Author: Marc

Now that we are stepping firmly away from politics, I thought I’d end the season with a couple of excerpts from an article I recently published in Aeon. Please go to the publication website for the full essay and links. Otherwise, I’ll present an edited (shortened) version in two installments. Here’s the first:

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The view that addiction arises through learning appears to be gathering momentum. In fact the famous “disease model” of addiction remains fully dominant only in the U.S. (It is less prevalent in the UK, Europe, and Australia, though it still has a strong following in the treatment world.) Yet the question remains: if addiction is learned, how does it become so much more crystallised, entrenched, in fact stuck, than other learned behaviours? Given that what we learn we can often unlearn, why is addiction so hard to get rid of?

Johnny was a British plant manager, and his childhood included several years in a boarding school where sexual abuse by clergymen lurked insidiously behind the rustlings of bedtime. Johnny grew up anxious but competent; he married, then divorced, and enjoyed regular visits with his grown children – a relatively normal and predictable life. Until it all unravelled. His friends and business associates found it hard to watch, and impossible to interfere, as Johnny approached end-stage alcoholism. He drank himself so close to death that his first reaction to waking up was surprise. By the final six months, Johnny’s days acquired a strange rhythm. They began with a walk to the fridge, rum and ice already crackling by the time he got to the toilet. They would end 4 to 5 hours later when he crawled to bed on his hands and knees, unable to stand. After a few hours’ sleep, there’d begin another ‘day’ of drinking, which lasted only until his next collapse. Johnny told me he would have committed suicide, but it was happening by itself.

Why was it so hard to overcome this behaviour pattern when it got close to destroying him? Why the horrendous sameness, the insidious stability? Why couldn’t he stop? These are the questions that a learning model of addiction has to answer.

I would call addiction a learned habit. In fact, the word ‘habit’ has been used to describe addiction for ages. Yet habits can be hard to specify. They don’t just show up in behaviour. Racism is a habit that’s invisible until it shows itself in a particular context. I would term addiction a ‘habit of mind’ – a habit of thinking and feeling that sometimes gets expressed in behaviour. But then how can we examine habits that aren’t clearly observable? Let’s look to the brain to find out.

From a neural perspective, habits are patterns of synaptic activation that repeat, when connections among neurons (ie, synapses) fall into the same pattern over different occasions repeatedly. When a person thinks familiar thoughts or performs familiar actions, a vast number of synapses become activated in predictable – ie, habitual – configurations. Patterns of neural firing in one region become synchronised with patterns of firing in other regions, and that helps the participating synapses form these habitual connections.

With each repetition, activated synapses become reinforced or strengthened, and alternative (less used) synapses become weakened or pruned. Meanwhile, active synapses give rise to the activation of other synapses with which they’re connected, and because connections between brain cells are almost always reciprocal (two-way), the reinforcing activation is returned. Thus, repeated patterns of neural activation are self-perpetuating and self-reinforcing: they form circuits or pathways with an increasing probability of ‘lighting up’ whenever certain cues or stimuli (or thoughts or memories) are encountered. According to Hebb’s rule: ‘Cells that fire together, wire together.’

In this way, the brain exemplifies the way all living systems evolve and stabilise. All living systems, from organisms to societies, ecosystems to brains, are complex systems with emergent properties. That means that their structure, their shape, emerges from the interaction of many components that change each other over time. In other words, these systems self-organise due to recurrent interactions (feedback loops) among their elements.

It so happens that there is a robust scientific language for understanding habit-formation in self-organising systems, centred on the term ‘attractor’. An attractor is simply a stable state, which can emerge for a while in a complex (e.g., living) system. So: seeds grow into trees and then stabilise to an attractor: the tree acquires a shape. Birds fly in sync with each other and form a V-shaped (or other-shaped) flock. Ecosystems go through periods of massive change (eg, speciation and species death) and then stabilise. Cities stabilise. Cultures stabilise. Even family dynamics stabilise. Family arguments inevitably fall back into the same infuriating script.

