of their attacks on him. He’s literally been shouted down on more than a few campuses. Does that make him a right-winger? Not yet. The view of Peterson as a (perhaps extreme) right-winger comes from the next act in this play. People who really do identify with the right, including the far right, started to proclaim their undying loyalty to Peterson, mainly because the far left seems to hate him so much. In my view, the equation is simple. If my enemy hates you then you must be my friend. Does that make him a right-winger?

This is just a superficial and no-doubt inadequate overview of the social currents surrounding the “most popular intellectual in the world” (something I read recently). But the thing about Peterson is that he’s not a political animal. He says what he thinks to be true, and he really doesn’t care too much about the fallout. I personally don’t think he enjoys being in the centre of this altercation one bit. He’s said many times in public that he’d rather people listen to, and argue with, the content of his arguments than slot him into a political ideology.

Anyway, I’m certainly no political commentator, and my understanding of the political face-off around Peterson comes from browsing articles and videos on the Internet. My own political sentiments are firmly on the left, as any regular reader of my blog surely knows. (When Trump got elected, I wrote a post entitled “Oh Shit.” I was depressed for weeks and made no secret of it.) But that doesn’t mean I have nothing to discuss with people who see things differently. And more to the point, this blog isn’t about politics. It’s about experiential, social, psychological, and neurobiological approaches to understanding addiction. I’d be glad to chat with anyone out there about the the political eruptions surrounding Peterson’s public persona. I’m sure I can learn something. Maybe over a coffee if I’m ever in your part of the world.

But I think it would be a shame to ward off Peterson’s ideas as if he were some sort of vampire, simply because of the political accusations flying back and forth. I don’t agree with everything Peterson says. In my review, soon to come out, I firmly criticize him for cherry-picking scientific factoids to support dubious assumptions and for a style of argument which violates the standards of scientific discourse — namely basing one’s authority on intuitions rather than methodical arguments grounded in data. Yet some of his ideas strike me as valid, powerful, refreshing, constructive, and of particular utility for enhancing personal growth. Whether you consider yourself to be on the right or on the left, it seems there’s much of value here, and I hope you won’t throw the baby out with the bathwater.

I haven’t been blogging much lately, mainly because I’ve been busy with other things. One of those things has been writing a review of Jordan Peterson’s book, 12 Rules for Life: An Antidote to Chaos. The review was commissioned by the Literary Review of Canada (LRC) — the Canadian cousin of the New York Review of Books. And it really got me thinking on how to solve the central problems in overcoming addiction (what many call “recovery”).

(Addendum: my review just got published. You can find it here.)

Peterson is an international phenomenon by almost any standard. He has amassed millions of YouTube followers and a stream of interviews from talk show hosts. His book was the top seller (overall!) on Amazon for at least two months and is still #6, four months after publication. A professor of psychology at the University of Toronto, Peterson has been cheered and even glorified for his radical approach to self-improvement — presented in his new book and his many online lectures. What he proposes is a set of guidelines highlighting self-honesty, personal responsibility, and what we in the addiction world have long emphasized as the bedrock of growth, empowerment — believing in your own intentions, intuitions and capacities for change. But Peterson has also been a lighting-rod for criticism. His detractors claim that he is anti-feminist, anti-LGBT, anti-social justice, and a voice for the politically incorrect (shudder) alt-right. This reaction has activated a subset of Peterson followers who are indeed highly conservative or libertarian, and sometimes quite vicious in their attacks on Peterson’s critics. But we have to extract Peterson’s message from the surrounding political hubbub. In my view he’s neither left-wing nor right-wing. As I emphasize in my review, he speaks as an individual, not a political movement.

If you haven’t heard of Peterson or listened to any of his many online lectures, here are a few goodies: A discussion of the book in a lengthy interview with Dave Rubin. A shorter version, in lecture format. An oft-clicked, contentious interview with Cathy Newman, a feminist British reporter and presenter.

So what’s all this got to do with addiction? I had to get pretty deeply into the book, and in the process listened to a lot of Peterson online, in order to write an intelligent review. In doing so, I found myself very often drawn to Peterson’s recipe for self-improvement. I think his advice is both practical and potent for people struggling with addiction, and I intend to use it more and more in my own work.

