Here it is, guys. A write-up of that talk I’m going to present. Actually, it’s a bit of an approximation, because I have to give another talk next week, before TED, at something called PINC, and I’m allowed 20 minutes instead of 8 minutes. So….this is more elaborate than what I can say on TED. It pretty much captures what I think about the issue of trust.
Nobody can trust an addict, least of all him- or herself. And that’s what I’m going to talk about: this lack of self-trust and why it’s so pivotal in addiction and recovery.
First — my history of addiction…(blah blah). And then, the 187th time I tried to quit, it actually worked. I think quitting became possible because, this time, I found a part of myself I could trust.
But why was it so difficult until then? Why is it so hard for addicts to “just say no?” We can answer this question only if we can explain what it is about addiction that works against self-trust.
There are two psychological phenomena that help explain it.
First phenomenon: Ego depletion. The inability of people to maintain impulse control for a long period of time.
Areas of prefrontal cortex in charge of self-control run out of fuel. Like muscles, these areas get weakened and strained with continuous use. So, you can maintain self-control for a while — but not for very long.
Classic experiment described: subjects come to the lab hungry. They are told not to eat from either a bowl of chocolate chip cookies (one group) or a bowl of radishes (the other group) sitting right in front of them. After 10 or 15 minutes, they have to complete cognitive tasks requiring self-control. Those who had had to suppress their impulse to eat the cookies did less well on those tasks. They had used up some of that precious cognitive resource.
Ego depletion is a serious problem for addicts of all stripes: because the thing you’re trying to control is there all the time. The bar on the corner, the phone number of your dealer, waiting in the phonebook — cues associated with your addiction are always present.
And addicts have to control their impulses, not just for minutes, but for hours, day after day, week after week. So, they run out of capacity, and they give in.
Recent research shows: people who believe in their capacity for self-control are less affected by ego depletion. But why should this be so? How can a subjective state, a feeling, have such influence on a fundamental brain mechanism?
I think it’s because, if you don’t believe you can do it, the task is actually two tasks. You have to control not only the impulse but also your own doubt. Trying to maintain that double inhibition, to maintain your confidence while controlling your actions…. it exhausts your resources all the sooner.
That makes it very tough for addicts. Why should they trust their impulse control? They’ve failed time after time. So for them, ego depletion is like a sledgehammer, quick to overwhelm them. And they fail yet again.
I’m always struck by a certain irony: People think addicts are weak and lazy. In fact it’s the opposite. Addicts work harder than anyone else at the task of self-control.
Second phenomenon: Delay discounting. This is the tendency to devalue long-term rewards in favour of immediate rewards. Example: You might choose 5 euros today vs. 20 euros in a week. The immediate reward is exaggerated in value.
For addicts, this amounts to getting high tonight, or going to the casino, or eating the whole cake, at the expense of future happiness: e.g., having a happy marriage, a good figure, or keeping your job, or money in the bank, or staying out of jail. These future reward are devalued — they seem not to count for much.
But the appeal of addictive substances and acts is made all the more powerful by the release of dopamine. Dopamine’s job is to rivet attention to immediate gains.
Dozens of studies show greatly increased dopamine when addicts encounter cues associated with their addiction. A kind of hyper-conditioning. This narrows their attention, and their desire — to what I call the neural now.
The only antidote for this delay discounting may be: having a dialogue between your present self and your future self, whereby the future self takes your present self in hand and says: trust me — things will soon get better. Stick it out…with me.
But addicts have a very hard time seeing their future self as anyone but an addict.
Yes, addicts have dialogues with themselves, but the problem is that they can’t find a future self who is trustworthy, who can carry the present self past the intense attractions of “now”. Any future self they that’s credible is NOT where they want to end up. There is no future to value.
Because it’s so hard to trust themselves, addicts trust the only thing they can trust: their drug, their drink, or the behavior that brings them temporary relief. And that works for a while, but then you wake up, empty, broke, betrayed, in even worse trouble, perhaps with withdrawal symptoms starting up….and you have failed yourself yet again.
Self-trust is hard for addicts to find, but when they find it, they may also find a pivot point. Their whole life can swing around: they may start controlling themselves because they believe they can, because they’ve caught a glimpse of a self they can rely on.
Unfortunately, current treatment approaches often don’t encourage you to trust yourself. They encourage you to see yourself as a helpless addict, a person with a disease. They encourage you to trust in a higher power — in God, or the group, or the doctor — not in yourself . (Trust in the group is not a bad thing, and it may be a means to an end — the end being self-trust. But the question remains, do they help you find that self-trust?)
Yet treatment centers based on empowerment are starting to spring up, and I think that’s an encouraging sign.
Here’s how I quit. Quitting attempt #187: I wrote the word “No” in big letters, tacked it to my wall, and recited it 50 times a day, so that I couldn’t stop imagining it. And I saw that I could keep saying “No,” next minute, next hour, next day. I’d found a way to believe in my ability to stop, and that felt like a new self — or at least a different part of myself — I could rely on.
So, for me, self-trust and recovery started at exactly the same moment. In a way they were the same thing, as self-trust initiated the first steps of recovery, and those steps reinforced the sense of self-trust.
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
While you your blog is somewhat of an alternative to 12 step programme, i find that your attitude pathologises drug users and people who use drugs just as much as the 12 step approach does.
You provide no critical view of addiction or the workings of addiction as a social construct and thus contribute to the marginalisation and pathologisation of drug users. I would argue that this is made worse by your addition of neuroscience: a scientific discourse positions your knowledge as a certain ‘truth’ – objectifiable, quantifiable and therefore there can be no other. I believe science and neuroscience can be done ethically and critically but your application of it is neither. I believe you could make your blog and your analysis of addiction better through an integrated approach to drug use – combining the socio-cultural with the bioloogical (neuroscientific) and the psychological.
I would love to send you some readings and start a conversation. If you are into it please let me know.
