The main specialty of my practice is to help people recover from their addictions, substance use and problematic, compulsive behaviours. I just added a new page to my website about addiction and recovery if you are interested. And here are some of my beliefs about this process. At the bottom are some reading suggestions and video clips.

Addiction is a notoriously complex and contentious field. There are no easy or universal explanations or solutions.

 

I currently believe the following:

  • Most people exhibit some form of addictive or compulsive behaviour
  • The mechanisms of addictive behaviour seem to be inherent in the human brain
  • The increase of addiction is a symptom of imbalances, stress and sickness at a societal level
  • Though certain features of the addiction phenomenon are common, and patterns or ‘types’ of addiction could be identified, each person’s addiction story is unique, so assumptions and stereotypes are unhelpful and harmful
  • Addiction is not a disease. I agree with Dr. Marc Lewis, who suggests that addiction has much in common with more positive forms of learning, ie specialization and narrowed focus through a process of synaptic shaping and pruning
  • Addictions to porn, sex, gambling, gaming, social media or shopping have much in common with addictions to alcohol and drugs. They involve the same brain structures, the same feedback loops, the same ‘learning’ mechanism. Therefore, many of the same strategies can be applied
  • Addiction involves movement along a spectrum which starts at abstinence, moves through occasional and social use, to habitual use, then abuse, and eventually dependence
  • We could say that a person’s drug or behaviour of choice is identifiable by paying attention to the speed and sense of inevitability with which they progress along this spectrum
  • There are usually underlying reasons why the drug or behaviour of choice is so irresistible to the person. They might be self-medicating, numbing physical or emotional pain, compensating for chemical imbalances in the brain, or coping with specific personal challenges
  • A person’s reasons for susceptibility to a particular substance or behaviour are numerous and complex, involving biological, social, emotional, cognitive and psychological factors
  • Most people experience a ‘tipping point’ where they shift from use to abuse. A substance or behaviour that appeared harmless, even benign, suddenly seems to be out of control and causing problems. It can take a while to identify that this has occurred
  • When this point is passed, certain areas of the brain want the addict to keep using. Even while the addict’s ‘executive control’, the higher functioning areas of the brain, want him or her to quit, the ‘addict brain’ will keep single-mindedly pushing its one and only agenda. It will seduce, coerce, con, manipulate, bully and shame the individual into ‘using’
  • In turn, the addict will hide, manipulate, exploit, steal and lie to themselves and others in order to maintain the behaviour. Indeed, they learn to do these things very effectively
  • The addict’s world becomes increasingly narrow, until they are left with one desire, one goal, one need, one strategy.
  • Once a certain line has been crossed, abstinence is the only realistic solution. The addict’s belief that they can learn to use in moderation is a con propogated by the Addict Brain
  • Simply quitting is not enough. The addict is well-advised to overhaul their entire life
  • Hope and a positive vision for the future are essential components of recovery
  • Addressing the original underlying roots of the addiction (eg trauma) will not make the addiction go away. It has taken on a life of its own.
  • Conversely, once the addictive behaviour has been stopped, the underlying roots will remain and must be dealt with, otherwise they will undermine the person in other ways
  • Balance in life is at the core of relapse prevention.

 

References:

Books:

In the Realm of Hungry Ghosts: Gabor Mate

Memoirs of an Addicted Brain: Marc Lewis

The Biology of Desire: Marc Lewis

The Globalization of Addiction: Bruce Alexander

Wasted: Michael Pond and Maureen Palmer

This Naked Mind: Annie Grace

Rational Recovery: Jack Trimpey

 

Clips:

Marc Lewis

Gabor Mate

Kurzgesagt

Johann Hari on TED