Hello readers. Are you still out there? I haven’t gone near my blog for over two months. So no new posts, a few comments dribbling in, and of course not as many readers. Something had to give. Having to sell our house in the Netherlands, buy a house in Toronto, move goods, furniture, children, etc, from Arnhem to Toronto…all the crap you go through in moving, made so much more complicated by the pandemic, having to cancel services and contracts…in Dutch…was just overwhelming. So I took a break from non-essential duties. And that seemed to include the blog.
More than that, I wasn’t sure I had anything new to say about addiction — the science, treatment approaches…anything. I didn’t want to just recycle earlier topics. So my last post, on Internal Family Systems (IFS) therapy for people in addiction, was looking like my last hurrah. But lately I started thinking I may have more stuff to share. IFS has changed the way I look at almost everything in psychology. It’s changed how I see emotional habits, “dysfunctional” behaviour patterns of all types, and of course the way I understand addiction. I’ve used it pretty methodically with myself — sometimes as an alternative to meditation. And it’s had a major impact on the way I practice psychotherapy.
So, moving on: the next set of posts will apply IFS theory and related ideas to our understanding of addiction — broadly — and find out where that takes us. If you haven’t read my last post — maybe take a look at that first to get the basic idea.
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I was talking with my wife about how common it is for people to feel inauthentic. It’s a big issue for adolescents in particular (that’s her field — adolescent development). Teens are always trying on different styles — different clothes, ways of talking, ways of seeing themselves. Who are they? Straight, gay, or bi — meaning what? — geek or jock, reserved or outgoing, serious or casual? And as they’re trying on these new identities, they often wonder if they’re being fake or real. It’s a big issue.
For people in addiction, the problem of “authenticity” is amplified and extended. We all know that stupid riddle: How can you tell when an addict is lying? His lips are moving. Insulting, of course, but there’s something to it. We addicts do lie. We lie because we don’t think we’re okay. We know that taking drugs is frowned on, to say the least. We lie because we continue to do something that most others disapprove of. Bye mom, I’m off to score some heroin, see you later. It’s just not something you’re going to hear.
My first big lie to my parents seemed necessary. I’d just used the money they’d given me for a winter coat to buy smack. I was 18, and I was anxious, depressed, and very lonely. Heroin helped. Gradually lying became habitual. I lied to romantic partners, parents, relatives, friends, work-mates, bosses — just about everyone — when the necessity arose. Being truthful about being a drug user — seriously? — is sure to invite heaps of social rejection, scorn, contempt, and often, serious consequences for one’s lifestyle and personal safety.
So addicts (I use that word to describe, not to shame) see themselves as inauthentic or untrustworthy. It’s a self-concept we acquire almost seamlessly. That’s not a great foundation for building self-esteem, and self-esteem can be crucial for developing self-care. In fact, seeing ourselves as inauthentic amplifies the shame and self-doubt that got launched in adolescence and boosted by drug use itself. What a drag.
But what if the idea of “being inauthentic” is just wrong. Like a map from the middle ages, what if it’s just totally inaccurate?
PLEASE NOTE THAT I AM HAVING SOME TECHNICAL PROBLEMS. TO GET AROUND THEM, I’VE DIVIDED THIS POST INTO TWO HALVES, PART 1 AND PART 2.
Please see Part 2 for the rest of this discussion!
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
Psychotherapy has never helped me. I hope your methods are better than here in The states. I’m grasping at straws here to let go of the 1 substance left I am kicking. Meth. I’m 4 days into the absence of it and it plain sucks. I have been able to stay active the past 3 days. Yesterday riding my bike in near 100 degree weather here in SW Florida has left me feeling drained today. Any suggestions ?
Sorry for your suffering. It sucks. Drink lots of water and go to an NA meeting. And good luck. Stick with it.
Find ways to detach from your mind. Bike riding good! If you can avoid thinking about the future and find a way to make peace with whatever you’re going through (knowing it will pass). Find other people who understand (this, in my opinion and not the steps or anything in the literature is the strength of twelve step programs). A lot on line now, all over the world. You can do this. Hang in there and “one day at a time” is a hackneyed phrase that contains a lot of truth.
