Three posts ago, I discussed the personality traits that make us most vulnerable to addiction. And I promised to say more about them.
Most experts agree that the two biggees are….
(1) an impulsive or risk-taking personality style
(2) an anxious, oversensitive personality style
Note once again that there is nothing like a standard “addictive personality” — contrary to popular belief. In fact, these traits are almost perfect opposites. In her upcoming (excellent!) book, Maia Szalavitz emphasizes a third gateway: an insidious combination of the two. Maia says this was the recipe for her own addiction, and I think that was it for me as well. So let’s call this third personality pathway…
(3) an impulsive or risk-taking style combined with oversensitivity
How do each of these trait structures predispose us to addiction?
Most experts emphasize the link between impulsivity and addiction. That’s pretty straightforward, but it’s especially problematic in adolescence, when every kid gets somewhat impulsive (except for the real nerds) because evolution designed us that way. Now trait impulsivity becomes a risk factor for all sorts of things: shop-lifting, uprotected sex, preventable accidents, etc. But when you’re an impulsive person at an impulsive stage of life, you’re especially likely to hold out your hand when powders or pills get passed around. “Hey, I want to try that!” Drugs and booze are risky, and risk-takers are first in line.
But there’s another, subtler, causal connection. Research links the impulsive/risk-taking trait package with inborn differences in the dopamine system, and this path to addiction was touted by Kenneth Blum as the reward deficiency syndrome. Due to normal genetic variability, some people have fewer or less sensitive dopamine receptors of a particular type (e.g., the D2 receptor in the nucleus accumbens, the brain region underlying reward seeking). According to Blum, these people need more dopamine to feel excited or engaged. I’ve written about this in detail elsewhere, but the idea is simple. If you need more dopamine to satisfy your underpopulated D2 receptor system, the easiest way to get it is to take drugs.
Now, if you know (maybe unconsciously) that you need more of a charge than others to feel good, then it makes sense to train yourself to seek and find risky situations. So, you may end up “hypersensitive” to high-impact rewards because that’s really what 
you live for. People who are extreme in their impulsivity also lack normal levels of social anxiety. So they don’t care much about how others react to their excesses. Then we are verging on the antisocial/psychopathic personality style. And those people can be bad news in all kinds of ways.
What about the anxious, oversensitive person? We become anxious about how others react to us, sensitive to rejection, and perhaps obsessively concerned about how we are acting, not only based on genetic patterns (e.g., not enough serotonin) but also based on our family environment. If you are raised 
by parents who are unpredictable, touchy, volatile, or anxious themselves, then you have every reason to become anxious in social situations — and a genetic blueprint that favours anxiety will help you get there. Why would such people be more likely to find drugs appealing and, eventually, addictive?
I can speak to that personally. My mom was volatile and somewhat of a perfectionist. There was a lot of love between us, but I learned to worry about how I was behaving — and my behaviour was far from perfect. What looks like social anxiety from the outside can feel like self-criticism and self-doubt on the inside. That was me, and like many others who feel this way, it led me to depression even before I got to boarding school — where 
I learned just how nasty life could get. Depression and anxiety are highly correlated with addiction for good reason: drugs make you feel different, either calmer or more uplifted, they give you the sense that you can control your mood by ingesting something, and you become less reliant on social approval because you’re standing right next to the feel-good tap. Particular drugs help (“self-medicate”) in particular ways. For me, it was the soothing caress of opiates; for others it can be the bright reassurance of meth or coke. For some, it’s both.
What about #3, the combo? Maia Szalavitz speculates that being a risk-taker and an anxious perfectionist was the recipe for her addiction. Same with me. From the age of 3 or 4, I was the kid who would climb up the rose trellis and 
stand on the roof, crowing. I was constantly cajoling my cousin, Nancy, to explore the ravine with me, though it was strictly off limits. To present my mom with the nicest possible bouquet, I picked every flower in our neighbour’s backyard. I slid down the ice slide right in front of my teacher, because I’d literally forgotten that she’d just told me never to do it again. That sent me on my first visit to the principal’s office — in Grade One! Then, as a teen, I wanted to try booze, and weed, as soon as they were offered. And I spent my last year of boarding school dreaming about our upcoming move to San Francisco, where the streets were said to be awash in LSD and other exciting chemicals.
But I think this is the most interesting part: my penchant for anxiety, depression, and self-criticism joined forces with a deeply rooted attraction to risk-taking. Take the pill, try the needle, why not? And then, wham! I suddenly feel like I’m the conductor of the symphony of my moods. Depression, be gone! With the help of my allies in the chemical kingdom, I’m the one in charge.
What this shows is that personality development brings divergent traits and proclivities to a point. Development takes the parts and welds them into a whole. And if that whole starts to coalesce around the attractions of substance use, there’s going to be a rough road ahead.
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
Interesting. I read your books in reverse order and I’ve just finished Memoirs of an Addicted Brain. I could identify with some of the feelings, especially around loneliness, hopelessness and feeling stuck.
What interests me is that I would say my two brothers and I all had social anxiety to varying degrees. The oldest eventually sank into depression in mid-life. I ended up addicted to alcohol in mid-life. However, the brother who had nervous tics as a child and had trouble making friends all his life, has never tried drugs and doesn’t drink much alcohol, despite having had plenty of reason over the years. He is also the most conservative and conventional. I wonder if being a absolute non-risk taker combined with having social anxiety makes someone less likely to go down the route of addiction? Maybe.
Very interesting point! I think you might be right. Maybe social anxiety requires a certain amount of impulsivity or riskiness as a bridge to substance use. But a lot depends on the specifics, too. People who have ever had disabilities, even mild ones, might cherish just being normal.
I have 2 sons, both addicted to videogames. One is risk-taking type, but not anxious, the other is anxious type but not risk-taking. The anxious son seems more addicted than the other.
One thing that fosters addictions in children is sugar consumption. Sugar is the drug of toddlers. It may be the gateway addiction for the rest of the addictions.
I rest my case! But you know, sugar can simply be the first in a line of “substances.” I don’t know if it fosters addiction as much as just being the first “special thing” we get our hands on early in life.