Complex systems are composed of elements such as individuals in a society or ecosystem, or cells in an organ or organism. These elements continue to interact – they cause changes in each other, which cause further changes in each other, and so forth – until they arrive at stable states, at least for a while.

So what’s the point of a word like ‘attractor?’ Complex systems such as us and our brains reach stability in a very different way than cars or billiard balls (nonliving systems). They have not lost their energy; they continue to grow and develop, to live. But for some period of time, the feedback loops that comprise them provide steadiness or balance, like your body temperature after you’ve gotten used to a blast of wintry air. At that point, we can say that the system has reached its attractor. Its components now interact in a way we might call a temporary equilibrium.

The attractor idea is tremendously useful for describing the development of human habits, because human habits settle into place; they are not programmed by our genes or determined by the environment. But how exactly do attractors form in growing systems, why do they form, and why do they hold the system in place? Attractors are often portrayed as valleys or wells on a flat surface, that surface representing many possible states for the system to occupy. The system, the person, can then be seen as a marble rolling around on this surface of possibilities until it rolls into an attractor well. And then it’s hard for it to roll back out. Physicists will say that the system requires extra energy to push itself out of its attractor. The analogy in human development might be the effort people require to shift out of a particular pattern of thinking or acting.

In human development, normative achievements can be seen as attractors. These might include learning to be a competent language user, or falling in love and having kids. But individual personality development can also be described in terms of attractors – recognisable features that characterise the individual in a particular way. And these features can be seen to branch out with development and form ruts — ruts that can remain in place for a long time.

Addiction is just such an attractor. The staying power of addiction doesn’t derive from a good fit with the social world or the playing out of some innate human tendency. Addiction involves an intense relationship between a person and a substance or behaviour. That relationship is itself a feedback loop that has reached the stage of self-reinforcement, and it is interconnected with other feedback loops that facilitate the addictive pattern. These feedback loops have driven the system – the person, the person’s brain – into an attractor that deepens over time.

 

…THE REST TO COME IN A COUPLE OF DAYS…

The news has been so depressing lately, it seems like a good time to post something positive. So here’s a look at some new research suggesting amazing benefits from psychedelics like psilocybin — especially for people who need help overcoming anxiety. The main question is: how do these drugs work and what new directions do they suggest for replacing loneliness with connectedness as our biology, culture, and technology continue to evolve in sync?

But first, a few laughs about how bad things have been, thanks to John Oliver.

The new research was conducted at Johns Hopkins University and New York University (NYU) and published December 1 in The Journal of Psychopharmacology. Here’s a nice overview. In this post I want to consider the brain changes produced by psilocybin (very similar to those caused by other psychedelics, including LSD and ayahuasca).

The participants in the study were cancer patients (understandably) experiencing lots of anxiety and depression about their illness. To quote from the Scientific American article, “more than three-quarters [of these patients] reported significant relief from depression and anxiety—improvements that remained during a follow-up survey” six months later, after taking a single dose of psilocybin (magic mushrooms) in a controlled setting. These long-term effects are exciting: lasting changes in people’s feelings and behaviour, which of course suggest enduring brain changes. I think these changes put a positive spin on how humans think about drugs, which is a refreshing change from all the negativity.

As my readers probably know, I have long divided drugs into good, bad, and somewhere in the middle. Heroin, crack, and meth…bad! In the middle we’ve got cannabis, maybe ecstasy, alcohol (for some but NOT others), and mild mood-helpers such as kratom. The good drugs — the psychedelics — aren’t good for everybody. There is always that minority who have bad trips, scary psychotic detours that may last hours or even weeks. But for most people, at least those willing to let go of their day-to-day constructions of reality (for a while), I think psychedelics can be a real boon. They can take us on a journey that reveals a universe we may not have known existed. Kinda like the explorers of the 1400s and 1500s who sailed past the horizon and discovered that the world was round, not flat. (If interested, see my piece on LSD and the brain in The Guardian, and a review in Scientific American.)

