July 16, 2024 • 42 mins
This episode of How to Be an Adult, the first of two parts, features a very special guest: Marc Lewis, Ph.D., psychologist, academic and bestselling author of Memoirs of an Addicted Brain and The Biology of Desire. Marc joins Luke in our studio to discuss how popular models of addiction are flawed, and how we...
The post About Addiction, with Marc Lewis (Ep. 16, pt. 1 of 2) appeared first on The Morpheus Clinic for Hypnosis.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
When I'm trying to get someone to stop
using alcohol or heroin
to kind of resolve that inner debate or
ambiguity in the climate. Addiction I understand since
I had it myself in my 20s. I
struggled with an opiate addiction. It seems like
we've all accepted the idea that we can't
just be, and we've always gotta do or
consume something, or else we're not Welcome to
(00:22):
How to be an Adult, a podcast created
by the practitioners at the Morpheus Clinic For
Hypnosis in Toronto, Canada. This is a show
for people just like you who've inadvertently become
adults
and don't know what to do about it.
I'm Luke Chao, and today I'm joined by
a very special guest, Mark Lewis,
author of best selling books like the Biology
(00:42):
of Desire.
He's formerly a professor at the University of
Toronto.
He's a cognitive scientist and a neuroscientist and
a psychotherapist in private practice.
He's the author of close to 100 articles
about development of psychology and especially to the
public
the field of addiction.
More specifically,
(01:03):
he advocates
against the medical model of addiction that I
think we can agree disempowers
the people it's supposed to help.
So Mark welcome aboard. Thank you. You're welcome.
Thank you. Let's begin with this. Would you
like you who are me
to try to summarize your views on addiction
in a couple of sentences?
(01:24):
So so generally, what I have been writing
about and arguing for for years now,
almost 10 years,
is the idea that
rather than think of addiction as,
a disease, a a brain disease, a pathology
per se. Think of it as,
a psychological habit, a cognitive habit, a very
(01:47):
strongly emotional habit, a habit which is
motivated by intense emotions and therefore becomes deeply
ingrained, deeply entrenched,
And partly for that reason, it's extremely hard
to break even though you certainly understand at
some level that it's not doing you any
good and in fact might be making your
life into a horrible mess, might become extremely
(02:09):
boring and destructive in in various ways.
And trying to understand what's the value of
substance use or other kinds of addictive practices
that make it,
hard to give up, not only because it's
a habit, but also because it's doing something
for you. Something that you're not able to
do as well,
or as,
(02:30):
reliably in the rest of your life. So
really looking at it from the point of
view of the science, the psychology, but also
from the person's point of view, the person
who is using substances
and having a hard time stopping. Well, all
of us who have even a
light addiction to our phones or to social
media,
let alone something like alcohol or cigarettes or
(02:51):
gambling,
your explanation of addiction seems just simply intuitive.
It matches
so many people's actual lived experience
Mhmm. Of what it's like to to to
find it impossible to put on your phone
or to
tell yourself
erroneously that you need a drink just because
you're going through a breakup when actually what
(03:11):
you need is something like love instead.
How did it end up being
that the predominant
model of addiction is a disease model,
which is so counterintuitive,
not just to me as a hypnotherapist or
to you as a psychotherapist and a scientist,
but to, I think, even members of the
public
whose experiences of addiction are are not
(03:33):
one where they become some kind of fiend
that's controlled by some kind of demon. I
would hope not. Yes. No. There was a
time in the 19 thirties, forties, fifties when
that was in fact the kind of public,
vision, the optics, the idea that addiction is
like a fiend. Mhmm. And and it it
was,
(03:54):
represented by, you know,
pictures of people doing
horrible back things or seeing their shadows in
the background where they're playing with needles and
so forth. And often in those days, black
people. People who had,
for whom
institutional racism was already making some pretty strong
negative points. Mhmm. And here's another thing that
(04:14):
they're doing. Yep. So there's all that. But,
you know, in answer to your question, I
think
the idea that addiction's a disease, it wasn't
motivated by ill intent. It was motivated by,
I think,
a positive wish to take the blame, the
the the stigma, the responsibility
off of the shoulders of addicts
(04:35):
and rather to say, hey. It's not really
their fault. They don't mean it.
Okay. So how do you do that? Well,
one way to do it is by saying
they've got a real problem. Let's call it
a disease because we know the people who
have diseases aren't responsible for whatever it is.