A prerequisite for increased risk becoming addicted is just being born. Everyone, in my own opinion, are susceptible and given the current state of the world the risks are probably higher for both addictive disorder as well as mental health disorder. Biology may play a role, however, in may respects, the environment impacts all aspects of our lives at various degrees. Some people tend to be more sheltered perhaps due to where they live, if they are able to meet their basic needs, if they are being adequately fed, clothed and/or secure or living in a war torn country etc…,.. However, the addict in the “alley” and the addict on Wall Street are exactly the same in terms of their internal turmoil which in many cases is rooted in shame. To the degree that a person has lost a sense of themselves may act as a measure to how they may compensate by drinking, smoking, using other drugs, gambling, work-aholism (they call it “multi-tasking” these days), technology/computers, eating, shopping, etc…, anything to use as an escape or distraction from their world. Susceptibility (the pressure of work and other demands of life) and availability place everyone at risk.
Loss, loneliness, isolation are a reality for the many baby-boomers who are getting older and for anyone who experiences a loved one who passes away. Technology is a double-edged sword in that you can reach people from most places across the globe, yet, many people feel more isolated than ever. Often I observe couples at a restaurant , coffee shops, waiting areas at hospitals or other public places who are on their phones, Ipads, computers or other technological devices as though the other person doesn’t exist.
Many teens and/or young adults have difficulty or feel uncomfortable talking one on one without their devices. Many have great difficulty with job interviews, which, by the way, are hard enough even if you have great person to person skills. These devices have actually caused, in my opinion, further fragmentation in most cultures across the globe. One of the main reasons perhaps could be the emptiness one feels and if I can have 500 or 1000 or more people as my friend on Facebook then maybe the emptiness will go away, or if I use enough drugs, or alcohol, or gamble or use any one of the many escapes this empty feeling will go away.
It is as though our society depends on dependency in terms of tobacco, technology, fast food, shopping, etc…, We have a high tolerance, as a species, to the inappropriateness of tobacco companies selling a product that is used as intended will kill you, unequal balance of wealth and natural abundance of clean water, air and uncontaminated foods. Over populated jails and/or prisons and the unjust Justice System. How is it one can live in peace, embrace brotherly and sisterly love, trust governments to do what is right for all people and transcend our human consciousness by dissolving the bonds, once and for all, from Kings and Slaves. We are in this together and if we truly cared and actually loved one another there would be no need to abuse ourselves with alcohol, tobacco, other drugs, gambling, technology etc…, It’s not just about one addict or addiction in general, to me, this is just the byproduct of the current state of the world in which we live!~ By breaking the bonds of addiction myself, I’m able to see much more clearly the extent and reason to how one becomes addicted in the first place.!~
Just wanted to add…my prior comment wasn’t about blame as much as it was about understanding the complexity of the whole process. I am responsible for my own “character defects” but I am also impacted by the world in which I live. If I am addicted I am responsible to do something about it especially if it impacts other people in my life. Though many people recover or “Discover” a much better more effective way of living it doesn’t mean the “system” itself isn’t dysfunctional!~
Thank you, Marc, as always. I am thinking about your post and my own life. I never took risks as a child…I was always too afraid of just about everything to take risks or anything else. But I took heroin and that took away the fear….and the social anxiety…and pumped up the dopamine. And after years of abuse, total abstinence brought little to no dopamine and very much depression, so I am happy to have found a middle road with certain meds and attempting to meditate every morning…to take a step back and lessen the anxiety and take a good look at myself, and my sons and the young lady sitting next to me. Hah!!
Sharing and maintaining faith are wonderful tools, but they don’t replace the missing dopamine and all the other neurotransmitters and neurostimulators. Thank you, Marc.
As for the post by Gary, “How is it one can live in peace, embrace brotherly and sisterly love, trust governments to do what is right for all people and transcend our human consciousness by dissolving the bonds, once and for all, from Kings and Slaves. We are in this together and if we truly cared and actually loved one another there would be no need to abuse ourselves with alcohol, tobacco, other drugs, gambling…” I don’t believe a word of any of this. I do not live in peace as a city dweller, I don’t seek brotherly love and know few people who do…life is more about respect than love, we are not all in this together, as is evidenced by war and violence and lack of respect and generally awful behavior by some people on every level of existence…and what does all this have to do with drug addiction? Nothing!!!
Hi BobbyG…
I sincerely appreciate your feedback, however, it is unfortunate that you may not be able to relate the condition of ones’ life be it poverty, trauma etc…, in terms of bodily response regarding chemical reactions such as “Fight or Flight” response etc. As far as peace is concerned this is something one has to create in their own life and isn’t determined by a place or external though it makes it easier to attain, so! it may be more difficult to achieve peace while residing in a city. Some people are much more at peace in a city and feel uneasy in nature because it is too quite.
However, I’ve never walked in your shoes nor you in mine and my opinions are only mine and opinions don’t necessarily translate into a truth. Everyone is at a different place in life sometimes we connect and/or relate to each other and sometimes we don’t, however, because there is a difference doesn’t mean we have to judge it.
Our own attitudes and outlook have an important role in our behaviors, responses and choices we make and trigger chemical reactions in the brain. Neuroplasticity, in reference to the brain, in terms of addictions and/or habits create ditch-like channels in the brain which is why we repeat over and over same old thinking, acting and behaving etc….,
However, due to Neuroplasticity we also alter the brain in ways that are healthy and life enhancing!~
~PEACE~!
Gary
Hello Gary,
Perhaps the inner peace is more important. You are right, Gary. I was in fact referring to peace in the world all around me. Very few urban centers are peaceful these days, and I think that in the country, I would become a TV addict (or maybe I would write a book)!!! And few governments do what is best for us, but in some cases they do protect us from the violence and theft by rapacious individuals and companies. Myself, I would like to have the dopamine flow of a successful criminal, but to do dynamic good things for myself and for others, not evil. I thought that opiates and cocaine together gave me that flow, and they did…for about two hours. That ain’t very long!!!! Best to you!!
You’re welcome, BobbyG. It sounds like you were one of those kids for whom addiction was waiting to happen…that unique configuration of personality traits and environmental events — exposure being a big one. But it sounds like things have come together for you. I’m glad! I also find meditation incredibly useful.
Gary, All the environmental and cultural factors you mention — and I only had time to skim, but it seems you’ve included nearly all of them — are certainly powerful goads to addiction. I’ve always been more attracted to looking at environmental impacts than genetic or characterological types. But I have to acknowledge that some people are just more comfortable than others in this chaotic world of ours, this “discomfort” can take on different forms, and those differences are PARTLY inborn. Being the father of twins has convinced me of this more than any other experience.
