Hi all. This is ridiculous. I’ve been back from South America for a month and have not yet returned to blogging. I haven’t even responded to many of the comments and sweet sentiments following the last post. Though I have skimmed through most of the dialogue and debate — with interest.
I have so much to share with you, but it will still have to wait a bit longer.
Having two publishers (one American, one Canadian) means having two editors. They each have very different specialties, and I have to edit the whole manuscript twice, once for each of them. This has been a burden, but also a blessing. They are both really good!! And the book will be that much better due to their excellent skills. That is, if I ever finish the edits and get a final manuscript into them in time for the publication date.
I’ve also received amazing help with some chapters from Matt Robert, a frequent visitor to this blog, and his partner, Cathy. Matt is a SMART facilitator and he knows the addiction field inside-out. Their help has been particularly useful for thinking about the historical context of the addiction field, current debate on many issues, and the implications of my framework for recovery.
Some day soon, it will all be done.
To provide a little content before I publish this, I’m inserting several (slightly revised) paragraphs from the second last chapter — the wrap-up chapter. Here’s a cool way to think about desire, which is, after all, the most prominent word in the title.
Why desire?
The potency of desire — which we can call an emotion or a motivational state — deserves a lot of respect, as does the neural terrain bequeathed to it by evolution. Focus on your mental state when taking a bite of pasta (or 
anything else). Notice where your attention is directed while you are eating. While the food is approaching your mouth, en route from your plate, at least some of your attention is likely to be focused on the food. For now, attention is linked with the goal of getting the food where it’s going. And you are feeling desire, at least at some level. Desire and attention converge into one beam. But as soon as the food is in your mouth, your attention goes elsewhere: back to the conversation or to the book you’re reading or the show you’re watching. The amount of attention you pay to the taste of that mouthful is a drop in the bucket compared to the amount you paid to getting it there.
So, perhaps sadly, maybe ironically, pleasure is a small part of the common experience of eating, even when you’re eating something delicious. Desire and expectancy make up most of the experience: the approach is by far the main act. But this disproportionate relationship makes perfect sense. The evolutionary requirement to focus on pleasure is almost nil. Once the food is in your mouth, it’s a done deal. But if you weren’t deeply engaged, focused, attentive, and determined to achieve the food-in-mouth goal, your survivability would be a poor bet.
This is of course the same with all other highly motivating goals. Like, for example, getting drugs, booze, cigarettes, money, or sex. I get into the brain mechanics a bit in the book, but the gist is this: the brain regions devoted to desire occupy far more volume and are far more complex than the roughly cubic centimeter responsible for pleasure.
The biology of desire not only helps us understand addiction; it helps us understand why addiction is not a disease. Why it is, rather, an unfortunate outcome of a normal neural mechanism that evolved because it was useful.
I hope that was a tasty tidbit, and I promise more soon!
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
Hey Marc
Good to have you back. We have chatted about this a couple of times previously, and we are both very much on the same page…. as Kent Berridge says, it’s more about wanting than liking. I was reading some interesting stuff the other day about how heroin users could reduce withdrawal through saline injections – the build-up and ritual of injecting provided more relief than the actual pharmacology. These are old studies, but I find this really interesting.
Really looking forward to the book.
Hi Shaun,
Good to BE back. I followed your debate on the previous post, and still hope to get a word in. As always, you are a straight shooter — ahem, perhaps the wrong choice of words on this blog. Anyway, yes, it really is all about Berridge’s findings, which I review quite broadly in the book. It’s a simple concept but it is tremendously important to understand. Not only for addicts, but for people in general. Because it’s a great impetus to mindfulness practice. I want to taste, smell, and see the world, not just crave more of it. I hope all is well with you!
Oh by the way, the findings you cite make sense to me, and I’ve heard people report just that. In fact, when I was shooting stuff, there were occasions when I’d shoot almost anything, including vodka, despite the disappointing results.
“I want to taste, smell, and see the world…” and I presume you mean the world as it is, not as we may wish it to be. To desire this, I think, brings us closer to happiness and what do we truly want more than happiness?
Yes, the world as it is. The world including pasta and other ordinary things, which often seem too boring to pay attention to. And then we’re getting close to death, and we say “oops, I really blew that one.”
But even addictive goals get missed because of our fundamental mindlessness. I mean, if you’re going to go to the trouble of taking drugs, you should at least pay attention to being high. Yet few people take notice until they want more.
