Hi people. I haven’t posted anything in the last couple of months. My last post went up in mid-July, then there was a guest post, and then…the silence of the tomb.
But I’m still here.
It has been a challenging and chaotic summer. Our planned (temporary) move to Toronto got rescheduled and rescheduled due to a death in the family and our wish to support the person left behind. Which meant a few trips back and forth to Europe 
for Isabel (my wife) and one extra trip for the kids and me. It wasn’t all bleak. We spent two weeks in the south of France, and there aren’t many places more beautiful than that. But it was surely disorienting.
Now back in Toronto, finally to roost, for at least four more months. But we had to shift from one rental to another. We’re still trying to get settled. And four days before the start of school, we found that our boys (12-year-old twins) weren’t allowed to attend the public school we’d planned 
for them. Frantic search for a new school — which now seems to have panned out well. Discovered a great ping-pong spot. Life goes on.
Now, with a little peace, I’m tempted to start blogging again. But I ask myself: do I have much more to offer in the domain of addiction and “recovery” or have I covered what I’ve got to say? I’m not sure. I’ve become a little less interested in the neurobiology of addiction for a very simple reason. Short of neurosurgery (and a very few available pharmaceuticals, which were already in use decades ago), there’s not much to do about the neural basis of addiction except to understand it better and then get to work on changing behaviour. So why not go straight to the behaviour? Which of course means the thoughts, feelings, internal voices and psychological background (emotional difficulties at younger ages) leading to the behaviour. I’m more interested in that right now.
This interest is fed by my growing psychotherapy practice with people in addiction (or struggling at the border of it). I am learning a lot. And I hope I’m helping my clients. At the same time, I’m pretty tuned into the gradual evolution of the treatment field, the growing strength of the harm reduction ethos, increasing frustration with the dominion of AA and its offshoots, and gradual changes in the policy/legal/medical/political issues that swirl around the enormous problem of opioid addiction in the US. Not to mention the social and societal factors that make it so hard for many people to quit or cut down. I get what residential rehabs sometimes do right and what they so often do wrong. I get the power of mindfulness/meditation and the various psychotherapeutic approaches (e.g., ACT, mindfulness-based relapse prevention, dialectical behaviour therapy) that incorporate it, along with the best (hopefully) from clinical psychology. So maybe there is more to talk about.
By the way, I still give talks on addiction all over the place and write occasional articles for scientific journals as well as the popular press. And I’m still working on that novel.
I also wonder if I should get more personal. I haven’t done anything illegal in a long time (except when it comes to parking and such). But am I a completely different person than when I was using opiates and coke (and acid and a few other things) 
and breaking the law almost daily? Of course not. I sometimes still feel incomplete and empty in ways I’ve felt since age 18. I still attach a particular meaning to substances, though my substances these days are pretty benign — and occasional. But I don’t talk about myself much, and maybe I should. You guys share a lot. Maybe I should share more.
That’s it for now. Just wanted to indulge in some speculation, thinking aloud. And I have an excellent guest post coming up in a few more days.
I hope you, my readers, are doing as well as you can. Warm wishes to all.
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
Thanks Marc. You absolutely did the wise thing: supporting family, finding a home and the right school are way more important!
My experience of coming out of addiction (prefer that to recovering!), is that when things settle, we just want to get on with living the life we were meant to, without the substance. It’s so much more peaceful, sometimes productive, and mostly benign.
I’m gradually moving into helping in the mental health field and that feels the right thing. The right opportunities always open up, when we have a questioning/questing nature. Perhaps just go with the flow, as long as there are alternative voices here on your blog and you can share exciting discoveries where recovery and new lives are always possible, no matter how deep the hole we’ve dug ourselves. Good luck!
Thanks, Annette. I’m getting an optimistic sense from your comment and those below that there may indeed be lots more to explore in a blog format. My work with individual clients is very satisfying. But this blog sometimes works like a community, and that’s gratifying in a unique way.
Marc, here’s a book you may enjoy at this juncture in your life. It is written by a good friend of mine who died earlier this year just before it was published. It is clearly her coup de grâce – a better “death blow” I cannot imagine, since her life’s work was all about … grace. https://www.wisdompubs.org/book/unbinding/praise
Thanks for this, Mark. I am intrigued. For others, this link may work better: https://www.wisdompubs.org/book/unbinding
I had trouble with the link posted above.
We know that contemplative practices change the brain in measurable ways. I suspect that contemplative practices, combined with study of “The Great Nature of Contingency”, which is what Kathleen’s whole book is about, change the brain in ways that we can’t really imagine until we … change the brain in those ways. Fun, intriguing stuff.
Good to have you back. Best wishes from Australia.
Thanks!