To quote from Scientific American, lead author Roland Griffiths says that psychedelics show “remarkable potential for treating conditions ranging from drug and alcohol dependence to depression and post-traumatic stress disorder….They may also help relieve one of humanity’s cruelest agonies: the angst that stems from facing the inevitability of death.” Griffiths’ interest in psychedelic research arose partly from his interest in mindfulness meditation, and he’s actually studied meditators who have taken psychedelics to enhance their “spiritual” practice. So when we look at the brain changes triggered by psilocybin and LSD, the most interesting finding is that psychedelics and meditation both reduce activation in something called the default mode network (DMN).

The brain is divided into several functional networks, each responsible for a different kind of engagement with the world. A network connecting prefrontal (and other regions) is in charge of problem solving, something we do a lot. A network anchored in the parietal cortex (that big middle part) is responsible for shifting attention to incoming stimuli, events that are potentially important in the here-and-now. But the default mode network is a set of cross-linked regions that extend from the middle of the frontal lobes (social cognition) to the hippocampus, which keeps track of the details of memory, to parts of the cingulate cortex involved in compacting memories into a gist-like overview, to areas in the posterior cortex that underlie our perception of other people’s motives and feelings.

As the name suggests, the default mode network is “on” a lot of the time. In fact it’s where we go, so to speak, when we’re not doing much else — when we’re daydreaming, reminiscing, imagining, rehearsing tidbits of future actions and possible conversations. But what does this network actually do?

To experience what it does directly, just try to meditate or still your mind for a few minutes. All those wandering thoughts, snatches of conversation, all the what-if images…maybe if I said this, she’d say that…I should really get on with updating my CV…I wonder what’s for dinner tonight…am I supposed to cook, or is it Isabel’s turn? The DMN network is what manufactures all those wandering thoughts and fantasies. (And note that more advanced meditators show less activation of the DMN.) So the purpose of the network seems to be to propagate the sense of a coherent self, an ego, a me. And the problem with that is that ALL of our worries, negative thoughts, concerns about how meaningless it all is, concerns about whether I’m going to get sick, die, be lonely, or get high, relapse, and how long that might go on…all that fussing is simply a cascade of revisions of how best to care for oneself, protecting, optimizing, enhancing…ME!

That self-involvement isn’t wrong, and obviously it has adaptive value. But it’s also precisely the condition for anxiety — the state of being uncertain about what will happen to ME. So muting the default mode network might be a very good thing, at least on occasion, leaving us less self-involved, less concerned about what might happen, and less motivated to make things “better” by, oh, you know, taking stuff.

Psychedelics release us from a preoccupation with ourselves by reducing DMN activation. They allow us to be more open, more connected with other people, with our planet, with our universe. Psychedelics can usher us through a Copernican shift from viewing ourselves as the centre of the universe to viewing ourselves as interested participants in something much larger and possibly much more interesting.

I have little doubt that, within a couple of hundred years, genetic engineering will advance to allow us to modify our biological makeup, that is if we survive that long. Maybe psychedelic exploration and mindfulness meditation will help point the way toward changes that serve as improvements. Maybe the DMN could be turned down, or even turned off, through a bit of neural restructuring, to reduce our concerns for self-optimization and make more room for the rest of the world. Less anxiety, less greed, less power-mongering…more love.

Sound cheesy? What can I say? I’m a child of the sixties.

 

 

 

 

 

 

 

These two-word titles seem to capture how little I feel I have to say at the moment. “Oh shit.” “Now What?” I’m hoping that something more profound will bop me on the head, but I’m not holding my breath.

I haven’t written anything in three weeks, which is approximately how long it’s taken me to get over the election. Now, rather than a surge of horror and nausea when I read the news, I get a slight sense of dissociation, vague anxiety, mild vertigo, and my mind quickly wanders to myriad possibilities none of which seems more likely than any other.

