Hi all. I recently got an email from Jeff Skinner, a member of this blog community, who came up with the following synopsis. To me, this brief statement (lightly edited) perfectly sums up the existential trap that awaits the addict facing recovery, like some lurking monster that you simply cannot sneak past. You have to face it head-on.
A high functioning addict has many degrees of freedom [i.e., choices] in handling the proverbial monkey. The addict can take a night off from drinking or drugging (or fooding or gambling). He/she can take a week off. He/she can reduce intake temporarily, even for long periods. What doesn’t change is that the meaning of existence is measured relative to the next time. This kind of freedom certainly produces tensions, sometimes big ones, but they can be tolerated.
The crisis comes when “the next time” is moved out to infinity (abstinence). Now life becomes existentially meaningless. This causes an unbearable anxiety/panic — one that can only be alleviated by taking, or at least scheduling — [or at least imagining] — the next drink or drug.
I have thought about this problem many times, and I still do. But I think Jeff expressed it with unusual clarity. He and I are both interested in your comments and will respond to them…
I’ve written a lot about the battle between craving and self-control, as have others. I’ve pointed out the neurophysiological events that stack the deck: the role of dopamine in narrowing attention and boosting desire, the resultant “delay discounting” that makes it so hard to think outside the moment, the nonstarter of “ego depletion” — a fuel tank that reads EMPTY before you get to the top of the hill, and the growth of synaptic networks (in cortex and limbic system) that colonize your psychological world with too many associations, action tendencies, and feelings related to the thing you want so badly, so often.
But I’ve never quite figured out how to capture the loss of meaning that stares you down when you think about quitting — FOR GOOD. For sure it’s about the accumulated synaptic restructuring (network pattern) that has strangled half your forebrain like some crabgrass invasion. It’s about the weakening and dissolution of the other synapses — the ones you might have used 
if activation didn’t keep returning to the more familiar circuits. It’s about all the goals your striatum forgot how to strive for, or even notice, over those years of seeking one thing above everything else. I can explain it in brain terms fairly well. But what’s hard to put into words is the feeling — the deadly vertigo, the whoosh of the void suddenly opening right in front of you, as you contemplate giving it up FOR GOOD.
How can life possibly be meaningful without IT? — when it’s been the foundation of meaning, the hallmark of value — for such a long time? And not just “meaning” in the abstract, but the sense of being taken care of, however perverse that is; the sense of where you belong in the world; the sense of who you are; the sense of what it is you do…
How do you overcome that ultimate challenge? How do you cross that gulf? I guess the answer is to start building up other networks of meaning and value, before you’re able to quit, maybe even before you can seriously try. Or at least at the same time. (For me, returning to graduate school was a big deal.)
But what if you don’t know where to find another source of meaning? What if you don’t know where to start? What if there’s just nothing else in your world, because you have no resources, no real friends, you’ve 
burned up all your other opportunities? What if you look out at the universe and all you see is a featureless horizon?
When the degrees of freedom shift from some to none, when there are no other choices, when you pack up your home, sell your furniture, and drop off the key, there’d better be at least one other place to go. Or you’re probably not going to make it very far.
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
I’ll add a postscript to my post in this first comment. Especially directed at Nicolas Ruff.
Two posts ago, Nick and I got into quite a debate about the pros and cons of “harm reduction” — or any other approach to recovery that does not strive for total abstinence. NN offered some words of wisdom from Stanton Peele — someone with whom Nick vehemently disagrees.
Is the present post relevant to that debate?
Nick, you might feel vindicated, because Jeff and I are saying something that you would also say: that as long as you continue to use, you have not accomplished the central goal of freeing yourself from the attraction of your addiction. So what have you really accomplished?
On the other hand, our “insight” here is that total abstinence may be a goal that is simply out of reach, or so incredibly difficult as not to be worth the effort, for some people.
And then I hear your voice retort: Fine then, think of “controlled use” as a step along the way to real recovery. And then I hear my voice say: But for some of us, it may be the final step — it may be as good as it gets.
And then there’s that other question: is the fundamental issue at the core of addiction really control, as you claimed? Or is it meaning?
But I’ll grant you that the “harm reduction” approach has this painfully vulnerable Achilles’ Heel, which leaves us facing some really tough questions.
