Previous Addiction Models Have Failed
We’ve been misled by two failed addiction models.
The first (and worst) was the choice model, which claims addicts choose their condition. The theory goes: as free human beings, addicted people choose to consume drugs. Since addiction ruins lives, it follows that the addict is a moral failure. Believers in the choice model of addiction aren’t shy about making moral judgments.
"Addicts are bad people."
"The devil is in them."
And so on.
The second hypothesis is closer to the truth but still incorrect. This is the disease model of addiction. You've likely heard this hypothesis. It's been the dominant paradigm in recent years. The idea is that addicts are victims of a disease. Like cancer, addiction strikes. The proximal cause may be environment or lifestyle, but the root cause is always the disease. The addicted person is like any other patient. There are interventions that can help, but the addiction itself is a type of disease.
But both hypotheses have been miserable failures. If anything, we have more addiction now than ever.
What is addiction, really?
Dr. Gabor Maté is a world-renowned author, doctor, and therapist based in Vancouver. He's best known for his work around addiction and trauma and was a past guest on the Vancouver Real Podcast . Dr. Maté has been a lifelong healer and has done extensive work in family medicine and palliative care, but it's his groundbreaking work into addiction that has earned him the most attention.
We now know that addiction isn't a disease or a choice.
And Dr. Maté has a better explanation: An addiction was at one time a solution to pain that has now become a problem unto itself. He calls addiction the ‘stupid friend,’ because it wants the best for you and doesn't want you to experience pain -- much like a friend. But the addiction is stupid because it only provides a single solution. And the solution that once worked is now maladaptive and is causing more pain.
Those in pain will seek solutions to ease or rid themselves of the pain. This is one of the most basic components of human nature. Pain is debilitating. It colors everything we experience and destroys our ability to cope.
As a society, we easily understanding this about physical pain. Anyone experiencing pain knows how every other concern disappears until the pain is relieved. In many cases, only time can heal pain. So the sufferer is often stuck waiting. We put much of life on hold while we recover.
Or, we use medication to blunt the pain. The drugs make the pain go away. And this situation is often the beginning of opiate addictions. It starts with intense physical pain, which leads to doctor-prescribed opiates, which the sufferer begins to abuse to ease the pain.
Physical pain is easy to grasp, but we struggle to comprehend psychological (or emotional) pain. We don't have well-established mental models to guide us through this landscape. Of course, those practicing holistic healing modalities like floating, yoga, meditation, plant medicines, etc. are better positioned to grasp the reality of emotional pain.
We've constructed a false barrier between mind and body. Emotional pain is every bit as real as physical pain. And we don't engage in pain-soothing addictions. But we fail to notice when we're doing it. Why would we when these addictions are completely accepted?
If a friend were to snort a line of cocaine in front of you over morning bagels, you'd be rightly concerned. But we'll watch that same friend compulsively check his phone, drink four cups of coffee, or swipe Tinder without blinking an eye.
It's a matter of scale. We accurately recognize that the cocaine is a signal of immediate danger. But we fail to detect long-term danger. The digital addiction is destructive. Even though our friend seems okay, his compulsive online behavior is a now maladaptive. It will certainly hurt him in the long run.
We imagine crackheads in alleyways, meth users tweaking on the street corners, or heroin junkies curled up on the floor of a skid row flop house.
If your friend is digitally addicted, what about you? When looking at addiction with courage, we must go beyond casting judgement at others and look within.
The world is full of addictive opportunities. Because an addiction is 'acceptable' in polite company does not make it any less of an addiction.
What's the Cost of Addiction?
Caffeine addiction isn't as destructive as heroin. But it's misleading to claim that caffeine addiction is harmless. Human psychology is complex. We're only dimly aware of the consequences of our actions. Who are you when you're making caffeine-addled decisions? Would your best self make the same decision? Ever found yourself exhausted around mid-afternoon? This is widespread and damaging to productivity. Caffeine addiction is partly to blame.
Or what about the digital addict? It's a burgeoning social problem that will take years to understand. What's the cost in lost connection? How many parents ignore their child's needs while glued to a device? How many children never learn social skills because they live online?
There is always a cost -- even for 'minor' addictions.
Dr. Maté tells the story of his own workaholism, which led to him not being present with his family.
Using the trauma model, Dr. Maté's workaholism made sense. It was a subconscious strategy he used to sooth the pain of abandonment stemming from his childhood.
Born Jewish in WWII Budapest, Dr. Maté's life was under extreme stress and danger the moment he was born. Both Hitler's Nazis and the homegrown Hungarian fascists were on a mission to rid Hungary of Jews. And Dr. Maté's mother knew this.
In a desperate bid to save his life, Dr. Maté's mother found a Christian woman to care for baby Gabor. He was one year old at the time and attached to his mother. For babies, this attachment is everything. And getting passed off like a football could only be experienced as extreme abandonment to baby Gabor.
It wasn't his mother's fault, of course. Adult Gabor knows that she did the best thing, and may have saved his life. But the conscious mind has very little to do with trauma.
Trauma runs deep. Traumatic experiences imprint on babies' minds. Just because someone isn't old enough to consciously remember doesn't mean they won't develop trauma from the experience.
How Trauma Affects Us
Dr. Maté explains that when we have trauma, we react to the past event that's imprinted on our mind. Current events can trigger the reaction in us, but our behavior is a response to something that happened long ago.
You can imagine how negative this is to the traumatized person's life.
It might be helpful here to do a thought experiment. How well do you think you would do in life if you were completely incapable of responding to the present moment?
The alarm rings in the morning and you can't get up. Your mind is so incapacitated by trauma that you don't even hear the alarm. You are simply consumed.
Isn’t that a description of extreme depression or psychosis?
Of course, most traumatized individuals don't have this extreme of behavior. But who can't relate to overreacting or misreading another's intentions? The person whose father was in a constant state of rage will be sensitive to anger. The person who experienced childhood rejection will react strongly to minor (even accidental) slights that trigger the feeling of rejection.
These old, painful imprints lead many to self sooth. Those little endorphin hits you get from constant social media distraction... they work... in a sense. But before long the addiction sets in.
Many of Dr. Maté's patients described heroin as 'feeling like a warm hug.' These are people with extreme trauma who might never have felt real attachment or love from another human being. Extreme trauma is almost universal amongst the most desperate addicts.
Trauma Goes Beyond Addiction
Researchers have developed a framework for understanding childhood trauma called the ACE Score. ACE stands for Adverse Childhood Experiences. The ACE test measures for ten types of adverse childhood experiences:
Mother Treated Violently
Household Substance Abuse
Household Mental Illness
Parental Separation or Divorce
Incarcerated Household Member
Long-term follow-up studies have shown remarkable correlations between adverse childhood experiences and negative adult results. For example, four adverse childhood experiences leads to a seven-fold increase in alcoholism. An ACE score of six brings a 30-fold increase in attempted suicide.
And even the likelihood of experiencing chronic disease rises amongst those with high ACE scores.
The relation between mind, body, and disease likely won't surprise readers of this blog. As a community dedicated to holistic healing, we know the power of modalities that integrate mind and body. But the adverse childhood experiences studies add statistical relevance to our intuition.
Trauma based explanations are just beginning to take root in our culture. And there are millions of people practicing different healing modalities. Over time, scientists, practitioners, and individuals will continue to better understand how to heal trauma. This is an exciting time to be human. Thanks to individuals like Dr. Maté, we're learning how to optimize our minds and bodies with real solutions built for humans rather than industrial models of medicine.