All the best. Nyah
What a strange thing to say. My emphasis on self-trust relies very much on a social perspective. My whole approach is based on efforts to integrate science and subjectivity in understanding addiction. And why on earth would you question my ethics? What do you know about them? Are you sure you don’t have me mixed up with someone else?
I studied critical theory over two decades ago. I think I learned some valuable lessons, but I’ve also moved on.
o.O
What a very odd post. Almost seems “auto-spam”-like. Maybe you were just the latest victim of the Syrian hacking efforts!
That sounds Syrious!!!
Do you always start a conversation with an all-out attack of someone’s ethics and by making unfounded assertions? Either something has been lost in translation or you have an predetermined agenda.
Way to go Marc…
Another great post, when people ask me how long I have been clean and sober, I say “Long enough to know better” and “short enough to resist” today I am clean and sober one day at a time.
Many programs are geared to the length of time you are clean and sober, in gaining recognition for time served, like; bragging rights. For me this giving the impression that some are better than others, it’s not so much the length of time, but what we have learned in that time.
I must always be careful and aware not to put down any programs or groups that have helped others, and in saying so… if it works for them let it go, live and let live.
I refused to live a life in recovery; I have seen too many people still going to programs, living a life dependent on something out side of themselves. Living a clean and sober life, but still tormented from the past or in the ability to trust themselves and are still unhappy; some call this a dry drunk.
Each individual person has his or her own story when it comes to their addiction. It’s usually determined as an addiction when we experience negative consequences, like the inability to trust ourselves, and despite those negative consequences we still do it…
Today I have regained my right for choice, or trust… I have looked at all the underlying issues in my life and have brought closure to those issues, so I no longer have to hide behind drugs or alcohol.
So I can say; I am no longer an alcoholic or drug addict.
When I say I have dealt with my issues of the past, I’m not only talking about the things that I have said or done, or what has happened to me, been said to me or done to me, but the issues from within “trusting in myself”. I have had a change of “Heart”.
So I was curious about “your methods” as I am always researching and open minded in order to better help the people I serve, as well as the sponsees I get the privilege of helping. In reading your article along with questions and your responses, I find it quite humorous. Our disease doesn’t just “disappear” just as my heart disease does not. Our disease goes SO much deeper than just using substances, it’s our way of thinking and our behaviors. And in my therapy, along with working a 12 step program, I was empowered to believe in myself. Yet I was also made to look at how distorted my thinking patterns were to which I am so very grateful. My life was not chaotic b/c of the substance use, it was the way my thinking patterns were along with behaviors. The substance use was just merely a “symptom” of my disease. I cannot imagine how unhealthy you must be, if you have not gone to therapy & worked on many things- yourself, you did not mention anything like that. But the self-centeredness comes blaring out from you. I am hopeful that perhaps some information was left out, and if so I do apologize. But seeing how so many are dying at an alarming rate and numbers have been at an alarming climb over last 5 years, many things need to be done.
Knocked it out of the park, Marc. Yet again, I feel like my own story is being told with the addition of neuroscience (wow, “addition” is really difficult to type when you frequently write about “addiCtion”, isn’t it?).
The only thing I’d add is that many who end up addicted didn’t trust themselves for whatever reason to begin with, whether it was due to childhood abuse, childhood “helicopter parenting” (overly controlling parents who never allowed kids to grow up and make their own decisions–therefore not developing a sense of self trust) or other external issues. I’ve just seen that tale told numerous times, enough to no longer discount it. Which, of course, doesn’t detract from what you are discussing in the brain once the addiction is present.
Just that sometimes there are people around the addicted person discouraging self-trust who have nothing to do with the treatment centers or certain programs. Sometimes it’s the families of the people themselves.
This is great though, absolutely. I don’t mean what I wrote as criticism.
Hi Persephone. I’m not very thin-skinned or I wouldn’t be doing what I’m doing. Like writing the book, or telling all these upright Dutch folks about the crimes I committed as a young man, e.g., at the PINC conference last Tuesday. In fact I gave my class on Thurs the same talk I did at PINC two days earlier. No time or inclination to prepare something new… Audiences are not very responsive here — so you hardly have a clue what they’re thinking….lots of room for paranoia — until you’re done and they clap, a little or a lot, or until afterward when they say nice things — or not. I sometimes think that Dutch undergrads can be quite judgmental. They’re a pretty straight bunch for the most part. (Or maybe I just don’t quite get them, because they are so much younger, blonder, and taller than I am : – )
Anyway, actually, you make a very important point. This is a complex issue, but my sense of self-trust was already pretty much shot before I got to Berkeley and fell in love with drugs — even before I got to boarding school. In fact maybe I’d never quite developed one. I was shy and anxious as a young teenager, which I made up for by being too boisterous at times, sarcastic and “clever” at other times, and by “making myself up” to resemble other kids whom I admired.
A few months ago, my dad and I got into an argument, and he told me I had a lot of ego. I reflected on that for a long time afterward. I think he was wrong. But the ego I did have was sometimes too much for him. And that was a problem for me as a kid. I guess there was a war of egos going on between us, during my adolescence, and he generally won it, being the big guy. So I often felt that there wasn’t much substance to me — to who I was — and that wispiness, that frailty, was my core — not much to trust in. Maybe that sense of being non-solid is something I have/had in common with other addicts. I’d be curious to know.
Well, I do remember a sort of completely non-scientific survey of sorts at rehab, the staff asking us all if we were “chameleon” types; people who can change on a dime, never one solid core of a person, but always shifting. Later, at a lecture, we were told we had been asked this because of that being a common trait observed (by the staff, by experts? We weren’t ever told with any certainty about that, everything was kept very general) in addicted people, this “chameleon” aspect. I don’t think personally that there is an “addict personality” necessarily, but I do think a lot of common factors lead to the problem.
In the last several years since rehab, I’ve thought quite a bit about this “chameleon” aspect. I was definitely someone who’d said a resounding yes to that question at the time, but it was no longer true of me. I think if anyone had looked further into the issue there, they’d not have found “traits of addicts”, but rather aspects in some people’s pasts that (quite aside from their addictive problems) do in fact lead to this, namely what you mention here. No solid sense of self.