Please STOP looking for miracles…..the secret to all change (which includes life long being ‘clean and sober”) is in the march through the Shadow as Jung would describe it….it is painful….no answers forthcoming….and must be endured before radical change appears……
NO ONE is advising addicts and alcoholics on how to get through this PAIN…..it does not ‘fit’ in a CBT type of treatment plan that fits in with their regulatory agencies ideas.
Even in 12 Step Programs; people in PAIN ARE SHAMED….it is time for this to be stopped…..and truths told.
It is why the oldtimers of AA primarily stuck wiith those who had experienced “BOTTOMS”…..these folk had no choice but to endure the PAIN of CHANGE….
No one is researching this…..no one is teaching this…. and until it is: addicts and alcoholics will continue to chose the OLD….I CAN GET AWAY WITH IT ONE MORE TIME….because they KNOW that PAIN; but do not know that there is a wonderful world awaiting them IF they just endure the PAIN OF THE UNKNOWN to get to the other side…..
billp, I mention Logotherapy below, and we use some of the principles that Frankl developed in our treatment setting. One of the principles of logotherapy is to embrace and find meaning in unavoidable pain.
I’m not really comfortable with this formulation. Suffering is inevitable. It will find you sometimes and sometimes pass you by. Better not to make it a self-fulfilling prophecy.
It reminds me of a committed drunk (long since dead) who I knew a long time ago. One night he stumbled and fell down a long flight of stairs, I think he broke a wrist, bloodied himself pretty badly. When we ran to his aid he curled himself up and said: “Don’t touch me! It’s my own pain, and I love it.”
There is much that hasn’t been researched because of the clinical mindset surrounding the disease concept of addiction.
Another undocumented fact is that, when addicted people take the plunge into the unknown of permanent abstinence (the Big Plan), they very often experience an immediate, enduring sense of relief from knowing that their drinking/using days are truly over. This is the Abstinence Commitment Effect (ACE) of Addictive Voice Recognition Technique (AVRT), posted as programmed instruction free of charge at the Rational Recovery website.
The ACE is the inverted image of the dry-drunk curse of recovery doctrines, a windfall discovery that brightens the rest of one’s days. The key to success is in objective recognition of the emotional recoil and mental commotion of making such a commitment as the thought style devoted to perpetuating the Option to drink/use, which we call the Addictive Voice, the sole cause of addiction.
Independent recovery, without groups, shrinks, and rehabs, is actually commonplace, as is now being acknowledged by NIH, and AVRT is a summary of how many accomplish it. Full recovery is an immediate option for all addicted people, whether they realize it or not, and have sufficient fear or motivation to take that desperate leap, “I will never drink/use again.” In other words, any tentatively sober addicted person may realistically hope to fully recover today, and begin life after recovery upon awakening tomorrow morning.
Stay away from recovery groups of all kinds, set your confidence for lifetime abstinence arbitrarily at 100%, recognize all self-doubt as your Addictive Voice, and you’ll do fine.
Too quick and easy? Too good to be true? Can’t be that simple? Can’t go it alone? These are perfect examples of the Addictive Voice that stall millions of addicted people at the threshold of life after addiction and recovery.
Jack Trimpey
Founder, Rational Recovery
I just went through your AVRT technique through the website, step by step. Very useful stuff. I can quibble about some details, but it looks like a powerful method. Only well-designed studies will tell us for sure how successful it is. And you do, at some points, mention how easy it is AND how hard it is.
But I guess that’s the issue that my post and many of these comments are addressing. The paradoxical nature of the decision to quit. How difficult it SEEMS turns into how difficult it IS, since our emotions and behaviors are directed by how things seem, not how they really are. Yet there is a line in the sand that, once crossed, opens up a whole new world. And most addicts know this at some level.
I commend your organization (and its offshoots, like SMART) for the great work you do in helping to pinpoint where the line is and what it is, and in giving people some kind of push to help them cross it.
billp, this is a very important insight. Yes, one must go through the pain of the unknown — I’d actually call it the pain of vast loss, but indeed it is unknown until you’ve gone through it — before you can get to the promised land.
As to whether people can be helped, counseled, supported, or taught how to make it easier to get through The Shadow….. Yes, I think they can. I think a lot of approaches to the treatment of addiction do just that — each in a different way. Granted, many of these are inefficient, and perhaps even delusional, or at least self-serving. But we — especially we recovered/recovering addicts — do try to help. And sometimes it works.
