So I’m having this relatively uneventful week, doing a bit of homework for my Dutch lessons, preparing for a class I’ll be teaching next term, defrosting the freezer, debating with a publisher as to why she should accept my next book, driving the kids to soccer and always arriving late, though no one seems to care, and wondering during my few un-busy moments what I’m actually doing with my life. Do I seriously think there’s more I can contribute to the addiction literature – besides blogging, which I love? Or should I hang up my spurs and take up growing tulips?
When all of a sudden I spy an email from the Mind and Life Institute, a group started by the Dalai Lama and a few other notables, whose mission is to identify links between the contemplative arts (e.g., Buddhist meditation) and neuroscience. I figured it was a generic invitation to their yearly conference. I went a few years ago, and it was actually great. Each day I woke up early, did a lot of yoga, ate a lot of vegetables, and spent many hours with my eyes closed, making infinitesimal progress toward enlightenment but getting pretty relaxed.
No, it wasn’t that. It was a letter, addressed to me. I had to read it twice to believe it. It was an invitation to spend five days with the Dalai Lama at his residence in Dharamsala, all expenses paid. I would be one of fewer than ten scientists or scholars or addiction specialists, and we would be meeting with him throughout the five days to discuss craving and addiction. The Dalai Lama remains deeply interested in societal problems, especially those that might be addressed from both Buddhist and scientific perspectives. According to the letter, he sees addiction as a major source of suffering in today’s world. I have to agree with him there.
So…yeah…I’m blinking rapidly and checking the address to make sure it’s not a hoax. They “very much hope you are able to join us for this special conference …” and would I please let them know as soon as possible. So I thought about it – for approximately 2 ½ seconds. I would give my left arm, maybe my right arm, to meet this man and talk about addiction with him and a few other folks. I’d go just for the ride. Just to be in his presence. Besides, Dharamsala isn’t Rotterdam. It’s halfway up the Himalayas. It’s a beautiful place according to the pictures. Just to be there would be an amazing trip, but to talk with this precious man about, let’s face it, my favourite subject. Yes, I accept!!!
I don’t know why I’m telling you all this. I guess just to share the most exciting moment in my life for the last couple of years. But this opportunity also brings to mind something I’ve thought about for awhile. When I argue my usual position, that addiction is not a disease, I often get a lot of flack. In particular, the disease advocates often argue that addiction must be a disease because it changes the brain, often irrevocably. And I argue back that I think addiction is an extreme form of normality, because normal learning also changes the brain, often irrevocably, especially when the learning concerns goals or intentions that are highly emotionally charged, such as falling in love, having a child, religious conversion, and, well, developing a serious fondness for coke, smack or booze. I haven’t yet been able to make my argument as articulate and convincing as I’d like to. In a recent post on a science blog, I tried to put it as succinctly as possible. And dozens of comments came back – most of which were not in agreement. So I’d counter that, if drug addiction was a disease, then so would gambling and other serious behavioural addictions be diseases, not to mention a passionate affair with the man or woman next door, and so on and so forth.
But how’s this for cutting to the chase: Just about everyone describes addiction as a continuous state of craving that can only be relieved by acquiring/doing the thing you crave. Whatever is going on in the brain, the psychology of it is 
pretty straightforward. So if I were a Buddhist, I’d probably say: hey, that’s human existence for you. Human existence is characterized by longing, by craving…and then being propelled by the craving into grasping – which means going after the thing you crave and getting it. Which always lets you down, since material things never satisfy the emptiness that’s at the core of craving. Which is why Buddhists recommend that you do some serious meditating and thereby give up your attachments. When that starts to happen, then you can watch yourself being in a state of craving without going to the next step, grasping. You can just watch it, see it for what it is, and let it go.
(Which may be why a lot of people find meditation extremely helpful for recovery.)
I wonder if the Dalai Lama will see addiction in a similar way. I suspect that he, of all people, will see it as an extreme form of attachment, which of course generates craving, which is why addicts suffer so much – until we’re able to watch the cravings come and go. I doubt I’d have to convince him than addiction is not a disease; it’s a highly focused state of longing – for something that glitters but isn’t even close to gold.
(Another reminder: Check out the Guest Memoir page, linked above. We’ve gotten a couple of new ones, and they’re really gripping. Please comment if you’ve got anything at all to add, or send us your own memoir.)
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
What an honor, Marc, and what a great opportunity!
Yes, craving is the root of all evil. My addict mentality tells me that if some is good, then more is better–and even more is even better.
Learning how to deal with cravings without feeling deprived could have huge implications for the well being and happiness of an awful lot of people. It could help fight the greed is good mentality that is crushing the middle class in the U.S., and could help counter the obesity epidemic, which I believe is due to food addiction.
Don’t forget the physical aspect of cravings. The HALT suggestion (never get hungry, angry, lonely, or tired) is just as important as any psychological tool.
Amen. I never reply but Marc always makes !00% sense in my recovery.
Oh, and I ran across this, recently. I need to brand it on my brain.
“Happiness is a place between too much and too little.”
– Finnish proverb
Congratulations Marc! How very exciting!