Mhmm. And so that was a way to
try to make it easier
to not be
(04:55):
cornered and persecuted for the
activities that went into addiction. Well, it seems
almost like
if a kid's got their hand in the
cookie jar again
Yeah. And by their own free will, they
put their hand in the cookie jar and
then the very compassionate
overly empathic
dad or mom says,
(05:17):
oh, no, son. It's okay for you to
eat all those cookies. It's not your fault.
It's my fault, not yours Mhmm. That you
got your hand in cookie jar. Doesn't that
seem to stunt a person's development?
Well, it certainly takes the responsibility
away. It does. Yes. So in that respect,
yeah.
It does. So Which for a 4 year
(05:37):
old is not a bad thing. Because, like,
what we advocate for for kind of, you
know, recognition
that
each of us is the captain of our
own ships.
Right? And it's true. We don't control the
winds or the waves. So later, we're gonna
talk about how, for example, disability or poverty
might impact one's ability
to cope with life and perhaps susceptibility
(05:58):
to to addiction. Mhmm. So we don't control
everything. It's not like we can each independently
just be an island. That's for sure. But
at the same time, it's
the very opposite is not true either. It's
not like we completely lack agency. Right. And
there almost seems to be this implication
in a lot of the discourse around the
disease model of addiction. Mhmm. That
(06:20):
an addict
in a more modern version of the fiend
lacks agency.
Mhmm. Did you perceive the same thing? Or
Yeah. That's pretty close. Yeah. In fact, when
I give talks, I often show a slide
that
presents a billboard on the side of the
highway in Massachusetts. I think it is showing
(06:41):
5 or 6 people who look
moderately
content but not very happy
and the slogan is,
it's a disease. It's not a how does
it go? It's not a choice. It's a
disease.
So what they're saying, you know, the subtext
is clearly that, you know, it's not our
fault. Mhmm. And they're looking kind of like,
(07:01):
well, it's too bad this happens. This is
really a drag, but, hey, it happens.
Well, it's also kind of the view
underlined
by AA
where one of the the 12 steps or
12 tenets is that you have to kind
of,
acknowledge
or admit that you've lost control over the
addiction and that you gotta give yourself up
(07:23):
to a higher power. That's right. And that's
never quite sat well with me because, at
least in my experience, we're working with my
clients to primarily primarily to quit smoking, but
also to, you know, to stop overeating food
or to not drink so much. Right. The
experience seems to be the more I have
my client take agency,
the better the outcomes are. Yeah. Whereas if
(07:43):
they just kinda give themselves up to the
addiction, to the feelings, to the impulses,
that seems very counterproductive
to the goals that they have.
Yeah. How the heck is it that AA
and the disease model
have become such popular models of how addiction
works when we're on the same page. And
I think a lot of our listeners in
(08:03):
their own experiences, even even if they've never,
like, used hard drugs, in their own experiences,
it seems like
they they do have choice and it's detrimental
to deny
that choice that they each have.
So I argue that a lot and I
talk about how a sense of efficacy
of self empowerment can be a very, very
(08:25):
powerful tool in overcoming addiction.
And and to put it simply, it's like,
I'm really sick of this. This this is
a shitty life, you know, life experience. I
don't like this. I don't wanna do this
anymore. I'm gonna make it. I'm gonna stop
it. And how do I do that? Well,
let me see. I could go see a
therapist. I could do this or that. I
could become involved in other activities. I could
make other friends. I could become involved in
(08:47):
in other social,
contexts.
And one way or another, they find a
way. And the statistics show very clearly that
most people who are addicted to anything,
including heroin,
or these days, Fentanyl, I suppose,
do in fact
stop. Mhmm. I was gonna say recover because
that's the coin of the realm, but I
don't like the word recover because it's got
(09:07):
this very strong medical
ring to it. But they do stop and
they stop,
mostly without the help of any kind of
formal treatment. In fact, the conventional
rehab setting, rehab and addiction treatment centers
have a very notorious history of not working
well. Costing a lot of money and the
revolving doors that, you know, means that you're
(09:29):
gonna be back again in 6 months or
a year or 2 years and so sorry,
guy. Mhmm. Wish we wish we could help.
There's almost this cruel irony
that
the practices, the paradigms, the philosophies
that make the most money
are the ones that are disseminated most widely
(09:50):
and often end up being researched more most
completely or at least publicized most completely. Publicized.
Yeah.
And the practices
that are impossible to monetize like quitting cold
turkey
seem to get no publicity
and then no research money.
Right. And it can be cold turkey or
it can be gradual. There's an awful lot
(10:10):
of ways to overcome addiction.