The questions you pose here are the issues we deal with every day in our setting. If one draws a pie chart of using life of someone in late-stage addiction, 90% is taken up by drug seeking and using – it is the narrowed focus of increased salience. Remove it, and there is a void. For the patient in early recovery there is the funk of nothingness that drags you back to using. The individual identity is inexorably linked to the drug and drug lifestyle – remove this and the user loses their identity.
12-step programs have some useful ways of dealing with this (For the record: I am not a fan of these programs in the professional setting).
I think the most important aspect of these programs is that they are a fellowship – they enable the recovering user to fill up some time and spend it with people who are like-minded. They swop the using identity with the recovery identity. In therapy this occurs to some degree as well – the relationship with the drug and the drug lifestyle is transferred to the therapist. The problem is that often this does not progress, and the new focus of attention becomes as addictive as the drug – you know those people that 10 years into recovery cannot go a week without a meeting!
A second aspect is the “just for today” approach. This means that you don not say “I am never going to use again”. You say “just for today I will not use – or just for the next 10 minutes”. Abstinence is broken into step-sized chunks rather than seen as a long and winding road.
There are, however, many pitfalls in the 12-step approach which are beyond the scope of this comment!
I know from personal experience that even when I was abstinent for a number of years I still enjoyed working with people in active because it kept me in contact with something that had once been the centre of my life – drug use. A bit like keeping the phone number of that ex-girlfriend/boyfriend who is absolutely toxic(but the sex was great)!
Marc, I mentioned Frankl to you the other day, and logotherapy encourages resolution of the existential crises, and I think that all of us who emerge from active addiction have an existential crises that needs to be resolved. We need to fill the black-hole of not using. In the words of Kent Sepkovitz: “The first step to recovery for us all might be to simply turn off the TV and feel the unique satisfaction of old-fashioned human boredom—hallucinogens’ only real antidote.”
What we try and do in our setting is create a space of unconditional positive regard. A place where the user can start developing a new sense of identity and meaning without the use of drugs. A place where they can learn to embrace the boredom of life, which needs to replace the false activity and busy-ness of drug use.
Like smokers, some want to give up “cold-turkey”, but the majority of those fail. More often than not there is a gradual creep towards recovery – that is why so many abstinence based programs have such high fall-out. We have found where you don’t insist on abstinence the patient tends to embrace the recovery process more enthusiastically because you are not telling them to throw away their life-jacket (the drug) and simply swim. Scott Kellogg terms this approach gradualism, and it makes sense.
Really interesting, Shaun. Did you know that your endorsement of “gradualism” runs exactly counter to Jack Trimpey’s exhortation to stop, for good, right now! It would be simplistic and dumb to say that I favor one vs. the other. I favor whatever works. But when you mention the “high fallout” of abstinence based programs, I can certainly understand that. And I know that AA suffers from that — the stats are unambiguous.
What sticks with me most from your comment is the 90% problem. If you spend 90% of your time thinking, worrying, planning, and fantasizing about ANYTHING, then your world is going to collapse when that thing is missing. That’s a great way of stating the problem. And yes, it drags you back to using. At least it can.
When I finally quit, I did it in one day. But that was after roughly 3-4 years of trying, failing, trying, failing, and perhaps making incremental gains. I’m a developmentalist by training — and I really do see addiction and recovery as a continuous developmental process. Except when it’s…what you might call “terminal”.
great!!! But in my opinion building up a new identity needs more than 10 years! I’ve lost my health several years ago, and I’m keeping working to learn a new way of living; sometimes I feel really in despair (when I can’t walk and have to stay in bed), often I’m facing with terrible pain!!! Psychoterapy has touched me how to embrace my pain, how to accept my void… a kind of new identity I must re-shape. Every day is a new challenge to deal with.The most important thing is not WHEN…IT IS GOING ON, finding ‘ the meaning’ in this fight, in this suffering, but serching who you really could be…again 🙂
Valeria
I believe that finding a new identity, or living a new identity, is a life-long process. This is something that needs to be worked on daily for the rest of our lives. Recovery, “rebirth” and similar concepts are often mistaken as a moment in time, but they are really a life-time of moments.