Many in Australia seek a different discourse on social drug use and addiction than the sensationalistic, moralistic, punitive, judgmental and highly ineffective conservative route our politicians take towards drug use in this country and I welcome the views put forward in your blogs. It energizes those who seek a different way of looking at this issue – one which actually admits that so far our efforts have been really poor in helping those afflicted and in fact possibly contribute to the harm drug users are so used to. Someone has to give voice for those who society doesn’t care about and we have to explore new ways of thinking on this. Keep it going Marc.
Okay, I get your point! Maybe it’s that simple…
I do think we over complicate this. I see endless theories, most of which do nothing to help the afflicted because they cannot be translated into practical help. Treatment has so far failed the majority. there has to be another way. we owe it to those who still suffer. we also need to clear the water that has been muddied. we now are confused between who is addicted and who is in trouble because of bad hypocritical laws and a failure to address the real causes of stress such as homelessness, unemployment, poverty, poor (or no) parenting, lack of opportunity, poor literacy and lack of education, boredom and entrenched welfare dependency. we focus too much on the symptom not the real problems and we make new theories rather than get down and dirty. Most of the AOD sector has nothing to do with helping the needy rather its about research, writing books and making squillions on the talking circuits. we are part of the problem. sorry to be so blunt.
I have been listening to people as a counselor for 25 yrs, and I have worked solely in the NYC area and surrounding counties. The mh and sa crisis in NY is about lack of empowerment, loneliness, lack of real community, and judgement and stigma. I recently self-published a futuristic play/short story on Amazon, called “The Transparent Pearl” about the collapse of the American welfare system. All proceeds from the book, benefit The Bally Foundation, a community fund to help people pay bills and get out of crippling financial obstacles. No strings attached, no red tape. Although my play is set in the future, this is a story about the attitude of American society today, and what it will become if we don’t learn to listen to each other, and form a new, more inclusive and empathetic American Dream.
Currently I work as an advocate for NY medicaid (disadvantaged people) and the judgement and stigma in the treatment field, as well as the poor treatment in many outpatient and rehabs/detoxs is heavily weighing on me. Very disheartening, not just for the disadvantaged, since some of these big rehab programs serve all socio-economic classes. I visit and try to educate/advocate for people in outpatient and rehab/detox providers almost daily, so I see the failure there. The addicted are not treated as intelligent mature adults, In the rehabs/detoxs they are lined up like school children and told to stop talking in line as they go to “lunch”.
There is no self-empowerment of people as cable of finding the answers to their problems. There is no listening to people, just dictating a cookie cutter approach. Everything I have learned in 25 years, is that people find their own way out, that each person’s brain ‘training” is different and we must tell people they can find the answers within.
And also what bothers me more, is a person with private insurance can get a vivtrol shot with a private psychiatrist and decide if they want NA/aa, counseling, groups or do nothing. A medicaid person is only given options of public outpatient clinics that force people to go to intensive outpatient 5 days a week in order to get vivtrol injections. Why? Medicaid pays lots for outpatient tx. Doesn’t matter if you have a family and need to work, the providers dictate tx, your poor and don’t know better.
AND as for the company that made vivtrol, they are not much better than the makers of Oxycotin. Over the past 2 yrs people reported developing depression and liver issues (one person’s eyes were yellowing and dr said it wasnt from that) from use after 5 months, but this was not on vivtrol website. I had to do my own research to find out about liver problems and depression!! FINALLY, now it is listed, liver/hepititis and depression. It was “left out” just like Oxycotin “forgot to note” how addictive Oxycotin was.
So should I just drink 6 pack of beer everyday if I want liver problems? Or just take vivtirol? I can pick my poison I guess.
Sorry I am so angry these days!! After 25 yrs, I stake my career on the fact that what I learned from people is: that addiction is a human condition and anyone can be a victim to it. We all have addiction in our life, but it depends when or how it gets destructive. Our life scripts start in childhood and really form in the teen years, as our early adult brain is emerging and trying to “teach us”….
thanks for listening!!!
PS MARC I TOO IDENTIFY WITH what you posted:
I sometimes still feel incomplete and empty in ways I’ve felt since age 18.”
Many people i talk to out there do too…..there’s an emptiness to life that is never filled, and American consumerism is always whispering that it can fill you up. I feel for me I might have less emptiness if there was more “real” community…less judgment, and expectations, and stigma.
Alison – thank you for your emotion – be somewhat comforted by the fact there are people who agree with you that it is a tragedy that a whole section of society is judged stigmatized and “treated” when in fact every human has habits and many have addictions, mostly behavioral and mostly “socially acceptable”. The drug and alcohol treatment industry does have something to answer for – but it is no different to medicine and the military – it requires illness and wars to sustain the “industry” – as it requires sick substance users to sustain the industry of profit that is the rehab industry – the same thing is happening in Australia with aged care – profits before people. and it getting worse as we ignore the hole inside the person and increasingly create addiction deliberately to sell products (mobile phone addiction as a classic example of created addiction)
Thank you for your comment it did help! this blog does help!