Many who said yes to this question also revealed that they had faced abuse, either at home or in school situations. In many cases where people have been dominated and/or abused by others (or even just shy kids trying to make friends), they are always sort of off center, going for whatever “self” they think will be most pleasing to others in the various situations they find themselves in. It’s like being in a slanted room, always trying to right yourself (especially in abusive home situations). I was kind of the same, either introverted as could be or the class clown. Like you say, always trying to make yourself up to be someone else, someone you considered admirable. Now you know you’re admirable in your own right; you don’t need to make yourself into someone you’re not.
Being not even remotely an expert or even student in any psychological field, I can only speak from experience. Once I got myself straightened out, I found I had to disentangle myself from a few almost lifelong relationships that had had me always shifting internally. With those relationships gone, no one left to react against or try to please, I found that I had coalesced (quite quickly, actually) into who I am today. I am who I am, and while open to new ideas, my “core self” is pretty much solid now. Really, I had faced quite a bit of control and manipulative abuse growing up, and with it gone, I could finally be me. But this me is a me I definitely trust, and doesn’t change with the wind. This me was always in there, too, I just never had the confidence (or it was knocked out of me at every turn) to embrace it. Once I did, it made all the difference.
Do you find the same thing to be true? Because one other great aspect of it is that the solid me is not someone I have any desire to disrupt, undermine or do self-destructive things to at all. Perhaps your Dad was just reacting to the fact that he can no longer push around or undermine THIS Marc. You think?
I wonder about this quite a bit myself. (Well, obviously….lol.)
The chameleon-like personality type can be a dimension rather than a category. Maybe even several dimensions bundled together. Whatever survey you responded to might have been digging for a sociopathic personality. That was NOT me (despite the bad stuff I did) and probably not you. I was much less strategic, much more angsty. And when my breaking-in habits got really bad, I was certainly diagnosable as “dissociated” — maybe even a bit of multiple personality disorder — though just a bit. Maybe one and a half personalities at most. I’m sort of serious.
These are strange waters. But no, I don’t think my dad was trying to push me around. I think he felt at a loss when he wasn’t the center of attention — the shiniest ego in the room — because he also had a real lack of certainty at his core. Sadly these things get passed down. My grandfather (his father) was almost pathologically shy. But very sweet.
If we try to undo some of the damage with each generation, we should be getting somewhere pretty soon.
Wonderful! Are you able to post the video after you give the talk? I want to see the crowd’s response!
You really do hit the nail on the head with the trust thing. I cannot count the number of times I was scared I would slip up. Controlling that anxiety in itself I think inevitably contributed to the numerous times I had trouble stopping my addictive behaviors (as you said, my ego was depleted).
In response to the 12 step programs and spirituality, I do think they CAN help someone when they use that “higher power” to find a sense of self-worth and love. To know that they are loved and supported just for trying. It removes some of the personal burden. I say this as I just read a testimony from a friend who has done a REMARKABLE job recovering from anorexia, and found her faith to be one of the strongest supports for her recovery.
The paths to recovery are as varied as we are, but I agree that the trust in self is a common element.
Elizabeth, you are of course right. Religion and spirituality can help some people tremendously. Especially if there is an external locus of control. I have written a bit about this here, although within a different context:
http://addictioncapetown.blogspot.com/2013/02/faith-based-rehabs-what-in-gods-name-is.html
And hope to write about it more in the near future.
I certainly found a lot of benefit from the 12-step program and meetings personally. I do, however, feel they have been co-opted by the justice system in the US where mandatory attendance is prescribed. I also think that they are not “treatment” but an adjunct to treatment for those who choose to attend such programs and benefit from them.
Personally I feel they have no place within the professional treatment setting.
Whoah! So much great information! Thanks for passing that blog link along, Shaun. While I’ve seen some benefit from spirituality, you remind me of the MANY more instances of failed attempts to recover in religious institutions for recovery because of the belief that “prayer” and “miracles” are all that are needed to get someone through the process.
Fortunately, the individual I was referring to went to a legitimate in-patient treatment center where religion was just PART of her recovery. Nutritionists, psychologists, psychiatrists, etc… were all present as well :).
Shaun I really like what you said in the blog you linked in your post. Makes alot of sense to me, even as a NONE .
Wouldnt it be ideal to have faith of whatever nature in a program that is founded on sound psychology – perhaps not integral but optional ?
Im very interested in your addition of spirituality to the trimodal model of addiction ie bio- psycho- social . Can you tell us more about it??
Very briefly Bill, as I don’t want to hi-jack Marc’s post, we offer spiritual counselling as an optional extra with pastoral counsellors. Sultan Bahu, an Islamic facility in my setting runs a very effective recovery program and offers both Muslim and Christian components separate to the treatment components. I will, perhaps, in the near future write a bit more about this subject, and will keep you posted. Drop me an e-mail and I’ll keep you posted. Thanks.
Great and thanks. My email is bill@smartne.org
Shaun, please hijack away!!! That’s exactly what I hope to see here: runaway dialogues and extra helpings of information. Go to it!
Hi Elizabeth. I’m glad to hear that you feel that way too. I’m getting similar feedback from a lot of folks. There is definitely a point of resonance here. And see my comment above, as to my own lack of “ego” (what an old fashioned and ambiguous term!) as a teenager. So there wasn’t so much to begin with, and maybe that’s an important point when you start “depleting” it further…
I’d be glad to post my talk… But I don’t think it’s one of my best. I kept going back to change it — quite substantially — at the coffee breaks and at lunch. The other talks were so personal and so fresh. So I made mine more personal too. But as a result it was just under-practiced.
I think I’ll do a brief post on the conference — tomorrow — it was so amazing. But anyway, I’ll have a scaled down version for TED by next week, and that one will be online. But if you let me know how to post the PINC talk, I’ll do it. Maybe through dropbox?
