This post links to a recent podcast, where I join Dick Schwartz, the founder of Internal Family Systems (IFS), and Gabor Maté, a well-known commentator on addiction and its impact on marginalized communities. As I’ve blogged about lately, I rely on IFS as a ground-breaking therapeutic tool in my psychology practice. Here in this podcast, the three of us put our heads together to examine how parts psychology and self-compassion can ease the anguish of addiction and related difficulties.
The Weekend University disseminates progressive, evidence-based ideas and opinions about the workings of the human mind and the possibility of relieving suffering, worldwide, through sharing this knowledge in our work and our lives. This post is hosted by Niall McKeever, the founder and curator of the Weekend University podcast series. The series regularly features lectures in psychology, cognitive science, neuroscience, evolutionary studies, and mindfulness approaches, as well as new ways to conceptualize pernicious social and geopolitical issues through the lens of these disciplines.
I was delighted when Niall invited me to share the mic (and camera) with Maté and Schwartz a few weeks ago. In a previous podcast in this series, I described how IFS enriches the reservoir of therapeutic techniques available for working with people in addiction. But this episode was a special treat for me. I’ve known Gabor Maté for some time, I often recommend his Hungry Ghosts book, and we spent a few hours walking around Vancouver and chatting years ago. But I’d never met Dick Schwartz. I’ve listened to scads of talks and interviews with him, taken online courses with him, I’ve truly immersed myself in his psychotherapeutic brainchild, but I’ve not had the pleasure to connect with him directly. Until this podcast.
So without further ado, here’s the episode: Rethinking Addiction.
I hope you’ll give it a listen. And before, during, or after that, take a look at the following point-form summary and relevant links posted on the podcast website:
In this meeting of the minds discussion, we’re joined by three of the world’s leading experts on addiction: Dr Gabor Maté, Dr Richard Schwartz, and Professor Marc Lewis.
Although their backgrounds vary widely, with Gabor initially training as a medical doctor, Richard as a family therapist, and Marc as a developmental psychologist and neuroscientist, all three of them have reached similar conclusions in their understanding of, and approach to treating addiction.
In a lively and wide ranging discussion, we explore:
- Why do we need to approach problems with addiction not by asking: “what’s wrong with it?”, but instead by asking, “what’s right with it?”
- Why both the ‘self-indulgent’ and ‘disease’ models of addiction are both fundamentally flawed and harmful (from a scientific point of view)
- The root causes
- How the internal family systems (IFS) model can improve our understanding of the mechanisms underlying addiction
- How Gabor Maté’s Compassionate Inquiry approach can help heal addictions by simply asking the right questions from a place of compassion and genuine curiosity
- Why IFS therapy may be one of the most effective approaches out there for working with addictions.
And more.
You can learn more about each speaker’s work via the selected links from this episode.
Selected Links from the Episode
- Marc’s website
- Marc’s blog post series on using IFS to treat addiction
- Memoirs of an Addicted Brain – Prof Marc Lewis
- The Biology of Desire – Prof Marc Lewis
- Gabor’s Compassionate Inquiry Training
- In the Realm of Hungry Ghosts – Dr. Gabor Maté
- The Wisdom of Trauma Documentary
- Gabor’s website
- IFS Institute Website
- IFS Institute Online Circle
- IFS Annual Conference
- Greater than the Sum of Our Parts – Dr. Richard Schwartz
- The Body Keeps the Score – Bessel van der Kolk
- What Happened to You – Oprah Winfrey & Dr . Bruce Perry
Postscript and retort:
Please forgive me for pooping out in the middle of the podcast. We had a power outage in my region of Toronto — a very rare occurrence — so I disappeared for about ten minutes and then returned when I was able to figure out (with my wife’s help) how to use my phone as a “personal hotspot.” Ironically, perhaps, it was during my personal blackout that Gabor aired his opinion that I saw “non-physiological” addictions as mental events disconnected from brain activity. Of course, that’s not what I think at all, as my book, Memoirs of an Addicted Brain, and many subsequent articles make clear. I think the brain is intrinsically, fundamentally involved in all mental and emotional activities, certainly including addiction. What I describe as “non-physiological” addictions in the podcast are simply those that don’t unleash massive physical withdrawal symptoms — e.g., addictions to cannabis or cocaine or, for that matter, gambling and porn. In my view, all addictions are psychological. But some, as epitomized by opiate addiction, tack on the additional agony of physiological rebound reactions, while neurophysiological supplies and demands get readjusted to life without the drug.