Podcast? Because you don’t have enough going on 😉
Your thought that the neurobiology is about understanding more and that the doing/behavior is sometimes otherwise (albeit connected) resonates with me. I found your work because Yoga Asanas gave me the step beyond 12-steo, or rather part of the twelfth step. Then I went into the eight limbs of the Sutras and began addressing my own human balance through the root and heart chakras. This is where it is connected but otherwise to neurobiology. I work on getting and maintaining my basics in order as a foundation (root). I have found work on the heart intense, rewarding, and challenging. I can know more and about addiction, but it is about opening myself up to others and the world. This is something I was never groomed to do. This is where damage was done for me (by others while growing up and then by my own choices). For example, the act of reconnecting with extended family members whom I share warm experiences with from my childhood. The richness of what I have from which I disconnected through my development which leaned heavily on what became an addictive coping mechanism for emotional experiences or lack of recognizing the emotional realm as valid. This is where neurobiology is all well and good, but I believe each person has this other place of being that is other to scientific understanding. I appreciate this post for that reason. We all have an opening up to do in a sense. Much gratitude for your work.
This is a fascinating parallel, Jubin. If I understand you correctly, there’s an analogy between understanding the brain and understanding the shakras, as a foundation or guideline for work on behaviour. They are remarkably different domains, I think we agree, but both are systematic knowledge systems that help to ground and make sense of experience. Yet the shakra/yogic/mindfulness approach seems so much more directly tied to actually changing one’s perceptions, experience, and behaviour. I can’t explore the parts of my brain through focusing or opening, yet you can explore your shakras and change your experience of the world at the same time. Well, good food for thought.
I also resonate a lot with your description of your own growth. Also for me, moving out of addiction was at the same time reexperiencing my emotions, viewing them as valid and valuable, and connecting with others as a result. Thanks for such a thoughtful comment.
Hi Marc, I’m sorry for your loss. I have been busy with ano old friend, 75, husband of dear friend lost to cancer at 54 last year. Granted my guy and I a house here in Florida where I’ve lived 35 years. Where my addiction to substances took off in full force at young age of 18. Now 54 I still have incredible urges to “do wrong, escape life for a while by smoking or snorting meth. The only substance that troubles Me. I just love it. Although not daily or sometimes not even weekly…..it is a deadly drug I know. The only therapy I can afford is run by the state. When asking how to treat my ADD, and anxiety together ( which I believe is the underlying cause if my need for a feel good substa ce), all my counselor tells me is to slow down coffe consumption (3 cups per day I drink), quit cigarettes, except use more , and eat healthier. WYD help is that.? Behaviour is a great topic. How to change???? I want to continue meth use on a twice a month badis…lol well maybe a line twice a daily would be nice. Yeah right. But, when I can get 20 worth it never goes that way. Imagine that. My old friend if 75 sold his house and moved in with us. Both good and bad. It’s curtailed my meth use for 1. I now have a truck to drive and he kept me working by packing up and moving him from other house. I recently tried some medical marijuana ( my sis in law has a script) yesterday It made me very I’ll. Sweats, spins, nauseated. Ughh, something SAFE !AND IT MADE ME SICK. meth doesn’t do that lol. Long winded but had to vent none the less. Sig I G off. Frustrated in Florida.
Smiling at your long-winded comment, but sure, nothing wrong with venting. I’d imagine that meth (never my drug of choice except, well, the few times I was ON it) would be almost impossible to schedule in the way you describe. I don’t see anything wrong with occasional use, as you probably know (as long as you know what you’re getting and avoiding obvious dangers like injecting). But keeping it occasional is the problem for many. This is one of those factors that really seems to vary hugely. People usually have to do a lot of work before they can confidently control their use. On the other hand, just looking forward to an occasional visit with a chemical friend does work for some people.
Whatever works!
Hey Marc:
Sounds like you might be in Toronto for a little while. Perhaps our paths might cross. I have not been able to stay involved as extensively in the Addictions/Harm Reduction field due to changes in work but still deeply interested. I like your thoughts on approaching addiction from a more personal psychological point of view. Think you have lots to offer in that respect. I remember the authenticity and power of your own personal story in Memoirs of an Addicted Brain. I too think lots about Addiction and Freedom and have found like many others the path to wholeness involves exploring and going down many paths. These days that includes learning more about NLP, the power of Pattern Breaks, the healing power of community, Vipassana Meditation and Loving Kindness Meditation. All part of the journey. All the best with your twins. I have four kids myself – all teenagers and a 13 year old who just started at a new school. Tim
Hi Tim. Good to hear from you. Absolutely let’s connect. I expect to be in Toronto for four months this time around.