Would the PINC talk be referring to CAMH? I do have dropbox, but I’m not sure if I have access to the video. If it is on the employee website somewhere, surely I can find it?
No, it’s a completely different talk. The self-trust thing was central.
Great Marc – very excited for you!
“people who believe in their capacity for self-control are less affected by ego depletion.” This is why we work from a strengths based point of view. I was speaking to someone who was told in their first session in a very expensive “traditional” treatment program that only one of them would make it, if they were lucky. Bet the brochure didn’t say that! I love the lyric in a Red Hot Chilli Pepper’s song “I’m motivated by your lack of doubt”.
“Delay Discounting”: Short term solutions for long term problems – at the heart of most addictive disorders.
A lot of what you say in this and other posts is what I try to put into practical application in our clinical setting, and let me tell you it works! Over the next year or so we are hoping to do some formal research around strength based non-abstinence insistent treatment approaches. Paradoxically we are finding more abstinence from this approach.
Shaun, this is really exciting! As I mentioned somewhere, there seems to be a good response from publishers to the theme of my next book — which is presently just at the proposal (blueprint) stage. But the theme of self-empowerment or self-trust is exactly where I think that book is going. That and subsequent talks and articles. The thought that you are putting these principles into practice, deliberately, consciously, and that it’s working, is actually VERY encouraging. I’d like to talk more with you, about what you’re finding out.
The paradox you mention in your last line is of particular interest. And that may be a manifestation of a larger paradox — a huge paradox: which is the incommensurable – ness (couldn’t make that one word) of helplessness and self-trust. It seems that these two opposites go together! I sometimes find a clear, almost comfortable sense of helplessness — as in having nowhere further to fall — at the same moment as I find self-trust. (see Lisa’s comment, last post — very relevant! — and my response to Fred below) And yet semantically these are polar opposites. So what the hell is that all about?
Note that helplessness, viewed this way, is NOT that sense of fundamental weakness or “disease” or flawed-ness that is often pitched by traditional treatment approaches. There’s a really important difference here, but I’m not sure how to talk about it.
Woah…. That simultaneous expression and experience of “hopelessness” that manifests “self-trust”….how to express helplessness without it becoming “powerlessness”….. These are a couple of paradoxes of treatment/recovery and big questions in the clinical setting.
I see so many polar opposites in addiction and recovery therefrom that need to be examined. I keep this little phrase in my head that I came up with:
“Balance is not achieved by standing tentatively in the middle-ground but rather by fully embracing and understanding the two extremes.”
It helps me remember that with addiction it is very seldom “either or” but more often “both plus more”.
If any of that makes sense!
That’s a great phrase. I will indeed keep it in mind.
I’d clear up one detail: helplessness is not hopelessness. Well that doesn’t make things any less muddled, does it, but they truly do feel different. Actually, maybe we should just throw out “helplessness” too. Maybe “acceptance” is the best term to put on this side of the paradox. But then it’s less of a paradox…
I mean helplessness! Subconscious perhaps? dealing in my field does sometimes seem hopeless at times. I love this quote from Dr Mark Willenbring:
We need to foster the humility to care, even though our treatments are only partially effective, and in some cases totally ineffective. We can’t abandon our patients because we cannot change the course of their illness.”
Okay, that clears things up. Best to keep our paradoxes straight, right?
Hopefully the POSITIVE PSYCHOLOGY movement will find its way into addiction treatment. Meanwhile, SMART RECOVERY is a personal empowerment program.
SMART recovery keeps popping up in this context. See the comment by Bill Abbott below. And I think this is all compatible with positive psychology, though I’m not completely sure. I haven’t looked into positive psych in much depth, mainly because I feel more at home with “negative psychology” : -) Seriously, if it goes below the surface, then that’s a good thing. Otherwise, it will get blown away by the raw gusts of emotion that go with addiction treatment.
Hi Marc, I enjoyed reading your speech. I related to it as I had indicated in the previous blog on the same subject. Now, however, I have a question/comment. I’m not familiar with “TED” or “PINC” so I don’t know who your audience will be, but I’m coming from the perspective of a non-scientist. I’m a psychotherapist, writer and poet, and have always been focussed on the psychological/emotional/spiritual explanation of things.
All this is to say the discussion of Dopamine and its role in our behaviors, specifically, addictions leaves me with many questions. For one, you talk about “the release of Dopamine” and how it impacts on us pursuing our objects of addiction. Also, that upon encountering cues associated with their addictions, subjects’ Dopamine levels rise. It’s unclear to me how this works. Do addicts start with Dopamine levels that are too high (or low), and if not, how does the Dopamine level go up? What does the increase in Dopamine actually do? Another thing that comes to mind is, if people with schizophrenia, for example, are treated with certain meds. designed to effect their Dopamine levels, might something similar not work for addicts?
Anyway, perhaps these questions will come up after your speech… and even if they don’t, I’d be interested in their answers.
Thanks, and good luck!
Denise
Hi Denise. I can’t explain all the ins and outs of dopamine in a comment here. It’s a crucially important neurochemical, centrally involved in addiction, attraction, focused thinking, and certain psychopathologies, like schizophrenia as you say, and also OCD. My suggestion: Read my book. That’s where I put the neuroscience and psychology of addiction together (in a nail-biting, cliff-hanging page-turner). That is my objective and unbiased suggestion.
Hi Marc. I will read your book, AGAIN 🙂
Hi Marc,
This is great! I can’t wait to see your TED talk.
The issue of addiction and self-trust is so important. I too feel that certain treatment approaches balk at this innovative approach. Many addicts, as you said could not trust themselves “there best thinking is what brought them to their darkest hour”, and yet there has to come a point where someone can learn to walk again, and on their own two feet. Becoming dependent on another person, or a group, or a higher power, is not a long-term solution in my opinion. Because that group, sponsor or even the sense of being guided by a higher power will not always be there, then what? When we are left to our own devices, this is the time where, as you said, a new self-paradigm needs to take place. If we can survive emotionally and not give in to that impulse, that escape from our emotional reality, then we become stronger and more trusting of our own inner resources. I have been here time and time again and each time it has been difficult to not react, and each time I don’t reach for that something that lies outside of me, there is a little more confidence, and a lot more trust in myself. That ability to self-soothe and comfort ourselves rather than to escape is so crucial for us to grow into our differentiated selves.
