Addiction, Biological Psychiatry and the Disease Model (Part 1)

Richard D. Lewis
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During my 19 years of working as a counselor (with an addictions specialty) in community mental health, I have witnessed the final stages of the takeover of the disease model of treatment. Prior to this I worked for a few years in two detox/rehab facilities that treated all types of substance abuse problems; in the field of addiction treatment the takeover of the disease model had already been completed. While there are some differences, there are many common threads to understanding the nature and treatment of addiction problems and those that get labeled as “mental illness,” and they often intersect on many levels. Biological Psychiatry and their disease model of treatment has had the same damaging effects on people experiencing both types of mental health problems and has also severely handicapped well intentioned people in the field trying to offer help.

In 1951 The World Health Organization acknowledged alcoholism as a serious medical problem. The first DSM categorizing mental health problems was published in 1952 and then in 1956 the American Medical Association declared alcoholism as a treatable illness. In 1960 E.M. Jellinek published his famous book The Disease Concept of Addiction. In 1965 the American Psychiatric Association began to use the term “disease” to describe alcoholism. The history of labeling and treating both addiction and mental health problems as “diseases” has a parallel period of development. While the disease concept was originally applied to alcoholism it has since been generalized to other drugs as well. And today even excessive gambling, sex, shopping, and social media use are now being declared addictions and more often also called “diseases.” The newly proposed DSM 5 scheduled for publication in 2013 may even have a category called “behavioral addiction.”

Biological Psychiatry together with the pharmaceutical industry has embraced and promoted this disease model and they use the same type of language to describe the nature of addictive “diseases” as they do with so called “mental illness.” They say it is genetically based, brain altering, and chronic, and they are ever so quick to prescribe several types of medication that they claim are needed to stabilize and manage this so-called disease, sometimes even for a person’s entire lifetime. In the treatment of opiate addiction, in particular, they even equate the prescription use of drugs such as methadone and suboxone with the use of insulin for someone with the real disease of diabetes.

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So if addiction is not a disease then how should we try to describe it in a different way, provide helpful treatment, and understand its connections to extreme states of psychological distress or to what gets labeled as “mental illness?” After more than two decades of trying to understand and help people work through both types of these issues, often at the same time, I would make the following observations in direct opposition to Biological Psychiatry and their disease model:

There is no definitive evidence of genetics being a CAUSAL factor in addiction. Just as with so called “mental illness,” their billions of dollars in research for the “Holy Grail” have come up empty. Their temporary hits and near misses receive tons of publicity, but their failures are hidden on the back pages.

All human beings are genetically predisposed to develop addictions and the symptoms that get labeled as “mental illness.” Nobody stands above or is immune from potentially developing these problems. In the right combination of circumstances ANY human being can develop an addiction and/or a state of extreme psychological distress. This will occur if any particular person is exposed to enough stress or trauma and/or if they use certain substances for a long enough period of time in a certain set of environmental conditions.

While there is probably something called a “genetic predisposition” for these two types of problems, we must question how this concept can ever be very useful. For example, in the case of psychotic like symptoms, if we take two people and subject them to a certain number of hours of torture and one person starts to show signs of psychosis after 18 hours and the other at 21 hours, should we spend millions of dollars to determine why there was a 3 hour difference between the two people? Shouldn’t our society be more concerned with why there was torture going on in the first place and what gave rise to those conditions and how to eradicate the material basis for such conditions?

In addition, and perhaps more importantly, there IS a genetic predisposition for RECOVERY from addiction and for what gets labeled as so-called “mental illness.” Human beings are born with a cerebral cortex in their brains and are quite capable (over time and under the right circumstances) of distinguishing the difference between thoughts and behaviors that are useful to themselves and to our species and those that are harmful and self- defeating. And also, human beings are quite capable of creating nurturing type environments with special forms of emotional support, thereby developing the most favorable conditions for these problems to be identified and eventually overcome.

There is no scientific evidence to call addiction a disease. Name another disease that you can wake up one morning and decide to no longer do a certain behavior ever again and then you will no longer ever have the symptoms related to that behavior. You cannot wake up and decide, “I don’t think I’ll have cancer or diabetes today”; they will definitely need specific forms of medical treatment. But you can make a decision to stop drinking or using other drugs and then make it happen in the real world, and for many people this can be a permanent behavioral change. Likewise, some people who experience severe psychological symptoms can also have an epiphany like moment and/ or decision which leads to a major transformative shift away from a debilitating mental state of mind.

With addiction, we don’t know why certain people, and not others, seem to cross a line from social/recreational use, or self-medicating use, of alcohol and drugs, to full scale out of control addictive use. When this occurs most people make multiple attempts to reestablish control, contain and limit the use of these substances hoping to return to an earlier stage when they were having more positive experiences than negative. People who develop a major addiction problem ultimately fail at these attempts to moderate their use, and their choice now becomes, either maintain the current dysfunctional behavior pattern or decide to become permanently abstinent.

For some people the decision to stop a major addiction problem can be quite difficult and complex, but it is not mysterious. Millions of human beings have broken major addictions with what is referred to as “spontaneous recovery”, that is, without any medical treatment, therapy, or self-help groups. I believe we can also say there are many examples of similar types of spontaneous recovery for people with extreme states of psychological distress, people who were fortunate enough to never be misdiagnosed and perhaps ultimately mistreated in an unjust mental health system.

Based on anecdotal evidence it is reasonable to conclude that, in examples of both these types of spontaneous recovery, there were supportive friends or family and a relatively safe environment that created positive conditions for a full recovery. And of course we are all too well aware that both addiction and extreme states of psychological distress can also become so severe and persistent that they may require more intense human intervention. Currently the theory and practice of these treatment interventions have, at best, very mixed results with frequent relapses and many inherent injustices that have been so well articulated on this website. Hopefully, future interventions can soon become the various forms of mainly drug free (with the exception of necessary detox medications) and nurturing support models of treatment developed and practiced by many of the knowledgeable contributors to this blog.

In opposition to the disease model we might find it helpful to conceptualize and understand both addiction and symptoms that get labeled as “mental illness,” more simply as useful coping mechanisms that over time “get stuck in the on position.” Let me explain. Human beings are driven to repeat behaviors that are pleasurable and/or take away pain, and they usually have sound cognitive rationalizations for doing so. These tendencies are very much related to our survival as a species, especially when you look at the drive to eat, drink, and procreate. In other forms of pleasure seeking and pain avoidance most people who use alcohol and other mind altering drugs more often feel very good in the earlier stages of their use. This is especially true when there are generally fewer negative consequences associated with their consumption. Some people have also postulated that human beings are, at times, attracted to altered states of consciousness. This can be a way to avoid boredom through experimentation, or, perhaps more often, become a creative way to escape or rise above the resulting discomfort or trauma experienced in a threatening environment. In the beginning stages of drug use, these substances may provide a temporary pleasurable escape from a harsh reality and/or become a very successful short term coping mechanism that actually prevents more dangerous reactive behaviors (including suicide), or perhaps even helps prevent the person from going “crazy.”