Wanting, Wanting, Wanting.
What is wanting, ? can we safely say wanting is craving?
Depending on our chemical make up at the time, and if their is any outside influences at play, like drugs or alcohol.
Is it craving of “Desirous” in what the brain is saying you need to sustain life, like salts, sugar, etc.
Is it in wanting, do to a low count in dopamine, for pleasure.? Sure people get excited for that fix, like that spaghetti to the mouth, but its the out come and the taste that is most delightful.
Is not all “Desirous” “Addictions” based on brain chemistry? is it not something that is handed down through or determined by genetic? and finally is it not triggered my crisses?
Crisis having many meanings, from trauma to being dehydrated…
Just having fun with you Marc, as you know I like to stir up the soup..
Respect Richard
P.s looking forward to reading your new book…
Hi Richard. Sure, have your fun! I’d say that “craving” is simply wanting something that’s not accessible. Pretty much the central theme of all great love stories.
Good to hear from you again, Marc! All the best for you, cannot wait to get my hands on your new book!
Yours sincerely,
Laura Tiainen, Finland
Thanks, Laura!
Echos of Kent Berridge. I look as addiction sometimes as the transition from liking the stuff to wanting the stuff – kind of rings true to your posting. And then to need which o course is the ” dependence” category now done away with at least in the US.
Hi Bill. Yes, the transition from liking to wanting…there’s a neat little chemical switch that does just that. Opioids (liking) suppress (ie reverse) the brakes on the dopamine system, hence dopamine geysers up and takes over. Berridge is my idol.
Hey Marc, good to hear from you again, good to have the thoughts about addiction stirred up once again. You’ve left me with a great desire to read your new book. I’m curious though, if I go to Canada will I read a different book? I never heard of that before.
Anyway, your excerpt above shed new light on my experience: I’m addicted to jewelry. I often identify a state of desire within me to seek and find new jewelry. There is definitely some pleasure in buying and wearing it, but the state of desire never goes away. Now I see it as much more of an organic phenomenon. Hmmm… now the question is how to approach the state of desire, knowing what it is.
One day I was at the Brooklyn Flea (market). I overheard a woman say “I already got my weekend jewelry fix.” I smiled and thought, it’s not just me.
Hi Denise. Great comment! I’ve heard of lots of addictions but this could be a new one for my list. Even buying it is still “getting”, ie. wanting. But wearing it…. Sigh….it is rather sad that shiny things lose some of their luster once they are ours.
What to do about it? I was walking through the UCLA campus this morning. I’ll be leaving here soon. So I told myself to stop thinking about what’s next and look up at the eucalyptus trees swaying above. They were so beautiful, but I had to slow down and NOTICE them.
Absolutely. I even have a system now in which I display (in my bedroom) the newly acquired pieces and try to enjoy each and every one as a piece of art. I don’t wear much of it at all; the addiction is to finding ever more beautiful pieces.
Does anyone remember old Marx and his theory on the commodity fetish? As we know, not only jewelry but also shoes, fashion, cars etc can be the object of fetish beyond any rational context. Can fetishism and what we know about that have a role to play in the wanting/desiring/craving analysis?
I’ve often thought of fetishes as belonging to the category of highly motivating goals. In fact, like addictive drugs, they exact a price tag — especially sexual fetishes which others may regard with disgust — yet people don’t give them up easily. The isolation, secrecy, and shame would all be part of the package.
Oh, the book should be identical in both countries. The Canadians have even agreed to quell their horror at American spelling.
Thanks, Marc
Yes, this is a fundamental part of being human. It should not to be relegated to the corners of anonymity. There has to be something further to flip our motivation. Sobriety is not its own reward, not a sufficient motivator. Intertemporal manipulation of goals, moving toward them, and making them the object of desire is rewarding and what makes for successful change (not some amorphous concept of recovery). Moving toward something, not away from a “disease.”
Cowering in the shadows of anonymity due to a process that has been adaptive for humans since the beginning of time isn’t helping anymore. Anonymity, schmanonymity. It’s time to come out into the light, people….and share what we’ve learned.
Matt, Why do your words remind me of a Mozart symphony? Or maybe we should go back in time and place you in the Baroque era. In any case, we’ll soon be talking in person about this very thing.
