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In the wake of a buying binge, I am not a satisfied man.
Addiction is centrifugal. It sucks energy from you, creating a vacuum of inertia. A passion energizes you and enriches your relationships. It empowers you and gives strength to others. Passion creates; addiction consumes—first the self and then the others within its orbit.
nebbish
What I don’t say is, “I’m obsessed. I just blew in from the record store and can hardly wait to get through my work here so I can rush down to the car to listen to this opera or that symphony. Then, unless I go to the store to pick up more stuff, I’ll go home and lie to my wife. And I’m feeling guilty as hell. That’s how I am.”
No, I become increasingly and reflexively critical, irritable, and self-righteous with my teenaged daughter. The more I indulge myself, the more judgmental I am toward her. I can’t be optimistic and believe in her growth and development when I know I’m sabotaging my own.
My relationship with Rae loses vitality. Because my internal world is dominated by obsession, I have little to say, and what I do say rings hollow in my own ears. Because my attention is pulled inward, the interest I offer her becomes dutiful, rather than genuine. When I’m in one of my addictive cycles, it’s almost as if I were engaged in a sexual affair, with all the attendant obsession, lying, and manipulation.
Above all, I’m absent. It’s impossible to be fully present when you’re putting up walls to keep from being seen. Intimacy and spontaneity are sacrificed. Something’s got to give, and it does—sometimes for days, sometimes for weeks and months.
I hated myself, and this self-loathing manifested itself in the harsh, controlling, and critical ways I’d deal with my sons and my daughter. When we’re preoccupied with serving our own false needs, we can’t endure seeing the genuine needs of other people—least of all those of our children.
And the truth is that as of this writing, neither my public acknowledgments of my behavior nor my thorough understanding of its impact on myself and my family has stopped me from repeating the cycle.
“Doc,” having pushed his addicted patient to tell the truth, will now go home and deceive his wife, his briefcase stuffed with the latest haul of Sikora’s loot.
Tonight I will attend my first twelve-step group. I’m apprehensive. Do I belong there? What will I say? “Hi, I’m Gabor, and I am a …” A what? An addict … or a voyeur?
They’ve been racked by withdrawal pangs, their throats parched, their brains beset by terrors and hallucinations. How can I compare myself with them? Will it feel like I’m slumming? How can I mention my petty dysfunctions alongside the tales of affliction I’m likely to hear tonight? What right do I have to claim even the dubious distinction of being a real addict? Calling myself an addict in such company may be nothing more than an attempt to excuse my selfishness and lack of discipline.
It’s one thing to be on stage as an authority figure, addressing an audience on stress or ADHD or parenting and childhood development, and to acknowledge that I’ve had problems with impulse control over the years. In that context my public self-revelations are received as honest, authentic, and even courageous. It’s quite another matter to confess as a peer—to a group who have had a much closer confrontation with life’s gritty realities than I have—that I’m “powerless,” that my addictive behaviors often get the better of me. That I’m unhappy.
I feel instantly at home and I realize why: the hyperkinetic, ADD-like energy of this bunch resonates with my own.
Aha, surrender is not some abstract, airy-fairy, spiritual concept. It’s individual, and it’s practical.
That’s me. I resist emotional work and I do want immediate results. “A sense of urgency typifies attention deficit disorder,” I wrote in Scattered Minds, “a desperation to have immediately whatever it is that one may desire at the moment, be it an object, an activity, or a relationship.” If it doesn’t happen quickly for me, I feel like bailing, and unless I’m extraordinarily motivated, I often do.
“That’s when I got that sobriety is more than just the absence of alcohol. It’s a way of being. It’s living life in its fullness.”
Sometimes it feels like things are completely falling apart, like this week. But I no longer confuse stuff that happens with my life. This moment is okay, even when things are coming apart at the seams. Right here, right now, at this moment, things are okay.”
“You do belong.” Sophie explains that the meeting is open to everyone. “If you have addictive behaviors, this is the right place for you. Unless it’s marked with a C for ‘Closed’ in the AA schedule, anyone with a problem is welcome. The C meetings are for alcoholics only.”
Recent brain imaging studies have revealed an underlying disruption to brain regions that are important for the normal processes of motivation, reward, and inhibitory control in addicted individuals. This provides the basis for a different view: that drug addiction is a disease of the brain, and the associated abnormal behavior is the result of dysfunction of brain tissue, just as cardiac insufficiency is a disease of the heart.
