In a thought-provoking article published in Bioethical Inquiry, authors Sergei Shevchenko and Alexey Zhavoronkov investigate a concept frequently neglected in addiction studies: the notion of time.
Entitled “Temporal Aspects of Epistemic Injustice: The Case of Patients with Drug Dependence,” this article contends that individuals suffering from drug dependence encounter a specific form of epistemic injustice correlated with their unique perception of time—referred to as a “disorder of temporality”—which stands in opposition to the rigid and institutionalized structures of healthcare.
The authors describe how healthcare systems, grounded in linear and measurable timelines, often perpetuate harm by failing to accommodate the non-linear, fractured temporal realities of people with addiction. This temporal mismatch, they argue, reinforces epistemic exclusion and obstructs access to compassionate care. The authors write:
“Before seeking effective solutions for cases of testimonial and hermeneutic injustice, we should first address the mismatch between the patient’s temporality and the mainstream temporality of healthcare institutions, as this discrepancy hinders access to care.”
This is such a piddly little insight understood in the practical work life of every ‘professional’ who deals with addicts, but you merely put it into intellectual/theoretical sounding language by talking of a disordered temporality, which again is a normative judgement based on your social conditioning. I am most certainly one of those who have the ‘unique’ kind of time you imply is unique to the addict – it is not. Anyone with a very difficult material existence who has to fight for what they need almost like a hunter gatherer or no doubt like fighting in a battle has this sense of time, and it is called being in the now as opposed to being in the intellect, which is the only place time exists – in thought. Time doesn’t exist in a clock – the brain turns the clock into time as thought. And probably it is a reversion to our natural sense of time. But regarding the phenomena in question, here is what I feel a more accurate, human description of the phenomena you are talking about would sound like – and it is a description of that which has been perceived and understood, not merely theoretically hypothesised or construed from the perspective of a judgemental and heavily socially conditioned academic or mental health professional.
Difficulty servicing addiction is comparable to difficulty finding food, or difficulty surviving, and this obviously entrains you to the immediate problems of life. Being homeless brings you into this state, and the focus you call time (intellect) is replaced by the attention to circumstances physical, emotional and psychological in the now. Clock time goes very slow when circumstances are gruelling, painful and difficult, and goes fast when there’s intense pschological engagement with something, and also the desruptive effects of the getting and using and being intoxicated by drugs, and often the energy draining and sickness inducing effects of the addiction, create obstacles that make appointment keeping more difficult, so altogether it is more difficult to make appointments or do abstract planning and organizing of action because this requires us to be centered in the intellect, where time is, rather then in the actual real world, which is only ever now. I really suffer this and cannot keep appointments and open my mail, and I suffer it for different reasons, and far from impairing my quality of life it’s a massive liberation from all the bullshit of black and white words and numbers and clocks that blight and destroy your lives and brains. Well worth missing a letter from the bank for if you ask me.
NB, although the addict experiences thought, this is not the same as being centered in the intellect because thought becomes a constant mechanical round of repetative thoughts concerned with the immediate problems of life and also shot through with traumatic complexes and the like – these are not what I consider to be the activity of the intellect because they are not thoughts structured by plans or times: rather they are the brain reacting to environment and suffering the usual inundation of traumatic complexes that it has not the time, space, energy, opportunity or understanding to address, and neither does the field of mental health and addiction ‘professionals’ – so what do they get paid for? To process social problems, that’s all, and to do it as cheaply as possible regardless of efficacy. Do you know that less then 5% of addicts get clean from one impatient stay at a detox facility? And over the life time of an addiction, only a third manage ever to get and stay clean, a third die as addicts, and another third actually die of their addiction, for example overdose or liver disease, although in my experience I am sure these statistics are getting far worse not better, because addiction is not the disease. Addiction is the symptom, and the real disease is you, not the addict – it’s society and the socially conditioned human consciousness at large.
Also, understand that, as Jiddu Krishnamurti always said, time IS thought, and time IS fear. Can you see that? Unbelievable as it might first sound to the intellect, we don’t feel fear on present circumstances but in their future implications, and therefore the soure of these future implications, being time bound, is thought as intellect. So intellectual abstraction produces the possibility of REAL fear. The physical energetic surge and physical nervousness of the human body is not fear, but reflecting on a dangerous situation one has just passed is again thought which produces real fear, and these two subtly different processes are not generally noticed by the socially conditioned mind. How do I know all this? The brain has finished it’s work and given itself over to SEEING rather then merely thinking. And I can SEE that everything you say and do in your professional and intellectual lives are absolutely worthless, because you are still stuck in thinking, and even worse in believing what you’re thinking as if it could be reality when it’s a mere socially conditioned representation of something radically other, namely what is SEEN.
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Buddy, we need to start collecting your comments together to publish an anthology.
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That’s very kind of you Jordan! In the meantime please do feel free to plagiarize liberally where you see what I see eh. And don’t worry, the next time i say a perfect sentence gravity will collapse around me and Hilary Clinton will beam me up to the moon and hold me hostage because the world mind thinks I’m dangerous. Only joking (I think) – have a nice day!