Sometimes, you know, it's it's complete abstinence. Sometimes
it's not. Sometimes it's controlled use. Sometimes it's
gradually decreasing Yep. Tapering use. But I think
we have to be careful about,
you know, the pointing of the finger here.
AA doesn't make any money. AA is
famous because it's free. Mhmm. And it's been
(10:31):
around since the thirties and,
it's extremely
useful and attractive to people who can't afford,
any kind of formal
medically oriented treatment.
So that's where they go. And AA does
work for some people. I mean, the, you
know, the the estimates are anywhere from 5%
to 35 or 40%. Mhmm. That's not too
(10:53):
terrible.
Mhmm. But 5% is not very good. I
mean, a lot depends on context. The the
nature of the group, the makeup of the
group, the relationship with the sponsor, the kind
of drug, the kind of other societal,
factors that you alluded to,
you know, which might might include economic and
social and prejudicial and race racism and all
(11:15):
kinds of things.
But anyway, long story short, AA
sometimes works. And
AA doesn't fit with a disease model perfectly
either. It was kind of a strange marriage.
So AA came came along the idea that
you can't make it go away. You can't
make it stop. That is that you have
to admit that from the, you know, from
the get go. However, you can control it
(11:37):
and you need to control it and you
must control it. Like if you're a diabetic,
you need to take your insulin. Mhmm. Okay?
So there's that.
But
but also the disease model, you know, the
implication that this is something that needs to
be treated
by a medical establishment
and can be addressed with certain drugs, with
certain pharmaceuticals, for methadone and Suboxone, and so
(12:00):
on and so forth. Naltrexone
is now a big deal. So, you know,
that doesn't fit with the philosophy of AA
very well at all. Mhmm. And a lot
of what treatment centers do and have done
for the last 50 or 75 years or
so have been to kind of merge the
2. The 12 step approach on the one
hand, cognitively, behaviorally,
and also the idea of being in a
(12:21):
group, the idea of fellowship.
Really important.
Fellowship. It's got nothing to do with the
disease model. You're not gonna do any better
if you're with a group of fellow diabetics.
Mhmm. Right? I can take your insulin. Yeah.
But but AA, the fellowship idea in AA
is really fundamental. It's really intrinsic to how
it works. So so somehow, this kind of
forced marriage took place in in
(12:45):
rehab centers that sprang up all over the
US, especially in the fifties sixties seventies,
merge these two models together
and tried to make a kind of coherent
integration between the 2. Right. Well, my my
read of AA
is that
it works
despite
each member having to kind of deny responsibility
(13:08):
or give up agency. Mhmm. It doesn't work
because of that. It works because of the
fellowship that you mentioned Mhmm. And the social
support.
Mhmm. One kind of mental model of addiction
I'm kinda playing around with inside my head
is that whatever it is that gives people
that that kind of dopamine hit, which I'm
sure is oversimplified, but whatever gives them that
nice feeling. Mhmm.
It's it's a poor substitute
(13:31):
for
the authentic
kind of connection and camaraderie,
even affection and love Yeah. That we get
socially. This is why the opioid crisis in
the US is so oftenly found
among lonely rural men. Mhmm. It it's because
if if they had loving families, if they
had lots of of friends Mhmm. They'd be
less susceptible to addiction. Yeah. And AA kinda
(13:55):
gives people that sense of community and fellowship
and camaraderie
that, well, unfortunately, methadone does not. Right. And
then methadone kind of, you know, hits the
neurotransmitters
correctly.
Yeah. And the fellowship, you know, just kinda
might do that obliquely.
Yes. So that's I don't know how educated
(14:15):
that reading of AA is, but, you know,
at least from my perspective, that's kind of
how I interpret how how it works.
I think that's a big part of it.
Yeah. I think that's not a bad way
of putting it. And the idea of fellowship,
camaraderie,
and,
feeling cared for, feeling that sense of belonging
really is fundamental. Yeah. And for any form
of addiction,
(14:37):
you know, I think it was put very
simply by Johann Hari. Do you know who
Johann Hari wrote a book called Chasing the
Scream, which is a wonderful book,
about the war on drugs. Mhmm. And Chasing
the Scream
pertains to,
what was his name? The the first guy
who was the head of the DEA, the
drug enforcement agency in the US, heard some
(14:58):
woman screaming down the hall. She was a
morphine addict and I suppose she was coming
off morphine and she was screaming and he
was chasing the scream. He was going to
put a stop to this this kind of
stuff. Right?