Similarly, extreme states of psychological distress can lead to altered states of consciousness that are mislabeled as a “mental illness” and a “disease,” but could instead be better looked at as a creative and necessary coping mechanism dealing with an experienced and/or perceived hostile and threatening environment. This coping mechanism, as with addiction, may also prevent more extreme reactive behaviors or provide an escape or temporary relief from intense physical or emotional pain. < Many contributors to this website have made similar descriptions of their own experience and drawn somewhat similar conclusions. I have learned from their experience and their resulting theories describing their journey. I have attempted to incorporate aspects of their ideas in my attempt to find a better understanding and description of addiction and its connection to so- called “mental illness.”>

Here is the rub. A problem often arises with both substance use leading to addiction and also with extreme states of psychological distress, when these behaviors and related thought patterns are sustained for extended periods of time, the formerly helpful coping mechanisms can gradually, or even suddenly, turn into their opposite and now become primarily self- destructive, self-defeating, and socially unacceptable*. This is especially true when the short term benefits of the behavior and resulting thought patterns start to shift and begin to cause far more immediate, as well as long term negative consequences for the individual and the people around them. Some people may now actually get stuck in this new state of being and be unable

to find their way out by themselves. This is the point when we might say that these once helpful coping mechanisms have now seemingly become “stuck in the on position.” * I am aware that socially unacceptable behavior can be both useful and necessary in changing the world for the better.

Ironically, people already showing symptoms of a persistent altered consciousness, such as depression, excessive anxiety, hallucinations etc. often ADD mind altering substance use to the mix as an additional coping mechanism only to have this behavior gradually (and sometimes quickly) exacerbate or intensify an already fragile emotional state. A few people writing on this blog about their own personal journey into a state of psychosis, have mentioned pot use as being a factor that may have contributed to their state of extreme psychological distress (marijuana use needs to be explored in greater detail in a future discussion). AND we can also say that the very use of these substances when combined with a stressful environment can become THE major contributing factor to the actual initiation of extreme distress symptomology. What may feel good in the beginning and dampen uncomfortable feelings, can soon become a CATALYST for increased anxiety, paranoia, depression, and possible psychosis.

In some situations many people who end up labeled with a psychiatric diagnosis are actually exhibiting symptoms that have developed over time through the chronic use of alcohol and other mind altering legal or illegal drugs. Psychiatrists and other medical doctors have very little training in addictions and often dismiss the significance of their patient’s drug use experience (if they even ask much about it at all) and are quick to assume that the patient is “self-medicating” a more fundamental psychiatric “illness,” rather than just plain, “self-medicating.” What usually follows is a primary psychiatric diagnosis coupled with multiple prescriptions for psych meds. Unfortunately the underlying substance abuse problem is not fundamentally identified and treated, and the new prescriptions only add to the chemical cocktail already circulating throughout the patient’s brain; all this ultimately makes recovery even more difficult, if not impossible.

Most people who enter treatment for drug problems have used and abused many different kinds of substances (usually both uppers and downers), therefore severe mood swings come with the territory. And most people who have abused drugs for any length of time have quite often already been labeled “Bipolar” by some doctor. Any review of the listed symptoms for this so-called mental “disease” clearly overlaps with the symptom presentation of many forms of drug abuse (and you could also include in the mix, prescribed stimulants and antidepressants) and all this becomes just another reason to critically analyze the use of the ever popular “Bipolar” diagnosis.

Taking a larger view of society, the symptoms of addiction and extreme states of psychological distress, if labeled as “diseases,” can shift attention away from their origins in a trauma laden and unjust society. This becomes especially important for those people on the bottom of the social and economic pyramid. The ruling classes find it both convenient and necessary for their survival on the top of the pyramid to blame “bad genes” or “broken brains” as the cause of these problems. Ashley Montagu, the famous sociologist (when targeting the Sociobiologists, the forerunners of today’s theorists for the disease model) labeled these similar types of “blame the victim” explanations as “genetic theories of original sin.” Both addiction and so-called “mental illness” are far more prevalent where there is poverty, patriarchy, and other forms of mental and physical violence; all this creates fertile ground for various forms of trauma experiences on a daily basis. Addiction and extreme states of psychological distress can become more humanely treated through some reforms, but they will never be fully eradicated, or even humanely treated on a broad scale, until the material conditions from which they have emerged are transformed in a truly revolutionary way.

Part 2 of this blog contribution will be titled: “Confronting The Addiction Voice On The Road To Recovery.” This will address issues and controversies related to the treatment of addiction problems, including the dominance of the disease model in 12 step philosophy programs and self-help groups, combined with a discussion of other alternative approaches and forms of treatment. Analysis of the pervasive use of marijuana and the growth of large scale methadone and suboxone programs for treating opiate addiction will be fodder for future blog discussions.

Disclaimer: The above views are based on my summation and study of direct and indirect experience working in the mental health field for over 20 years. In no way does this represent criticism of any particular human service organization or detox/rehab facility. I have worked in the past, and continue to work with many dedicated professionals who, under very difficult conditions, do great service for people with all forms of extreme states of psychological distress.

44 COMMENTS

  1. AA Co-Founder, Bill Wilson was one of the biggest proponents of nutrition in sobriety, specifically the benefits of vitamin B-3.

    He drove around with pamphlets that described the vitamin B-3 (niacin) benefits… He was inducted into the Orthomolecular Medicine Hall of Fame for his work.

    Had Bill Wilson lived longer, it’s likely that the AA meetings of today would be as much a *nutritional* program as a *spiritual* one.

    More here –

    http://discoverandrecover.wordpress.com/sobriety/

    Duane Sherry, M.S., Retired Rehabilitation Counselor
    Sober since February 1, 1987

    • At the risk of being called a “heretic,” I could care less about whether this is a “disease” or not.

      What is important, IMO is to end the use of force, and allow people to find non-drug options that work.

      Why are people who are addicted to alcohol or drugs given mind-altering prescription drugs as part of their “treatment?”

      It makes no sense!