Your Blog, with its accompanying comments, is such a gift. The risk-taking/high sensitivity trait nails my experience. I want to emphasize here that my addiction was sex, not drugs or alcohol (although drinking occasionally approached dangerous levels). My focus was always sexual fantasy, acting out compulsively with women off and on until my fifties. Then back to fantasy on the Internet.
Thanks, Carl, for letting me know. I’m starting to think that that combination is really quite dangerous.
all humans are anxious, all humans impulsive, therefore an addictive personality is present in all of us, to varying degrees, some more so than others, some extreme, some subtle. the behaviors possible to improve the low self worth commonly seen are endless. we all have habits. what we are talking about is mostly normal human behavior socially critiqued and we are allocated dependent upon social norms into the deviant or the hero. a sporting superstar is as much an addict as a street junkie, both devote there life to their drug/behavior in order to feel better about themselves. the plaudits of the Olympics (which we are about to see) are not dissimilar to the rush the junkie feels. when will we stop looking at drug use as something unnatural. human nature is to avoid pain and fear, to seek happiness in an otherwise dreary life. another thought provoking post Marc.
Terry, this excerpt is a bit long, but touches on a similar point about all humans and addiction:
The human traits that sustain a person’s devotion to worthy causes,
lofty goals and respectable activities, are the same traits
for sustaining something as clearly destructive as an addiction.
I will use a professional athlete as an example.
The feats of a professional athlete are extraordinary, almost “abnormal”,
to use another word.
In time, professional athletes change their life’s goal that they have
been obsessed with. It is a goal they have been focused on for a good
part of their life. It is almost all they know, and it’s a goal that
friends and people have bent over backwards to help them achieve.
This is nearly an opposite, mirror-image of an addiction.
Changing the lifestyle is probably as foreign and as difficult,
requiring as much soul searching and spiritual reflection as recovering
from a destructive and debilitating addiction. Society praises one and
condemns the other, for obvious reasons.
During my recovery process, it became apparent that these
human mechanisms involved with both Addiction and Dedication
are basically same mechanism.
This “Ah-ha”-realization, freed me from the shame and guilt of being addicted,
and allowed me to fall back and even trust “common sense” again.
Whether identifying and becoming an expert with something positive, like a sport, or negative, like an addiction, It becomes something you know A LOT about, something you can bank on, you can “feel at home” with, and feel “normal” about.
Some people retain these identities for life and some lose the identities.
some athletes remain in the field in a different capacity, and some change their life direction all together.
This is similar to people involved with addiction and recovery.
It must be traumatic for an Olympic athlete to “surrender” a lifetime
goal and identity, the very thing they have spent
most of their conscious life submerged in.
And in the same way, it is traumatic to leave the lifestyle and function
of an addictive life.
It dawned on me that the trauma of quitting something, is therefore “normal”,
or NATURALLY traumatic for any human being, and is not unique
to the addicted.
Clearly, if addiction was only an abnormal weakness, a person would succumb to the addiction repeatedly throughout life.
But with the insights mentioned above, I was able to allow and perceive myself as a human being with a natural problem rather than a human being with an abnormal weakness.
There was now a “common sense” understanding that the addiction was a eclipsing my actual wants and desires.
Discovering you can trust yourself is a private, personal thing, not measurable by methods, and points to defining addiction and recovery in more than only scientific terms.
D. C.Bright
thank you – addiction is but a habit out of control – a harmful self destructive thing in its extreme at one end of the habit spectrum if you like. habits are normal, all humans have them. you are right about the difficulty of changing an entrenched habit be it healthy or otherwise. one of the greatest obstacles for substance addicted people especially those addicted to illicit drugs is social stigma, marginalization, labeling & control. without that drug users may find it easier to deal with their use when it becomes problematic – hence my call for drug law reform, legalization of all drugs and an end to the war on the people who use the drugs that society decides aren’t OK. imagine a war on antibiotic users?? a recently retired great of Australian tennis is considering a comeback 5 weeks after retiring. relapse occurs everywhere and is also normal in habit change. addictions are never given up, they are replaced by other habits. Charles Duhigg explains that very well. Terry
The statement:
“Addictions are never given up, they are replaced by other habits.”,
could be said differently, which may be helpful for people
struggling with an addiction;
“Habits are ever-present in life, and freedom from habits that have become an addiction, occurs.”
Terry, you should read Chasing the Scream by Johann Hari, if you haven’t already. He makes your argument well and describes the positive effects of decriminalization in several countries.
I like your point about addictions being replaced by other habits. There’s a lot of truth to that.
I have read it Marc. there is too much confusion while ever drug use is seen as a crime. maybe 3-5 % of people undertaking any habitual behavior will progress to addiction. there will always be a need to treat some but creating an underclass of those who use certain drugs while hypocritically enabling multiple other addictive chemicals and behaviors to flourish only harms. The Olympic games this year is the greatest collection of addicts to be seen in one place but none of them will be called the same names drug users are, in fact they will be given medals for their addictive behavior. the war on drugs is lost and common sense needs to prevail. i am a workaholic and a gym junkie now – much better for me and my pocket than alcoholism – but i remain even after years of “therapy” essentially the same anxiety riddled individual – the behavior can change but i doubt the original wound whatever that is cannot – i am now reading Gabor Mate’ and his notions of failed attachment relationships resonates with me – it all happens between 0 and 5 years age when those neural pathways are being cemented.
Curious if other readers have found that original habits and authentic wants and desires have re-aligned after being diverted during their period of addiction.
It could be one factor why a percentage of people that were addicted to something are not compelled or enticed to returning to the addiction.
Re-realizing authentic wants and desires may be a life-changing , “Ah-ha” realization, despite personality trait-vulnerability.
In fact , those same personality trait may contribute to the re-realization of a persons authentic wants and desires.
