Understanding Addiction

“Developmental neuroscientist Lewis examines his odyssey from minor stoner to helpless, full-blown addict….as [he] unspools one pungent drug episode after another, he capably knits into the narrative an accessible explanation of the neural activity that guided his behavior. From opium pipe to orbitofrontal cortex, a smoothly entertaining interplay between lived experience and the particulars of brain activity.” Kirkus Book Reviews

“Memoirs of an Addicted Brain…takes on all of human longing. Unlike many of his brain science colleagues and fellow addicts, Dr. Lewis can write.  One moment, he is remembering the details of his life as an addict; the next, he is reconstructing, based on newer scientific findings, what the drugs were doing to his brain.  The result is not just a book about a brain on drugs, but a picture of addiction as an unavoidable urge of human nature.” Ian Brown, Globe & Mail

“An engrossing and vividly written swirl of raw personal drama, themes of despair, loss and triumph, brilliantly rendered brain science, and clear thinking on the experience and essence of addiction. Illuminating even to experts, accessible to all.” Gabor Maté, MD, author of In the Realm of Hungry Ghosts: Close Encounters With Addiction

“Great writers create new genres, and that’s exactly what Lewis has done in writing the memoir of his addicted brain. It’s a heartwrenching story, beautifully written, and no one should be allowed to pronounce about addiction without having read it.” Evan Thompson, PhD, Professor of Philosophy, University of Toronto

“Lewis teaches us how normal yearnings and strivings can be short-circuited by drug addiction. In the end, his triumph is remarkable, and not only because he emerges from serial addictions to become a successful neuroscientist. He also recorded his young life with such perceptiveness, and recounts it for us now with such vividness, that his analysis of brain mechanisms comes alive in a way that is unprecedented in modern literature.” Prof. Don Tucker, Department of Psychology, University of Oregon

“Dr. Lewis has captured how our brain systems make our realities and how our realities buffet our brain systems. He presents a clear explanation of the horror and self-destructiveness of mind-altering drug use, of the drug addict as victim of inner and outer pressures and demons, and of the evolutionary strengths of our brain gone awry.” Prof. Sid Segalowitz, Department of Psychology, Brock University

“This is a splendid, moving, and highly informative book on drug addiction, described from the inside of the mind as well as from the inside of the brain. It is written very well by an expert on both perspectives.” Nico H.Frijda, PhD, Emeritus Professor of Psychology, University of Amsterdam

“Marc Lewis vividly conveys the alluring yet dangerous universe of mind-altering drugs and the painful paths of addiction and recovery. His experiences with LSD, heroin, and other powerful chemicals are woven together with clear explanations of the brain mechanisms underlying drug effects and addiction. Beautifully crafted and illuminating on multiple levels, this is a book you won’t want to set down.” Kent Berridge, PhD, James Olds Collegiate Professor of Psychology and Neuroscience, University of Michigan.

“Memoirs of an Addicted Brain may be the most original and illuminating addiction memoir since Thomas De Quincey’s seminal Confessions of an Opium Eater. What makes it such a standout from the genre’s overflow of self-indulgent mediocrities isn’t merely its supple intelligence and subtle style but the unique perspective of the author.” TheFix.com

“Memoirs of an Addicted Brain makes a valiant effort to be both diary (of a misspent youth) and textbook on the neurology of drug addiction.” Winnipeg Free Press

“Opponents of addiction memoirs complain that the attention- grabbing genre is tapped out…Cannily, in Memoirs of an Addicted Brain, Marc Lewis mixes the tried and true with a novel approach–a primer on the neural chemistry of addiction…The long fall and gradual recovery is an inherently appealing story, and Lewis tells it well. And for genre skeptics, Lewis supplies a surplus of educational material.” Vancouver Sun

“[Memoirs of an Addicted Brain] is compelling, and for readers grappling with addiction, Mr. Lewis’s mechanistic approach might well be novel enough to inspire them to seek the happiness he now enjoys.” The Wall Street Journal

“Marc Lewis’s Memoirs of an Addicted Brain is a cracker…The science is up to the minute. Lewis clearly knows his stuff.” The Australian

“As strange, immediate and artfully written as any Oliver Sacks case-study, with the added scintillation of having been composed by its subject.” The Guardian (UK)

“A surprising and charming addition to this crowded genre.” The Boston Globe

We are about to launch a “Guest Memoirs” page, as promised. Here is a description of the project, including details, benefits and risks, and the procedure for publishing your memoir.

Anyone who wishes can share the story of their addiction/recovery with other readers of this blog as well as members of the general public who will soon be able to find it via Google.  The only requirement I ask is that the stories be “true” to the best of your recollections. The length can be anywhere from a paragraph to a couple of chapters. Please feel free to post an anecdote or two, or else notes on an interesting period of your addiction or recovery. You don’t have to tell your whole life story!!!