In our day, it most commonly refers to a dysfunctional dependence on drugs or on behaviors such as gambling or sex or eating. Surprisingly, that meaning is only about a hundred years old. For centuries before then, at least back to Shakespeare, addiction referred simply to an activity that one was passionate about or committed to, gave one’s time to.
But the Romans had another, more ominous usage that speaks to our present-day interpretation: an addictus was a person who, having defaulted on a debt, was assigned to his creditor as a slave—hence addiction’s modern sense as enslavement to a habit.
“chronic neurobiological disease … characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.”
The issue is not the quantity or even the frequency, but the impact. “An addict continues to use a drug when evidence strongly demonstrates the drug is doing significant harm.… If users show the pattern of preoccupation and compulsive use repeatedly over time with relapse, addiction can be identified.”2
Many behavioral, nonsubstance addictions can also be highly destructive to physical health, psychological balance, and personal and social relationships.
the purpose of all addictions is to create an altered physiological state in the brain. This can be achieved in many ways, drug taking being the most direct. So an addiction is never purely “psychological”; all addictions have a biological dimension.
we need to avoid the trap of believing that addiction can be reduced to the actions of brain chemicals or nerve circuits or any other kind of neurobiological, psychological, or sociological data. A multilevel exploration is necessary because it’s impossible to understand addiction fully from any one perspective, no matter how accurate. Addiction is a complex condition, a complex interaction between human beings and their environment.
Addiction has biological, chemical, neurological, psychological, medical, emotional, social, political, economic, and spiritual underpinnings—and perhaps others I haven’t thought about.
Although tolerance is a common effect of many addictions, a person does not need to have developed a tolerance to be addicted.
a person’s physical dependence on a substance does not necessarily imply that he is addicted to it.
But you don’t have to be addicted to experience withdrawal—you just have to have been taking a medication for an extended period of time.3
Withdrawal does not mean you were addicted; for addiction, there also needs to be craving and relapse.
The addict comes to depend on the substance or behavior in order to make himself feel momentarily calmer or more excited or less dissatisfied with his life.
“The heart of addiction is dependency, excessive dependency, unhealthy dependency—unhealthy in the sense of unwhole, dependency that disintegrates and destroys.”5
the misconception that drug taking by itself will lead to addiction—in other words, that the cause of addiction resides in the power of the drug over the human brain.
Compulsive gambling, for example, is widely considered to be a form of addiction without anyone arguing that it’s caused by a deck of cards.
opioids prescribed for cancer pain, even for long periods of time, do not lead to addiction except in a minority of susceptible people.1
It is true that some people will become hooked on substances after only a few times of using, with potentially tragic consequences, but to understand why, we have to know what about those individuals makes them vulnerable to addiction.
If she becomes an addict, it’s because she’s already at risk.
It’s well known that many American soldiers serving in the Vietnam War in the late 1960s and early 1970s were regular users. Along with heroin, most of these soldier addicts also used barbiturates or amphetamines or both.
“The high rates of narcotic use and addiction there were truly unlike anything prior in the American experience,” the researchers concluded. “Equally dramatic was the surprisingly high remission rate after return to the United States.”5 These results suggested that the addiction did not arise from the heroin itself but from the needs of the men who used the drug. Otherwise, most of them would have remained addicts.
Most people who try them, even repeatedly, will not become addicted.
whatever a drug’s physical effects and powers, they cannot be the sole cause of addiction.
some people, a relatively small minority, are at grave risk for addiction if exposed to certain substances.
Statistics Canada reported in 2005, for example, that 4.6 percent of Canadians have tried crystal meth, but only 0.5 percent had used it in the past year.9 If the drug by itself induced addiction, the two figures would have been nearly identical.
The experience of caged animals does not accurately represent the lives of free creatures, including human beings. There is much to be learned from animal studies, but only if we take into account the real circumstances. And, I should add, only if we accept the tremendous suffering imposed on these involuntary “subjects.”
As we will see, emotional isolation, powerlessness, and stress are exactly the conditions that promote the neurobiology of addiction in human beings as well.
The Vietnam veterans study pointed to a similar conclusion: under certain conditions of stress many people can be made susceptible to addiction, but if circumstances change for the better, the addictive drive will abate.
Once the stress of military service in a brutal and dangerous war ended, so, in the vast majority of cases, did the addiction. The ones who persisted in heroin addiction back home were, for the most part, those with histories of unstable childhoods and previous drug use problems.14
Lack of meaning, not simply the dangers and privations of war, was the major source of the stress that triggered their flight to oblivion.