Thanks for your suggestion re a more personal approach. I am giving it a lot of thought. And it seems we’re in sync when it comes to a really multidimensional approach to understanding and overcoming addiction. I’m learning to include nearly all of the components you mention in my work with clients…through exploration and intuition as well as whatever training I’ve had. Except for NLP. I wonder if I should give that one some attention.
Please email me and we’ll arrange to meet some time.
Very best,
Marc
Maybe go hit a meeting and help a newcomer?
I do help newcomers…just not at meetings.
Hahaaaa!
That’s awesome! So why don’t you help newcomers at meetings?
I, too, am glad to hear from you and, specifically, to hear a little about you personally. I look forward to your posts and the insights therein, and totally look forward to being a part of wherever the evolution of your work takes you (us). As a psychotherapist myself, I would love to hear more about your work with clients and the directions that it takes. Your thoughts on just how far neurobiology can go without neurosurgery reminds me of something Gabor Mate says when discussing the futility of talking too much about genetics since they are not something that can be overtly changed, thus the importance of focusing on what can be. In my therapy practice, I still find myself a bit stymied by the general underlying belief by almost everyone I see for addiction issues, in the old talking points of “disease, abstinence, either/or, addicts vs. normies,” etc. I have come to think of 12-step as the “Catholic Church of the recovery world” because it looms so large and is so deeply embedded in the dominant narrative and ethos of our history with addiction (especially here in the US), often keeping my clients undesirous of working outside of these concepts (I certainly don’t mean to imply that I try to impose my views on them, of course). Again, I’d love to hear more about what you do personally when working in psychotherapy. Maybe a comment or two on Michael Pollan’s new book? (My own personal guided work with psychedelics has been life changing for me, especially in regards to addressing the parts of my psyche that I attempted to regulate through my addictions). I hope that you start having a nice time in Toronto and that you and your family get to feel grounded for a while.
Hi Eric. Thanks for the warm words. I am thinking of exactly that: sharing what I think goes on in effective psychotherapy with people in addiction. As I develop my own style, I also plan to hook up with Peter Sheath, who has contributed some real wisdom in this blog ((https://www.memoirsofanaddictedbrain.com/connect/birmingham-model-the-view-from-the-ground/))and elsewhere. We are just now planning a visit to compare notes on how to help.
Also, I don’t want to push neuroscience and psychotherapy into opposite corners. There are several places where it seems they may intersect in critical ways — without the neurosurgery! For example, we are just learning about the default mode network in the brain (google it) and how it maintains self-directed and repetitive/ruminative thoughts. Apparently psychedelics diminish its activation. And so does meditation. This may be a powerful insight. And old ideas like transference (the voices and expectations we carry from childhood) look different when you see them in relation to epigenetics. How much are our disastrous perceptions of self and other deeply programmed by childhood experience — and what can we do about that?
So…lots to explore. Thanks for your ideas.
Marc, Default mode network! Yes, I am aware. I am almost through Michael Pollan’s new book about the therapeutic use of psychedelics and he focuses on this network in his discussion. (I also saw him speak on the topic this past Summer–very interesting). I have found meditation to be no less than totally life-changing in my own pursuits for emotional healing, and am glad to have useful language to accommodate my own discussions on the topic. It is such relief to have contact with others (especially other mental health professionals) who share this common understanding. I look forward to further discussions.
Hope to see you while you’re in Toronto
I shall email you immediately if I can find your address.
Hi Marc, I’ve enjoyed, appreciated, and learned from your posts. I have my own interest in neuroscience and trauma recovery. I’ve recently trained in brainspotting (developed by former EMDR trainer David Grand in 2003 – brainspotting.com), and they offer a special training in applying brainspotting to addictions. I saw a brainspotting therapist for almost 2 years – resulting in profound changes in my life, reduced activation load on my neurophysiology, and an interest in becoming professionally trained so I can share it. Brainspotting was voted #1 effective modality in treating Sandy Hook (mass shooting) survivors – see Newtown-Sandy Hook Community Foundation, Inc. http://www.nshcf.org Always more to learn, heal, and share!
Thanks for this, Terri. I know absolutely nothing about it, but I’m going to look into it. I went to the website just now. How very interesting. I have some skepticism about translating visual fixation to specific subcortical processes, but…whether the science is completely valid or not, if it works it works, and that’s key.
At one time I practiced meditating with a focus toward the left or right visual field (with eyes closed)….the idea being that the contralateral frontal lobe was being activated — either right or left PFC — by that shift. And the tone of the meditation, the thoughts and feelings, seemed to differ distinctly depending on which one was most activated — or so I imagined. Never managed to do it in the scanner so, again, lots of speculation but cool ideas to explore. There’s a world of mystery in there.