      Duane

  2. Richard,
    I can’t tell you how good it was to read your post! I often find myself struggling very much when I hear fellow sober people talking about the “disease” of alcoholism. The original literature didn’t actually use that word— it used “malady” or “illness”, and only in the spiritual context. You are indeed right that the drug/alcohol recovery world has been completely coopted by the medical, pharmaceutical, and psychiatric industry, and in my opinion, it is causing nothing but harm, taking people further and further from the root causes of why they were drinking/drugging too much in the first place.

    I have been sober for a little over two and a half years, and 0% of it came from medical/psychiatric treatment. I definitely see my relationship to alcohol as stemming from a spiritual issue— I felt a deep emptiness and profound disconnect in myself and with the world around me, and I turned to things outside of myself to change that state, because I was convinced I couldn’t resolve the problem myself. There is nothing “diseased” about that, and when I hear people around me saying “My disease is doing push-ups in the parking lot,” or “My disease wants me dead,” I just shake my head in dismay. Talk about sacrificing one’s inner agency, and one’s sense of humanity!

    For me, personally, I choose to not drink today because I don’t have any desire to. I am amazed at the way my life is unfolding in front of me, and it’s only started to do so since I got sober, which was what helped me gain the momentum to completely terminate my relationship to Psychiatry, as well. I would rather die than go back to the enslaved life I once led— enslaved to the psych diagnoses, psych drugs, and psych treaters, and enslaved to that desperate yearning to escape from the moment because I’d come to see myself as less than human due to everything I’d been told about my “serious mental illness” (my label was bipolar).

    It’s really hard for me to see person after person in my sober community put down drugs and alcohol and almost instantaneously pick up a psychiatric label and a stack of scripts. “Oh, my doctor told me that getting sober has revealed my underlying bipolar disorder”; “Yeah, I became an alcoholic because I was self-medicating my depression and anxiety.” On, and on, and on, I hear these things. The dual-diagnosis phenomenon is something I’ve been frustrated with for a long time— of course a person is feeling depressed, anxious, “manic”, “psychotic”, or whatever else!! They are consuming large amounts of psychoactive substances every day, and that has a significant impact on the brain and body, as well as on the ability to live a healthy and contented life!

    When people ask me for help getting sober, I always suggest that they stay away from the psychiatrist’s office. I sense that magnetic pull in some people to head that way in early sobriety, when they are in tremendous pain and desperation, and get a quick answer with a quick fix to why they are feeling so miserable. I try to share with them my experiences living with a psychiatric label for nearly half my life, and that at the end of the day that sense of ease that comes from hearing “You have depression/bipolar/whatever, and that is why you are feeling this way,” is not only temporary ease, but actually is just masking a pit of despair, marginalization, isolation, self-loathing, and imprisonment, lurking in the darkness just behind the new psychiatric label and the drugs that come along with it.

    For me, coming to understand just why I felt that deep emptiness, disconnect from the world around me, isolation, hopelessness, and anger at myself and my life has brought me to a place where I no longer feel the need to escape or seek relief in something outside of me on a daily basis. It is a beautiful thing, and it had absolutely NOTHING to do with medicine, psychiatry, treatment, etc., etc. It had to do with taking responsibility for myself and my actions, coming to believe that I was a human being just like everyone else and not broken or diseased, and learning to trust my gut and my inner voice, instead of running to an “expert” to tell me what to do, or to a bottle to forget how horrible my “bipolar” life had become.

    I am eternally grateful that I got sober, because I know I would be dead today, likely by suicide. Had I not stopped seeking relief in alcohol, I never would have found the inner strength to tell Psychiatry to screw off, and to drive out of McLean Hospital as a patient for the last time. Sometimes I go back there, for work (I’m a “peer specialist”) or to help other people get sober from alcohol, and it is a beautiful thing to be on the other side of those prison walls.

    Can’t wait for Part 2 of your blog, Richard! I have a feeling I will greatly identify with it, as well.

    Laura

    • Laura,

      Apologies for simply cribbing off someone else’s site (see below), but Jung, too, saw addiction as a spiritual quest. Duane made a good point about AA, Bill W. and nutrition. I highly reading the biography of Bill W. and the founding of AA. It’s called “Pass It On.” One of the best bios I’ve ever read.

      …Rossa

      “Dr. Carl Jung is one of the greatest contributors to AA. Jung’s “theory” of the archetype is mirrored in the addict’s spiritual journey in alcohol and other drug addiction treatments.
      According to Jung’s biography (Bair, 2003), in the early 30s, Jung became indirectly responsible for the foundation of Alcoholics Anonymous (AA). He saw a patient (Roland H.) who was an American and suffered from Alcoholism. Roland H. had many weeks of therapy with Dr. Jung but would not abstain from alcohol. After therapy ended, Roland H. returned to Dr. Jung a year later making the claim that it was too unrealistic for him to seek treatment/cure for his alcoholism through psychiatric measures.
      Dr. Jung suggested that he join the Oxford Group, which conducted its meetings through strict ritualistic procedures (Jung was hoping a more spiritual “treatment” would help Roland)…. Jung hoped that it would give Roland H. the strength to cease the use of alcohol. And it did: Roland H. had undergone a spiritual/religious conversion which caused him to cease using alcohol! Soon thereafter, Roland H. committed himself to helping others with alcoholism as well.

      Roland H. returned to the United States and met with Bill W., another alcoholic, and told him of his spiritual conversion in Europe as suggested by Dr. Jung. Bill W. had then a similar conversion as Roland H. had had, and soon alcoholics would encourage each other to abandon alcohol. This resulted in the foundation of AA (Alcoholic Anonymous). ‘

      Bair, D.(2003). Jung: A biography. Boston: MA, Little, Brown and Company

  3. Great essay Richard, with “coping mechanisms” the standout term for me, in understanding why addiction or other forms of coping, are not a disease of the brain, but a profound sense of dis-ease within the body/brain. As you say;

    “Similarly, extreme states of psychological distress can lead to altered states of consciousness that are mislabeled as a “mental illness” and a “disease,” but could instead be better looked at as a creative and necessary coping mechanism dealing with an experienced and/or perceived hostile and threatening environment. This coping mechanism, as with addiction, may also prevent more extreme reactive behaviors or provide an escape or temporary relief from intense physical or emotional pain.”

    Regarding addiction, Jaak Panksepp points out how opiate addiction may be a reflection of internal opioid systems, as part of our innate human dependence needs, in our responses to a sense of threat, both externally & internally.

    “LOVE & THE SOCIAL BOND:

    Social bonding is of enormous importance, for if it is inadequately established, the organism can suffer severe consequences for the rest of its life. A solid social bond appears to give the child sufficient confidence to explore the world and face a variety of life challenges as they emerge. As John Bowlby poignantly documented in a series of books, a child that never had a secure base during childhood may spend the rest of its life with insecurities and emotional difficulties.