There will be a comment section at the end of each published memoir, allowing others to reply, reflect, ask questions, or whatever. I will not be editing the memoirs or the comments. I will take a brief glance at each memoir received, mostly to get a sense that it’s appropriate for this feature, before publishing it. However, beware: anybody can write anything in the comment section, so if you have a thin skin, you might want to give this a miss. But I expect very few comments to be offensive. And…if you receive comments that are truly nasty, just alert me by email and I’ll remove them.

I may also comment, and if I do, one of the things I’ll try to do (especially if requested) is to supply a little neuroscience information that might complement your memoir.

I expect that it will do many of us a lot of good to see where others have been. The main thing to keep in mind is that there are a lot of lonely, confused people struggling with their addictions. Just being able to see what others have gone through, and how they have managed to survive and improve their lives (e.g., recover, in part or in full), will be of great benefit to these people. Just knowing that they are not the only ones who have felt what they’ve felt and suffered what they’ve suffered can be a healing process. Rays of light are always encouraged. For those of us who are not in such dire straits, it is always interesting to compare notes!

Your memoir will be anonymous unless you choose to include a name or pseudonym. That’s your choice. So here’s the format I request:

Title (if you like, or just note “untitled” which is fine too).

Name or pseudonym, only if desired.

Keywords: If possibly, please supply 3-5 keywords, so if we ever get around to it we can index the entries for easier organization and access. I think these should include the name of the thing you are or have been addicted to (e..g, opiates, alcohol, stimulants, sex, gambling, eating, or even more specific terms like “”cocaine” or “heroin” — and, of course, multiple addictions are welcomed 🙂 Also include specific programs or treatment approaches that are highlighted in your memoir, such as Narcotics Anonymous, mindfulness meditation, methadone, or whatever. The rest I leave up to you. Perhaps include keywords indicating important features that have been associated with your addiction, such as “lying” or “stealing” or “dealing” or “hospitalization” or whatever.

The memoir: Put the text of the memoir in the email, NOT an attachment. Please do not use special characters. Normal characters like quote marks usually come through fine.

REQUEST:  Will a few of you please send me something in the next week. That way we can launch the memoir page with actual material, which will look a lot better than just a lot of white space.

All emails to me — the memoir itself and any questions you may have — can be sent via the “Contact” box, which you can access via the button at the top of this page. Or else mail to marc@memoirsofanaddictedbrain.com.

Reader responses (here and on my new blog on the Psychology Today website) highlight both sides of the self as experienced with dissociative drugs (DXM and ketamine). There is a sense of being centred, perhaps while in free fall and watching the world go by, and there is a sense of freedom from constraints. You no longer care about the rules and regulations of that other world, the one you left behind, now that you are so very present in this one. On the other hand, you can’t seem to take this experience back home with you. So can it be of any real value? Without being moralistic about the fact that you got there with drugs, there’s also a real loss, a real sadness, about having to say goodbye to that magical place.

My own days of dissociating.

So what do I say to Charles? I used to drink bottles of DXM in my twenties (they hadn’t invented ketamine yet). I would sometimes drink a 250 ml bottle and then go to see a movie. Sitting there, melting in that cushy seat, I would feel that the movie had a special significance — that the people on the screen were really there for me, and I was a part of them. The people in the theater, breathing and whispering all around me, felt like an intimate tribe. (Then I’d try to leave the theater after everyone else, because I couldn’t walk without stumbling.) Or I’d sit on the Toronto subway brimming with exaltation. Every stop seemed a fantastic production, a special performance just for me. All that screeching of the brakes, the careening people, and finally….that glorious moment of stillness, punctuated by the dramatic whoosh of the opening doors — all at the same time! My emotions, my sense of astonishment, and the freedom of the moment were real. But it was a temporary reality. One that only crazy people can hold onto for good. In fact, ketamine is the drug that has been used most often to study the experience and the neurochemistry of schizophrenia. Hmmm….that doesn’t sound good.

A true self?

My diversions with dissociatives seem pretty juvenile compared to Charles’ existential struggles. Blockade your NMDA receptors for a few hours and you really will experience the world in a new way, you really will drop a lot of baggage, that baggage being all the rules, judgments, and mental habits you’ve been acquiring since infancy. Is there a true self left over when comprehension begins to disintegrate? For Charles it seems that way. He feels like he’s returned to his soul, or some reincarnated entity that came before birth or before the long road of knowledge acquisition, cognitive development, and increasing socialization that he’s followed ever since. But is this his true self?