What an important lesson that is! (For everyone, and I especially mean me!)
I relate this to what I call the switching of the self preservation instinct. When I was very young, I learned that in order live, I must not do drugs. This really didn’t match up too well with the brain I was born with, however. I was going to inexorably seek out and use “addictors.” That is, use anything that was going to raise my “feel ok system.” At some point the self preservation instinct switched and now, in order to live, I had to do drugs. Switching that self preservation instinct back is terribly difficult. Specially considering that I have the same brain that got me into trouble in the first place. Now, it means dealing with all the ignominy on top of everything that was present in the first place. I don’t know the answer to this dilemma, but I do know the dilemma, all to well.
Great way of putting it! Jack (comment above) calls the voice of the addictive urge “the Beast” — see the website he refers to. And he’s one of the leading addiction treatment guys in the U.S. He sees the addictive urge as something outside oneself — something that opposes the self in every way. But you’re saying that the urge is an urge of self-preservation. And I agree with you. That brain machinery which Jack disparages is actually at the core of who we are. It IS us. Desire is what makes us tick, for good or evil.
THAT’S WHAT MAKES IT SO DIFFICULT TO STOP!
As Shaun points out, AA/NA steers clear of “sober for the rest of your life” talk, and asks addicts to focus on abstinence over the next 24 hours— an achievable goal that sidesteps the existential angst over “never again.” This is a deep piece of psychological wisdom often overlooked in abstinence discussions. Nobody’s asking you to go the rest of your life sober, because in your present state, that notion is inconceivable. You get there by using the “swiss cheese” method. One day at a time, a marvelous if overused epigram.
This makes sense to me. If you can really do one day at a time it bypasses the “never again from this day forward” trap.
It’s no easy way out though. You have to walk the line between unavoidable relapses and just giving it up. A true razor’s edge.
I agree, but one more thing. You must know at some level that the “one day” is a cover for “forever” — I can imagine that leaves a serious loose tile, so that a bit of cynicism would shoot you back to using. Nevertheless, it is clever, and many people say it works.
When are you coming to Amsterdam next? Soon it will be time for our annual tete-a-tete.
One Day at a Time is a mental trick, for sure, and wouldn’t be helpful for everybody.
I’m probably going to be in Amsterdam while you’re off having tea with the Dalai Lama. 😉 Sent you an email with dates.
Dirk
Hi. This blog helps me so much and I have been directed to your post by Marc. I have to be honest and admit that I have issues with the NA/AA approach on several levels, but the one day aspect is something that I just wanted to agree with right here.
“Never again” i feel is not only psychologically impossible, vertiginous, but also fits so neatly into addictive black and white thinking. It is another form of denial and the fast route to fck it up etc.
I am now eighteen months in, and it was only when i understood that all i had to do was to wake up and see if i still wanted it the next day, that I started to make progress and enjoy a life bit by bit hour by hour.
I have not put myself in either box, but I have begun to find a life outside either camp, that each day offers enough and more rewards to wake up the next one and make the same choice. And if that is the swiss cheese method. I’ll buy it.
Wonderfully put. I resonate very much with the method you describe. And yet I know that it can’t work for many people.
I think it comes down to stages — you could say stages of addiction, or just stages of life. As we mature and see things in a more nuanced, more creative way, then, yes, we can give up our addictions, through a day-to-day process, because life really does look more interesting and satisfying without it. But that may not work for people who are “younger”– and hence more rigid, more prone to the black-and-white mentality. And I guess I’m talking about the kind of rigidity that is either a product of chronological youth OR a product of being an addict in such a severe way, with so many bridges burned, that you’ve returned to a child-like mindset: reach and grab for the familiar and damn the torpedoes!
When I quit narcotics at age 30, it had to be “forever” — that’s a long story, but believe me, nothing else worked. Then I had the privilege of quitting again just over two years ago (age 60). I’d been on daily oxycodone for about seven months, before and after surgery on my lower spine. The surgery worked well, and the pain continued to diminish, until I really understood that the drugs were a matter of choice, not necessity. Yes, I still liked the way it felt, but that was no longer enough to keep going.