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What you can see clearly and completely, you can respond to truthfully, and truthful action means responding naturally and therefore honestly to what is when it has been clearly and completely perceived. It is rare to find anyone who knows such action, because such action is impossible when perception is directed, circumscribed, prejudiced or constrained in any way by the intellect. And it is only in truthful action, i.e. action responding to the clear and complete perception of what is, that leads you to the truth which is far beyond the reaches of any human concept and therefore any intellectual endeavour. You can’t capture it by calling it a word. Obviously you must see it, and there is no point in telling you what you will see because it is beyond words. And this truth is what you are. You are the truth, but nothing you think or say can ever touch or represent that truth which is not a something – it simply IS.
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Iceland is nice so long as you’re not afraid of dead people or volcanos. But Loch Ness is marvellous, laverless and cardavarless.
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DUH!
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Addiction in almost all cases – perhaps all cases – I have known, which have been innumerable, I have never found a convincing case of someone who stumbled into their addiction by accident because they were using it simply for enjoyment, hence the ‘bad behaviour’ conclusion that is still pretty much predominant socially today although is receding as the link between trauma and what we call addiction is becoming increasingly undeniable not just to so called addiction professionals (sic) but also to society at large. I have been to two rehabs in my life and heard many life stories, and one of the rehabs got us all to do our life stories in front of each other, all but one of the 12 I heard were so appalling to listen to, they made you want to cry, which is a big no no because if the person telling the story cannot cry over their life it doesn’t feel quite right to shed tears on their behalf, but a couple of times tears would nudge at the door. The other one was tragic in a very different way because the person had a very upper class British life and had an exciting time with what to any of us would have been a very lush lifestyle, and the tragedy was an emotional spiral that lead to alcoholism, but not quite the same in terms of violence and horror as the rest. Mentions of sexual abuse or rape were more then half of them, literally, which I feel must be considerably higher then the general population although true figures are really impossible to know given an unknown proportion of people who don’t ever raise it with the police. Perhaps all but one or two included poverty: I can’t remember how many included violence: but ever one of them was a story that would arrest you if it was isolated and read out as a TED talk to show the real human story behind addiction. So I find that trauma is ubiquitous in addiction AND ‘mental illness’, and also in cases of homelessness and in the criminal justice system as we call it in the UK, although many cases of depression and anxiety I feel are not necessarily caused by an abnormal degree of trauma – we just don’t have any understanding how traumatised even the least traumatised among us are, because we think we should compare it to the social norm rather then to the state of truly natural human beings free of the demands of a toxic all consuming society.
And notice how we judge all these groups in society and loath and detest them and shrink from them and fear them, making their lives intolerably miserable. This is part of what you call the addiction, an essential ingredient I would argue. Another essential ingredient is the afore mentioned trauma. Another essential ingredient is the ‘self-criticism’ of the socially conditioned repetative, mechanical criticism which shouldn’t be called ‘self-criticism’ because there is no real self criticizing the real human being. It is the constant critical assaults of thought which is a mechanical process induced by convincing the brain of the values internalized by this society, such as I am a junky or homeless or a criminal or mad therefore naturally I am defective and wrong rather then being the product of this total social process which created all these conditions out of the raw material of Mother Nature in the form of healthy, natural human beings, whether the baby or the traditional, organic human cultures (or ‘tribes’).
I don’t like the term addiction because implicitly the problem is defined as the drug behaviour when we talk of their problem as addiction. Their problem is the traumatising social experience they have had including in the family and interactions with education, police and other ‘authorities’ who treat traumatised kids punatively, their socially conditioned tendency to judge according to the prejudices of a punative society rather then understanding themselves and through that understanding, gaining control over their addiction, and also in the obvious fact that they themselves generally understand the problem as their behaviour rather then in the emotional, psychological, and physiological basis of the addictive behaviour because as all seasoned addicts will tell you, stopping is not the difficult thing – it’s staying stopped, and even when one recovers from a hellish addiction which made life miserable, relapse is STILL the rule, not the exception, which is proof against the dominant prejudice including among addiction specialists that the problem is stumbling into our addiction through our own bad choices and misadventure. And given that the addiction specialist also treats the behaviour as the problem they hinder the recovery of the addict by reinforcing this misconception in them and by misdirecting their advice at ways of trying to manage one’s behaviour which never works. One must penetrate more deeply in one’s own observation and understanding of one’s whole life and see the drug or alcohol behaviour within the context of the whole movement of emotion, thought and environment, and then you understand the actual terrain and dynamics of your addiction and that understanding is what is required. It means you will understand when you use and not punish yourself for it, rather then try to fight yourself which naturally only weakens you further and makes relapse more inevitable and which most addicts, even those desperately seeking recovery, are trapped in. Furthermore, if you understand the actual emotional, psychological, behavioural and environmental landscape and their interactions, you will understand when you can desist and put away the drug or drink, and will not need courage because you won’t have fear, including the fear of ‘self-punishment’ should you get it wrong. This complete clear understanding can only be discovered by the person going through it, although listening to people going through it, which is something that addiction specialists do, does at least help them to understand and see through the obvious falseness of some of the crude dominant social misconceptions around addiction such as ‘it’s a life style choice’ and ‘it shows a lack of will power’ etc.