And here I should insert a note. What do they call those alerts that commentators, lecturers, film-makers, professors and so forth are now being asked to put forth before they get into the nitty-gritty of what they have to say? Those warnings that “this material may be disturbing.” If you are particularly sensitive to anti-Trump verbiage, then you may wish to skip the rest of this post. I’m trying to make this light. I received one or two comments following my last post, criticizing me for expressing strong “political” views in an addiction blog. And I respect the commenters for saying what they felt. I really do. But I won’t hide the fact that I really hate that guy. It’s not exactly political. I just can’t stand him.

I’ll spare you all the usual listing of what’s wrong in the world, from Brexit, to the right-wing populist movements sweeping Europe, to Trump. Well I guess I didn’t spare you. But for me what it comes down to with Trump is pretty simple. He’s a liar and a cheat. Almost everything he says is a lie. He replaces it the following week or the following day — usually with another lie. And most of his campaign promises were mere strategic gambits to win votes. He’s not going to build a wall, or prosecute Hillary. Who ever imagined that he would? He’s even talking about taking a serious look at climate change and maybe endorsing the Paris Accord, which is of course good news. It’s just a shame that he got voted in on his promise to ignore the environment because climate change is a fantasy promoted by the Chinese.

I’m not quite depressed. I think I’m suffering from anhedonia or dysthymia or something… those are clinical terms for (let’s see if I can remember) not feeling particularly good but not particularly terrible either. I just looked up “dysthymia” — it’s actually defined as “persistent mild depression.” Well, that’s close.

If there’s anything useful I can say at the moment, it’s to suggest we look at the present glut of bad news as waves rather than particles. Sounds spiffy to use quantum terms. Waves seem like tendencies, currents, gusts…in a universe that is constantly in flux. Whereas particles…give the sense of matter, substance, stuff that collects in corners until there’s so much of it you really have to rent heavy machinery to get rid of it. So when the Buddha talked about impermanence as the main act, maybe he was thinking more in terms of waves than particles. Impermanence actually seems like good news at the moment.

I sometimes wonder what’s at the core of all these right-wing leanings. Let’s preserve what we’ve got. Let’s keep America American. Let’s maintain our way of life because it’s being threatened. Damn right your way of life is being threatened because….get ready…you’re going to die! What could be more threatening to anyone’s way of life?

But when I walk around in the crisp sunshine and notice how incredibly vivid and beautiful the leaves are, in their fall fashions, and when I watch one of my twins stuff missing homework into the other’s knapsack, both already mounted on their bikes, breathing steam, I think: this is just fine. This is a great moment. This wish to preserve things the way they’ve always been (as if that were a good thing)… What’s the point of that?

I once read a book by a Buddhist/cognitive scientist type scholar (Francisco Varela) who said something like this: Don’t even try to fill up your experience (viz consciousness) with yourself, with the sense of being a self, i.e., yourself. Because if you were successful, if your experience was full of yourself, then there wouldn’t be room for anything else. Nothing else coming in, or going out, no novelty, no change, no nothing. The illusion of being a distinct, essential self (yeah, you and the other 7 billion) is not only impossible to achieve but also a really bad idea. Experience is pretty amazing, so let’s not fuck it up by trying to make it stick to how we wanted it to be.

(Or as Matt so succinctly put it in a comment to the last post: “Why whine and worry about the way you want it to be, when it’s right there in front of you being what it is.”)

I guess, to follow my own advice, Trumpism is just a current of change in a world that’s already changing beyond our imagination. It won’t last either. Might as well watch it and be fascinated.

 

I feel heartbroken and sick this morning, as I’m sure many of you do as well. How could this happen? I had a post ready to put up today or tomorrow…I was going to wait a day or two until the election fever died down. As it is, this fever isn’t going away any time soon. It’s mutated into a chronic infection. I can’t imagine getting past this sense of tragedy, failure, disgust…for quite some time.

