Addiction
Other than Man’s Search for Meaning by Viktor Frankl, perhaps the most powerful book I have read in my life was In the Realm of Hungry Ghosts by Dr. Gabor Maté. I read (technically listened on Audible) this in preparation for my interview with Dr. Maté, which you can listen to below. For whatever it is worth, this is our most consistently watched podcast we have ever produced. Addiction is a highly searchable theme, we posit.
Here’s Dr. Maté’s definition of addiction. I think every word matters, and bears slow and mindful consideration.
Addiction is manifested in any behavior that a person craves, finds temporary relief or pleasure in but suffers negative consequences as a result of, and yet has difficulty giving up. In brief: craving, relief, pleasure, suffering, impaired control. Note that this definition is not restricted to drugs but could encompass almost any human behavior, from sex to eating to shopping to gambling to extreme sports to TV to compulsive internet use: the list is endless.
Note he doesn’t say “substance,” rather “any behavior.” Cell phone checking, shopping, gambling, etc. are just the tip of other examples — and there is a deep-seated reason that we need to escape in these, says Dr. Maté. But let me briefly touch upon the three other theories of addiction that seem most common before I get to his:
4 Theories of Addiction
Addiction is a character flaw. So, if you simply had more motivation, willpower, or moral constitution, you would be able to break whatever behavior or substance you were in the clutches of. This has been disproven so many times — and at many levels, it’s hard to even give it credence. But I’ll just take one area I’ve studied a good bit — willpower. Research study after research study confirms willpower isn’t inexhaustible. Think of it as a muscle. The more you use it, the more it wears down. If it weren’t the case, all those New Year’s resolutions we make: 95% of us wouldn’t quit them in January. We rely on willpower, which is a horrible long-term method 100x over, but some cultural resilience for this theory remains.
It’s the drug/behavior itself. Well, maybe. Certainly if I am addicted to shopping and you gambling, it’s highly probable I could abstain from gambling and you shopping. If not the case, any addict would be an “all-in” addict, and they would be in a really bad way from an early age. But that isn’t the case. So while there are a near-endless array of things we as individuals can be addicted to, we seem to have unique makeups that keep us away from most. If it were just the power of the substance itself, this would not be the case.
Genes. For a good run, this was the leading theory. But Maté brings up a really good point (actually, many points; I just would rather you read his book than me butcher it). If genetics were the cause of addiction alone, we wouldn’t see addiction on such a rise in the past 100 years. Or during the pandemic. The accurate word would be “epigenetic” — we all have genes that could be turned on to cause addiction. But we don’t have to turn them on, and many do not. And we can turn them off too. Much like with a healthy diet, we can turn off inflammatory genes that we may have turned on with unhealthy eating. Which brings me to Maté’s on/off switch.
An attempt to elevate the pain of unresolved trauma. I’m going to mostly quote Dr. Maté here, but I want to take a second to posit that, let’s say, you were addicted to something in your 20s. Don’t beat yourself up for it. Or even if you are addicted to something now. Again, the addiction isn’t the problem. The addiction is the attempt to solve the pain, and what causes the pain is the problem. Addiction to anything (say, running) is your mind’s adaptive attempt to heal the pain. It only becomes maladaptive when you want to quit and cannot. Which is when it becomes time to address the pain. If you can resolve the pain, so too can you resolve the addiction. Per Maté:
“Addiction is neither a choice nor a disease, but originates in a human being’s desperate attempt to solve a problem: the problem of emotional pain, of overwhelming stress, of lost connection, of loss of control, of a deep discomfort with the self. In short, it is a forlorn attempt to solve the problem of human pain. Hence my mantra: “The question is not why the addiction, but why the pain.”
And the source of pain is always and invariably to be found in a person’s lived experience, beginning with childhood. Childhood trauma is the template for addiction—any addiction. All addictions are attempts to escape the deep pain of the hurt child, attempts temporarily soothing but ultimately futile. This is no less true of the socially successful workaholic, such as I have been, than of the inveterate shopper, sexual rover, gambler, abject street-bound substance user or stay-at-home mom and user of opioids.
Not only is the urge to escape pain shared by all addicts, substance users or not, the same brain circuits are involved in all addictions, from shopping to eating to dependence on heroin and other opioids. The same brain circuits, the same brain systems involving pleasure and reward and incentive, the same neurochemicals—not to mention the same emotional dynamics of shame and lack of self-worth, and the same behaviors of denial and dishonesty and subterfuge.
It is time to realize, then, addiction is neither a choice nor an inherited disease, but a psychological and physiological response to painful life experiences.”
Is Dr. Maté 100% right? I don’t know. I know that the psychological and medical community is starting to bend more toward his perspective. But that isn’t the aggregate of all researchers. Is it something to deeply consider? I believe so. And I think, after reading In the Realm of Hungry Ghosts, if nothing else, you would invariably look at the over-eater, the gambler, the alcoholic, or anyone in an entirely different light. You probably wouldn’t see the addicted side of them at all, but be sympathetic to the hurt that rests inside that person, be it from childhood trauma, PTSD, etc.
I’ll end with a quote from the book: “It’s hard to get enough of something that almost works.”
If there is something in your life that “almost works,” I would strongly encourage you to listen to the podcast in this blog, and if that resonates to read In the Realm. Because I think that book might be better than “almost.”
– Mike Spivey
We are our own happinesses
We are our own griefs
We are our own remedies