That’s when I went through the kind of process you describe. It took a month or more, but I became aware, day by day, that this wasn’t fun. That I could do more and better yoga and just live without it, and that became what I wanted. I no longer preferred the state of being on opiates to the state of being off them. And that…preference…kept surfacing day by day. So I tapered down and stopped, never because I had to but because I preferred to. That kind of graded, spectral, in-the-moment awareness was simply not available to me thirty years earlier.
To wake up and realize that you don’t want it…that’s a beautiful thing. But for some it’s a luxury that you just can’t afford.
Great post 🙂 We would say that the problem goes one step further; it’s not enough to try to find happiness in something more meaningful, one must become happy without relying on meaning whatsoever, since everything that could be meaningful is transient, habit-forming, and hence addictive itself.
The addict is unsatisfied without – the key to overcoming addiction is to become satisfied without. Though part of this is about facing the addiction itself head-on, as you say, one must also be able to face the meaninglessness of the rest of experience head-on. The latter is arguably more difficult.
Meditation, thus, is not about finding meaning; it’s about relieving the need for meaning. By cultivating objective awareness of the pleasures of brain chemicals as well as the anguish of their absence, one achieves a state of equanimity that is above pleasure and pain. Though a meditator experiences both, they are affected by neither. Not an easy task, but it does seem to be the only way out; otherwise it’s just about replacing one addiction with another.
There is sanity in this proposal. But it’s not easy. You have to walk a narrow path: between 1) being serious and persevering 2) just saddling yourself with a new obsession (I must meditate every day to kill my ego!)
The Christian formulation is “For the gate is narrow and the way is hard that leads to life, and those who find it are few.” Matt 7:14
Just a metaphor! I am NOT a Christian.
excellent observation, i find it troubling my default-which was set by religions-is set to “pain is the touchstone of all growth/” It doesn’t have to be be my meditations tell me. As if in;
http://www.urbandictionary.com/define.php?term=lachrymology
Beautiful synopsis. I have had powerful experiences in which the meaninglessness hits you over the head like a mallet. The humanists want to remind us that we create our own meaning. Social and personality theorists say that “meaning making” is what we do — that’s what being human is all about. But there’s a sadness in the idea that we must construct meaning: that highlights its arbitrariness, and its transience. And, as you say, addiction really is just another way of creating meaning.
So — as a novice meditator and Buddhism admirer — I get what you’re saying.
I wonder if it’s possible to see that surrender (to meaninglessness) as not so much difficult as relaxing. Sometimes letting go of trying to make meaning really does feel like taking a day off.
HI Marc
John”the Grenade Launcher” here.
Before I comment I would like to announce to you (no one else GAS I am sure) that the DSM has finally tagged a name onto my disease. I must admit it’s pretty weak. “Acute Inflammatory Body Disease”. It’s actually a series of diseases caused by a compromised Blood Brain Barrier.(Remember the MRSA?) It is a composition of 9 different disorders in one and I believe closely related to my alcoholism. It has been anointed in DSM 5 if you have a copy..I have 8 the avg is 3-4.
Back to the blog….From a daily drinking alcoholic’s POV:
After 10 years of sobriety my biggest problem is losing the social milieu I had before I quit. I have to keep reminding myself that the last two years were bad enough that I was losing friends and family anyway.
The problem is exacerbated by the condition I noted to Marc.It and my age make it difficult to start over. That is one reason I defend AA like a pit bull..
After so much time cravings have almost nothing to do with it…it is primarily the fear of being in the wrong place at the wrong time where wine is available and I have had a REALLY bad or even good day. So once again it is socially related.
Rgds
JLK
Great to hear from you! — and I detect no grenades today…hope you’re not slipping. Congratulations for being DSM anointed. I’ve lost track of what’s come together and what’s fallen apart in DSM V. I think they also picked up eating disorders as an addictive problem, booze and drugs are now holding hands with tobacco under the SUD label, but sex and internet addictions are still out in the cold space of the undefined. Oh well, everyone gets a turn sooner or later.
Thanks for your observations. Sounds like a no-win situation: it’s hard to be social while abstinent but hard to keep friends while drinking. So, yes, it’s a different kind of void you’re facing, not so much about missing IT as missing what you got from it — at least what you tried to get from it.
And that fear you mention….man, it takes guts to face that anxiety and keep holding on. I admire it.
Bhante, thanks for sharing! Do you correlate the “intoxication” of delusion, passion, and aversion that the Buddha refers to as the same as being lost in addictions?