If you aren’t already familiar with the work of folks like Peter Levine and Bessel van der Kolk on trauma (both shock and developmental), you might want to add them to your list of things to look into. I think the overlap between trauma and addiction is woefully understudied and hardly reflected in actual treatment.
I’m very intrigued by Heller’s NARM model (“NARM uses both top-down and bottom-up approaches. Top-down approaches emphasize cognitions and emotions as the primary focus. Bottom-up approaches, on the other hand, focus on the body, the felt sense and the instinctive responses as they are mediated through the brain stem toward higher levels of brain organization.”) and Schwartz’s CRM model (“CRM resources support the client in being fully conscious and embodied in the present moment which allows the dandelion root of intolerable affect to be excised and the trauma loops that drive defense responses (ie, addictions, DSM symptoms, relational problems and negative cognitions) rendered unnecessary and therefore dismantled without flooding, abreaction or catharsis.”). And of course, Porges’ polyvagal theory which supports all of this.
From what I’ve read, it’s extremely valuable to integrate somatic work in healing (van der Kolk encourages yoga and practices it himself) and that makes a lot of sense to me, who has lived my entire life above the shoulders.
Two other thoughts. One is that EMDR works great for shock trauma but less well for developmental/attachment trauma. The other (completely off the wall) is that I suspect that we are going to learn more and more about the role of the vagal nerve in all this. Is it coincidence that the vagus runs the length of the chakras?
Sorry if this doesn’t make sense given the late hour, but count me in with those, who like commenter Terry, see you as giving a voice (a very educated voice) to those who aren’t being served by the current state of addiction treatment.
https://www.cbc.ca/news/canada/british-columbia/12-step-nurse-addictions-1.4805538
Dr. Lewis in his most recent blog expressed a lack of stimulating fodder for writing. The above article on the CBC website is about one person’s frustration with choosing an alternative to 12 steps and the harsh consequences for standing for himself.
Perhaps Dr. Lewis or a colleague could write about this or other cases where people grow out of their addiction rather than resign themselves to becoming diminished.
I know there are plenty of cases in a number of books but in place of new subject matter for this blog a story or two might serve just as well.
Best,
Harry
I encourage readers to take a look. If you’re interested in the domination of the addiction treatment field by the 12-step movement, this evolving story is really an important reflection of what’s going on. It involves a legal challenge to court-mandated 12-step “treatment”….as pursued by one very determined guy.
This is Lynda Sarkisian, and my last(only) comment so far was about my leaving Sex Addicts Anonymous after twenty six years and the complete dishonesty of twelve step programs in general.
I might have mentioned quitting SAA because of the way they obviously violate tradition 8, and comparing it to how NA being almost the only fellowship that abides by all twelve traditions. I kept up with NA because of the books that I still love so much and so much of what I’ve heard in those meetings. Unfortunately for me, my addict still doesn’t know the difference between NA and “step thirteen! That’s a discovery I made nearly a month ago. My first program was NA back in12/88. The first four years were exclusively devoted to acting out sexually and with NA people exclusively!
This morning I made an attempt to cancel a meeting hall club membership that I made over the weekend only to find myself fantasizing about who I could thirteenth step. (Shitty drug of choice). The club director said I do need the membership just don’t go to meetings. She obviously had no clue about sex addiction. I told her in 26 years I’ve never met anyone whose acting out was so centered around a particular program. She didn’t sound promising, but said she’d bring it up at the next board meeting whether or not my dues can be refunded.
To all who think sex is just like any other addiction, YOU ARE DEAD WRONG!!!!
This is Lynda, again. I ran across this site when researching why people leave twelve step programs. Hope my blogs about SAA don’t offend anyone.
Lynda, don’t worry about offending anyone. This blog welcomes diverse opinions. I’m working with someone with a sex addiction, and it is heavy stuff! Not fun.
Substance abusers getting all the resources and attention screw all else sucks royally. It comes across as the only addiction anyone can have, and other addictions simply aren’t real. No one can be addicted unless substances are involved(I’m crying as I write this), and substances are simply the only thing that can whip a person’s ass! I was a suicidal mess when I started SAA 26 years ago. I was not on dope because I was adamant about acting out only with NA people. I’ve even wondered if I might have had it at least a little easier if I was on dope. All that shame! All that stigma, but I wasn’t addicted because I wasn’t using. Fuck that shit!!!!! There was a guy in SAA who sounded like she was bottoming out on food. I would love to see other addictions get more attention. I don’t mean just sex! I mean sex, food, gambling, etc. When will people simply wake up?!?!?!