Anyway, whatever. It's a wonderful book. It's a
beautiful narrative, and what Yohan Hari says and
this is,
this is highlighted in his TED talk. So
if you don't have time for the book,
(15:18):
you should go get to the TED talk.
Johann Hari, j o h a n n
h a r I. And what he says
is the opposite of addiction is not sobriety.
The opposite of addiction is connection.
So there it is. I'm completely in agreement.
Yeah.
So, yeah, in a way, most addictions
(15:39):
and even addictions,
you know, we can sort of understand with
opioids and alcohol,
they do connect with opioid receptors and help
us to feel more relaxed and more comfy
and cozy. That's an addiction I understand since
I had it myself in my twenties. I
struggled with an opioid addiction for years.
But even people who are addicted to cigarettes,
(16:00):
to tobacco, or psycho stimulants, cocaine, or methamphetamine,
Although it's not cozy and comforting per se,
it does make you feel that you belong
with or to
a a drug, really. This is my familiar
experience. This is my world which I can
go into whenever I want and feel taken
(16:20):
care of and feel safe, you know, and
that's a big deal.
And, of course, that is indeed,
an alternative. It's a substitute for feeling cared
for or feeling like you belong with a
social or familial. And it's always a poor
substitute because cigarettes can never love you. No.
Even a even a dog, a cat can
love you. Yes. Right? And, of course, a
(16:42):
friend, a partner, a child by the way.
I don't know about cats. No. No. I
I definitely do know about cats.
But but, like, even like a hamster. Right?
Even a hamster
can like cozy up next to you Yes.
And cuddling. Yeah. And a hamster therefore is
superior to a cigarette.
Yeah. I mean, I know what you're saying.
Yeah. Yeah. Well, so I I work with
a lot of smokers. At this point, I'm
(17:04):
not even surprised if it's over a1000.
And so frequently,
I hear that cigarettes give companionship. Uh-huh. Cigarettes
give
my client a sense that
they have a friend and then quitting smoking
almost feels like they're betraying a friend or
abandoning a friend. Or abandoning. Yes. That's why
(17:25):
I really have to make the point that
your friends are not trying to kill you.
But cigarettes aren't trying to kill you.
Well, I mean,
the the the the the We anthropomorphize it
and say, yeah. Well, in fact, yeah, they're
really bad for you, and they are going
to increase your chances of dying from various
diseases for sure, but they're not trying to
(17:46):
get So it's fair to to give all
the agency
to the human being Yeah. In the equation.
I know you agree with that. And yeah.
Yeah. So you're right. I am anthropomorphizing cigarettes,
but when my client
anthropomorphize
a cigarette Yeah. But describe them by describing
them as a friend. I mean, we must
further that analogy
For sure. By painting,
(18:06):
you know, the the feelings that they get
from tobacco as a treacherous,
traitorous kind of friendship and not actually the
real thing.
Yeah. I know. You and I have talked
about this before a few times, and I
think we agree,
in a lot of ways. I think there's
an awful lot of overlap between our perspectives,
but it's not total overlap because I think
(18:28):
you feel much more absolute about that than
I do.
And I think, for example, of
a good friend of mine named Sean Shelley.
He,
he struggled with his own addiction in Cape
Town, South Africa,
and he's fine with me saying that. He
he talks about it all the time. He
after he gave up, on crystal meth, he
(18:49):
got his PhD, became, involved in all kinds
of,
agencies and bodies that were trying to help
people who had addiction problems throughout Africa. He
actually served on the United Nations, Committee For
Drug Reform. Mhmm. He's done a lot of
wonderful work and, you know, came a long
way, so to speak. However, he he talks
about what, for example, smoking heroin does for
(19:11):
young black men in Cape Town, and it's
not evil, and it's not, you know, it's
not,
what's the word, malicious or malevolent.
It's rather it's a social habit that does
involve a chemical influx, but it's also something
they do together
makes them feel
like, well, we talk about alcohol as being
(19:32):
a social lubricant.
Like, there's something to that. Right? Yeah. And
opioids are also a social lubricant. In fact,
opioids, when you give opioids to rats and
mice, they,
they have more fun together. They play more.
They really do. Yeah. So, you know, opioids
soften edges. Yes. Okay. So let me explain
the absolutism.
(19:52):
It's actually more in language than it is
in thought. Okay. Because
I'm not a prohibitionist. Yeah. I I actually
have
no,
disdain for and
I don't think that drugs are all bad.