    Until recently, we knew nothing about the neuro-chemical nature of social bonds. Even though all humans feel the personal intensity of their friendships, family attachments, and romantic relationships, there was practically no way of studying how these feelings might be constructed from specific brain activities. In the past score of years there have been several breakthroughs, like the discovery that neural circuits mediating separation distress are under the control of brain opioids.

    The first neurochemical system that was found to exert a powerful inhibitory effect on separation distress was the brain opioid system. This provided a powerful new way to understand social attachments. There are strong similarities between the dynamics of opiate addiction and social dependence, and it is now clear that positive social interactions derive part of their pleasure from the release of opioids in the brain.

    From this, it is tempting to hypothesize that one reason people become addicted to external opiates (i. e., alkaloids, such as morphine and heroin, that can bind to opiate receptors) is because they are able to artificially induce feelings of gratification similar those normally achieved by the socially induced release of endogenous opioids such as endorphins and enkephalins.

    In doing this, individuals are able to “pharmacologically” induce the positive feelings of connectedness which others derive from social interactions. Is it any wonder that people become intensely attached to the paraphernalia associated with their drug experiences, or that addicts tend to become socially isolated, except when they are approaching withdrawal and seeking more drugs?

    SIMILARITIES BETWEEN

    OPIATE ADDICTION & SOCIAL DEPENDENCE

    1) Drug Dependence 1) Social Bonding

    2) Drug Tolerence 2) Estrangement

    3) Drug Withrawal 3) Separation Distress

    a) PSYCHIC PAIN a) LONELINESS
    b) LACRIMATION b) CRYING
    c) ANOREXIA c) LOSS OF APPETITE
    d) DESPONDENCY d) DEPRESSION
    e) INSOMNIA e) SLEEPLESSNESS
    f) AGGRESSIVENESS f) IRRITABILITY

    Summary of the major similarities between the dynamics of opioid dependence and key features of social attachments.”

    Excepts from “Affective Neuroscience: The Foundations of Human and Animal Emotions.” by Jaak Panksepp.

    Most people in our community here see the issues of mental health and the disease model of suffering, in terms of abuses of power within a hierarchical structure of health care, and looking at the “world out there” this seems a completely obvious and reasonable conclusion. As you say;

    “Addiction and extreme states of psychological distress can become more humanely treated through some reforms, but they will never be fully eradicated, or even humanely treated on a broad scale, until the material conditions from which they have emerged are transformed in a truly revolutionary way.”

    Yet what seems so obvious to us in seeking to understand observable behaviors, may need a deeper understanding of just how our behaviors are stimulated from within, in order to “transform the material conditions from which they have emerged.”

    How many human beings take daily behaviors completely for granted, with barely any knowledge of our internal makeup, where perception and motivational functioning, is created?

    Do we need a revolution to reorganize the world “out there,” or further realization about the world inside us, where the so-called “system,” of dominance hierarchies, is actually created?

    IMO As long as we tend to see the world in divisions of us & them, the so-called system will remain intact, as a self maintaining system of unconscious action and reaction. Having said that, I do believe that beyond the easy sound bite of headline debates, much is happening lower down the hierarchic chain, as new discoveries like the polyvagal theory inform new understanding about our susceptibility to trauma, and the body’s role in states of profound dis-ease, and our need of self-regulation in coping-mechanisms.

    Warm regards,

    David Bates.

  4. Hi Richard:)) Comrade! As you say;

    “So looking at the world today with all its backwardness and on going oppression, yes we need to scream out “WE NEED A REVOLUTION.”

    Yet do we first need to understand the ground rules for a real evolution/revolution? Over the coarse of three decades of emotional/mental anguish which lends itself to an obvious need of diminishing pain through ANGER – RAGE & REVENGE, I screamed the desire for JUSTICE and found non. Yet in the end, while coming to terms with the past is so obviously relevant, only NOW is truly important, in a deeper need to BE.

    When we acknowledge unconscious function, with the mind’s “yeah, yeah I agree,” can we be certain of our ground and where we’re coming from, in terms of truly understanding our motivation, and our understanding of what we think we see, “out there?” IMO What we tend to see are images of objects, which is how we have all fallen into the trap of a mind reading diagnosis, because we’re now so cut-off from the finer sensory awareness of our entire being, as the vibrant organic creatures of nature, we are.

    Like most people, I take great comfort from music and its power to inform the senses on so many different levels simultaneously, even that level of Descartes fundamental error “I think therefore I am.” Consider the genius of John Lennon & “imagine” if you can, a long and winding road, in this evolution/revolution destiny, we are ALL on?

    “You say you want a revolution
    Well, you know
    We all want to change the world
    You tell me that it’s evolution
    Well, you know
    We all want to change the world
    But when you talk about destruction
    Don’t you know that you can count me out
    Don’t you know it’s gonna be all right
    all right, all right

    You say you got a real solution
    Well, you know
    We’d all love to see the plan
    You ask me for a contribution
    Well, you know
    We’re doing what we can
    But when you want money
    for people with minds that hate
    All I can tell is brother you have to wait
    Don’t you know it’s gonna be all right
    all right, all right

    You say you’ll change the constitution
    Well, you know
    We all want to change your head
    You tell me it’s the institution
    Well, you know
    *You better free you mind instead*
    But if you go carrying pictures of chairman Mao
    You ain’t going to make it with anyone anyhow
    Don’t you know it’s gonna be all right
    all right, all right
    all right, all right, all right
    all right, all right, all right” _The Beatles.

    Consider Bion’s notions of groups and their binding/bonding assumptions, which energize group behaviors, and “quick answers” about what seem such perfectly obvious actions to be taken;

    “The Transmission of Affect in Groups:

    The most striking peculiarity of a psychological crowd (group mind), is the following: Whoever be the individuals that compose it, however like or unlike be their mode of life, their occupations, their character, or their intelligence, the fact that they have been transformed into a crowd puts them in possession of a sort of collective mind which makes them feel, think, and act in a manner quite different from that in which each individual of them would feel, think, and act were he in a state of isolation. There are certain ideas and feelings which do not come into being, or do not transform themselves into acts except in the case of individuals forming a crowd. (group) (p, 53.)

    The power of words is bound up with the images they evoke, and is quite independent of their real significance. Words whose sense is the most illdefined are sometimes those that possess the most influence. Such, for example, are the terms democracy, socialism, equality, liberty, etc., whose meaning is so vague that bulky volumes do not suffice to precisely fix it. Yet it is certain that a truly magical power is attached to those short syllables. They synthesize the most diverse *unconscious* aspirations and the hope of their *realization* (p, 54.)