Or is the true self rather the sum total of all that knowledge and comprehension, the tinker-toy configuration of familiarity that we build up over the years, as well as the peaceful, self-forgiving messages that blow through that complicated structure on good days? It seems to me that the true self actually includes the self-imposed constraints, rules of conduct, and uncomfortable habits that we’ve worked on for all these years. But also the energy and insight capable of changing them. If that’s so, then the true self might be something one wants to learn to accept, just as it is, with all its confusing habits. Rather than something one wants to relocate in a purified wonderland. Charles thinks he can find his soul by taking dissociatives. But I suspect that what he finds is a state of cognitive relaxation that can be very pleasant and that seems incredibly meaningful because it allows him to imagine himself at the centre of the universe.

Or maybe there’s a third answer. Maybe there is value in watching your values disintegrate, watching the rules melt away, just so you can finally get a glimpse of how those habits dominate you from day to day. If that’s the case, then Charles might be advised to see what’s left the next day: just loss, a headache, and some nausea….or is there some wisdom he can take with him?

The talk I gave in Amsterdam had the title, “A Brain Disease or What?” This post is about the or what? But in attempting to define addiction, I come up with three words, rather than one:

Habit

Relationship

Narrative

…and these words have to work together to explain what addiction is.

The idea that addiction is a deeply ingrained habit is relatively simple — at first. In fact that is the default definition generally posed against the disease definition. And habit is no stranger to the mind or the brain. We don’t reinvent our perceptions and conceptions; we refine and consolidate them over time. And the brain works by creating circuits which are fundamentally self-reinforcing. It doesn’t seem much of a stretch to see addiction as a habit of seeking an expected reward and going through various motions to obtain it. It’s just that, with high motivation and endless repetition, this habit is deeply ingrained.

But many also see addiction as a relationship, for example between you and your drug, your beer, or your porn collection. That’s almost correct. Except that addiction isn’t a real relationship because it doesn’t consist of two interacting partners. The drug doesn’t adjust to you. You adjust to it. And adjust and adjust until the supposed relationship, in your mind, is locked in. So I’d say that addiction is the concept of a relationship.

That’s not special in itself. The study of child-parent relationships in mainstream psychology has mostly fallen under the banner of attachment theory. Attachment theory is all about the child’s concept of the relationship with, let’s say, the mother. A secure attachment means the child expects the mother to be available when needed…emphasis on “expects.” An avoidant attachment means the child expects the mother to be unavailable. It’s not just mother’s behaviour that matters; attachment styles are predicated on child temperament as well as maternal behaviour. It’s children’s expectations that maintain their “attachment status” throughout life. An ambivalent or resistant attachment style means the child needs the mother excessively, expects disappointment, struggles against the need, and pushes away at the same time as pulling. Sound familiar? So if we think of addiction as a concept of a relationship (which I’ll call “relationship” in quotes), it seems to match an ambivalent/resistant attachment style. I want you, I need you, you’re not going to be there for me (about six hours later), you don’t help me enough, there’s no one else I can go to for the help I need.

Let’s put these first two elements, habit and “relationship,” together. “Relationships” are certainly habitual. They build on themselves over time. Many teenage or even adult children continue to berate their parents for not paying enough attention to them or not understanding them or not giving them enough, whether the parent does everything or nothing to change this conceptualization. And habits are relational. My habit of brushing my teeth involves a relationship with my toothbrush, and my dentist. So far so good.

Then what about narrative, the third element of the triad? I’ve written a fair bit about this, especially in the last chapter of my second book on addiction. We are constantly telling ourselves who we are, what we’re like, where we’ve been, where we’re going, etc. The life narrative is very much like what we might call our identity. It is not our personality — our underlying nature — but the way we construe ourselves. I’ve argued that changing one’s narrative is a potent way to move beyond addiction. I act like this because, Omigod, I was really suffering and this was the only solution I could find. So I’m not just a piece of shit; I’m a desperate seeker. But I don’t want to be doing this, and I don’t have to be doing this, and the future is changeable even if the past isn’t. The magical thing about narrative, or story, is that it is told. It doesn’t stay inside; it’s communicated with others, who can help us to hear it, hold onto it, reflect on it…and change it. Changing the narrative allows us to focus on the “relationship” more clearly, and to refashion beliefs about what that relationship entails, especially, what to expect. And it can change our habits, first by unearthing them, exposing them to the light, and then by a determined effort to choose B rather then A in situations we recognize as pivotal.

It may be that our narrative sits on top of our “relationship” (with what we’re addicted to) which rests on a set of habits. A hierarchy? I can see currents of change — deep change, “recovery” — moving down the hierarchy, from narrative to “relationship” to habit, or possibly up the hierarchy. Maybe both directions at the same time.

But there’s something huge missing from this analysis, and that is the role of compulsion. We have to go all the way back to habits and think about them again. Some habits, maybe most habits, are unconscious, and they trigger thoughts and behaviours before we can say “stop!” Compulsion is, for some, the defining feature of addiction. Next post, I’m going to look at how compulsion works and what to do about it.