Good question. If you click “reply” right under his comment, and place your question there, he’ll probably get a notification directly, so more likely to answer it.
Let’s say that the trap door never snaps completely shut so that there is never an absolute loss of control over either amount or initiation of the behavior (operant or classical conditioning). We’ve all seen people who meet whatever criteria we use for addiction able at times to control both.
But I guess the question is what drives people back to a behavior that has proven bad for them but still exerts an attraction. Craving certainly plays a role, memory of the good times, hope for success. I can’t remember if homeostasis has been mentioned in our discussion, the balanced setting of the system. Two mechanisms for maintaining or re establishing homeostasis are tolerance and sensitization – perhaps more of that later. There’s a pre addiction homeostasis, an active addiction one (shown by withdrawal or intense craving), and a post-addiction one. That the system does not simply return to the pre addiction setting in the post addiction homeostasis can be shown by how readily the active state can be reestablished compared to established in the first place. Disruptions to homeostasis are stress inducing and the system is invested in returning to its default setting. This is one reason why there is so much relapse, especially early: even though the active state sucks and the thrill is gone, it’s the norm, it’s familiar, you know the rules. So the pull back is systemic. The establishment of the post addictive homeostasis takes time. Withdrawal and its attendant stress need to be undergone, nervecell receptors need to be up- or down-regulated, cues need to be recognized, desensitized, and disabled, etc.
But that active addiction setting remains, stored, dormant, and awaiting reactivation.
It’s like learning to ride a bike; you never forget. So there’s always this drag: I can change a subsetting without changing the system setting. “I’ll stick to beer.” “I’ll just take $100 to the casino.” “I’ll just play World of Warcraft for an hour.” Can my intention confirm dopamine’s predicted reward/relief from the behavior after increasing evidence to the contrary?
Some of the meds used to ‘treat’ addiction are really meant to prevent the ‘overshoot’ that occurs after a period of abstinence, drugs like acamprosate. The problem with the overshoot of course is overdose, but barring that there’s the problem of reinstating the active addiction. But suppose that threshold is not met. One doesn’t o.d. One doesn’t trigger fullblown addiction relapse. Is that more satisfying or more frustrating? Can one satisfy the physical need and not the psychological want? That’s I think what methadone does, and why there’s so much drug-seeking among methadone-maintained clients.
I think that there’s a qualitative shift when one becomes ‘ready’ to give it up, an epiphany, a moment of clarity, a spiritual awakening, whatever. Apparently it has to come from inside (the blind don’t need light; they need eyes). We don’t know how to facilitate that change. I’ve heard some say it started with a plea or cry for help, to god, to anything. So maybe it has to do with a relinquishing of control. One of addiction’s nastier aspects is to delude one into thinking that there is control, there is choice; changing seats on the Titanic I’ve heard it called.
Thoughts off the top. Hope they’re relevant and some use.
Man, you really know your stuff, inside and out. Been there 🙂 ???
I have nothing much to add, but I especially like what you say about learning to ride a bike. I have often proclaimed that heavily carved synaptic pathways never go away. Activation can take new routes, new pathways can be developed and strengthened, but the old, well-worn, well-known networks are physical structures in the brain. Even if they’re only reactivated a little, only occasionally, perhaps only in dreams and fantasies…it doesn’t take much to keep the structure intact.
And once those pathways are fully reactivated, indeed everything changes back. The scorecard is replaced and that insidiously familiar homeostasis is in business once again.
I am going back to the original quote from Jeff Skinner.
I agree with a lot of what he says – and I appreciate the ability to talk about the high functioning addict. However, I think to be clear it is worth pointing out that for example the heroin addict or the sever alcoholic does not have the freedom to take the week off. This is something I really noticed from my own spiral of addiction, as when I got to the bottom, I no longer had the control to manipulate play deny (also to myself). The physical withdrawal was a real shift in how addiction interacted with the other areas of my life.
Cocaine, crack though – the compulsion is for the high – and measuring time to the next hit makes so much sense. The week off becomes a half life until you feel you can function again.
I am interested in the idea of the crisis. In early rehab the idea of absitinance, as the endless never ending wait for the hit terrified me. It generated the idea of a life of loss, a life of the unfulfilled tied up addict.