It’s happening faster than you think, Lynda. Check out the International Society for the Study of Behavioral Addictions ((http://issba.elte.hu/)). Tons of research, and more and more clinical work, treatment, policy change. In some places, including parts of Australia and the UK, gambling is considered a more serious problem than any substance addiction. Keep making noise. That helps!
Hi Marc,
We met at the SPP Conference. I was so excited that you read my poster and comment on it. I am now starting to explore your blog and glad that you are going to start talking about your practice with treatments.
I hope everything settles soon.
Hi Susana. I do remember you, but I can’t say that I remember what your poster was about. My excuse: I was still pretty jet-lagged that day.
Welcome to the blog!
Shouldn’t Elon Musk be able to solve this, given how he talks about the capabilities of AI and with Neural link? I think addiction is so complex, or maybe it’s laughably simple, but because it manifests all types of ways it appears complex.
Your insights have been uniquely helpful for me in feeling less confused and alone. Your blog posts are often within search results when I ask google questions that aren’t easy to find in the most accessible addiction literature.
The other day I recorded something in my notebook from one of my searches for answers or signs of hope that you’d written:
“Addictive acts seem to put something into the self, a feeling of triumph or pleasure that was not otherwise available.”
Yes. It’s articulating things like this that has made your writing stand out from the crowd, and why I hope you continue to share your thoughts.
For me, “depression,” or emptiness, is definitely in the drivers seat–it really has made sustaining hope and seeing change as a realistic possibility for me just impossible. I can’t seem to find it in me to suspend facts and evidence (about myself, my life) in order to have faith in…something…that leads to a version of me without the need for an addictive behavior.
Hi Katie. Thanks for letting me know. I had no idea that my stuff appeared in answers to questions on Google. I use that function a lot myself.
Yes, the emptiness problem. It is so so central and so difficult. I think there are really two key strategies or approaches: one is to replace the substance with something else, even another substance if it’s too hard to connect with others just now. Or a pet or an author…anything can be a bridge, a way out. The other is self-compassion or self-acceptance, whatever you want to call it, and some form of meditation seems the quickest way to get there.
I second a podcast…or perhaps a blog update–a fresh new design, angle…maybe standalone…let me know if you need a designer!
(Mostly) only joking. 😉
I’ll think about it.
I second, or third, the motion, podcast. Doesn’t have to be every day but once in a while would be great and I am positive you would have an audience. I’m sure you know many interesting people with various viewpoints on addiction and could have some good discussions. I love your video’s, they are very helpful and useful, why not take it one step further?
Um, okay. I’m starting to hear that more and more. I’m not usually a podcast guy, but I listened to one this morning and loved it. How nice not to read and just to listen, and hear someone’s tone of voice…someone’s laughter. What an intriguing idea. Sounds like a LOT of work though…
Marc: This is what I ask you: What about the less educated among us? Mindfulness therapy, cognitive psychotherapy, etc., are for us college kids (I’m 60). What about my dear friend who dropped out of high school, and for whom in his rural upbringing any “therapy” was not only a foreign language, it was scorned. When they told him in his mandatory drug classes in jail that addiction is a disease and his answer is AA/NA, he believed them, but it did nothing for his cravings and he is still using when he can. He bought the disease theory and says, What can I do? same as if he had been told he had diabetes—what can I do? I’m not a doctor. What to say to these drug users? I cannot talk about neural pathways to him, because then I’m not a friend, I’m his instructor. Where is the “authority” he might understand and believe who does not embrace the disease model?
The “authority” of the disease model is being whittled away, slowly but surely. See previous posts. But therapy isn’t just for the well-educated. Anyone can comprehend the value of talking stuff out with someone who listens, cares, and has occasional insights and good ideas. And meditation. Again…it’s simple! We just have to frame it in simple terms if we want to make it seem more accessible to all.
Marc, you’ve given a tremendous amount to the world with this blog and your books and your speaking. I’m super grateful, and would happily sign up for whatever the next act is – podcast, more blogging, whatever. My psychotherapy practice is better because of your work. AND if this is your last post for a long while, I’ll continue to appreciate the archives. Have fun with whatever you decide to do. You certainly don’t have to keep this going in its current form, or turn it into a public diary, and certainly don’t let it be an obligation. Your heart will likely give good guidance on how to proceed.
In addition to your insights and ability to communicate complex ideas in understandable terms, I am especially grateful for the welcoming and respectful tone this community has (mostly) maintained. I think it’s because you’ve kept the focus on what works, and been humble in acknowledging that there is no “one true path” for treating addiction. Rather, I’ve felt that we’re all engaged in a shared struggle, using science, personal experience, old wisdom and new insights, to help each other and others who suffer.
Thank you also for the opportunity to write a guest post – I was honored to do it and appreciated being invited to a platform that I hold in very high regard!
Best of luck in whatever the next steps look like.