    Bion on Groups:

    Bion’s major work, “Experiences in Groups,” was published in 1961. His starting point in groups, was the work of Melanie Klein and the mechanisms she ascribed to the earliest phases of mental life, mechanisms that involve psychotic defenses. These psychotic defenses persist in the life of all normal individuals to a greater or lesser extent, but they are especially characteristic of groups, and revealed in the “basic assumption” that binds the group together. MY INSERTION: (In “A New Earth,” Eckhart Tolle suggests that much of normal group behavior in the 20th century can be described as essentially psychotic?)

    Generally, “basic assumptions” are about the affect/emotions of “anxiety, fear, hate and love.” Specifically, by a “basic assumption,” Bion means an assumption such as “the group exists for fight or flight,” or the group depends on a leader, or *the group has hope based on a belief that through it a new messiah or solution will emerge.* How thoroughly such an assumption holds varies, but a basic-assumption always exists. (p, 63.)

    The fight/flight assumption is fueled by hate and its close relative envy. The affect/emotions of envy, hate and aggression are directed towards the breast/mother (society), who’s creativity is envied in earliest psychical life. To deal with aggressive hatred and envy toward something which is also loved and “essential” for survival, one split’s the good and bad. One then fears, or has anxiety about retaliation, and is overwhelmed by hate and envy at the sight of, or fantasy of others merging without one, which leads to anxiety about being left out. Anxiety, exacerbates the paranoid-schizoid defense of splitting. (us vs them?).

    The results of splitting range from the psychical disavowal or denial of reality to the inability to make links between ideas. The split is healed through the *realization* that there never was a bad breast/mother (them in society), there was only the aggression within oneself, and it is this, that made the breast/mother (them in society?) bad.

    As in psychosis, and for that matter the unconscious, time plays no part in basic-assumption activity. “The basic-assumption group does not disperse or meet.” If the awareness of time is forced on a group in basic-assumption mode (as with the unconscious), it tends to arouse feelings of persecution. At some level the group (unconscious) is always in its basic-assumption, which means no member of the group can cease to be in it, even when the group is not gathered. The group remains a group through its basic-assumptions, by the resonances they trigger, and the positions (us & them) they assign. (p, 64.)

    Bion did not believe that basic-assumptions are all there is to group behavior though. He believed that there is a work aspect to groups, which does the job for which the group is formed, and the basic-assumption aspect, which acts on the basis of unconscious affect/emotion. The same group is simultaneously a work group and a basic-assumption group; and one or other of these aspects will dominate from time to time. This dual definition allows us to recognize that the group can be quite mad and yet apparently stable, organized and purposeful, as in the case of a cult. (p, 65.)

    The group can be apparently sane (*a university department for instance*) and yet occasionally irrational or persecutory in its dynamics. For the group can and usually is, organized around its work function. But, as it is also bound together by its basic-assumption, it is stressed that organization and basic-assumption bondage are radically different. As Bion articulates;

    “In contrast with work-group function, basic-assumption activity makes no demands on the individual for a capacity to cooperate but depends on the individuals possession of “valence,” a term borrowed from physicists for “instantaneous” involuntary combination of one individual with another, for sharing and acting on a basic-assumption.”

    This idea of valence should take us into exploring the transmission of affect/emotion, yet Bion avoids the issue of a mechanism, suggesting only the existence of a “proto-mental system” which is both physical and mental. The problem with “valence” as a term, is that it captures a truth, yet does not differentiate between what one is valent toward or what one is valent with (although it does connote the activity of the senses).

    MY INSERTION: Peter Levine gives us an affect/emotion interpretation of Bion’s notion of “valence,” in his book, “In an Unspoken Voice”;
    “Bodily feelings embody a relationship between an object or situation and our welfare. They are, in that sense, an elaboration of the basic “affective valances” of approach and avoidance. Feelings are the basic path by which we make our way in the world. (p, 338).”

    Bion’s idea of a “duality” of motivation within a group (work and a basic-assumption) allows us to recognize that a group can be “cognitively” responsive in relation to “symbols,” and see something else is going on “affectively,” (unconscious affect/emotion).” (p, 66.)

    Excerpts from “The Transmission of Affect” by Teresa Brennan, PhD.

    As in the life of each individual, there is far more unconscious “feeling” going on beneath Descartes need to understand the world in “objective,” mechanistic terms, in our group assumptions about real needs and future directions. Will humanity face up to the challenge of climate change, for example, with the same old-world, “us & them” assumptions?

    Philosophy & physics, seek to peer beneath the mask of consciousness, and here in our MAD community we actually have the lived experience of doing just that. Yet, IMO We get caught in a double-bind, with a need to appease consensus reality, in our interpretations of recovery, which seem to give tacit approval to our experience, as fundamentally, all BAD. IMO We need to devote more time & energy to Dr Michael Cornwall’s profound question, “if madness is not what psychiatry says it is, then what is it?”

    Convulsions of the soul, perhaps? Do we all need to free our mind, as John Lennon advises, from emotional fusion, in our assumptions about what we think we see “out there?” Do we need to pause, and FEEL the e-motive projections from within? Apologies to my mad brothers & sisters, for the obvious pun, but do we NEED to explore and articulate more of what lies beneath the “freaking obvious,” in our experience of altered states of mind, as a coping mechanism?

    Just IMAGINE, the “long and winding road,“ http://www.youtube.com/embed/Xqu9qhBHWNs we are ALL on;

    “The *delusion* is extraordinary by which we thus exhalt language above nature:- making language the expositor of nature, instead of making nature the expositor of language.” _Alexander Brian Johnson.

    “The brain is slowly waking and with it the mind. Its as if the Milky Way entered upon some cosmic dance. Swiftly the head-mass becomes some enchanted loom, where millions of flushing shuttles weave a dissolving pattern, always a meaningful pattern, though never an abiding one: A shifting harmony of sub-patterns.” _Sir Charles Sherrington.

    One of the basic-assumptions, as Bion puts it, is the notion we are already fully-human?
    Perhaps not yet? As more knowledge resources, continue to fuel the slowly waking brain?

    Warm wishes,

    David Bates.