Carlton,
I am fascinated by the amazing responses that I have read about addiction and how each one has such a unique view point on the matter. I spent twenty five years looking down the barrel of a loaded gun while in active drug and alcohol addiction and having been clean from both has both opened and closed doors but it has also allowed many questions to arise. I am a firm believer that addiction is not a disease nor an incurable condition that I will always have hanging over my head and I am curious as to why people feel that this “behavior” or “habit” can not be put on permanent pause. Further down it discusses how those that are in the Olympics are addicts but aren’t discussed as such but those that have chosen a different addiction path -illicit drugs-are criminalized. What is wrong with that? Societal view on what is acceptable or what is acceptable “human capital.” Thank you for sharing, I really enjoyed your post. And yes, self trust seems to be the key which can be difficult due to the nature of how society is built around the idea that everyone else knows whats best for you and so, at least in my case, I learned not to trust my own voice. I agree that sometimes science may need to sit down, not that it has not propelled us into a greater understanding but it seems people always want to base their assumption or indoctrination on some scientific claim about what is wrong with my brain that causes me to be an addict. It can be frustrated and deflating at times. Thank you.
Reagan
Reagan,
A major change of how addiction and recovery is comprehended may be imminent.
There is an ever-growing diversity of individual accounts of the addiction/recovery experience occurring.
For example, just in this blog over the last year or so, you can see this occurring.
I think that a new model for the addiction/recovery will come from the field of Humanities, rather than the Sciences.
The profoundly different beliefs surrounding something like addiction and recovery have a value unto themselves, and will not need to be considered “right or wrong” in a new overarching model of addiction and recovery… if it comes from the Humanities.
Even those two terms, “Addiction and Recovery” may change to terms more appropriate in some way.
Reagan, I apologize for the poor wording , so here is the point re-phrased.
You wrote:
“Further down it discusses how those that are in the Olympics are addicts but aren’t discussed as such but those that have chosen a different addiction path -illicit drugs-are criminalized. What is wrong with that?”
The point is that the same mechanism and driving force that produces dedication and perserverence such as in Olympians, , musicians, dancers, the things that draw person to anything, is the same mechanism and driving force that produces an specific addiction with a person..
This is not to saying Olympians are addicts.
And to make a distinction;
Addiction generally produces carnage in a persons life and society, where as an Olympian, musician, sports player, etc generally does something of the opposite in thieir life and society.
Further, the point is the mechanism and driving force involved… and in hindsight, it seems to be the same thing.
This is point is one element of a new model for addiction I am proposing, called The DILECTION Model.
The notion seems to be readily understood by people that are not very familer with addiction and recovery.. it even makes sense, so it may be recieved by the public before it is in the scientific and medical field of addiction.
Mind you , it will not “change” addiction, but it will change our UNDERSTANDING of addiction and recovery, and hopefully answer alot of those questions that arise, as you mentioned.
Reagan, here is one reply to your question:
“I am curious as to why people feel that this “behavior” or “habit” can not be put on permanent pause.”
A common and universally experienced element of life is being overlooked when considering the cause of addiction, and it could be due to the fact that it is also the same element that is often considered the cause of a persons re-gaining of freedom from an addiction. (or recovery)
Here is an analogy:
The tragic story of Romeo and Juliet is understood and accepted as a phenomena of life, albeit a very tragic one.
The scientific/medical field can offer descriptions of dopamine levels and receptor blockage in th eBrains of R&J.
The cognitive reasoning and rational evaluation of R & J can be evaluated and described.
But yet, the tragedy is globally understood and accepted. People the world over are moved and upset, and also empathize with the R & J’s situation and the scenario on a human level There is not too much puzzlement about it despite the destruction of lives and the utter tragedy of it all.
The terms: “behavior” or “habit”, “disease”, are not readily appled or considered the cause of a tragic scenario like R&J’s.
Please forgive me, but the following in meant is a humorous and lighthearted way:
Yes , R & J could try to put a permanent pause on the situation, but it would probably not last long.
Hopefully, this analogy points to a common and universally experienced element of life as being the (initial) source of addiction, as well as recovery.
This is what the Dilection Model of Addiction (Di`lec´tion n. 1. Love; choice.) is based on, and why the wording and writing is a critically important thing.
Carlton
Yes, substance use and other ways to change how we feel are universally human. I never meant to imply that only a small number of traits can lead to addiction. That’s why I used the term “vulnerable” — some people are more vulnerable than others. Human diversity in all things.
the matter of vulnerability versus resilience is very interesting and may correspond to the degree to which an individual is governed by their anxiety. maybe it is only a small difference between normal and not so. i don’t believe their is much difference between an addict and your average Joe except for the tendency to go too far and never seemingly be satisfied. no off switch. i do Carlton believe the potential for addiction always remains in an addict well after they have changed habits. the speed with which i became a gym junkie years after ditching alcoholism is my testament to that. it is perhaps unwise to think an addiction is cured. i learn to accept myself and in doing so took up positive habits/addictions rather than negative self defeating ones and as the late maturity seemingly common in addicts developed i began to be able to control behaviors i once couldn’t. why are there no very old addicts, or are there ??
When research turns towards older or ex- addicts that are not typically heard from, It may provide new evidence that will allow the current parameters and definitions of addiction and recovery to be re-thought and re-drawn, and in a natural and common sense-ical way.
History, literature, plays, has accounts of some people revisiting places, relationships, etc, only to find that their feelings, thoughts, beliefs, have changed. It is not the same any more, and they may find they don’t want to go back, even though they tried.
Things they thought they could never live with, they later find they no longer want to engage, or be with.
There are many stories of sadness, loss, etc, but there are also accounts of freedom and relief that they are no longer stuck or compelled to return as they thought they would always be.
Accounts like this relating to addictions are very rarely heard, and certainly cannot be spoken about at addiction and recovery groups.
There is little encouragement, and little compelling reason to voice things like this, and who would believe them in the current belief and understanding of addiction and recovery?
Besides, it is not easy to express or explain, and cannot be taught either.
How does one teach or explain how a piece of music, book, movie, sports team, town, city, person, home, school etc, that they once cherished and clinged to…no longer moves or compels them.
An individuals recovery process from an addiction starts when an individual actively WANTS to change things like this,
but the outcome on an individual cannot be predicted or measured.
This website is the first one I have seen that people have posted accounts of this nature, and I think its because its not attached to a recovery program. People can post other than advice and warnings, here, which is quite remarkable.
It is a good sign that addiction and recovery may be considered and understood is ways not heard, or considered before.