Fred, thanks so much for conveying these feelings and thoughts. I certainly agree about the outstanding tone of this community. It sometimes strikes me as miraculous, considering the emotional charge of the subject.
I find your comment and many others like it (above) tremendously encouraging. Moving and heartening. And I’m back to thinking that it’s a real gift to have some sort of knowledge base and perspective that can actually help people through, and//or help people who are helping people through.
So I’m decided. I’m going to keep going with this blog for now. You’re right, it doesn’t need to be a public diary, and that might be difficult for me at times. Rather, there are new ideas coming up all the time — from precisely the sources you mention — and I’m getting new perspectives from my more extensive work with psychotherapy clients.
So…I’m forging on!
For the past couple of days I’ve been reverberating from one line in your post:
“I sometimes still feel incomplete and empty in ways I’ve felt since age 18.”
First, I admire your honesty and willingness to be vulnerable, which has awed me since Memoirs of an Addicted Brain. Second, your admission raises deeper questions that are worthy of exploration.
I find it telling that someone who has triumphed over extreme addiction and gone on to accomplish so much in life — as an author, public intellectual, therapist, scientist, blogger, husband and father — still and yet, sometimes feels incomplete and empty. The same feelings that drove many of us into the warm embrace of this or that drug.
After decades without abusing substances, and having succeeded in so many realms, what is still missing? What would it take to feel full and complete? Or is that even a goal? I don’t mean to psychoanalyze you, I’m just deeply curious about all things related to addiction — what drives us to it, how we do or don’t recover from it, how much wholeness is even possible. And if anybody has the answers to those questions, it’s you!
I don’t think I have cosmic answers, Lisa, but a simple answer is that people almost never feel full and complete all the time. Why would we? Life is certain to bring suffering as well as joy, loss as well as accomplishment. The psychological wounds from childhood can be accepted and soothed without being fully healed, and probably that’s the best we can do. I’m pretty much a Buddhist about this stuff. If I feel centered and whole about 70% of the time ( 😉 — then I’m doing damn well.
The tools I find most useful for accepting my own sense of emptiness or meaninglessness are pretty simple: I try to meditate most mornings. Even ten minutes worth. These days I’m back to Headspace when I feel I can use a “guided” leg-up. And I try to become aware of my own transference: how does a particular challenge or loss make me feel in my child’s mind? and to what extent can I just say, that was then, this is now, it’s just an emotion…let’s move on.
Maybe I’ll get it up to 78% with another decade of practice. Maybe not. As so many thinkers and teachers have recently highlighted: anxiety is a fundamental human state and the goal of being happy all or most of the time is incredibly unrealistic for our species, as for every other species (except hummingbirds).
I don’t see perpetual happiness as a goal. Fear, anger, sadness and many more unpleasant states are all part of the human experience—essential, it seems, for spurring emotional and spiritual growth. However, I don’t necessarily feel empty or incomplete when I’m feeling shitty. Indeed, I can feel a great fullness when attending to pain or sorrow. Maybe we’re just talking semantic differences, but the distinction is important to me.
PS Next time you’re in the SF Bay Area I’d love to take you to lunch. Or better yet, a hike in the Berkeley hills! Nothing like a walk and talk in nature to sort out all matters large and small.
Here is my “work in progress” of my “alternative steps” I offer for people to check out:
I tried to focus on self-empowerment…..and one doesn’t have to use all steps…it’s to offer people some other ideas than aa/na steps…..
12 New Steps for the 21st Century
Self-Empowerment Steps for Addiction (shame/guilt/judgement free)
1. Addiction is a normal human condition. Everyone has experienced addiction in their lifetime. Addiction starts to take hold in my life when I look for something in the outside world to soothe myself, or make myself feel needed, or powerful or accepted…
Addiction habits: Internet, food, drugs, alcohol, sex, gambling, sports, relationships, procrastination, anger, parenting, thrill seeking, power, money, status, self-image, perfectionism, over achievement/responsibility, exercise, work, cell phones, gaming, shopping, shoplifting, tanning, American dream, sugar, caffeine, cigarettes, aging, grief.
* We can have more than one addiction, and they can interact with each other…or we can also have addiction transfer…
2. I can feel empowered over my addiction. I am in control of understanding my addiction. When I am told “how” or “forced” to “manage” my addiction it can build resentment. Resentment is the path to relapse for many.
3. Addiction is a learned brain habit I acquired in my life, and I can learn not to depend on it anymore. *The habit had a beginning, a middle, and it can have an end. I hold the answers to how the habit started, developed and why it has such power in my life. *The memories that created the habit are in the dark hallways of my mind. *Take a flashlight. Make an insight map you may find you have more than one addiction. * I will be kind to myself. Judgement free and guilt/shame free.