Thank you for all that you do!
Sincerely,
Julie
Julie, I could not have said it more perfectly. That’s exactly how I see it. Indeed, every act of trusting yourself and being trustworthy builds more muscle, more flesh, on that internal self who really is our friend, our caregiver, our supporter. This is the sense of self that keeps getting really seriously lost — like it’s not even a ghost in our memory — when we continue to give in and “trust” in the act, the substance. It really is a choice each and every time, but the choice gets easier.
You can see how the tale of Ulysses and the siren song gets to be a well-worn metaphor when people think about addiction.
Hi Marc,
great post as always!
Don’t worry about the PINC I think 20 minutes are better than 8, because you don’t have too summarize; it is often more difficult to be synthetic…Moreover, do not forget that you know ‘the argument’ much better than any other viwer, because you had experienced the drugs on yourself…and this is the most important difference between you and the other reserchers who study addiction…a big difference, belive me…
By the way, continuing to talk about trust, I completely agree with you, that this double inhibition eventually exhaust all the resources! Just yesterday I was thinking about my recovery, I found a great relief just when I delivered my health problem to competent doctors. I felt a sense of liberation! Because I could reduce my control and especially fear!!! Trusting of the doctors, I’ve learned to better live with my health problems. For anorexia was the same: blindly trusting of my analyst, I learned to accept myself for who I am, to belive in me again and trust me. It has been long, arduous and painful, but it’s worth making. She has really changed my brain…The brain is plastic and it can be changed; this is the good news 🙂
Hi Valeria,
Thanks for your pep talk. And it really went pretty well. There were glitches, but my audience was apparently more forgiving than I was.
What you say about trusting others seems at first to go against the thrust of my arguments. But, as others have said, trust in others — professionals, doctors, even God — can be a very good thing. It does relieve the burden of ego fatigue, and that’s crucial. I like to think of it as a means to an end. Because indeed, the brain is plastic, so we can fold this sense of confidence back into ourselves. And there it can remain — no more appointments necessary!
I love the post. I wish it weren’t negative on the potential role of a higher power. I don’t think self-trust requires rejecting faith. When I came in to 12 step, learning to use prayer and to trust in a higher power was really important for getting me through withdrawal and threats to my sobriety. My addiction felt like a spiritual malady, and a spiritual solution made sense to me. Developing a spiritual life was, for me, a source of strength that I hadn’t been aware of before. I don’t think there’s a conflict between trusting God and trusting myself. My faith in God is a part of me and has helped me heal. I did it – I put down my addiction. I showed that I can trust myself. AND I credit (my faith in) God’s help for pulling me through. I choose to see my sobriety as tied to my spirituality. But, perhaps the faith I acquired in 12 step just tricked me into believing that I could do it, which made it easier for me to stave off ego depletion. That might be what was going on. I’m OK not knowing exactly why or how it worked. I’m just grateful for my new life.
However, if we accept the hypothesis that my faith was (at least in part) an effective mental trick for overcoming ego fatigue, a couple questions open up. First, we know that many others in 12-step have had similar positive experiences, so this mental trick CAN work for some and perhaps should be viewed supportively for its results when it does. Second, for those for whom this trick does not work, what is an effective (non-faith-based) substitute? What can a friend/therapist/sponsor offer to someone to assist them in overcoming the pernicious effects of ego fatigue if a higher power isn’t an option or hasn’t worked? My recovery, and my service to others, will be stronger the more tools I have. Thanks in advance for thoughts on this.
Hi Fred. You make an excellent case. You’re right, I should not have implied that the trust in a higher power, such as God, is necessarily at odds with the development of self-trust. It’s just that a lot of 12-steppers seem to maintain their faith/trust in God/the group as an end in itself, and some are actively discouraged from relying on their own steam. We’ve heard a lot of dialogue on this blog as to how that can be harmful for some, though perhaps helpful for others.
Your experience seems to suggest a sequence, from surrendering oneself to trusting oneself, much like Marek’s comment below. I think it’s great that it worked that way for you and that it CAN work that way for others.
I have also experienced a state of “pure helplessness” that has a sort of cleansing effect. I go back to it from time to time. But strangely, for me, that’s not connected to my addictive tendencies. Because when you acknowledge that your little life is like a leaf blown about by the cosmic winds, there is a kind of stillness, and you know right then that nothing you can do (such as taking stuff) is going to change it.
As to your questions, please see other comments here, especially Bill Abbott’s comment below. It sounds like SMART recovery is one way. Maybe “motivational counseling” is another. I have to learn about these options myself.
Hello, as a recovery porn addict I can say that “helpless” attitude worked for me in first two months, but from beginning of May after few relapses I decided to change my attitude to strong inside word “NO, I don’t wanna do it, I’m stronger”, I don’t know how would it work in the beginning of my withdrawal, personally I think my willpower was too weak for that kind of attitude at the beginning (meditation trainings propably help me now)
Maybe “helpless” attitude for first phase and then stronger attitude after some time in sobriety would be the best combination?
That makes a lot of sense. I mean, it’s certainly one avenue. I just looked up the ACT approach to therapy, and that also recommends some focus on helplessness as well as self-acceptance. But the idea of a sequence leading to self-trust seems well suited to addiction. Addicts are notoriously bad at trusting themselves at first — for good reason. Also See Bill Abbott’s comment below.
Hi Marc–your post really hit home with me. Could you give me more info or maybe a name a book or 2 that’s talks about how to begin the journey to self trust?