All I can offer for now is an analysis/prognosis provided by Michael Moore a few months ago. Moore is one smart cookie. And here’s a recent blog post by Tim Urban. This one is really excellent for post-election malaise. I promise it will cheer you up.

When things feel overwhelmingly bad, one of the things we try to do is to explain and understand what happened. These two commentators help put it all in perspective.

Too many people with damaged lives in that country of yours — which feels in many ways like my country too. Never mind that most of the damage was extended and entrenched by Republican policies over the last many years: opposition to raising the minimum wage, opposition to universal health care, guns for all, reduced taxation on the wealthy, training people to blame others for their misfortunes rather than look at the elephant (pun intended) in the room.

None of that seems to matter now. People with damaged lives will try anything to change the way they feel. They will take extreme measures to change reality, to wrench it, twist it, with whatever comes to hand, something strong, powered by defiance. Consequences be damned. It’s sort of the ultimate “fuck you” directed at…well directed at the adults upstairs….Obama, Hillary….the adults who seem somehow to be responsible for whatever pain we’re feeling.

We know about that — better than most.

I don’t have much else to offer that might help with your despair (if that’s what you’re feeling). I hardly slept. I watched the election returns until about 5 am local time….then I started to give up hoping and fatigue got the better of me.

Maybe just two things to mention:

Sometimes a sick system needs a chance to swing all the way wrong before the pendulum reverses its direction. Maybe with a Republican president and Congress, legislation, policy, the courts will have had a full run, their unfettered chance to make things as wrong as possible — and then things will swing back leftward. Because there won’t be anyone to blame and because the politics of selfishness and fear are unstable — they can’t last indefinitely.

The other thing is: I’ve been ranting to my kids about the election, what’s at stake, almost daily for a couple of months. My boys are just ten, so they’re not political pundits, but Julian would often ask me at breakfast if there was any more news about Trump in the newspaper. They knew who the good guys and bad guys were…at least from our perspective. So this morning I stumble into their room while they’re getting dressed and I tell them: Guys, the news is really bad. Trump won. At first they thought I was joking: I’ve been citing the polls to them daily — how could that be? But after a minute or two, they just went on with their day. They finished getting dressed, practised a bit of piano for their lesson this afternoon, had their cereal, and forgot about it. Life goes on for them, and I guess it does for all of us.

Shit happens. That we know. But we persevere and make the best of it. We try to look ahead and hopefully we notice the slant of the sun in the autumn leaves and the invigorating air that enters our bodies with each breath. And we try to be aware that everything is impermanent. Stuff just keeps changing. That doesn’t mean it’s the end.

We can learn a lot from kids. A little knowledge might be a dangerous thing, and just being here now is still the only place we’re ever going to be.

 

Last post I described common denominators between drug addiction and compulsive gambling. Today I want to ask: how do we assign responsibility for promoting products that benefit some while seriously harming others — because they are too attractive?

I got back from my trip to Australia about three days ago and I can finally see straight this morning. I came home travel weary but armed with some great new insights and perspectives. Most of what I learned was by way of the “Many Ways to Help” conference organized by the Victorian Responsible Gambling Foundation. In particular, the counsellors, case workers, policy makers, and researchers in the audience and at the podium repeatedly raised the question of responsibility — and how responsibility is related to technology, access, and profit.

Let me unpack that. Gamblers in the Melbourne area come in droves to the Crown Casino, a multi-level pleasure palace packed with every conceivable form of entertainment and an enormous number of high-tech slot machines distributed among the bars, bandstands, restaurants, craps and roulette tables…along every corridor, in every nook and cranny. These machines have been designed to appeal to a great variety of individual tastes. In some, the spinning character set settles into a poker hand — usually a losing hand. Others rely on matches among fruits, goblins, jewels, and shining, flickering, mesmerizing tokens lifted from fairy tales and Kung Fu movies. Some mix cards, dice, and fairy-tale images on their glittering screens. The variety and artistry are incredible.