In fact, I think that the resurgence of
psychedelics recently,
(20:12):
as a possible treatment for PTSD, for example,
is a very good thing. Mhmm. And Ketamine,
for example, could be used recreationally or it
could be used therapeutically. Right. And, of course,
cocaine and heroin originally had therapeutic uses.
So, like, I'm not I'm not one to,
like, demonize drugs. Right. The reason for for
the
absolutest speech is because for better or for
(20:35):
worse,
the less room you'll leave for doubt when
you're communicating,
the stronger the point you make. So I
guess,
you know, for this kind of academic conversation,
you know, I'll just add in the asterisk
Yeah. That, you know, I'm not I'm not,
like, against
the
responsible and informed
use of drugs in a way that's legal
(20:57):
for your jurisdiction. Mhmm.
Okay.
But yeah. When I'm when I'm trying to
get someone to quit smoking,
then I do have to speak in an
absolutest way. I believe that. Or when I'm
trying to get someone to stop using alcohol
or heroin
to kind of resolve the inner debate or
ambiguity in the client's mind. Mhmm. You know,
(21:18):
I'd as a hypnotherapist,
I kind of had to give one clear,
unambiguous,
neatly packaged idea Mhmm. As simplistic as the
idea would be if we kind of try
to unpack it in more of a
scholarly kind of context. I can see that.
I mean, as a clinical psychologist, I often,
you know, will use words and ideas also
(21:39):
in a way that's intended to help people
think and feel a little bit differently about
whatever it is they're engaged in that seems
to be harming them or blocking them. And,
no, you're right. It's not an academic,
you know, point that you're making. You're not
trying to make a foolproof argument proof point.
So it's a different yeah. Well, I kinda
feel like keeping in mind that, you know,
some of our listeners are are kind of,
(22:01):
they're kinda tuning in because they they can't
afford,
hypnotherapy or psychotherapy. Right. They they can't, like,
afford rehab for sure. Mhmm.
So, yeah. To kind of see,
let's say, tobacco Mhmm. As
a trader and not a friend is gonna
help in one's journey to to quit smoking.
Yeah. I can do that. Yeah. So that
(22:21):
that that that I'm not actually as black
and white of a thinker as to what
I communicate. That's true. Yeah.
Yeah. And, certainly, I'm not anti drug. I
mean, there's, like, uses for almost every drug.
And I wouldn't I don't even draw a
line between what you might call recreational and
therapeutic use
because
there is no clear line Mhmm. And especially
with psychedelics.
(22:42):
I mean, psychedelics, if you wanna think of
it as treatment, think of it as a
treatment for life in our current right?
The cosmo follows an age because psychedelics help
you connect with nature and think about your
role in the universe. And Mhmm. Do you
wanna call that treatment or it's not treatment
or, recreational, it's something else. Something's hard to
define. Yeah. Well, in previous episodes, we we
(23:04):
we've kind of
spoken against the mind body dichotomy Mhmm. Where
it's kind of this artificial
divide
to say we can, like, just treat the
mind Mhmm. Or we treat the body independently
of the mind. Well, no. Yeah.
You know, like, anything that you put in
the body, it's gonna affect your mind. And
if you think in certain ways, it's gonna
(23:25):
affect the body too. Yes.
So yeah. We're,
you know, each one individual organism
at its, you know, kind of a fictitious
concept
to divide mind and body. Yeah. I agree.
Yeah. It's way too neat. Yes. It doesn't
really make much sense if you think about
it a little bit more. Yeah. So
you've been, kind of trying to challenge the
(23:47):
the medical model of addiction Mhmm. And with
some success, considering how many books you've sold,
Mhmm.
I'm sure that along the way you've gotten
some pushback. I'm sure along the way you've
kinda rubbed people with a profit motive in
the wrong way.
So how's this journey been like? How successful
have you been in kind of like helping
others to overcome the the the the stigma
(24:07):
of drug use or the idea that it
is a disease as opposed to a learned
habit? Mhmm.
There's been certainly pushback.
Generally speaking, I think my
my argument, my view, my perspective has been
taken well. And a lot of a lot
of people are saying, yeah, that makes sense.
(24:27):
Okay. Got it. I'm not the only one
who takes this position. There's there's quite a
number of other people who sort of addiction
scholars or addiction,
might might be doing research in addiction or
might be doing clinical practice related to addiction
who also feel that the medical model has
gone in the wrong direction.