Congratulations Marc!! Wow!!
That’s fantastic Marc! all the best to you in the new year, always enjoy your posts…
Marc, congratulations! That’s an amazing honor and opportunity!
Again, Congrats on this fantastic opportunity! I cannot wait to hear of the enlightening experiences you will have.
On a side note, you should know that you have successfully transformed my concept of addiction. I definitely accepted the authority of NIDA, as most of us researchers do, but it really isn’t an adequate explanation, is it? A disease doesn’t really qualitatively change over time. You can get rid of the cancer cells and you can get rid of a virus, or they are still there and thus not disease-free. But what of addiction? You may be purely focused on the drug, which is seemingly like a disease. However, those same neural circuits don’t actually go away during recovery, but get rewired into a new network of more adaptive “self-medication” (e.g., meditating instead of booze, running instead of cocaine). There’s no “getting rid” of something, it’s more of a transformation of states. That’s the way I’m seeing it now. I hope that makes sense!
I am so happy, Marc. Carry us with you. I know you do. What a wonderful honor for your work and your life. I’ve said it before… you are a healer. So proud to know your voice. It speaks with such love and understanding. How beautiful.
I’m still experiencing addiction (as the mother of an addict) as a “disease” as it seems a form of such extreme behavioral distress. Where you are a danger to yourself and others. Psychosis? I’m so out of my depth I shouldn’t even be using these words!
but that is where I am although I am also in full concert with the Buddhist beliefs which are a big part of my own life.
In any event… many beautiful blessings as you journey to the Himalayas.
Namaste.
Marc I can’ think of a better person to attend this. I liken your ability to comprehend the matrix of neurobiology and substance use to understanding the relationship between mastered jazz musicianship and spirituality. It takes that kind of mastery to get to the higher order nuances/thought processes you indicated in our last interaction that you have been pondering all of your career. Allen Watts talks alot about the different view eastern spiritual perspectives bring to western knowledge. I look forward to your sharing of the enlightenment you experience.
Fantastic – to have this opportunity with the Dalai Lama, and some other special people.
Your book, engagement and dialogue have identified you as a person to be included.
I just heard Patrick Carnes speak, and for now I perceive addiction as a disease.
True it has commonalities with other brain changes. However, the key element in using the identifier are the very serious physical, emotional, relationship HEALTH CONSEQUENCES, thereby meriting the use of the disease identifier.
So their are both commonalities and significant differences.
Holy Hecks Marc! That’s a fabulous offer and I’m so glad that you are going to go. Keep us posted on how it transpires. I’m so excited for you!
YES!!!! 😀
Congratulations on this invitation, Marc! What an honour! I’m delighted for you, and I’m delighted ad honoured to know you. I can only imagine your joy when you opened that envelope and absorbed its contents. As Janet said, “carry us with you.” When do you go?
Marc — I am absolutely thrilled about this. The universe, and the future of addiction/recovery studies, is unfolding as it should. The disease model just won’t exist at the altitude of this auspicious event.
The fact that craving is the source of suffering is the Second Noble Truth. As generally understood in Buddhism, our disorder is not desire. Desire is the energy of our realm. Our problem is our habit of clinging, grasping, attaching, to our desire. That is how we create suffering. So, basically, I bet you could be fairly safe in thinking that not only will your theory of addictions — as a learned, albeit unskillful, practice — be acceptable to His Holiness, you might have to explain why you’re coming up the mountain with it about twenty-five hundred years after the Buddha very clearly stated it.
So now, one thing you might do is flesh it out with supportive neuroscience, of course, and H.H., a science nerd, would no doubt appreciate that. But what else can you bring to this especially enlightened discussion?
Well, the Third Noble Truth is that the suffering can be brought to an end, and the Fourth Noble Truth outlines the Eight-fold Path to that goal. It would be incredibly illuminating and wonderful if today’s study of addictions and recovery could open a portal into a secular empowerment of this ancient wisdom.
I’m not going to be able to sleep tonight for thinking about this. And I could go on all night right here. But Marc, I just want to say that this is just totally excellent, and I am so pleased for you, and for all the great people who contribute to this blog, and, for everyone.
John
John, Who are you? You continue to stun with your intellect and
expression. Thank you for saying what you say the way you say it.
We are summiting. Thank you. The world looks better, and different.
John, you and I have exchanged a couple of emails on this. But I just want to say publicly, in case anyone else is reading this, that I really appreciate these insights.
The idea that “desire is the energy of our realm” is perfectly consistent with the central role in evolution played by the ventral striatum/nucleus accumbens — which can be described as the primitive core of the action brain. At the center of the action brain is this little machine that stamps motivational thrust onto each component of an action plan. It does this in order to move action segments down the assembly line, to the motor cortex, so they can take wing in the world, to travel onward.
Yes, it’s an old idea, at least in Buddhism, but addiction studies sure do put a unique spin on it. Addiction takes the old wisdom and applies it to a life-and-death issue, as opposed to a more abstract or existential dissatisfaction, a what’s-it-all-about-Alfie complaint. A new spin that can hopefully bring East and West together in an immediate and compelling way.
Not to mention helping people like us.