  5. Richard,
    I look forward to reading Part II of your blog. Recently I’ve been corresponding with a mother of a son who has a “dual diagnosis” – schizophrenia and addiction (in this case to marijuana and other recreational drugs). I have always been skeptical of dual diagnosis. I see it as a money earner for academics, etc. and a make work project for social services. Heaping an addiction diagnosis on top of a mental illness diagnosis makes helping the person more complicated than it should be. There is really only one problem, (a problem of living) but the addiction diagnosis brings in e.g. 12 step programs, and criticism by family members of their relative for continuing to be an “addict.” This makes recovery even harder. So far, I have not found any guidance for helping families treat the two symptoms of the same spiritual distress as one. I’m hoping you’ll fill this gap.
    Best regards,
    Rossa

  6. Hi Richard,

    It is great to see you here as a fellow blogger! I welcome your questioning of the disease model from your in the trenches experience, becauae I believe in the end, what will finally discredit that model in the eyes of the public, will not be a mountain of academic research refuting it, but the critical mass of heart felt human stories like Laura Delano’s here- and clear eyed anecdotal wisdom from providers like you who are eye witnesses to what you believe is true and real. When we are willing to speak our truth to power about what we feel in our hearts and guts as you and Laura are doing here, then we will be heard. We stand with the causalties of this dog eat dog, social Darwinism driven, caste system culture- and refuse to have the injustice fueled emotional pain that is happening be papered over by being diagnosed as individual pathology.

  7. Dear Richard,

    I read your blog with great interest an enthusiasm. I have long been concerned about the effects of labeling addiction as a disease. I first explored the utility of this concept as an academic, I must confess, from the lens of social labeling theory and the study of subcultures and marginalized populations.

    The disease model did not seem to make as much sense as learned behaviors, subcultural norms, ingroup/outgroup dynamics, blocked access to opportunities and/or coping mechanisms, and a host of other social and relational factors, not to mention the addictive and mind-altering properties of substances themselves (not you need to be predisposed to a disease to get high and then experience the cascade of logical consequences that may flow from acting from this altered state?). My mentor was himself a recovering addict, former addictions professional and, ironically, subject to binge drinking. It was painful to watch him struggle to navigate between the 12-step model and understanding addiction as a social phenomenon. It seems he could not fully embrace either (and perhaps there is truth in that too).

    While a disease model of addictions didn’t ring true in graduate school, it rang even less true when I looked at my peers in college and my twenties. I saw people succeed in “sobering” up by dodging the label of alcoholic or addict. I also saw people who needed to embrace the label and the identity of someone suffering from a lifelong disease. I’ve seen those from both approaches stumble, get lost and, sadly, not find their way back.

    This is such a challenging issue and there are no easy answers. I great respect for those who have embraced the 12-step model and changed their lives and others. I would just like to see more options out there for those for whom “disease” don’t fit.

    Thank you so much for tackling this controversial topic!

    Warmly,
    Jennifer

  8. Dear Richard,

    Can I congratulate you on a brilliant article. I agree with all of what you have to say. In fact, it’s so refreshing to see someone write so well about the issues that I care so passionately about… and to find someone who agrees so much with what I believe!

    I have blogged about your blog on our online recovery community, Wired In To Recovery.

    http://wiredintorecovery.org/blogs/entry/15536/highly-recommended-reading/

    You will note an interesting aspect of the comment from my colleague Michaela Jones, the reference to Broken Britain and the blame game that exists there – how she ties it in with some of your thinking. The Recovery Movement in the UK is very exciting, but having to struggle against strong interests wishing to maintain the status quo (treatment based primarily, but not entirely, on a medical model) and a government who seems set on widening the social divide between the rich and poor.

    I should add to your blog of course that the disease model is great for drug companies, who can sell more drugs… and sadly create more psychological and physical problems.

    Finally, I should add I spent 25 years as a neuroscientist – I trained with the father of dopamine research, Arvid Carlsson, and ran my own lab which focused on addiction for many years – before leaving the field because I felt that neuroscience had not helped anyone recover from addiction. It was very good at promoting itself, but the way forward for me involved a different journey, working directly with people affected with substance use and related problems. And that eventually led me to developing Wired In and the Wired In online recovery community.

    Can’t wait to read your follow-up blog. Keep up the great work and please keep in touch. I now live in Perth, Western Australia.

  9. Hi Richard,

    I reread your first article in keeping with your request that I “review” all of your articles. As I recalled, this was a very excellent, informative article and I agree with most of what you said. In fact, as you attacked the gene, disease theories, I started wondering if my usual good memory had failed me this time. You did a great job exposing that the gene, disease theories for alcohol/drug abuse and what gets called “mental illness” are totally bogus.

    As I am increasingly impressed by the article as I read, I come across this BOMB:

    “While there is probably something called a “genetic predisposition” for these two types of problems, we must question how this concept can ever be very useful. For example, in the case of psychotic like symptoms, if we take two people and subject them to a certain number of hours of torture and one person starts to show signs of psychosis after 18 hours and the other at 21 hours, should we spend millions of dollars to determine why there was a 3 hour difference between the two people? Shouldn’t our society be more concerned with why there was torture going on in the first place and what gave rise to those conditions and how to eradicate the material basis for such conditions?”

    I find this whole paragraph a total negation of everything you’ve said and will say in future articles about the bogus claims of the biopsychiatry mental death profession that addiction and the emotional distress/trauma from environmental abuse/stressors are due to one’s own faulty genes, a despicable “blame the victim” ploy you forcefully reject elsewhere. Dr. Littrell pulls this in her articles that I try to notice and call her out on it when there is no truth, proof, evidence of such “BELIEFS.” Dr. Littrell uses her experience with her father for her BELIEFS that alcohol abuse “is probably” genetic, the type of victim blaming claim that makes my blood boil. To me, this type of claim with no evidence whatever, justifies the continuing waste of billions of dollars in the evil, fraudulent coverup pretense of eugenics that the white wealthy robber barons, past and present, with their corrupt cohorts in government prove by their wealth and power that they have superior genes while the have-nots have inferior genes that justify their abuse, exploitation, slavery, injustice, harm and early death. The psychiatry/BIG PHARMA cartel was/is the perfect weapon to unleash on one’s own citizens by while the military industrial complex may be unleashed internally or externally for anyone who dares challenge our growing fascist global police states under psychopathic rule. See book and web site, POLITICAL PONEROLOGY, and many articles on the impact of psychopaths on Wall Street and other institutions.

    I’ve posted this excellent review of the great book, PSEUDOSCIENCE IN BIOLOGICAL PSYCHIATRY, elsewhere, but I’m posting it here again because it exposes not only the fraud of the bogus claims that genes cause addiction or white male old boy network votes in back rooms that create the bogus mental illness stigmas, but also, the very real, but ignored environmental stressors causing the severe emotional distress and trauma. Dr. Colin Ross wrote a book called THE TRAUMA MODEL and though he’s had his own quirks with regard to certain theories, I think he was very intelligent, far more honest and insightful about the real causes of the symptoms treated by so called mental health experts.

    http://www.antipsychiatry.org/br-pibp.htm

    Your article was quite long, so I’m going to try to address another issue you brought up with which I am very familiar. That’s the connection between betrayal, trauma, abuses of power and addiction. Are you familiar with the excellent book, THE BETRAYAL BOND, by Dr. Patrick Carnes in which he makes the total connection between these strong trauma/betrayal bonds and addiction and he criticizes the so called addiction/mental health fields for failing to see and acknowledge the connection?