And
so the pushback that we have gotten, some
(24:50):
of that come it comes from all different
sources. For example, whenever you kind of perturb
a societal habit, you know, you're gonna get
some kind of crap from somewhere, from maybe
from many places. So one source of that
for me was in the US, especially where
I give talks sometimes,
it's like people say,
if we don't call it a disease, then
we can't get medical insurance to cover the
(25:11):
cost of treatment.
Yeah.
Sorry about that. That's actually
a political and economic issue. It is not
a psychological issue. It's certainly not a scientific
issue or a biological issue. You wanna talk
about your health care system? Yeah. It's pretty
stuff. The, American health care system obviously epitomizes
certain real problems where profit and,
(25:33):
healthcare,
you know, meet head to head, not in
a very satisfactory way.
So, yeah,
Sorry about that. You need a name for
this, so then you can throw money at
it or get the insurance companies to throw
money at it. Same thing for a lot
of other things by the way,
racism.
Now, we have anti racism. So now, we
(25:54):
can support
research dollars for anti racism or clinical or
institutional practices
for anti racism because we've given it a
title. Terrific.
Bullying. Again, anti bullying programs.
Domestic abuse. Right? Child abuse, all kinds of
abuse has now gotten very much highlighted and
entitled and now it sorry. I don't mean
(26:16):
entitled. I mean, given a title, given a
category
heading label
makes it easier to pinpoint it and to
say, okay. This is how we need to
deal with it. Whether it comes from a
source of contributions, whether it's monetary, whether it's
governmental, institutional, legal, whatever it is. It helps
you, you know, focus on the problem and
(26:36):
try to do something. But so in that
respect, I see the argument.
Right. If I take away the label, what
are we gonna call it? How are we
gonna deal with it? Well,
like you and I have been talking about,
it's a much broader issue than just a
person's
relationship to particular substances or activities.
Whether it's booze, whether it's drugs, whether it's
(26:56):
gambling,
whether it's porn, whether it's phone use, whether
it's Internet use.
There are so many kinds of addictive activities
and,
it's completely intermingled with the rest of our
psychological and social lives. Mhmm. It isn't a
distinct phenomenon or a distinct category. So don't
even try. Mhmm. There's better ways to understand
(27:17):
it. Yep.
One pattern I've noticed
among people So, you know, you you mentioned
porn. There's alcohol. There's all sorts of drugs.
One pattern I've noticed 2 patterns, actually.
One of them is that
it seems like we've all accepted the idea
that we can't just be, and we've always
gotta do or consume something or else we're
(27:39):
not good enough. Yeah. That's part of it.
Yeah. And that's tied in
with this idea that
we shan't love ourselves because it's arrogant
or because it's gonna,
I guess, divide up a finite amount of
love as though we don't generate more of
it ourselves. Mhmm.
But it's almost like
this, at least these two views
(28:01):
Mhmm. Seem to exist in every client I
have
who
smokes cigarettes or drinks alcohol. It's where, like,
they can't just sit alone with their own
thoughts like a monk on a mountain top
feeling their hearts and feeling loving kindness. Yeah.
And you might say I'm overly simplifying things,
and I I would admit in some ways
(28:21):
I I am. Mhmm.
To to say that if only we all
learned how
to quietly sit with our own thoughts. Yeah.
But but being a monk on a mountain
top is not gonna be the way for
most people. But here's the cool thing. We
don't actually have to seclude ourselves with civilization.
Mhmm. When we each have private homes or
(28:43):
at least bedrooms,
we can all retreat into it. Even in
a city, we can put on our, you
know, noise cancelling headphones. Yeah. We could close
our eyes. We could pretend we're on a
mountaintop. So I'm just kinda painting an image
with a mountain top, but the idea is
wherever we find seclusion,
wherever we find privacy and quiet, is our
mountaintop.
(29:04):
And, you know, so it's no excuse that
there's no mountain in sight in downtown Toronto.
We're like, even in in like, we're in
the downtown core right now. We're actually not
far from one of the busiest intersections in
the city. Mhmm. It's actually also very quiet
in here because we boarded up the windows.
Right. So this is like a an example
of a mountain top in here. Yeah. Now
(29:27):
let's say here
I'm breathing deeply enough.
Mhmm. I'm looking to wear the glass is
half full in life. Mhmm. I'm thinking of
those I care about.
I'm generating within myself
nice, warm, and fuzzy
feelings. Mhmm.
Right? Now, I'm I'm kind of losing my
(29:47):
desire to go play a video game. Mhmm.