You guys really light up my life! Thank you so much for all your good wishes. I guess I wanted to share this with you because, more than anything, I knew you’d get how special it is.
I will certainly take all of you with me, and that’s not just a vague metaphor. I have learned more about addiction from you, over the past year, than from any other source, including my own addiction. Especially the human, personal face of it. That’s a part of me now.
So….you will definitely be there with me.
Mark you need a Wing man for this event ……… It MUST be me !
Did I mention I’m a photographer ? A wing man photographer is there a better combination ? I ask you ? If I had a vagina and a liquor store I would be king of the wing men ! I don’t but I’m pretty damn good !
Congratulations. Once we receive the blessing of recovery, the blessings keep coming. Life becomes better than we ever could have imagined.
As a recovering alcoholic, I feel joy whenever someone enters recovery and whenever someone in recovery achieves something wonderful. Thank you for giving me joy today. I needed it.
We all need it. Thanks for sending it back.
This is amazing! I recently began practicing at the Shambhala Center in my area. My “practice” is pretty weak at the moment but I honestly see changes even just going once a week. I think I agree with your “not a disease” theory although I do not know all the science yet. Whether it is or isn’t, it will truly be interesting to learn what comes out of your meeting.
We are talking a lot about meditation (and mindfulness) and addiction recovery in the group I work with. I’m excited about what we and I am discovering there. Letting go is something that does work (AA has this right) yet is not easy to master. The guidance and teachings of Buddhism can be really helpful here.
Practicing meditation is so powerful, that even a few days of it starts to change the intensity of one’s feelings and the angle of one’s perspective. Little changes, but you know at once that they’re going in the right direction.
Yeah, letting go is a strange and subtle kind of trick. For all those people who couldn’t figure it out from AA, Buddhist/meditation/mindfulness provides a whole alternate route.
Im green with envy . IN Smart Recovery, the group Im active with in the mutual support for addictions arena, we are heavy into this now especially in New England.
The Dalai Lama is very supportive of the science involved in emotional management so its no surprise he has invited you , Marc .
I have found what I call ” Mindful Awareness Practice ” or MAP – taken from work at UCLA, very helpful for me and many others and we do an exercise at most Smart REcovery meetings I facilitate locally in the Boston area.
I also recently completed the MIndfulness Based Stress Reduction program at UMass Med School where this all started years ago by Jon Kabat-Zinn and Im going on with them to deepen my own experience as well as be better able to transmit it to others.
Will look forward to hearing much more about this trip .
Thanks for this, Bill. Coincidentally, I’m just about to see a “client” — the first person I’ve ever considered seeing as a therapist to target addiction problems. I’m discovering perspectives on addiction treatment, here on this blog, that make me think that one can actually make a difference. And everything I learn brings me back to further consideration of mindfulness/meditation.
More later, I promise.
PS. This may be a silly question, but is it just a coincidence that your name is “Smart”? Seriously.
Its not a coincidence but it is not my real name either. Years ago when I was paranoid about anonymity – like many harboring shame and guilt which is so useless and counterproductive– I took this as pseudonym for public offerings etc etc
I can change it if you like – if you tell me how
As to anonymity, and shame and guilt related , just came across this which might be of interest to others .
http://www.courant.com/news/opinion/editorials/hc-op-casey-addicts-should-go-public-20121228,0,15787.story
This is fascinating! Isn’t addiction a bit like living through a famine or climbing a mountain or being lost at sea for weeks on end before finding land? Why shouldn’t we be proud that we stood up to this challenge of a lifetime — and survived. Not to get too rhetorical, but “survivors” have a much-improved reputation these days, at least in most domains. So, we should be able to take some pride (as well as some shame) away from the experience of addiction. In which case…..anonymity doesn’t fit well anymore.
Except that….some of us see a very concrete and practical need to wait a bit, maybe until the rest of the world catches up.
Despite the link you just posted, above, we’ve gotten to know you as Bill Smart. So….your choice, but I’m not asking you to make the change!
Please see comment by Suzy in recent post: https://www.memoirsofanaddictedbrain.com/connect/where-mindfulness-training-meets-up-with-addictionin-the-brain/
This was a reply to the above comment, but I’ve asked Suzy to stick it where more people will read it.
What an incredible opportunity … also, what a profound acknowledgement your work and ideas in this area. Kudos! As others have already said, I eagerly anticipate posts about your experiences and discoveries in Dharamsala.
I’m feeling pretty eager about it myself! I feel very moved by the idea that addiction is an extension of what the Buddhists call attachment — the primary source of human suffering — which is a compelling argument as to why we can’t call it a disease!
I’m eager to find out, not only what HH thinks about all this, but also about what the other “experts” have to say. I can’t imagine the disease model and the Buddhist notion of human craving coexisting, ie., floating in the same room. One of them has to break down.
And….thanks.
Marc
This is amazing! What a priviledge, what an honour and what a man.
You said it!
Dear Marc,
Thank you for sharing this news. It really is quite exciting and pleasing. I can hardly wait to hear of your adventure. 🙂
Hi Jocelyn. Twist my arm and I’ll tell all!