    I think it has been very deliberate and hypocritical for society to pretend they believe in the disease theories of substance abuse or even so called mental illness while they vilify and scapegoat the so called drunks, addicts and nut cases. And I love that great theory that if an abuse trauma victim who self medicates dares to try to call her abusers, betrayers to account, they are BLAMING to justify their addiction as the great disease theory goes. This is the typical evil BIG PHARMA has done that Dr. David Healy exposes when Mitch Daniels came up with the “brilliant but evil ploy” of attributing every noxious, dangerous side effect of their toxic SSRI’s or other toxic drugs like suicide, heart attack and others on the so called mental illness of the victims. Totally invalidating, blaming, stigmatizing, gas lighting, bullying, mobbing and poisoning the victims in the guise of mental health is enough to drive one to suicide in addition to self medication if you check out the work of Dr. Heinz Leymann’s THE MOBBING ENCLOPEDIA and related work on the web and Amazon.

    If you think about it, this is the perfect, typical “blaming the victim” setup and I’ve seen very evil, abusive psychopaths just about drive their nearly destroyed targets over the edge by constantly publicly accusing the victim (and any nervous person in the vicinity worried about being targeted for their own drug abuse or problems by the bully) of BLAMING for the addiction or continually gas lighting the target that she/he has bipolar if she/he tries to call the bully(s)to account when the terms are totally bogus in this context, but such bullies are great at promoting their vicious lies and ploys with great authority with large doses of ridicule while they bamboozle onlookers to help destroy their victims. See books like STALKING THE SOUL, MOBBING, THE BULLY AT WORK, and the great web site, BULLYONLINE by Dr. Tim Fields.

    You may want to check out the web site, LOVEFRAUD.ORG for more information on such psychopaths/sociopaths or just evil people the BIBLE and other works describe quite well and the book, THE BETRAYAL BOND. And despite biopsychiatry’s hijacking of the power to define and bully the rest of us about so called addiction and emotional distress/trauma, there is a good reason for the saying, “It’s enough to drive you to drink,” showing that people once understood that one could be hurt or stressed enough to be driven to drink or other substances (including binge eating, etc.). Even the Bible recommends wine for the depressed. Now, I know you aren’t a big fan of mainstream religion, so I am only using the Bible in this context because it’s old and has lots of folk wisdom in PROVERBS and other parts. There is another part of the the bible starting with “Who has woe…” that goes on to describe the misery of somebody addicted to wine all too well…”

    As everyone is catching on, by hijacking and redefining addiction and so called mental illness, the power elite gets to cover up its abuse, exploitation and rape of the majority, blame the victims for their normal reactions to such abnormal treatment, inequality and traumatic events and make profit centers of those harmed by the massive damage and suffering they inflict by demonizing them as vile, dangerous addicts and crazies who need to be “treated” with their “good, safe” drugs for public safety and other evil lies. Dr. Gabor Mate exposes this evil in his books and videos I have cited to you recently.

    I have to go, so I’m signing off for now. I will revisit this project later as time permits, but I addressed my major problem with this article with my comment about your seeming to back- peddle on the bogus gene claims for what many experts know and expose as self medicating trauma per items I posted on Dr. Steingard’s recent first neuroleptic article including Dr. Carole Warshaw, THE DOMESTIC VIOLENCE ENCYCLOPEDIA, etc.

    Again, I thought this was a very informative, excellent, empathetic and compassionate article overall, so I hope you will take my comments with the good intentions of only making this article even better due to lots of research I’ve done in this area.

    I posted this comment here in case I needed to reference the article for my comments and for future readers, but will leave a note on your third article you suggested I use for comments.

    Peace,

    Donna

  10. Hi Richard,

    I understand what you are saying, but I still think you make some inconsistent remarks when on the one hand, you DO negate biological determinism vehemently, but then, you give biopsychiatry an opening with this statement in my opinion:

    “While there is probably something called a “genetic predisposition” for these two types of problems, we must question how this concept can ever be very useful. For example, in the case of psychotic like symptoms, if we take two people and subject them to a certain number of hours of torture and one person starts to show signs of psychosis after 18 hours and the other at 21 hours, should we spend millions of dollars to determine why there was a 3 hour difference between the two people? Shouldn’t our society be more concerned with why there was torture going on in the first place and what gave rise to those conditions and how to eradicate the material basis for such conditions?”

    I suggest you do read Dr. Jay Joseph’s great posts on this site and look at his articles listed there and at least reviews of his books, THE MISSING GENE and THE GENE ILLUSION at Amazon in which he exposes all the twin and other studies supposedly proving the bogus claim of genes causing addiction or bogus DSM stigmas in general are fraudulent. He also shows that the modern eugenics used to justify the NAZI Holocaust are based on the same evil ploy that the wealthy white old boy network in power is entitled to their robbery of a huge unfair share of the world’s resources due to their supposed superior genes while those they exploit and enslave supposedly have inferior genes. It’s just an excuse to push their toxic neoconservative social agenda.

    The nature versus nurture argument has never been solved, but as you show with the work of Robert Sapolsky, environmental factors usually trump genes for good or bad. So, if there was a difference of a few hours when one submitted to psychosis in traumatic environments, it could be environmental causes rather than genes. I know it sounds like I am splitting hairs here, but I have been disgusted to find the military and other combat situations like domestic violence use bogus gene claims of pre-existing “mental illness” to falsely claim that certain people are more vulnerable to PTSD or really have the fad bipolar due to their bad genes or even their childhoods to invalidate them and deny them disability or other benefits to which they are entitled. As I said on Dr. Jay’s web site, could you or anyone possibly compare two people’s combat or abuse experience and come up with an exact comparison as to who had the most traumatic experience over long periods of time on duty or in abusive environments? In terms of your example of giving in more quickly in a matter of hours, it could be that the one who gave in faster was having a bad day, was sick that day, didn’t sleep the night before, got bad news that day, etc.

    Anyway, I am dead set against claiming genes have any special influence over addiction or severe emotional distress since most evidence points to environmental causes and there is no evidence that genes are the cause. Stanton Peele goes into this in his book, THE TRUTH ABOUT ADDICTION AND RECOVERY as do many other sources. He claims even your heritage can affect you in that Jews frown on drinking a great deal while the Irish have tended to relish drinking more, which is based more on social/cultural standards rather than genes.