People in addiction have three main problems:

1. They want to create a massive change in their lives, but the change is so massive that it overwhelms their capacity for self-control, self-direction, choice, or whatever you want to call it. So they fail, again and again.

2. Because they fail at doing the one thing they know they should and must do (and usually want to do), they experience enormous levels of shame and guilt, often taking the form of a critical, self-denigrating internal dialogue.

3. The third problem is that problem #2 (self-denigration) fuels the depression and pessimism that greatly contribute to problem #1. A horribly vicious circle.

In my view, Peterson has some really good suggestions for overcoming both problems 1 and 2, which of course eliminates the existence of problem 3. I’m going to give you the gist of those suggestions here and then expand on ways of implementing them in my next two posts.

1. Peterson’s approach to problem 1 comes to the surface in this talk, about 33 minutes in:

You need a goal, but we don’t want your distance from the goal to crush you…Set a high aim, but differentiate it down so you know what the next step is. And then make the next step difficult enough so that you have to push yourself past where you are, but also provide yourself with a reasonable probability of success.

Of course the next question should be, How do you set up incremental sub-goals in the case of drug addiction? Shouldn’t you Just Say No to Drugs? I don’t think so. In my psychotherapy with people in addiction, I try to aim at steps in the right direction, beginning with controlled use or harm reduction. More on that to come.

2. Peterson’s approach to problem 2 is also highly practical but a bit more nuanced. To give you a sense of it, I’ll quote a few sentences from my review:

Peterson says “the self-denigrating voice…weaves a devastating tale.” Engage with the internal critic, he urges. Don’t listen to its exaggerated claims that you’re completely worthless. But don’t ignore it either. “Called upon properly, the internal critic will suggest something to set in order, which you could set in order…voluntarily, without resentment.” In other words, with a little work, that voice can become a valuable ally.

Again, the question is, How? How do you turn a damning, denigrating internal critic into a negotiating partner who can help you move ahead? I’ll  provide some concrete ideas two posts from now.

Jordan Peterson seems to understand how hard it is to achieve necessary changes in how we approach life, especially when it comes to breaking entrenched habits of thought and behaviour. He approaches these challenges with both the compassion of a fellow traveller and the practical wisdom of a good clinical psychologist. He also ties his ideas to compelling lines of thought from philosophy (especially Nietzsche), social science, evolutionary theory, and even religion. A fascinating thinker, overall, with an especially helpful perspective for refashioning psychological approaches to addiction.

Just got back from the US the day before yesterday, and I’m mostly trying to reset my body clock, nine hours ahead of where it was in California, or maybe behind, or is it ten hours with Daylight Savings…? I haven’t quite got it worked out.

Anyway, just this morning it occurred to me that I forgot to let you guys know that the Great Debate is finally available on YouTube. Here it is. Thanks to Shaun Shelly for crunching all those gigs into something relatively bite-sized (pun intended?) and doing whatever he had to do to dampen background noise. The sound quality isn’t bad for a talk in a theatre.

I’ve got lots more to share with you from my time in the US. I continue to love Americans, loathe their politics, and try to stay afloat in that peculiarly American miasma made of equal parts hope and despair. The societal challenges are so huge. How will they ever be resolved?

But the biggest challenge I witnessed, up close, in my face, was the suffering and anxiety, the attempts to come to grips with mortality rates and the loss of friends and loved ones, that continue characterize the opioid epidemic. Overdose deaths are still the leading cause of death in Americans under 50. And suicide is a close second (in some reports), exacerbated not only by substance use but prevalent during periods of abstinence. The system (if we can even call it that) is completely broken.

I gave a talk in Long Island and did some version of my usual spiel about the “disease” label and the problems it creates, in our scientific and social understanding of addiction and in the twisted ethos of a treatment industry powered by profit and offering little more than a quick fix for a problem with deep roots. But the day after my talk, something changed. I sat on a panel with the program directors of several community and state organizations tasked with helping addicts survive and, ideally, stop using. The meeting and discussion were hosted by THRIVE, a community-based organization  (note: this is not the for-profit rehab by the same name) that describes itself this way:

So if that’s what we have to call it to get people what they need, in a country whose healthcare system is almost entirely lacking in rationality or compassion, then that’s just the way it is.