For me the big shift was to start to view this in a different light, to see absitinance not as an end game, but as a day to day choice. This very much fits into meaning as well. I guess I manage my recovery by acknowledging that any day any time of day i can go get that hit. No one has banned me. The question becomes why would I do it.
Using is a binary world in which meaning and fulfillment are a direct relationship between you and the drug. It’s a great relationship, no question about that. In recovery though I have been able to find meaning in things outside of that twilight one, I have found meaning in interacting with reality, with people, with projects, writing , ideas. I have began to forge an identity that links me into a world that other people recognise, that are touched by, that I have an impact on.
SO back to high achieving addicts. The statistics for long term recovery in the UK at the moment are shocking. I was able to work through the horror of all i had destroyed, the relationships i had marched over, as I had the ability to find volunteering to start writing to rebuild my friendships and family relationships, in short to keep looking forward and create an identity that encompassed the past but also the present – and that I am proud of.
This is something that many of the people that I have met on this journey did not have. These are the people that spend 30, 90, 365 days dreaming of new future, a place of respect in society, only to find that it is not offered.
Thanks for that, a really fascinating reply.
I use a variety of drugs/medications, having MS. But the only thing I could say I’ve truly addicted to is tobacco which doesn’t do you a lot harm until it kills you.
But when I got really close to a bona fide addict and started to notice other peoples’ behaviors in the light of new knowledge, I realized that there are a lot of addicts around who fake being sober pretty well.
The stuff you are talking about is something I don’t know well but I’d like to know more.. Also, you write well.
Thank you. That is a great message to wake up to!
I blog as well, and write a lot about this. Here is the link:
http://catchmeawry.wordpress.com
Your comment about the high achieving addict – I faked very well for a long time. This is one of the reasons I write as Mimesis. The game is untenable though, as the addict at the end of the day is not in control, and as the hit becomes bigger, things start to crack at the seems.
Jeff, was it you, or maybe Nicolas Ruff, who pointed to that Leonard Cohen line: “That’s how the light gets in…” Mimesis, that just came to mind for some reason.
But if the crack is too big, everything is over-exposed. And it’s a blurry mess, not a base for becoming integrated.
Exactly my point. And the song that comes straight away is Jeff Buckley’s cover of Lilac Wine
http://www.youtube.com/watch?v=5PC68rEfF-o
Mimesis, what you describe is so encouraging. And underneath your story is a reversal of the formula provided in Jeff’s comment. Instead of seeing the addiction as multiple degrees of freedom and abstinence as zero (I CAN’T DO IT, PERIOD), you’ve offered a reciprocal formula: addiction as zero degrees of freedom and abstinence as an expansive landscape of opportunities, chances, hopes.
I see what you mean. Abstinence FEELS like a frozen wasteland offering zero fulfillment, until you look to the other side and imagine the reality of it, and then you see that the addiction is in fact the frozen land.
I guess that’s the “different light” you saw things in.
I love the idea that the formula works backward and forward — it’s one way in the hemmed in, miserable mind of the addict, and completely the opposite way when you go through the gate and let life proceed without addiction.
I have been thinking a lot about these posts – blogs like this provide a tremendous opportunity to carry on working through things in your head
There are a couple of quotes from Camus that run around my head, “Nobody realises that some people expend tremendous energy merely to be normal”; and ” In the midst of winter, I found there was, within me, an invincible summer.And that makes me happy. For it says that no matter how hard the world pushes against me, within me, there’s something stronger – something better, pushing right back.”
I was brought up Catholic and the abstinence issue I find myself linking into belie and faith. I do not believe that any recovery addict can truly that they will be clean and sober for the rest of their life. The trick is to enjoy the moment – each day – and something starts to grow. That moment that day is all that matters. Belief is asking for promises, whereas faith simply requires trust – it has no end game, but allows each minute to be enjoyed for what it is.
Lovely! And also note Dirk Hanson’s comments above. He reminds us that one-day-at-a-time is a very helpful “trick” that AA has been using for many years.
You know, as I think you can see from my blog I have issues with AA philosophy. I just wanted to repeat again. This is a very powerful blog to have out there – I think for many of us we work through things still in an in the end kind of way. I have directed many friends in my position to this blog to help them work through their head as well.