Hi Victoria. I’m glad it hit home.I don’t think too many people have thought of this as a specific treatment strategy. But please see the comment by Bill Abbott below. He says SMART recovery takes that approach, so that might be a good place to start.
What also comes to mind is Acceptanc and Commitment Therapy (ACT), a goofy name for a pretty cool treatment — it’s sort of a step-by-step do-it-yourself approach to mindfulness, but with some very useful extras thrown in. Here’s their website: http://www.actmindfully.com.au/acceptance_&_commitment_therapy
You can also find individual therapists who will go through the procedure with you. Also, there are many other forms of mindfulness therapy, from more classical Buddhist approaches (i.e., Buddhist meditation) to very Westernized approaches (like maybe spending ten minutes with your eyes closed on your way home from the gym, but not while you’re driving).
I hope these ideas are useful. If others have other suggestions, now’s the time. Also, can you please get back to US with whatever you might find on your own.
Terrific! Empowering! And done with love and deep understanding. Great job, Marc.
I am sure your speech will be superb.
Marc
I say Nyaaaahhh !!! to Nyah
This is so true and just what we try to get across at Smart Recovery and shifting ones locus of control to the internal side .
I like the analogy of the elephant and the rider with the elephant being the limbic system and the rider the pre frontal cortex . The elephant is bigger and stronger and the poor rider sometimes gets tired of reining it in all the time , so the elephant goes his own way and gets his ” food” .
The trust angle is a good one. And since most people with addictions have a huge issue with lack of self worth , and now burdened with guilt and shame,no wonder relapse is so common .Why should they trust themselves , especially since no one else seems to .
But the good news is if they get into a support group like Smart , suddenly that changes , and they feel increasingly empowered because so many there do trust them and that they can succeed .
Marc I was wondering if youd consider letting me post your blog as a guest blogger on the Science Corner blog of mine on the Smart New England website , smartne.org .
Thanks for all this and for the wonderful ( mostly) comments written here
Bill
Hi Bill. I agree with you on all fronts, and thanks for the reference to SMART recovery. I’ve recommended it to Victoria, above, based on your description. I really don’t know much about it, but I need to learn. I like the idea of a support group that deliberately focuses on self-trust as well as mutual trust. What a good idea. Smart, in fact.
If you’re asking if you can post this post on your blog — for sure! Just please provide a link to this site so that others can find us.
As soon as I have a moment, I’ll check out your site. Sounds like a good place to get educated.
I’ve heard of the horse-and-rider analogy. But sure, the limbic system — and specifically the “extended amygdala” which includes the amygdala as well as many parts of the striatum, including the infamous nucleus accumbens — might be more like an elephant. Or not. After all, it did co-evolve with the rider. It’s just that the rider does indeed get tired, or is not that skilled to begin with, and that’s when accidents happen.
Ill do better than a link to this site. Ill link to the book and tout it a little in a brief intro to your blog .
Smart is a science-based approach to mutual support group meetings with the science being mainly CBT , specifically REBT of Albert Ellis. It was founded about 25 years ago to be a secular alternative to 12 step thus providing choice to those who want such help. And Smart is all about self and learning to make better choices for yourself to lead to a better life
Smart is an acronym for Self Management and Recovery Training and you can access lots of info at smartrecovery.org
Bill
Thanks, Bill. This historical reminder is a real help. I even used it in my latest (17th?) revision of my book proposal. SMART seems like the other time-honored contestant, the other guy in the ring, when it comes to the great recovery controversies.
And thanks for the link to my book. This helps!
That’s a fine little talk. Here are a few thoughts, for what they’re worth.
If there’s any area in which something could be added, it’s in your account of stopping:
//Here’s how I quit. Quitting attempt #187: I wrote the word “No” in big letters, tacked it to my wall, and recited it 50 times a day, so that I couldn’t stop imagining it. And I saw that I could keep saying “No,” next minute, next hour, next day. I’d found a way to believe in my ability to stop, and that felt like a new self — or at least a different part of myself — I could rely on.
So, for me, self-trust and recovery started at exactly the same moment.//
What’s needed is, as you say elsewhere in this thread, are //efforts to integrate science and subjectivity//
Subjectively, the last thing one does looks like the cause of what followed. If you ask smokers How did you quit? you will hear things like “I said ‘no and stopped” or “I took the gum” or “I did hypnosis,” and so on. And some will say things like “I moved to another city,” or “I took up Buddhist meditation” or “I discovered Scientology” or “I met my future wife.”
These things *might* be true (possibility 1) ), but there are a number of other possibilities. 2) As you say, it was attempt #187. So we might have a cumulative effect of 186 previous attempts, with #187 putting things over the top. The ex smoker who says, “It was the gum,” maybe be discounting the several attempts previous, using hypnosis.
3) Perhaps none of the efforts, including the last, were the cause, rather, for example, the person’s dysthymia went into spontaneous remission. That the smoker just did a course of gum may have had no effect, despite his subjective impression it was so
4) Variant of 3) ‘none.’ Perhaps there was some sort of developmental phenomenon. The person ‘aged out,’ so to say. In your case, you had matured enough to want some kind of career path, and had acquired some ego related resources.
5) Another variant of 3). The person’s biochemical processes, just started working differently; the drug, for example, ceased to yield its high and no alternative was found.
To put it concisely, based on experiences of a number of people, how many can start saying ‘no’? For what drugs/behaviors/compulsions, and in which contexts. For what compulsions is it unclear what a “no” would be addressed to, e. g., food?
You have put yourself, and us, in an excellent position with this blog, to elicit a sample, at least of motivated people, as a basis to answer such questions as: What brings about recovery, for typical cases of specific substances or behaviors? No one person, with just his personal data (or even the data from his group) is in a position to arrive an objective, correct conclusion, esp. if he or she is wedded to an idea, beforehand, as ‘This is what works.’
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Congratulations on these exciting opportunities.