    Also, did you read the great review of PSEUDOSCIENCE IN BIOLOGICAL PSYCHIATRY further down in my post? This review and book exposes the absurdity of the gene theories behind bogus DSM VOTED IN stigmas and addiction in a very amusing way.

    I hope you noted the book, THE BETRAYAL BOND by Dr. Patrick Carnes that deals with the fact that trauma and substance abuse are very intertwined as you have noted. You can check out review of this great, highly regarded book on Amazon. Dr. Carnes criticizes the so called mental health profession for failing to see or acknowledge that, so it’s great that you have focused on it in your work rather than the typical “blame the victims” ploy. I was impressed with that along with other things you seem to be more aware of than most experts in this area. This approach is in keeping with THE TRAUMA MODEL that many recommend should be adopted by the mental health field because trauma with all its many symptoms including self-medication solves the bogus comorbidity or dual diagnosis approach of psychiatry.

    I know it’s tempting to believe that certain addictions or “mental illnesses” run in families due to genes, but as you know, dysfunctional families can cause lots of abuse and nasty behavior patterns leading to addictive behaviors, trauma and/or severe emotional distress passed down from one generation to the next.

    Please don’t take this as an attack on you because I think your articles here are fantastic and show that you are very well informed and up to date on the latest theories and practices that actually help people rather than shaming and blaming them as does mainstream so called “treatment.” I do understand what you are saying and it is true that people may have different genes, but not inferior genes with psychiatry always trying to prove their victims have the INFERIOR genes to blame the victims rather than admitting that unjust, toxic, oppressive social conditions cause most if not all of what they falsely stigmatize as “mental illness” to serve their masters in the power elite at the expense of their victims.

    Anyway, you are entitled to your opinion, but given your seeming forceful negation of genetic determinism, I say, why give the enemy any ammunition when they sure have enough in their billions of dollar arsenals to promote their ongoing bogus eugenics claims. I think we agree on this issue and our disagreement is a matter of semantics that can confuse the issue.

    Per your request, I’ll send you an email.

    Nice to hear from you.

    Donna

  11. “quite capable (over time and under the right circumstances) of distinguishing the difference between thoughts and behaviors that are useful to themselves and to our species and those that are harmful and self- defeating”

    I think this is a great article. Me, I subscribe to a non-medicalized view of “bad habits” and I think peoples’ personal power to break habits in their lives is undermined by the disease model. One only needs to look at Hollywood stars who have millions of dollars and a blank check to purchase the “best” “addiction medicine” “care” and how it rarely works out.

    I like psychologists Stanton Peele, John Booth Davis, and Jeff Schaler on this issue.

    The books “Addiction is a Choice” and “The Myth of Addiction” are starting points.

    I have ended some “bad habits” in life and am yet to end others I’m still habituated to, sadly, but I know that it is up to me and there isn’t a technical expert in the world who can end them for me. I think people need to keep open the idea of moderation, and that this total abstinence first approach we often see can be too much pressure for many people.

    I also wonder why neuroscience researchers blame “reward pathways” for bad habits, but not good habits. And I think saying a brain is “rewarded” is like saying a liver feels “rewarded”. It’s a line of thought that disembodies the human from their entire world by blaming the brain. If something feels good, whether it be blasting yourself with heroin, or even thinking you’re superior to others, people are gonna do it. How long they do it depends on what comes first, death or a reassessment of their values. I most appreciate the reminder in this piece, that MILLIONS of people have quit “bad habits” without recourse to so called “addiction medicine” technical “expertise”. So true.

    I really recommend youtube searching for Stanton Peele. And Googling John Booth Davies “Myth of Addiction” and Schaler’s “Addiction is a Choice”.

    I think there is some good economics papers too on time horizon values. People thinking of and planning for a long life, or just indulging today and throwing caution to the wind. I do think the prohibition on substances puts them behind a glass case that mystifies them to young people. I think if all drugs were legal people would use them more responsibly and the war on drugs is just a war on humanity responsible for criminal violence on a huge scale. The “addiction medicine” industry is just a piggyback on biopsychiatric thinking extended to bad habits, and every criticism of biopsychiatry can be applied to it too.

    I don’t think calling “addiction” bad habits is a “blaming someone” type thing, I mean, if you lived on a deserted island like Tom Hanks in that movie “Cast Away” there would be no-one there to judge the “goodness or badness” of someone doing a certain drug all day every day. It’s up to the person to decide what is having a net positive effect in their lives. If you’re neglecting your kids and your responsibilites because of a bad habit, people are going to judge you, but blame from outside is not important. It’s how the person thinks about their own decisions. If you have terminal cancer already, smoking isn’t going to rob you of a future you won’t get anyway, is it? We do live in a society with other people, and it would be “ideal” for everyone to live a moderated, temperate life, but this is a problem in human life that has been struggled with since the Ancient Greeks and beyond… and it is a problem that will outlive all of us. On how to live… you either find a path, or you put yourself at the mercy of others like “addiction medicine specialists”. There is a reason that doesn’t work out for even the richest Hollywood stars. That reason is, it’s quackery to think there is a technical fix to the “over”indulged life.

    Good piece. Thanks for writing it.

  12. I would like to offer the author of this blog thanks, as I am currently on my own journey pursuing the serenity that comes with emotional sobriety, which includes many fumbled attempts to get right by means of psychiatry. Though I am not educated in the conventional sense, my experiences have brandished me quite an expert in the field of forced treatment. I have been to over 30 facilities under the guise that my “mental illness” spurred my polysubstance dependence, namely opiates, bentos, and the gamet of antipsychotics and mood stabilizers.
    I have been in an endless struggle trying to find a way that works. It seems that I have become beyond stuck in what seems to be an endless set-up-to-fail system. I cannot be free of illicit drugs without being weaned onto a ridiculous amount of psych meds, which no doubt have huge side effects. Without a doubt the feeling of being subdued would drive any free thinker up the wall, and for me, the detox from such meds as Seroquel had driven me back to the other extreme submission of a methadone clinic.
    I am not a superhuman. I do need careful attention and support during the physical withdrawal period that many drugs carry. I have found no luck in finding a safe, holistic institution where I can truly heal my neurochemistry, not “treat” what should be hailed as a naturally occurring process that if worked through could be the nd we are essentially looking for as far as learning to reverse our thought patterns and behaviors.
    I am still, today, on methadone maintenance as my means for staying functional in a society that promotes illness for profit. Not even close to ideal, but I am currently psych-med free, and on the road to finding my chosen path to happy destiny. Thanks for writing.
    Your new reader,
    Giulia w.