Point, counterpoint….with all the ornamentation. Probably could use a syllable filter, though. And think twice about posting when I’m in a fugue state..:)
Or else someone will take a cannon to your head.
Matt – I was very moved by your reply to this excellent post. It gives me hope.
Are you the SMART facilitator mentioned? There are some amazing folks in that group.
Yes, I am. I find it a practical program with more flexibility to put together a program that works for the individual. That’s what has to happen eventually, no matter what the method is.
Joan,
I too was moved by Matt’s post. Every night I lie awake sad and frustrated, knowing that my goal must be to move towards something positive, not away from something negative, but I’m seemingly incapable of putting these ideas into action the next morning. What is SMART? I’m in need of help.
SMART is an acronym for Self-Management And Recovery Training and is grounded in the principles of CBT and REBT(Rational Emotive Behavior Therapy). It is an open discussion format and group problem solving approach. Find out more at smart recovery.org. There are also chat rooms there and online meetings.
Thank you so much. I will investigate today- I really appreciate your help!
Matt,
Where does Smart stand on Moderation?
They don’t tell people they can’t moderate. But SMART is an abstinence-based program just because it’s easier.
I have read the Memoirs of an Addicted Brain twice. I have run out of dopamine. What is this smart recovery? I am educated man with loving adult sons, a profession, and a life long heroin abuser. it appears my synapses are sculpted, no more motivation for anything, including sex.
Dr. Lewis, I’d like to know more, I need help.
best for new year from PAris
This post reminds me of a book I enjoyed by Mark Epstein, called Open to Desire, which explores the phenomenon of desire from the perspectives of Buddhism and psychotherapy. In the book Epstein stresses that “desire” is not the problem it is sometimes misunderstood to be. Rather, desire – the drives within us that propel us to engage others and the world – is elemental to the experience of a satisfying life. The desires that each of us have are part of what make us unique. The key, of course, is engaging mindfully with desire – recognizing its ephemeral qualities, and that desire, as a phenomenon, is always with us.
Great comment! The most important thing is to understand that satisfying our desire doesn’t mean solving our problems…
This is very helpful, Fred. In fact I just ordered the book. I’d like to think about its message and see if I can sneak it into the final draft of Biology of Desire. I’m very taken with the idea that desire has to be redirected, not snuffed out — as if that were possible, when people recover from addiction. You have to use the desire engine to pull yourself toward another goal, more precious than the one you’re giving up.
My recollection is that the first couple chapters really cover these key ideas. After that, it delves into some pretty Freudian stuff, which I didn’t find as relevant to my recovery. So, you can probably get a lot out of the book without much effort! He goes so far as to say that within desire lies the life worth living. I think one could conceptualize addiction as a shortcut people take when healthy desire is thwarted. Lonely (*desiring* connection but not willing to risk reaching out)? Use drugs. Anxious (*desiring* a sense of mastery and trust but not able to find safety)? Use drugs. Hate your boss (*desiring* meaningful work in a respectful environment, but don’t believe things can change)? Use drugs. By discovering these deep desires and pursuing them from a place of vulnerability and integrity, one can build a life one loves. That’s the ultimate therapy. When healthy desires are expressed and pursued, the need to use may recede to just a small point on the horizon, instead of staring us in the face 24×7 as a solution to the pain of a life where desires are disowned, dismissed, denied or derailed.
That sounds like a conceptualization that fits well with my own take. The rekindling of those desires is such an important component of recovery. And it seems to depend on one’s ability to “think past” the most obvious solution, the ready made one. Which requires a certain amount of perspective and insight.
Good to know what I can skip. I think there should be a law against books that go on too long.
Dr. Lewis, I read and reread the Memoirs. The absence of dopamine in my brain is overwhelming. I feel no desire for anything. So I use sometimes and it destroys me every time. The NA program….I have exhausted its possibilities, it feels that way.
Thank you for brilliant book, about survival, and moving ahead. I am surviving, thank you, but not moving ahead.
best to you
“It is rare that happiness alights just so on the desire that called for it.”
Marcel Proust
What a lovely way to say it.
Desire is what makes up life and we all do it or die. There does not need to be the shame that surrounds a bad habit, it doesn’t help in the least. But, to know that desire is a natural process and that a drug or drink might fill that bill for a person at the time is worth knowing. At the time it is the best that can be. Moving forward a time of abstinence can be very helpful. I just don’t think that using should be made the culprit that it is not.