Hi Cher
Go to lots of different meetings with like-minded people who share your experience.Listen to trusted friends. (note: a meeting is two or more people)This is a process of problem solving and discovery, and it’s not realistic to think about it alone, particularly in the throes of withdrawal. If someone is very directive that you must do it a particular way, listen to what they say, smile kindly and keep exploring. There is no one way to do this. There’s the way that’s gonna work for you.
This kind of reminds me of Simrad’s observation that the main source of our suffering are the lies we tell ourselves. Those little white lies to enable us to avoid unpleasant truths provide a little dopamine bump just like the drugs of abuse all do.
Hi Nick. I love disagreeing with you, as you know, or maybe it just comes naturally — a habit. Which brings me to the point. Those little lies aren’t so much dopamine bumps as just running on automatic. But even if they are dompamine bumps, they’re usually negative. You get dopamine for escaping harm as much as you do from pursuing reward. And lying isn’t fun.
At least not at first. It only gets to be rewarding (and maybe we agree on this) when it becomes defiant. You’ll never see my secret. So there! Get the fuck out of my life…that sort of thing. But it’s a consolation prize. Defiance isn’t much of a reward compared with, say, love and acceptance. So on this I think we agree. Lies can become a source of suffering that outweighs the addiction itself. They isolate us.
Marc, welcome back to the the right half of the North American continent!
One of the most frustrating aspects of addiction are the lies, untruths, stealing, prostitution etc. that appear to be baked in the patients behavior. Over the years I have come to realize that this kind of behavior is a ‘integral’ part of addiction. Indeed, without this behavior addiction cannot be sustained or maintained. Now I have theory and an explanation.
Addiction invades the biological instincts of survival and throws the patient into a survival mode. Human are created to thrive and flourish. Think of Maslow’s Pyramid. Addiction turn the pyramid upside down. The overwhelming focus now is obtaining the drug to survive. Other aspects of thriving are pushed aside which Marc in one of his many presentations describes as ‘synaptic pruning’. Do whatever it takes to survive – lie, cheat, steal, prostitute and over a period of time this behavior gets powerfully entrenched. I call this ‘internal homelessness’.
Just as homelessness cannot end by opening homeless shelters, soup kitchens or giving the patient the key to a one-bedroom fully furnished apartment, addictions cannot be treated just by palliating the withdrawal symptoms. Unfortunately, the present policy is heavily focused on harm reduction to keep the patient alive. The widespread distribution of naloxone and syringes to reverse overdoses and reduce infections is offered as a first step towards seeking treatment. The majority of the patients don’t take the next step.
The goal of treatment is getting these patients back into a thriving or flourishing mode. A lot of services are needed – medical, psychiatric, housing, legal etc. Unfortunately, services are expensive and only a small fraction of patients receive them. For many, the behavior results in a patient receiving ‘three hots and a cot’, Our jails and prisons are full of such patients.
Dr, Colin Brewer, one of the experts in the field and a contributor to this website, describes recovery as learning a new language!
I have come to realize the untruthful behavior is a symptom of the disorder and has to be seen in the context of recovery. It is amazing to see the behavior dissipating when the patient recovers and Maslow’s Pyramid is reinverted. It takes a village to treat a patient.
I am just working through all your blogs Marc – changing my life … I just wanted to say please continue … after reading that you were wondering about whether to go on.
I have never had such a coherent and informed view of these issues. Like you newe to IFS and EMDR and in the last two years after 40 years of such struggles I finally feel the way through. So glad. And so grateful when i read posts like yours and know this work is being introduced to others. (btw, between 15 and 53 tried pretty much every method of psych available, psychdynamic, psychanalytic, gestalt, CBT, even ACT … all helped in little ways but nothing like the trauma/ somatic/ IFS … I think all the others leave out the body
Hi Alex. Thank you for these words of encouragement. I don’t know if I’ll continue to put up new blog posts, but I sometimes get comments like yours, suggesting the posts already up are still being read and are still useful to people. So…thanks. Sorry for the delayed reply.