Gabor and I seemed to patch up our misunderstanding through a flurry of recent emails. But I’m still simmering, as you can see. Let it not be said that Lewis dismisses the brain’s role in addiction! And speaking more broadly, the notorious mind-body distinction needs to be thrown out — for once and for all — not merely recycled. Descartes has been dead for centuries.
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 for the link to this Marc, the first listening was refreshing, and having 3 professionals at once with an attentive and listening host is works well.
Looking forward to the second listening. Great to actually see you, you look well!
Best,
Carlton
Thank you, Carlton! Indeed I’m feeling well, though I may have looked a bit sleepy at moments during the podcast. Good to hear from you. I hope you’re also doing well.
Thank you so much for all your work in the field of addiction. I myself got sober 28 years ago with the help of A.A. but was feeling a little despondent with its philosophy 3 years ago. I found secular A.A. online and through this medium came across yourself, Gabor, Lance Dodes, Maia Szalavitz among others to be a revelation. The idea that I was not in control of my own body but needed a higher power to take care of me never sat well in my thinking and to hear theories of why I drank to excess expanded in your, and other books really helped me to come to terms with my own life. Keep up with the good work and this social medium as it is a great resource especially with your links to other sites not least being your latest ” the Weekend University podcast series.” Thanks again.
Thanks Marc that was a great summary between the 3 of you, I wish more people in the treatment field could listen to this, there is too much judgement and diagnosing rather then compassionate understanding of where the behavior/symptoms are coming from. Especially liked Richard’s statement of how those struggling to connect to Self, often have more complex traumas and have a longer journey to heal. At times, the treatment field is so quick to judge “personality disorder” and deam a person “unfixable”….especially the homeless…which is a trauma in itself.
I agree with Alison that “disorder” and especially “abuse” are unhelpful terms.
However, I think the next big step in the understanding of addiction may be researching people that have found that their feelings for an addiction have changed, and life no longer revolves around “control”, “maintenance”, or even self-awareness, regarding the addiction.
There was a group of researchers at Mt Sinai hospital here in NYC and a group in Hong Kong looking into brain pattern changes, but that was several years ago, and haven’t seen any followup articles on it, but it is the next rock to turn over in the understanding addiction.
Hello Maec
It has been several years since I have commented as my last entry seemed to have upset you, probably with good reason.
For some reason my E Mail picked up your blog and I am answering because of a major break-through in my struggles with addiction, and I thought you or your readers might be interested.
It started with a search for an effective non-addictive pain killer for my arthritis. I was lucky to find a local physician who worked with addicts. His primary treatment was a pain-killing drug called Buprenorphine. After several months of use as a fairly effective pain-killer something drove me to have my first alcoholic drink (in 17 years) while my wife was out of town. 12 years of AA pounded in my head that “one is too many and 100 is not enough”. Needless to say, I was concerned about my behavior but I didn’t need to be. Not only did that martini taste terrible but after drinking it I had no desire to drink another. A couple months later I had a glass of my favorite tipple; expensive white wine but the reaction was the same. In the last year I have had a total of 6 alcoholic drinks always with the same reaction.
I can’t guarantee the eliminating of my alcoholism was due to the Buprenorphine but I am 90% convinced that the pain killer (also not addictive) is the driver behind the elimination of my addiction (at one time averaging 1.5 bottles of wine per night, every night).
Best Regards
JLK.
Hello JLK,
I don’t remember being upset, but it’s certainly possible. Anyway, yes very interesting that buprenorphine extinguished your desire to drink. I can imagine that, though it may be that the length of time you spent abstinent also contributed a lot. That happens regularly. We just get out of the habit of sensing/interpreting/valuing a particularly physiological and cognitive effect as “fun” or something similar.
But please be a bit careful. Buprenorphine is certainly addictive. It is the primary ingredient in Suboxone, and it is a strong opiate — which is why it suppressed your pain. Still, it might well be worth staying on it for pain relief. Bupe is considered less pleasant than its cousins, morphine, oxycodone, etc. So it can more easily be tailored to a regimen whose purpose is medical rather that psychological.
Thanks for sharing this.
PS. Which is not to imply that a certain amount of fun isn’t acceptable. It is. The current societal/medical premise that antidepressants and other mood-altering pharmaceuticals aren’t allowed to feel good strikes me as 100% bollux! Of course they should feel good. The best antidote to feeling bad is feeling good. It’s that simple.
On the other hand, an accelerating pursuit of drug-given ecstasy has a few built-in costs that become more apparent as time goes on.