I'm losing my desire to catch up on
the latest episode of the show I might
be watching on Amazon Video. Right. Right?
I I I try to introspect
to understand humanity.
It's under the idea we have more in
common than we have differences, and I, you
know, can examine myself way better than anyone
else. So, you know, if I ascertain that
(30:10):
a practice seems to help me, then
plausibly it could help another.
Yeah. So I kind of imagining that if
I only were to teach people how to
find their version of a mountain top,
to be with
wear the glass is half full for them,
to breathe deeply enough, to think of those
they do care about, then they're gonna start
(30:31):
losing their desire to have to consume, to
have to do, to have to to, you
know, fill in the void because the void's
being filled in with the the good things
I'm having them think about.
Do do do do do you think that
love is an adequate solution?
That's the question.
I I think there's an awful lot of
stuff that
compiled together
in in your perspective there. And I I
(30:53):
think in many ways, I do agree.
Well, the two main things are, I would
say, sort of mindfulness capacity to reflect and
to have some silence so you can reflect
on your own thoughts and not take everything
as a given and not just rush into
rush along with capitalist enterprise and be a
(31:14):
cog in the machine or a brick in
the wall as Pink Floyd Mhmm. Put it.
Right? So, yes, that kind of mindfulness is
super important.
That's a little bit different than the sort
of practice of love and kindness and goodness,
which, yeah, that's another way of fulfilling
our potential as people.
Both of them can help us not require
(31:36):
other kinds of input and other kinds of
busyness.
The busyness thing, you know I mean, back
when I was when I was being,
supervised as a grad student in psychotherapy techniques,
I studied psychoanalysis
and stuff. They called it the manic defense.
There There's something called the manic defense. It's
really simple idea that of all the defense
mechanisms,
(31:57):
being manic
is kind of like the default. It's the
basic one.
Because by going after goals and doing,
you know, achieving,
whatever it is that you're going after and
moving towards or away from
very particular things in the world,
you are feeling,
(32:19):
feelings of connection, involvement, and utility that are
really good to feel.
So what about that? Well,
we don't necessarily wanna get rid of that
because, you know what, every
baby needs to feel that in order to
pull away from mom and dad and to
go reaching across the room, and learn to
crawl, and grab at things, and pull them
(32:39):
off the shelf, and suck on them, or
play with them. And all of cognitive development
requires that kind of manic is a strong
word, but it requires going after goals. Mhmm.
So how is addiction different?
It's somehow it is like a white noise
machine. It's kind of it
it blocks out other forms of connection.
(33:01):
Mhmm. That's that's what I would say. Right?
So
yeah. So the kind of connection you get
by pursuing normal goals, so to speak, like
good goals, goals that are interesting and novel
enough to be, you know, worth thinking about,
gets replaced by going after the same thing
day after day or hour after hour or
month after month or year after year. That's
(33:23):
a whole different kind of enterprise. That's not
just being too involved in activity and not
having enough time to reflect. That's there's a
kind of intrinsic
boringness to that.
Repetition numbs you. Right? It turns off a
lot of aspects of having a well functioning
mind, brain, and heart.
(33:44):
But as for the role of love, I
mean, you and I agree about that.
Feeling love for other people, feeling that connection,
concern,
care, respect,
and for oneself,
fundamental practices,
practices,
strange word, fundamental way of connecting,
with other people that is tremendously fulfilling that
indeed feels really good. And by the way,
(34:05):
yes, it does actually stimulate opioid receptors.
In fact, mother's milk has opioids
in it. So,
when I use the word love,
I'm not talking about like romantic love, which
is highs and downs. Right? It's it's
it's a little artificial,
and it's seldomly lasting.
So I took a Vipassana meditation course,
(34:28):
one of the 10 day Goenkara retreats Okay.
Many, many years ago. In fact, 2 weeks
before I opened the board of his clinic
for hypnosis, and I got back and I
opened up. I rent out this office, which
is now our studio Yeah. And I opened
it up 2 weeks after I got back
from that retreat. Right. But,
the term is loving kindness,
which is an English translation of of the
word meta,
m e t t a. So what when
(34:50):
I mean when I talk about, like, sitting
quietly
with your own
thoughts Mhmm. And feeling your own heart and
causing your own good feelings that way, I'm
not really talking about, like, pursuing romantic love
or even, like, parental love or love for
a child or even love for, like, a
cat or a dog. Right. I'm talking about
loving kindness that's for all human beings. Right.