4. Addiction protects me from feeling my emotions. I can find my most difficult emotions, feel them and overcome them. I can be strong.
5. Addiction is ignited by normal human desires, wants and longings.
The addiction focuses on the “chase” of what we desire, want or long for, not always in getting it and enjoying it. Addiction is not right or wrong. Addiction must be separated from morality.
6. Addiction does lie to us, but we all lie to ourselves in different ways and at different times. Everyone has the truth inside them and can reconnect with their own truth. Find a person or more to help guide you.
7. The addicted brain is a “stuck” brain that struggles when it attempts to make healthy decisions. Addiction can be compared to a temporary psychosis or foggy brain when at its worst, and at this point, addiction can lead me to make my most destructive decisions. My decision making returns once I am able to refocus my addicted brain.
8. Negative self-evaluations, shame, guilt, self-conflict, failure, resentment and emotions can spark my impulse to self-medicate (whatever works for a reward for me) and turn on my cravings. The more I seek to escape, the more reward I crave, the more destructive my addiction gets.
9. Insight is an escape tunnel for any addiction. Insight empowers me to understand where my addiction came from. Insight also reconnects me to myself, my values and dreams. Addiction can make me forget who I am, but it can’t erase who I am.
10. Finding the answers to my addiction can be laborious when I don’t have support or understanding with family/friends or in my community. If I feel unsupported and judged my addiction can increase to protect me. It’s called survival.
11. I can quiet addiction habits by creating new healthy habits. Picturing a new future can create a new focus in my life and create healthy habits. Compassion and kindness can help start new habits.
12. Addiction can bring anyone to their knees. Anyone. America as a society can be blind to embracing addiction as a normal human condition because it’s often focused on its own addiction, the American Dream: success, appearance, money, power and status.
*These 12 Steps are a modernized look at addiction, based on my experiences and insight I gained from counseling with people in America for 25 years. Thank you to all these people I worked with; they taught me, inspired me and empowered me over my own addictions. Questions: alisonlewiscounselor@gmail.com
Alison Lewis,
Hi Marc – it’s good to see what you’ve been up to since we’d heard from you last. Sending condolences for your loss. Am excited to see more of what’s ahead as you continue your exploration and learning.
As for me, I’m writing – at long last – a third edition of a book I’d written in 2009. It’s been on the shelf for awhile, calling to me as I tended other things. Excited to be back at it… with it, really.
As I wrap up the draft this fall, I’d love to write something bloggy, and from a great appreciation for what you said here:
“So why not go straight to the behaviour? Which of course means the thoughts, feelings, internal voices and psychological background (emotional difficulties at younger ages) leading to the behaviour. I’m more interested in that right now.”
Me, too!
That, and the impact of strong, supportive communities to support those changes we seek, those actions we’re wanting to take in our lives.
For me, mutually supportive, nurturing community is the thing that fills that sense of emptiness you mentioned.
Have you seen Johann’s newest book yet? I love that he echoes this message, over and over.
Thank you for the courage of your transparency… again.
Long time, etc.
Everyone knows a lot of addicts and we all know increasing numbers of dead addicts so where can we find a new idea?
Of course the entire *disease model* was just a a detour into liquidating any possible personal responsibility in becoming addicted which received thunderous applause until it was recognized that this also eliminated any possibility of agency.
I study other areas which do not bear directly on addiction and it may be that the underlying condition is a form of severe obsessive compulsive disorder which does not have clear attending behavior. The disorder is of the nature of a closed head injury where in the potential addict appears okay from outside observation.
The potential addict is extremely obsessive cognitively and rejects the human condition and his/her personal condition as just not good enough.
Life is simply beneath their obsessive perfectionist standards and the failure of Life to meet their personal standards and expectations.
It is this gap that enrages them and which they seek to medicate obliterating all pain and discomfort while increasing frequency of pleasure. This is the life that is expected.
Here I am ruling out accidental addiction arising for severe physical injuries.
Think of your book where you credit being shipped to school and the formation of a reactive conversion to depression as pushing you into depression. Is this the BEST account? Is it not better described as a revolt against chronic dysphoria only aggravated by harassment that you resolved to medicate?
Broadly – pain is unpleasant yes and generally pointless of course but there is a LOT of pain in life and many lives surely must have been mostly painful and uncomfortable but why accept that when the syringe is at hand?
I began to develop this idea by studying the extreme psychologies of famous leaders who demonstrate that there are people who are extremely outside any sort of generous band for sanity and yet who pass well enough for family and close associates who are reasonably bright and observant and this is possible because extreme madness CAN be maintained by some and one can discover severe degrees of OCD without behavioral cues. Let us imagine a really nice Doctor who everyone who contacts him takes him to be a perfectly fine fellow but whose rage against life itself is so severe Heroin is the answer. Hmmmm?