I found this really curious! Not just the information but the dynamics. IFS in action. Gabor Mate doesn’t show any emotion on his face. I felt he was dismissing of you? It reminded me of my family interactions? The outage seemed pertinent!
Hi Shelagh. Yes, I reacted to Gabor’s demeanor…as well as his words. But both are forgivable. I provide my response to his words in the post, above. I think he made a fast-and-lose interpretation, a misinterpretation, of my use of the term “physiological”… It hit a semantic sore spot of his. We’ve resolved the issue since, and he apologized. As for his demeanor, he’s the first to admit that he carries a fair bit of anxiety, which he attributes of course to early trauma. Probably rightly so. Given that, his tendency to avoid eye contact makes more sense as self-protection than passive aggression/dismissal. I think he’s a good guy, sincere and insightful, underneath those quirks.
And the power outage…was clearly an act of God.
Hi Marc,
I am a training postgraduate in clinical psychotherapy, and I am into my second week of delivering an addiction workshop at a recovery centre for psychological dysfunction. So hearing you three discuss your ideas was a brilliant learning point for me.
Don’t worry about how your ideas were taken. I am more a developmental, interactional thinker who has based my working models from Gabor, but I understood your model about learning and addiction. Your coming from the view of the neuro/behavioural systems that create dysfunctional learning patterns in adaptation to trauma. Thats how I took it anyway, and I agree! I agree with Gabor’s too. The IFS model is brilliant, Richard’s work is new to me but makes so much sense. I must admit I enjoyed seeing Gabor disagree, solely because it helps us developing practitioners feel relatable to you guys. You three have inspired many people including me, but theres almost like a god-human type gap because you guys seem flawless from your near perfect writing and thinking ability. Seeing disagreement and human characteristics on display takes the learning to a new level, it becomes relatable. Thank you for this podcast, your work and for being so honest in your blog. So much that I felt it was worth sharing my thoughts.
Best wishes
Ged
Maia Szalavitz’s story on addiction in today’s New York Times is somewhat related to this topic I think.
Personally, I would also would describe the addiction-experience as a love/addiction relationship, and I’m sure a big majority of ex-addicts would agree. However, defining the “”how”” of the transformation from the addiction is nearly impossible.
One good thing, if a Love/Addiction relationship is proven true and embraced, the looming gloom of “not being normal” may be listed from peoples individual recovery efforts in the future.
Here is the link to the article, (the responses are pretty wide too).
https://www.nytimes.com/2021/12/06/opinion/us-opioid-crisis.html?smid=url-share
I don’t believe in God. Connection with the felt. Glad you got to repair stuff with him.
To Shelagh: So am I!
Curious, has the neuropeptide hormone, Oxytocin been researched in the study of addiction?
( Happy 2022!)
Marc, so glad that you posted this discussion. I couldn’t have chosen a more perfect panel to reflect where the confluence of my personal healing process and professional areas of interest find themselves right now. I find that while it is important that I severed the relationship I had to heroin years ago (and to the other substances and pursuits that manifested as addictions), it has been so healing to now thank those parts of me for doing their part to try to keep me alive and sane in those days. I vilified my addictive patterns for years and not only does it feel better to integrate them within a more compassionate and understanding paradigm, it also tells a much more accurate story to explain my addictions in this way. And as a psychotherapist, I am a bit obsessed with IFS these days so I’ll consume any material I can find on the subject.
(And I knew what you meant. And I also know that you knew what he meant).
Thanks for sharing this.
Marc – watched Disney plus Dopesick – pretty well done. then yesterday heard about Sublocade being used with Success in Timmins. What is your opinion on Sublocade? What have you heard? Tim Greenwood https://www.sublocade.com/how-sublocade-works
Hi Tim. I thought that subdural, slow-release buprenorphine has been available for some time, but I’m probably confusing that with naltrexone. Frankly, I don’t pay much attention to these trends currently, but of course I heartily endorse any sort of harm-reduction approach.
Our friend, Shaun Shelly, is quick to ask why we don’t enable addicts to acquire hydromorphone or even diamorphine (heroin) more easily, and I wonder that too. When I look at the webpage you link here, the first words I see are “Block Rewarding Effects”. Is that really necessary? Do users have to be numb to remain free of street drug acquisition? Is a little buzz a dangerous reminder of the “glories” of life on the street? I’m really quite mystified by this direction in HR thinking. But I’m not on the front line, and it’s quite possible that I’m missing an important perspective.