Thanks Carlton – there is also very little about the benefits of drug and alcohol use even for addicts who mostly do benefit for quiet some time in most cases before the ship starts leaking badly. too much is about harm and problems and that does not resonate with users who generally use because the drug (or alcohol) does something for them. the millions who seek drugs despite all the education and the war on drugs are testimony to both a need and a positive side to drug use lost in the hysteria. i would go even further than legalization of currently illicit drugs which generally are far better at alleviating anxiety than anything medicine has come up with. there will always be those who reach chaos and become chronic but even those change as time goes by – my experience is many mature out of addiction around their 40’s when as you say priorities etc change and what was once sought is no longer as important. it would be interesting to know what goes on in the brain then to lessen the hold addiction has.
Not everyone has an addiction problem from childhood, which they then grow out of. My problem with alcohol developed very slowly in my late 40s. This is the case with a lot of mothers and middle aged women who feel unhappy and stuck. It seems like a grown up thing to do to have a drink to relax at 5pm, and gradually the one drink becomes a bottle without ever intending to drown sorrows etc. And there are some addicts who remain addicts and live to old age.
Yes – Thanks Heather – the problem with addiction is that there are so many variations of it – i think if we go back to anxiety in general we will find we shift our responses to that over time. i was as a child an asthmatic, then an alcohol and drug user, then a workaholic with OCD and a gym junkie – drug or alcohol use is but one habitual way to feel more secure or happier. i like your use of the term “stuck” – trapped is another one – life gets dreary, relationship go stale, boredom needs pleasure to erase it, drugs provide pleasure, a least for awhile.
i believe all addicts remain addicts in some way all their life. the sad thing is those who are old are forgotten yet the story they have to tell about surviving or more importantly managing addiction needs to be told. there are children of the 60’s now turning 60, the old folks homes are going to be very interesting places soon . we should discuss management of addiction more rather than abstinence for abstinence tends to fail one way or another as habits shift.
Well, Terry, our topics and points are profoundly different but it is great to see thoughts “outside-the-box “, are possible to write publicly without being screened or removed.
Good luck with your causes!
as i have studied addiction for some 40 years in myself and others all i know is that what we have tried to so far do has not worked to help the addict. with reams of research no real answers have been found. many addicts get well despite what the treatment does to them. yes i am outside the box but it is time this whole issue got a different look and just like neuroscience is now seeing the “disease” differently so should society look at drug use differently if for no other reason than to separate the problem users from the addicts and remove social bias. i can’t lay claim to helping addicts unless i question the status quo as much of what we now do only causes more harm. i apologize for going off track.
I don’t think you’re off track here, Terry. Most of us on this blog have serious doubts about the status quo, both in conceptualization and in treatment… in fact, that seems the one thing most of us agree on.
Thanks Marc. I spent the weekend watching the Netflix documentary The Culture High – I recommend it to all although I may be preaching to the converted. I am more and more shocked as to the harm caused by the punitive approach to drug use. in my clinical practices it is the confusion in having to deal with both addicted people and those who are in my view victims of the war that are essentially imprisoned by being forced into treatment for simply using drugs rather than because they are addicted. there are degrees of drug use and that is also hard to relate to any theories.
I just devoured the biology of desire…reading books has often been a good habit! Vulnerability, this often came to mind while reading Marc’s text. Vulnerability can lend itself to beautiful growth or premature rot. My ex-girlfriend noted that my mother kinda “ruined” me because of my hyper-sensitivity, a hyper-sensitivity that also manisfests itself in a capacity for crafting melodies and performing music, well, say, a little deeper than the average performer. This said, rather than state an opinion I’m wrestling with, let me ask: a person who has the capacity for vulnerability , are they more susceptible to being dragged down by a product/substance just as they are to flourish with another?
You can think of vulnerability/sensitivity as a personality dimension of its own. Then, like other dimensions, you’ve got two extremes, both of which look unpleasant. Hyper-sensitive…? No thanks. That’s like walking on very thin ice. Even if you can pop out the occasional poem or even symphony. Closed up and impenetrable? Not much fun to be that way or hang out with same.
But even if the middle is the ideal ground, there’s so much that depends on what other characteristics go with it. I like my vulnerability served up with a side of humour, and some compassion to dip in, on a bed of intelligence, but with a tangy salad of curiosity and creativity to start…and something sweet for dessert.
Thanks for the answer. I have to agree. At times I have confused vulnerability with an openness to softness, a softness, though, with some firmness. It’s difficult to establish the distinction at times…and something I’m trying to remember to attend to. I must ask if you know Michael Polanyi’s work. He complements your approach, methinks. In short, the process of knowing and being-in-the-world consists of an interplay between tacit and explicit knowledge. We know the world not through a subject-object split, an interesting and sometimes fruitful work of the imagination Descartes pioneered, but rather through a passionate attending to the world/people/self. That is, through passionate engagement we develop the habits that allow us to have insight into what we’re undertaking. This can be applied to scientific discovery, what Polanyi was in part trying to understand, and plain life. I think the neuroscience you refer to confirms his epistemology-disciplined passion becomes a habit and this becomes manifest in a re-composition of the brain. I hypothesize. One more point on Polanyi, he also points to the importance of community. So we learn through support networks and in the company of masterful people. Naturally this goes both ways.
Rod – the addicted are often gifted, seemingly living ahead of their time at times. look at all the great minds who battled with drug use. they are also seemingly so very weak on some areas of life. the answer from me to your question is Yes.
I’ve often wondered how these personality traits contribute to the (1) types of drugs we are drawn to and (2) reasons for drug-taking (3) optimal paths for recovery. Could personality traits and states be helpful in determining the best pathways to recovery? We are seemingly going toward the “personalized medicine” route with pharmaceutical treatments, why not with cognitive/behavioral treatments?
I totally agree, Liz. Check out my book. Multiple pathways to recovery, in lieu of the notion of a normative cure, is at the centre of my approach to addiction. And I stress the value of one’s personal narrative as a way to actualize and move further along one’s individual pathway.
As for different drug favourites predicted by personality types, yes, I think so. In a nutshell, anxious/insecure/self-deprecating types will find peace in opiates….and impulsive types that crave thrills will go for coke and speed. But of course these are very coarse predictions. I’ve seen in others and in myself a certain amount of crossover.
We are all somewhere on a spectrum, right? It’s hard to find any hard-fast rules as to what approach works best ;).
Marc
Just read with interest your last blog post and write to express some concern
You have entered some dangerous territory with this
.