What offers all this excitement, this sense of fun, and what keeps gamblers playing and losing and playing and losing, derives from innovations in design, programming, psychological modeling,  video game development, and the technological know-how to package all these in a single product. And of course the paycheques of the designers, programmers, artists, and so forth come from a casino industry that rakes in enormous profits.

The attendees at the conference were pretty pissed off. Because, despite the various placards encouraging gamblers to take it easy, and despite various government regulations that force casinos to notify gamblers when they’ve reached the danger zone, there’s a confluence of factors that attract people to play as much as possible. Especially at the slot machines, where play becomes almost mindless (see previous post). The conference attendees spend their lives trying to help people who continue to lose — not only their money but their homes, marriages, interpersonal relationships of all sorts, and even their lives — sometimes directly via suicide, sometimes slowly through the alcoholism and other forms of escape that ride on gambling addiction. It just doesn’t seem fair. The casinos know what they’re doing, and they’ve got the resources to do it very effectively.

But there’s another side to this argument. The casinos (and other gambling outlets — I’ve chosen slot machines at casinos as an overt example) are just businesses. They exist to make money, pay their employees, and increase their profits, just like any other business. Does it make sense to blame them for being good at what they do? Is it their responsibility to protect the fewer than 1% of adults in the Melbourne area who are “problem gamblers” (and the 2.4% who are “moderate-risk gamblers”)? See recent research findings here. Or should the government come down hard on an industry that brings pleasant entertainment to many but serious harm to a few? These are some of the questions at the forefront of the discussion about problem gambling in Australia. And the same questions are debated just as hotly in the US and the UK.

If the answer is “maybe,” then let’s take the argument further: Should the manufacturers of fast cars be held responsible for accidents that result from speeding? Should the makers of video games like The Sims and Candy Crush be penalized for making the most attractive (and addictive) games ever known? Should Facebook be banned? Nir Eyal has a fascinating blog that explores the issues and ethics at the core of addictive technology, and the answers to these questions aren’t simple.

Aren’t adult humans supposed to be responsible for controlling their own impulses? After all, the world is full of temptations, some of them natural, some manufactured. It’s hardly conceivable to block temptations at the source, especially when most people can steer around them quite successfully. And would we want a world that minimizes tempting attractions, even if we could achieve it?

Where this conundrum interests me most is where it intersects with the problem of drug addiction. And alcoholism. The parallels are mind-blowing. First, stigmatization, family disintegration, avenues of treatment, and support groups continue to blossom in both realms. Second is the question of making profits off people’s suffering. Third, how do we balance the suffering of the few against possible benefits to the many? The sale of addictive drugs like heroin, methamphetamine, and crack line the pockets of drug lords and gangsters, but they also pay simple farmers all over South America and Asia. And the legal addictive drugs like oxycodone and Vicodan (most famously) certainly profit Big Pharma, but they also provide badly needed relief for the millions suffering pain. Next, should we restrain what might be called the technology of attraction at all? The substances I just listed, as well as modern slot machines and internet gambling, evolved from links between profit and technology. Technology needs money (e.g., profit) to grease its wheels. Even scotch whiskey — at least the good scotch that I like — is the product of an industry that harms a portion of its users while feeding some of its profits into technological advancement. Alcoholism kills 88,000 Americans per year. Yet almost nobody recommends a return to Prohibition.

So maybe it’s the same problem in general — the same problem for gambling industries, video game makers, social media designers, drug manufacturers, and distilleries with exotic names like Glenkinchie and Laphroaig. Many of the products that make modern life fun, pleasant, interesting — or even just bearable — for many of us also make life hell for those who lose control. Should we assign blame for making, selling, or buying something that’s too desirable? Do we just turn responsibility over to the user, or is there a sensible way to restrain the dealer? Is there any concept of regulation, packaged warnings, education, or harm reduction that could help across the board?

I’d love to hear your thoughts.