A Guide to Treating Symptoms of Mental and Physical Illness (continued...)
PART III: Improvement Costs Little & Requires No Expertise
Addiction is defined slightly differently depending on who you ask, but the differences are mainly variations in emphasis or focus rather than true disagreements about the condition. Dr. Gabor Mate has famously said that “the opposite of addiction is not sobriety… it’s connection”. Dr. Andrew Huberman has defined addiction as a “progressive narrowing of rewards (things that bring you pleasure)”. In The Doctor’s Opinion, an opening chapter of the AA Big Book, the writers introduce Dr. William Silkworth’s famous characterization of alcohol addiction as a threefold condition: a physical allergy, a mental obsession, and a spiritual malady.
We know that there are people with brains abnormally sensitive to reward and abnormally deficient in normal processes of dopamine production (dopaminergy) and release and these people are physiologically what we call ‘addicts’. There is a great deal of confusion about the following point though: not everyone who develops a drug dependency or gets a DUI or ends up in inpatient addiction treatment is an “addict” of this type. We all have reward pathways and we all become physically dependent on many classes of drugs when they’re administered regularly. We all tend to make errors when calculating short versus long-term costs and benefits (depending, based on personality, to mostly weight immediate gratification too heavily). As my profoundly wise man I know has said “not everyone in rehab is an addict… some of them just need better pain management or trauma therapy or effective sleep medication or…[etc.]”.
Here I’m going to basically ignore the narrow psychiatric and medical definition of ‘addict’ (someone with brain abnormalities which make them feel anxious, insecure, empty and make them have an abnormally strong reward response to dopaminergic and serotonergic substances and behaviors) and use the broad definition: anyone who engages in behavior with long-term risks of harm or loss to gratify short-term impulses, often tied to psychological/emotional/spiritual deficits. By that definition almost every person in the modern world is an addict, to some extent. I believe that the problems of addiction are getting worse for our society and are, indeed, built in to the very way it now normally functions. Specifically: our society makes people feel insecure and lonely and anxious and envious and then sells them goods and services to reduce those feelings (briefly and imperfectly). This cycle (negative emotion or spiritual void followed by corporate consumption, followed by reappearance of the void, etc. ad infinitum) seems to be more ubiquitous and more serious for nearly everyone and for our society as a whole… and it seems to be more profitable for the sellers than ever before.
I remember learning that drugs could give people feelings of wonder and bliss and energy and focus (in elementary school) and immediately knowing I would consume them. Why would I not?! A pill to make a day feel grand and take away the boredom and pain which seemed to speckle my life? Why wouldn’t everyone take that deal? Obviously I learned about the medical phenomenon of craving and dependency but-I told myself-I was strong. Didn’t I forego adequate nutrition for weeks at a time while cutting weight for wrestling? Wasn’t I smart and logical? My reckless self confidence, combined with the impulsiveness and risk discounting of male adolescence meant that I fell into use of substances and behaviors headlong, in a way that seems frankly crazy to me now.
What I didn’t realize was the weakening and confusing effects of over-indulgence in reward behaviors. I didn’t understand that I was an addict (in the narrow sense of one with an abnormal brain and body). I also didn’t appreciate how indulgence in these behaviors tended to weaken self-discipline and control in all areas of my life and introduce justifications and self-deceptions… which would eventually become delusions. I felt invincible and superior and brash, as many adolescents do. It would take years of progressive struggle and failure to weaken my armor of self-assurance. When I want to describe the condition of serious drug addiction to others I often use the analogy of anorexia: we (addicts) know intellectually which behaviors are useful and which are risky or costly, just as the anorexic knows the value of nutrition and its basic requirements. When it comes time to make individual decisions, though, our brain equivocates and lies and dissembles… giving us the reasoning and excuses to do what we deeply want to do already (use drugs or starve ourselves). Those desires come from a deeper and largely unconscious part of the brain (the so-called “reptilian brain”) which is more fundamental and powerful than the values and reasoning and conscience of our frontal lobes. The delusion is the more insidious (and misunderstood) part of addiction, in my opinion… not the cravings.
Yet those delusions seem more and more common. The millions of adolescents who have ambitions to be social media influencers… despite the clear tendency for heavy social media use to damage mental health and identity formation in young people (especially young women); the rhetoric of “fat acceptance” and HAES (‘health at any size’) and intuitive eating activists (including medical professionals) that diets nearly always fail and that obesity isn’t a medical concern and that a preference for life as a non-obese person is “rooted in white supremacy” and is “ableist” or bigoted… or whatever: what else can these obvious post-hoc logical structures be called, other than delusions of those who are engaging in costly behaviors? If addiction is the habitual priority of behaviors which grant short-term pleasure or soothing at the cost of long-term health or balance or happiness, what else can we call a reflexive dependence on our phones or over-indulgence in sweets or fast food… or the instinct to isolate and avoid challenge and social anxiety in favor of Netflix, despite the clear mental health implications?
These are all extremely common behaviors. They’re so common that very few people that you or I know don’t regularly engage in one or more of them and there seems to be a progressive social emphasis on validating the urges and habits of the public, in the name of “reducing stigma”. I would submit that this emphasis is, at least partly, about weakening resistance to indulgence in behaviors which are enormously profitable for corporations. Fat activists uniformly complain about the “diet industry” but say nothing about the processed food or fast food or streaming service industries. In reality, they both make money: one side profits when you binge and lie around instead of going outside and being active… and then another side profits when your body inevitably gets larger and softer and you seek products and pills and exercise plans and devices and memberships to reduce your dissatisfaction and insecurity.
In Part IV of this article I will go into more detail, but I want to end with some very general claims:
The human body and mind evolved to eat and socialize and behave in certain ways and we can learn a lot about healthy lifestyles from investigating that “state of nature” (without dipping into the ‘naturalistic fallacy’).
This lifestyle is generally low cost. It demands time and focus and sustained engagement but it rarely demands expensive medications or specific diets or niche meditation practices. The changes are available to nearly everyone and they are not complicated or esoteric.
There is a massive complex of corporate interests which wants to convince you that this isn’t the case: that you need to be a vegan or go to GOOP conferences or take pharmaceuticals or use equipment to be happy. This, in general, is simply not true.
Simplify your life, be good to others, reduce impulsive and addictive dieting and consumption and leisure practices in favor of activity and sunshine and socialization and you may be able to live a happier life. Most people could.
Delray Beach, before sunrise, January 2024.
Waking up at a comfortable time and going outside (exposing your eyes to yellow natural light) helps regulate circadian rhythm and the production/release of serotonin, melatonin, norepinephrine, hydrocortisone, etc.
It will boost your mood and help you wake up in the morning, and sleep at night… and it costs nothing.
PART IV: Discipline = Freedom
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