First the idea of Pleasure Deficiency Syndrome has been largely debunked. Maybe some people have less dopamine receptors , but add the word syndrome and you enter the dark realm of disease. Further, there is an implication of cause and effect that is not in my opinion warranted
Second is the idea of trait. You correctly reject the idea of “ addictive personality “ but then identify two traits as possibly being associated with increased vulnerability . This too has a dangerous side ie labelling and hence introducing the possibility of stigmatizing . The dividing line between trait and personality is murky at best- if there at all .
The common feature of most if not all people who develop addictions is they don’t feel very good about themselves. I worry that trait identification as a label ,although may be helpful as an awareness of a risk factor also has the potential of “ excuse” similar to that of having a downsides of having a disease. And conversely that “since I don’t have those traits Im safe . “
You are wonderfully trying to reframe what this thing we call addiction is all about, but am concerned that the tactic you have adopted in this recent outing has the potential of being counter-productive
Hi Bill. Thanks for the challenge. Always (at least almost always) welcome.
I met Kenneth Blum, who fathered the Reward Deficiency Syndrome, last year and I found him a lot smarter and more knowledgeable than just about anyone I’d talked to recently about the neuroscience of addiction. I know his RDS idea has not been popular lately, and replications have been disappointing. I still think it’s the simplest way to describe the link between impulsive personality style and proneness to addiction. There is truth there, though, as you say, “syndrome” may be misleading.
Look at some of the other comments in this section…for a quick survey.
Re traits: Don’t forget, I’m a psychologist. Traits are the fundamental categories of personality according to mainstream theorists. My approach to personality is far more developmental and nuanced, as you know, but I see no problem in referring to classical psychology terms which have been around since the time of Aristotle.
I certainly agree about the impact of negative emotions and self-deprecation, and I see these as primarily environment driven, as I described at length in my first book, re my time in boarding school, the role of trauma, etc. . But there is such a thing as temperament; and personality traits, although partly if not mostly shaped by experience, still have an “inborn” component. As I say in the post, I started climbing up the rose trellis at age 3-4. People can use anything as an excuse. I can’t stop that.
Thanks for this endorsement, but don’t worry, Bill. I’m not changing my tune. I’m just writing about a topic that I often avoid. Well rounded is good, no?
Marc and Bill,
I remember at SMART, they were constantly avoiding designating meetings to specific addictions or traits, because they felt that people may conclude that they, or their addiction was an exclusive addiction, and
maybe hold back their own recovery process.
But AA may embrace something like; “Personality pathways to addiction”,
It could help a person confirm or come to conclusions about themselves.
Well, I’d hate to be relegated to that camp. But I don’t like the idea of avoiding terms and concepts because people might think x or y. People will think all kinds of crazy shit no matter what!
Hi Marc,
But since there will always be a large percentage of people that stop blaming themselves gain comfort believing that addiction is a disease or a condition you are born with.
Recognizing personality traits that makes one vulnerable could be helpful to many in that camp… is not a bad thing for those who believe that way.
BTW- at SMART, I think the decision not to have specific addiction meetings was also because the cognitive approach is considered to be non-exclusive to any particular addiction or group of addictions.
Which makes sense…it would be like saying the law of Gravity is universal, but there are a few planets that are exceptions to the law.. or something like that 🙂
I don’t ” suffer” as you do from the dogma of formal education. and psychology until recently has had to struggle with very little in the way of solid empiric quantitative data endpoints. So I can opine from a fresh and holistic view from a lot of recent review of the field. So as I asked before where is the evidence of cause and effect?
But you are also an eminent neuroscientist. So I’d be interested for you to show me the neuroscience that shows the pattern or signatures of trait vs personality – to me they are more convenient cubby holes to allow for improving clarity with the understanding of the whole gemish of personality. toss in mood and temperament of course for good measure.
I’ll give you reward deficit as a possible explanation – if you’ll drop syndrome which leads to diagnoses of disorder and then disease if the medical folks get ahold of it.
I’m not sure what you’re talking about: “trait vs. personality”? Traits are categories of personality. Yes, of course they’re cubby holes. Indeed you won’t meet a “pure type”…though you might get close. If these terms improve clarity, then what’s the problem? Of course they’re not the whole story.
I already said that “syndrome” may be misleading.
The language is full of typology, to help us identify categories, to organize our thinking. That’s how language works….
What I find fascinating Is how the majority of people I have encountered through my time recovering are JUST NOT truly addicted to everything or MORE.. despite all the trite aphorisms. To the contrary I have observed addicts settling on one preferred substance or family of substances or certain process addictions (behavioral) as opposed to others.
Whereas I can identify myself as a hybrid of the two personality types, my discomfort with females led me to cocaine (and crack) which empowered my sexuality and desirability (especially if I was holding) which I became horribly addicted to despite experimenting to excess with a host of other addictive substances. I will never use cocaine again but I easily drink alcohol moderately with no desire or craving to overimbibe..
I don’t want to discount the phenomenon of cross addiction but does anyone know if there has been any research on why certain type personalities might gravitate to one substance versus another.. are there behavioral, emotional, environmental or
physiological factors that might figure into why one might descend into alcoholism vs opiates vs stimulants or gambling vs overeating etc. and could profiles of these vulnerability subsets be generated?
Or am I totally off base with my admittedly unscientific observation of the ONE magical substance (behavior) that emerges?
I welcome comments.
I’m pretty sure Marc is able to drink moderately since coming off drugs, too. A lot of programmes tell you to avoid any other potentially addictive substances, so that is interesting.
I have never been tempted to try drugs, apart from dope which I didn’t like and didn’t bother to repeat. I think it is opportunity, as well as personality. I chose alcohol because it is socially acceptable, and I liked the taste. The path opened because for a while we lived in a wine district and got a cellar together. It became acceptable to open a bottle of wine with dinner at least twice a week, and too easy to gradually allow that to sneak up. My addiction started when wine became a way to stop feeling so bad, instead of an occasional celebration.
Personality? Maybe. The thought of doing drugs scared me, but I also couldn’t imagine myself being comfortable in that scene, and wouldn’t have any idea how to go about it.
As you say, Heather, interacting factors are the rule….there is no single cause responsible for one’s course. Yes, I can drink socially….I don’t like the feeling of being really drunk. But I’m not perfect. Sometimes I drink too much. What’s most important for me is that when I do drink too much for a night or even a few nights, I then swing back the other way. That wasn’t the case when I was addicted to opiates.