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PS1: I wonder in which areas ‘ego depletion’ applies, and why? When you started saying and writing ‘No’, it seems *not* to have happened. Indeed, looks more like the opposite: ego strengthening. After a few months, wasn’t the psychic ‘muscle’ stronger?
PS2: I’m not saying one can’t get beyond the hundreds of conflicting stories of
‘My recovery and how I did it.’ I think ‘addiction medicine’ is in the state of medicine a few hundred years back, when, to heal a wound, some said, ‘this plant’s leaves’ and some said, ‘crocodile dung’ and some said, ‘glorious pus’ and others, ‘keep it clean.’ Each approach had its proponents and success testimonies. Systematic investigation eventually sorted out which truly worked, which harmed, and gave a causal account of why.
I like your points. I think the developmental angle is especially relevant. So there may be causal processes at several time scales which converge. In fact, the physiological changes would also be developmental and also contribute to the outcome of quitting, but they would accumulate so slowly, and be so difficult to gauge, that one might never know how much of a contribution they are making.
I don’t try to say that my way is/was the only way that works. It’s just that I’m on this talk circuit now, and I’ve been encouraged to say, in as few words as possible (e.g., for TED), how I did it, as a way to reinforce or at least concretize my message about self-trust.
You’re right, everyone seems to say that the way it worked for them is THE way, when in fact, as you say, the way it worked for them might involve a composite of causes (including pure chance) that even they cannot identify or articulate. This is a crucial insight. So that when someone says “This is the only thing that works — after all, I’d tried everything else, and this was it” we must be very conscientious in how we interpret that information. The danger is: if you try “the only thing that works” and it doesn’t work for you, that’s when you feel truly hopeless!
If I had the time or the energy, I might indeed try sampling people in a serious way. But I don’t, and I’m sure others must be doing such things — I mean there are stats out there after all. And also, will we ever get further than the conclusion that different strokes work for different folks? I think it’s better to understand WHY treatment needs to be so flexible than it is to devise a scheme as to which things work what proportion of the time.
Thanks for your insights, as always.
Hi again. Re identifying a causal relation between what you just did and what happens next….I’m reading a philosophical summary on the debate about conscious intention as NOT the cause of action. Fascinating, and very relevant to your points here. I think that will be the subject of my next post.
Marc, this is awesome! What worked for you, the “NO” sign is proof of where “self-trust” is lost in the first place… Kindergarten! That’s where the first subliminal “signs” are placed and where “constructed knowledge” begins. Public education began in the churches and to this day follows the same set of morals and standards, that are not reality. We have all been robbed of our innate gut instinct and the ability to trust in ourselves.
When I learned about this in Cultural Anthropology in 2006, I understood why the 12-step program contradicted itself for me and why it doesn’t work for many others. It still follows a religious standard even though they call it “spiritual”, and “powerless” to me indicates weakness. I find it interesting too that the word “addiction” has religious roots.
The SMART recovery website is wonderful and, having been around for 25 years, it should have been included in the graduate course “Understanding the Nature of Addiction” that I just took in 2012, where the 12-step was highlighted as a protocol for successful treatment. That, to me, reinforces the religious ideal, and the fact that all organized religion was designed, and is used to control the people… especially the women or… the mostly “co-dependents”!
For the last 20 years, I have kept myself from becoming an addict through nutrition and education, and the SMART concept reverberates that. The other, and perhaps most important element of my “self-trust” accomplishment was/is creativity, which, incidentally, is also robbed from us by our education system! Creativity teaches instinct and self-trust and I have found that most of the “rooms of recovery” in America are chock full of creative people… and so are the bars!
I don’t have much time on this shared computer and much of my research is still buried since my fire, but I wrote two final papers in grad school that would fit nicely in your blog. The addiction final, of course, and “the Evolution of American Music”, which includes B.B. King and explains, sociologically, how we got where we are.
If anyone would like to read them, I’d be happy to share.
This is really fascinating. I never thought of the absence of self-trust as a cultural project — but you’re quite right. Even in the U.S. where individualism is supposedly the fundamental ideal — or maybe especially in the U.S. — self-trust is greeted with suspicion. In classrooms, indeed, discipline and self-expression are considered to be diametrically opposed. How strange and how destructive, when you think about it.
My recent experience at PINC (see next post) was a real eye opener as to how creative people combine discipline and self-trust. Seems like an excellent model of how recovery can combine a very personal route of self-discovery with fundamental lessons on responsibility and discipline.
If your “addiction final” could work as a blog post here, please send it to me. I’ll be glad to consider it as a guest post. Please note the standard length though. My posts are usually too long.
Marc kindly agreed for me to repost his blog content ( not this stuff ) on our Science Corner at the Smart Recovery New England website , smartne.org
thanks again Marc .
This will go up today- fyi
Bill
Thank YOU, Bill. These connections are great all around. My only concern is that your link doesn’t turn green (or some other color?) — which would identify it as a link….to the casual observer — although it does seem to work fine. I’ll have to try to figure out why not…
Hi Marc
Another great blog and, although you won’t need it, good luck with the TED talk. It’s really strange how this stuff works, sometimes it baffles me. I have been doing some work over the past few months around developing a new set of policies and guidelines to cover the interventions that the organisation that I work for provide. In doing this I am trying to instill a doing with rather than a doing to philosophy. As such most of the guidelines and policies are very risk averse and based on a premise that we cannot trust the people we work with. Over the years this has meant that, in trying to control the chaos associated with substance misuse, the treatment system has become ever more rigid and, in many ways, very dogmatic.
I firmly believe that the beginning of the treatment journey sets out the map as to how it is going to evolve. Maybe the person is at exactly the place you describe where they have a great big NO and the genesis of self trust. If they have turned up looking for help maybe they have exhausted all of their options and need to believe that someone else can put something else on the table. The skill is in offering something without dis-empowering and, at the same time, optimizing the development of trust. I also believe that weaving some of the principles Acceptance and Commitment Therapy into the guidelines and policies is the way forward and will help to establish an organizational minimum standard. I’m hoping to do away with the dogmatic, rigidly robust protocols we currently have in place and replace them with Flexible, Adaptable, Cohesive, Energised and Stable guidelines that create an environment where self and mutual trust can flourish.