I just wrote about that phrase from Howards End, “only connect” on mimesis. It has been running through my head today thinking about it all.
Thank you. That’s good to hear.
Hey thanks Dr Marc for keeping this blog alive and others too.
In spirit of advancing a science/evidence based cure for addiction I think we all should be part of change the paradigm.
Therefore, because of folks like Dr Marc I post the following url, which will involve dr gabor mate.
http://www.recovery2point0.com/
Thanks, Kevin. I was one of the speakers on this forum when the initial webcast came out last April or so. There are many fabulous people to learn from in the ongoing series, including Gabor Mate!
Fab! Hope we both can participate, and others here as well. Strength in numbers and all!!
namaste
Fletcher, in _Sober for Good_, mentions, p. 175, a handful of her 222 recovered ‘masters’ who very occasionally drink: Chico W (on rare occasions, “a glass of wine”), Rebecca M and Sandy V.
The question is an empirical matter, one to be investigated, not one about which there has to be dogma. Further, she mentions some commonalities among those who end up with ‘moderation’ or ‘rare use,’ e.g. psychological stability, steady employment. But it may well be true that among serious, heavy drinking alcoholics (2 quarts of vodka per day (Chico)), ability to infrequently use, is rare.
The main point I want to make, however, is that, “Never again ingest X (or do X)” whatever its application to drugs or ‘substances’ can never be fully applied to any number of behavioral ‘addictions’, so called. In the broad area of compulsions,
it’s quite clear: Is the goal, “Never again check your front door, after you’ve locked it”? For food, clearly, and sex (almost as clear), the ‘never again’ could only be part of a recovery: “Never again, jelly doughnuts.” or “Never eat between meals.” “Never again, prostitutes.”
I’m afraid this rampant ‘(drug) addiction’ metaphor has distorted the inquiry into recovery from several types of compulsive behavior, where moderation or infrequent resort must be part of the picture. A further area of distortion has to do with withdrawal, where all the issues of Marc’s original post get pushed aside, the focus being on physical cravings due abuse of certain drugs, only, such as alcohol.
Excellent point, NN. With food and sex addictions, abstinence may be just as unhealthy (well, I should say, deadly in the case of food) as the addiction. But that’s really just playing with words. You’re right: the focus on substance abuse does distort the dialogue. For many compulsive behaviours, including hand-washing, abstinence is simply not on the map.
And so the degrees of freedom remain. For some, this might mean you can have your cake and eat it too. But for many, I think it requires quite a delicate tightrope walk for a long time, until the cravings genuinely subside — even before or during “the act”.
The whole notion of “choices” can’t really stand alone. You have to factor in the quality of the available options. I wouldn’t mind having just one choice if it was a really good one. (This is pretty much the way I feel about my marriage!)
Let’s say that the goal for many sufferers of these ‘disorders,’ compulsions, harmful habits, whatever we’re going to call them, is to loosen their hold by enlarging behavior repetoires.This might be done by replacement of the old behavior with new and more healthy, balanced and moderate ones or by fitting the old behavior into a larger pattern that imposes limits through context. For example, “I can’t have that third beer or I can’t get the kids to soccer practice.” We’re leaving out the fighting the obsession control (“Maybe Friday night I can have three beers instead of my two limit; and what about Sunday afternoon if there’s a doubleheader on?”) or the tightly gripped behavior (“I will not have more than two no matter what”) which probably aren’t going to last long.
It has been speculated that SSRI’s, and more recently Ketamine, might exert their antidepressant effect by promoting neurogenesis. What do our Buddhist and meditation contributors think?
as a buddhist aspirant, it is suggested to not indulge in unskillful behavior/thoughts. See things clearly, stay mindful as much as one can. In my readings/understandings of Buddha’s teachings there is neither right nor wrong, simply it is termed skillfulness. One is not supposed to drink or ingest mind altering chemicals to be at one’s most skillful thereby avoiding suffering.
there are plenty of other translations to buddhist philosophy…and plenty of stories which calls certain thoughts/actions right/wrong, and/or achieving merit
This also remind me of the suffering attributed to grasping for future or clinging to past…therefore one cannot be fully in the ever=present now.
Personally, I’d go with the ketamine option….. or is that “my disease” talking?!
No, that’s your sense of humor talking.
I meant your sick sense of humor.
You would be correct Nicolas!