I’ve never been much swayed by the argument for total abstinence from everything…except when that argument comes from Matt on this blog… Matt makes a damn good case for it. Or….except when someone lives their life next to the cliff edge, and any tremor (not just an earthquake) can spill you off.
HI Ron. As I say elsewhere, I’m pretty sure that personality “types” pull for substance types… in the addict’s ideal world. But there is no ideal world. So when you can’t get your hands on x, you might just as well take y. I know a lot of addicts like that…and I sometimes functioned that way myself.
As you say about yourself, anxiety about one’s lack of power can pull for cocaine, for obvious reasons. But anxiety about threat, safety, social rejection, etc, can pull for opiates. So…I’d say it’s the word that comes after “anxiety about” that matters most.
Wow. #2 and the section written about it compares my life to a tee. I am 28 years old now and I was hooked on drugs and alcohol for 5 years during college and a little bit after. I always had this self doubt and oversensitivity and anxiousness. I still have it. I do not know what to do to get rid of it. I am starting to think it is never going to go away and just accept it. I managed to get off drugs for 3 years now. But the feelings and self doubt are always there. Along with an obsessive voice that constantly judges and ridicules me. My sister does not have these traits. I still feel lost. Therapy has not helped. Just really sad about everything.
Hi Thomas,
As a separate thing, did you find the struggle and eventual freedom from the addiction a successful experience and accomplishment unto itself?
And if so, has that experience and accomplishment been an exception to the continuing feelings of self-doubt and anxiousness?
Hi Thomas, I’m sorry to hear your distress and despair. It’s probably true that these feelings aren’t going to “go away”….they are part of you. Mindfulness/meditation, and related therapy approaches like Acceptance & Commitment Therapy, take a very useful tack: your personality is part of the world and it is imperfect. Relax and observe it, let it be, and become aware that it is more like a suit of clothes (that you can’t remove) than a core self. Use some humour: there I go again… how silly is that…..sort of thing. Try to find a comfortable place inside all that, and don’t worry if you’re not there all the time. You won’t be. But it may become a home you can return to more and more often.
A Buddhist meditation class I went to, they talked about feelings being like weather. You can’t escape them, but they do change and pass. But this concept may not be very helpful when you’re stuck in the middle of a big storm.
Marc I think your work is awesome. I’m finding these posts very helpful, and I haven’t even been addicted to drugs!
I think most of us use our substance of choice to either take the edge off our feelings, or heighten our feelings. Once we get off the substance it can be really raw to be confronted with your feelings without the substance to take off the edge. It takes a while to realise that most people have feelings of self doubt and anxiety at times, and this is normal. Creating a fuller life and things to be proud of helps me. Right now I’m doing a fitness challenge with a few others. As well as getting me out of my cave and mixing with others, I can see the changes in my body which makes me feel good. I’ve found that guided meditations and self-hypnosis can help change the way you feel about yourself, too.
Rather then seek addiction prone personality styles, I suggest we seek recovery prone personality styles. Too much focus on illness prevents our focus on recovery
Guy lamunyon
The egomaniac with an inferiority complex, as they say. I’ve said all along that there’s no reason not to believe that people can be born with (as well as acquire) the vulnerability to addiction. I like the comment about entering the dark world of disease concept. A little more light and a little less heat would be illuminating.
Well at least we agree on something!
I think I had a combination of these traits, but what got me into substance use was a malignant repudiation of my natural people pleasing tendencies. People often talk in meetings about being a “people pleaser” as motivating their use, or more precisely, not being able to please everybody, and that feeling getting wrapped up in one’s identity and feelings of self-worth. There’s nothing inherently wrong with wanting to please others, per se, unless that’s the sole motivation for one’s behavior. I ran with a range of social groups when I was young, and got along with the eggheads and the jocks and the losers and the dopers and the burnouts. Everyone. I never thought of these as static categories, but that’s what we humans tend to do to make sense of the world, as this discussion demonstrates. We label and discriminate. I appreciated moving fluidly among these different groups, but the members of these various groups, including my family and adults in positions of authority were not so comfortable. When unfounded rumors began to circulate that I was doing drugs and drinking, I was confronted and told I had to completely change my associations and activities, who I hung out with, played music with, sports, etc. or I would be sent away. So the rebellious teenager in me decided to show everyone how lame they were. You don’t think I can do all these things you want me to do AND do drugs without you knowing about it? So I did the day after acquiescing to all these constraints on my behavior. Amphetamines, opiates, booze. It was the late 60’s and every legal prescription drug known to man was available in your parent’s medicine cabinet. Later in life, I had a massive iatrogenic infection due to a re-repair of a previous injury and consequently became dependent on opiate pain medications. There are as many roads to “addiction” as there is variability in the range of human experience. The same with recovery. The emphasis on science, or psychology or spirituality misses the point about such a multifactorial phenomenon. I’m with Guy L. and Nicolas R above. A little more light, a little less heat, and a focus on “recovery prone personality styles” instead of addiction.
Very interesting post. Is there any correlation between birth order and vulnerability to addictions? I’m guessing the elder is usually anxious but too responsible to be a risk-taker. Are the babies in the family more likely to get hooked because they can be risk-takers, and they might also be oversensitive? That was me!
I think this is complicated, John. Usually the oldest child suffers with jealousy and a need to remain “in charge”. The younger kid might indeed take more risks because he/she doesn’t have to hold up the family shield… yet I was the risk-taker, not my younger brother. And I don’t think sensitivity correlates much with birth order. Maybe there’s no underlying pattern.
I agree that there are various forms of personality. There has to be in order for a society to flourish. However, I think being human makes us vulnerable in which we adapt to our circumstances as an effort to cope. Sadly this coping behaviours often happen in bizarre ways distorting our perceptions, and subsequent behaviour. I am not fond of blaming addictions on personality types.