Peter, this is beautifully stated and so well considered. There is much I could respond to, but three of the most powerful points you make seem to be:
-that the beginning of treatment sets the course for the remainder of treatment
-that people can be in very different states of readiness/unreadiness to quit, to trust themselves, to say NO, and a treatment plan needs to be flexible enough to correspond with their present stage, not some idealized formula
-that it is crucial to offer a very large dose of “help” without disempowering the person
Indeed, these seem to be the cornerstones of a really progressive approach to treatment, and I admire you for putting them together so clearly and coherently. And ACT…yes, I know what that is and I like it too.
Not much more to say at the moment, except that you seem to be in just the right place in your thinking to greatly advance the implementation of treatment. Please let us/me know how it goes when you try to put these ideas into action. In fact, I’d love it if you would just send me a slightly elaborated version of your comment for a guest post. It seems really important.
I think that faith and trust in oneself is the highest of spiritual attainment. How could it be otherwise. And how could you afford it in the truest sense to anything else unless you own it yourself.
This blog had a profound affect on me and seems to have been the “spot on” thing that I needed to hear – at just the right time.
I struggle with an addiction to alcohol (ethanol) that I manage in a way that does not create anti-social behaviour. But it is something I do everyday and I am aware it is an addiction. I have wanted to change my dependence on it for a very long time and have been thinking a lot recently about my lack of self trust in this area. It has intrigued me because I have a very disciplined life and have created a habit of goal setting and pushing through to achieve things. I also overcame a serious food addiction and gave up smoking (sometime ago now).
That’s the funny thing. I’ve always known that I can stop, that I will stop but I’ve been waiting for the right impetus to give me the reason to stop. Knowing that drinking habitually has health implications has not been enough. I’ve been waiting for the health crisis that I knew would give me the where with all to stop. Which I was also aware was pretty crazy – why wait for the health impact to come – why not stop now and prevent it? All these thoughts would go round in my head, but still I persisted.
When I read your blog you talked about the future self needing to take control and then bang! It happened. My future self matter-of-factly took control. My first night drink free for a long time. My husband even poured me a drink, I accepted it but couldn’t drink it. My future self was in control and was able to think clearly about the benefits of stopping.
In a way it is such a relief – no more cognitive dissonance.
I know it is early days tackling an almost life-long habit (probably 30 years habitual drinker) but I’m on a journey now. I’ve taken notes from your blog and I plan to make the changes I’ve been wanting to make for such a long time.
I just wanted to say thank-you!
Self-trust is key to living a sober lifestyle. When we constantly continue to not trust ourselves and our decisions, then we will continue to make the wrong ones. Discover yourself and who you really are on your path to recovery. And most importantly, learn how to rely and trust on yourself, because at the end of the day, that is the most important person in your life.
Good luck,
Laura
t is very helpful for me as well as others. So thanks for posting this blog.
This post was very informative. Unlike a lot of redundancy that is out there your blog pointed out a key component in the battle of addiction & life for that matter, self trust. I think your view is on point, but I also think a lot of addicts are not aware of their lack of self trust. They may not even realize the lack of trusting themselves. It becomes a priority to trust the effects of the drug/addiction. The alteration in behavior, especially moral reasoning is masked by desire & cravings. The addict may not even be aware that he lacks self trust. From experience addicts will do just about anything to get their means including lying. Just as much as an addict deceives others to obtain and continue using, he may also be deceiving himself by thinking it is the norm for him to get high. Of course there may be feelings of remorse afterwards, but are these feelings of guilt/shame enough for an addict to realize it is self trust that is absent? Maybe & hopefully; in my opinion you have to be some what self aware first in order to know you can’t trust yourself. Without knowledge of self trust it may become second nature or habit. Now the question I have is, how does society open that door to an awareness of self trust? I didn’t consider myself having self trust issues as an addict, simply an addict. Your blog opened that door, but thats because I made that choice to read it. If I didn’t I’d be clueless to it. Makes perfect sense now, but to the unaware probably not so much. Self trust should definitely be a part of every recovery program, step, rehab, counseling, advertising for rehabilitations, TV commercials, websites, D.A.R.E programs, etc. Not limited to addiction, but in all fundamentals of life. I think we are taught at a young age to be trust worthy to others & vice versa, but in my opinion self trusting is not emphasized enough if at all. We grow up first trusting a parent/guardian, doctors, superheros, teachers, friends, media, religion, employers etc. Why aren’t we informed to self trust first & foremost?! Maybe it’s because we were taught to confide in other sources to have a sense of security. If we can focus more on teaching self trust & self awareness instead of chasing it elsewhere it could resolve a major part of this concern of mine. Even if it won’t completely resolve the current epidemic, at least it may leave small imprints for a better brighter tomorrow. It is our duty to leave the steppingstones, to be the godsends. Critizing other’s opinions, views, writings, trying to make our subjectives noticed, pointing out the so called factual errors doesn’t do jack for the mere reality, addiction exists point blank. Justifying doesn’t contribute to anything, on the other hand, sharing the knowledge does. Thank you for your blog it definitely gave me a new perspective on self awareness. Now all “we” have to do is spread it like wildfire for future generations. Namaste
My apologies for the repetitiveness & any grammatical errors. I’m no English major, just a single mother that trusts her gut & has faith in a better tomorrow.
Marc, I have recently started reading your blog and find it very helpful. I want to thank you for that.
You say the following in this post. I’m always struck by a certain irony: People think addicts are weak and lazy. In fact it’s the opposite. Addicts work harder than anyone else at the task of self-control.
I am finding it difficult to make sense of it. Can you please elaborate?
Well done on the very well laid out, concise, and poignant writings here. WOW stumbled across like I needed it yesterday! thank You for going to the trouble of setting up blogs like these. You just never know who you might help and you have helped me already.