Now if every addict realized, as every mental health sufferer or homeless person or so called ‘criminal’ (in short, real damaged children of this society and proof of it’s many failings), if each of these realized that ultimately it is only they themselves who can become a true expert in what they are going through and it is only they themselves that could really educate society to any degree of satisfaction, then they would begin a meaningful journey of observing and understanding themselves and of developing the capacity to convey this to the society that needs to understand it’s own problems in order to solve them. Think how much more conducive this approach would be to recovery then being managed and criticized and judged by the ‘addiction professional’ who in their socially conditioned ignorance think it is they who are the expert and the addict an unreliable narrator. Unfortunately, this is not understood by suffers and even less by society at large, except for the odd exception doubtless a few of which are on this website because being critical of psychiatry or addiction services is proof of true insight into the real phenomena at hand.
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Maybe the medical community should get out of the business of declaring legal activities, to be “mental illnesses?” Oh, or have they? Since when I dealt with a loved one dealing with a bad drug interaction, in connection with a likely case of alcohol encephalitis, I was told there was nothing the doctors could do … nothing … but most importantly, they could not write a script to allow my loved one to spend a week or so at a seeming Soteria-like healing home.
Especially since, decades ago, what a doctor told me, that a “safe smoking cessation med” (Wellbutrin, which is not even approved as a “safe smoking cessation med”) doubles the amount you smoke, not decreases it, and it certainly doesn’t help you stop smoking.
And when you’re inappropriately abruptly taken off of the non “safe smoking cessation med,” and suffer the common symptoms of antidepressant discontinuation syndrome in late 2001 … Oh, now all the so called “mental health professionals” claim ignorance that “brain zaps” are a common adverse withdrawal symptom of the antidepressants, until 2005 … then, in a very hubris filled manner, finally admit to their ignorance, thus to their complete and total lack of “professionalism.”
https://www.cambridge.org/core/journals/psychiatric-bulletin/article/brain-shivers-from-chat-room-to-clinic/642FBBAE131EAB792E474F02A4B2CCC0
And there is also medical evidence that the psych drugs increase alcohol consumption, whereas I still hear some good things about AA, a non-medical approach to alcohol discontinuation support – from both Catholics and Baptists.
Perhaps, the medical community’s greed (and especially the psychiatric community’s) problem, is usurping more control over society, than they can handle?
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If you want to understand why beauty, truth, insanity and natural health are the same time, check out that Icelandic nutcase Bjork. A good starting track is ‘Human Behaviour’. See how true the lyrics are and which perspective it is coming from – nature. Then check out her romantic Venus As A Boy and her utterly insane mimetic critique of our insane culture, It’s Oh So Quiet. It is not possible to understand either mental health or insanity without understanding Bjork because she was the nearest thing to a Janus headed Goddess who does both that we’ve so far had. I’m sure all babies will be like her one day.
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Ms. Lilly,
Under the catagory of the “broader bioethical debate”….exactly where does my addiction to prescribed antipsychotics, benzos, & anticonvulsants every 24-hrs for 12 years fall in this “temporal” & “…distinctive experience of time” ?
THIS “…. rupture in the relationship between an individual and the prevailing rhythms of society” seems to be completly ignored…as if it doesn’t exist at all….when it’s prescriber generated.
The ‘prevailing rhythms of society’ ie; “…normalized time” defined by psychiatric prescribers & the addictions they create, are ‘lifetime’, in my “temporal” experience.
When the article states “…addiction care can move toward a more humane and inclusive model that respects patients not only as individuals but also as knowers of their own lives”, it begs…no…screams the question of prescriber-caused drug dependence….the enormous, diseased elephant in the room, known intimately by the tens of thousands of targeted victims.
But THIS is the most offensive of all when including the countless psychiatric prescribers as ‘drug dealers’….
“Even the most damaging addictions can serve as a partial compensation for dislocated individuals… belonging to a drug-using community provides much-needed relief from constant social exclusion and aimlessness.”
The authors are blinded by hubris.
Unforgivable.
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Amen, and also the whole addiction sector is full of such people. No wonder the revocery rate of addictions are so appalling when you get all these arrogant self-appointed experts in the field rather then concerned human beings, i.e. human beings concerned to uncover and understand the actual problem, the truth of the problem and respond intelligently to it, which is so vanishingly few, and it would mean recognizing the sufferer as the true expert in what they are going through and potentially also a real expert in the actual concrete dysfunctions of a social system that turns punitive and commanding the moment you come unstuck in any way. I think there are people discussing these things seriously such as Dr Mate but we’re very far from recognizing the absolute sacredness of the real experiences and real lives of each human being. Thank you for voicing some of my rage.
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This is an excellent series of papers edited by a pioneering LSD therapist and is well-worth a read:
https://www.abebooks.com/Future-Time-Mans-Temporal-Environment-Yaker/116737382/bd
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