Seems to me that these two types of personality you describe align with
Bill W – (1) an impulsive or risk-taking personality style
Dr. Bob – (2) an anxious, oversensitive personality style
What I have noticed is that when a child’s developmental period is disrupted, their sense of self escalates to a more than (impulsive, risking taking) or less than (anxious, oversensitive). In my opinion, I would call those personality types, responses to trauma, or two forms of dissociation from a reality that the child is unable to cope with at the time. Seems terribly oppressive to me to search out genes, or rationalize personality types, when in fact being human makes us vulnerable to cope in bizarre ways to adverse events. Blaming addictions on personality ignores the very influential environment that acts upon the organism and dismisses the prior attachment history. Why would we pathologize a shy personality or an outgoing personality – when it is the environment that acts on the organism. These responses (1) or (2) are a normal human reactions to cope with an adverse event but sadly only become maladaptive later in life. Of course a trajectory into addiction could go one way or another but that again that depends so much on the age, attachment, social support, culture, etc. I wish we could stop pathologizing addicts and turn our attention to various forms of adverse events. Sadly, not so long ago they use to say incest victims were none the worse for wear.
…and yes, sadly…as humans, we know now after eons that incest and inbreeding are bad. But somehow we haven’t been able to translate that into change and diversity (the opposite) being good. Most humans resist both. Changes in awareness, perception and experience can be beneficial when motivated by kindness, compassion and the drive for personal growth and helping others. The core affliction in addiction is the desire to keep things the same and resist change. That’s why desire or dissatisfaction with the way things are is called the root “poison” in Buddhist philosophy.
As you say, humans learn all kinds of coping behaviors to deal with adverse circumstances in their lives developmentally. They become habits because they worked at the time. In addiction, we often retain them well past the time when they ceased to be useful.
Lynn, why do you say that I’m blaming addictions on personality types? Certainly not. In almost all my writing I emphasize environmental impacts, of the sort you describe here. Usually I get hit with the opposite argument: what about genetics?! Further, I’m a developmentalist. I see personality as developing…of course with experience. To say that personality types set up vulnerabilities does NOT imply that it’s all in the genes. I’ve argued against that repeatedly. Yet genes are part of the picture.
The cool thing is that we come to the same conclusion either way: vulnerabilities of either or both types ARE important causal mediators of addiction…no matter how you think they arose.
It’s strange that this post has brought all you “environmentalists” out of the woodwork, but you mistake me as the opponent voice. I’ve repeatedly said in this blog that there is no such thing as an addictive personality.
The latest I’ve heard in the nature/nurture, aka the genes/environment debate, is that nature/genes load the gun, but nurture/environment pull the trigger. The Dunedin Study is a longitudinal study that has followed over a thousand people for the past 40 years, since their births. dunedinstudy.otago.ac.nz
Other readers may have noticed that every type of personality is represented in the various addiction recovery programs they may have been involved in over the years, and not just the ones described in this post; “Personality pathways to addiction”.
Perhaps the source of addiction is a more universal thing, rather than being specific malady, or personality type, and perhaps not even insidious by nature.
I’m not sure what you mean, Carlton, but I agree that there is something fundamental about how human brains work that predisposes us to addiction. But, as I noted above, for me personality types are just one factor among many…..and “malady”?! Never!
Perhaps “Personality pathways to addiction” could apply for the BELIEFS surrounding addiction.
Its a mouthful, but;
“Personality pathways to the contrasting beliefs about addiction”,
could help people understand themselves and their situation with an addiction.
Yes, beliefs about addiction are also mediating factors. If you believe that addiction is a form of satanic possession, you’re more likely to avoid it, I suppose. Or to give up trying to quit if you’ve failed a few times. But beliefs aren’t simple either. The belief that addiction is “natural” can be a blessing, because it reduces shame, or a curse, because you don’t apply the brakes when you need to.
For some people, “natural recovery” may mean that the actual feelings surrounding the addiction have changed.
Most people can probably look back at a very important, memorable, and intense relationship that they could not imagine living without, yet the feelings surrounding that relationship have changed.
Desires, habits, and compulsions relating to that relationship have changed, and breaking away is usually very traumatic and terms like a day at a time”, or “apply the breaks” don’t apply any longer.
And in the same way, an addicts feelings may change about the addiction
they were once dependant on.
The “natural” state of sobriety may no longer has to be consciously actively, or skillfully maintained, because the feelings about the addiction have changed.
Genetically built critically low functioning dopamine/reward cascade is the common denominator, IMHO, everything else is replaceable & more or less an association.
This post is a revelation for me. I’m an overly sensitive risk-taker who’s struggled with addiction and the need to self-medicate since adolescence. I’ve often wondered what the difference is between someone who tries a potentially addictive substance or behavior without getting hooked and someone who tries the same thing and becomes an addict. Now I see why I’ve been prone to self-medication and addiction–and why I’ve unconsciously gravitated towards others with the same predisposition. I’m not sure why I’m a risk-taker, but like Marc I can trace my sensitivity to anxiety learned as a child with loving but highly volatile, unpredictable parents. I’m also not sure how this new self-understanding will help me in the future, but already I can sense a burden lifting. Thank you, Marc, for the insight.
Very interesting link between addiction and personality. The one on anxiety and self-doubt resonates with most people i have met. Their self-esteem has taken such a beating that they need escape and affirmation from a substance. Sadly, the guilt that follows plummet s their esteem to a lower low. Love the insights in your articles.
An interesting overview Marc, thanks. The one bit that seems perhaps to be missing is the view put forth in Gabor Maté’s book In the Realm of Hungry Ghosts whereby a person can be born with “normal” incentive-reward circuitry but early experiences can actually cause deficiencies in brain chemistry in this area, resulting in a vulnerability to addiction.
(BTW, I read your Memoirs of an Addicted Brain a few years ago and found it excellent. Having got over a process addiction, I now find myself exploring the subject of addiction again having got entangled with alcohol. Onwards and upwards…)
I just heard Luke Williams interviewed on the radio about his book, The Ice Age: a journey into crystal meth addiction. He’s an Australian journalist who was addicted to crystal meth himself. I can’t wait to read the book, he seems so lucid and insightful about the state of being addicted to the drug, particularly the ego and sense-of-self aspects of it. I have not experienced drug addiction myself, but I’ve had depression and anxiety. Depression, anxiety and maybe also drug addiction involve an unstable sense of self, and maybe that’s where a drug like crystal meth can slot into someone’s life.
Very true, Karen. Drugs provide stability….not the most useful kind, of course, but they do create a structure that shapes each day: find, get, use, get high, come down….repeat. It’s hard to live with instability in oneself. But the Buddha and many other wise ones say that is what we must do.
This is insightful into the whys behind addictive behaviors. Those who are living as high-functioning addicts might learn a thing or two about themselves from reading this.