(35:13):
And that one can feel when he's he
or she is on their own. Yeah. And
I would say also that that kind of
love, and yes, it meta, that Buddhist term
covers it. It's
there is something that is intrinsically connects that
with mindfulness.
Because to love in that way, whether it's
someone else or yourself, you need to get
them. You need to actually think about what
(35:34):
it's like to be that person. What's it
like for you? I don't know what it's
like for you. You have a very different
life than I do, of course.
And what's it like for people of other
genders or races or economic conditions and all
that stuff requires a certain amount of reflection
and thoughtfulness,
which to me is pretty close to mindfulness.
It's like, you know, what's it like? And
(35:55):
also when we are loving ourselves, caring for
ourselves,
I use a kind of psychotherapy now in
in my psychology practice called, internal family systems,
which is getting quite popular these days. It's
IFS is the acronym. IFS,
Internal Family Systems.
First thing I always tell people, it's not
family therapy.
No. That's a misnomer.
(36:17):
The internal family is this, the family of
parts or voices, they call them parts of
ourselves.
The part that is craving
fulfillment,
like the addictive part, give me more. The
part that is critical,
you're being an idiot. I can't believe you're
doing that again. What a jerk. You know,
the part that whatever. There's a number of
(36:38):
different parts of us that just pure needy.
I feel alone. I need to be cared
for. The part that, you know, all that.
Okay. So what about that?
It's kind
of analogous
to the way we need to understand other
people is to really consider them. What's it
like to be you?
What's it and then in IFS, it's it's
(37:00):
it's astounding the way it works. In IFS,
you kind of look at your parts very,
you know, very, deliberately
and say, what's it like for you internal
critic to be this
critical mean, you know, accusatory
part of me? What's that like for you?
Well, I do that because you get in
so much trouble all the time. You're always,
you know,
(37:21):
screwing up and, you know, banging your head
against the wall and I just can't have
that anymore. I need to get you under
control.
Oh, that's different. Mhmm. How do you know?
How do you get that? Well, you really
have to look inside. So it is a
kind of mindfulness
Yeah. Involved in understanding what's going on inside
or in other people. Well, it kind of
raises the idea that the questions you ask
(37:44):
yourself
are going to evoke
certain
answers or even certain
domains of answer. Yeah. So asking the question
of one's inner critic,
what's it like for you? Mhmm. Evokes 4
higher quality answers Mhmm. Than asking the inner
critic, could you please shut up? Yes. Right?
Exactly. Yes. So That's the main point. Yeah.
(38:06):
Yeah. Well, often the questions we ask ourselves
are just simply not very good questions. You're
right. So a common question is, what's wrong
with me? Well, anytime you ask the question,
what's wrong with me? You're setting it up.
You're setting, like it's a leading question. You
gotta come up with everything bad bad about
you. Yes. It's a leading question. Exactly. And
with the addict self, the famous addict self,
which, you know, in AA is doing push
(38:27):
ups in the parking lot. They actually have
this expression. You know, your addict self
your addiction is doing push up push ups,
strengthening itself while you're in here trying to
be a good boy or girl.
Sorry. But, you know, that doesn't quite wash.
So, like, what is this addictive part actually
trying to do? The craving part. I want
more. I want to drink. I want to
drink tonight. I don't want to be sober.
(38:49):
I don't want to, you know, abstain.
What's that like for you? Well,
I know that this helps you. It soothes
you. It makes you feel better.
I want us to feel better so to
speak. I mean, it's kinda strange to put
that in language, but I want us to
feel better. So that's what I do for
us.
In any kind of good communication,
(39:09):
you want to assume good
faith. Yes. So in your inner dialogue, you
want to assume good faith. That's pretty much
the idea. And in fact, Richard Schwartz, the
founder, his latest book is called No Bad
Parts.
Precisely that. Yes. All kind of on your
side one way or another.
Yep.
Yep. And even the part that wants you
to use heroin or go on a bender
(39:32):
has some kind of positive intention. And when
you're asking the right questions,
you arrive at that positive intention and then
you can meet that positive intention
in some more
holistically
appropriate or beneficial way. Yeah. Yeah. Pretty much
so. And so when you really get into
conversation with these parts of oneself,
(39:53):
the addict self being the most prevalent,
is like,
okay. I wanted to instead of, like, trying
to get rid of you and toss you
in the trash and, you know,
talk you and tell you're whatever, until you
give up on me, I'm gonna I'm going
to accept what you need, what you want,
and we're gonna work together,
which sounds really odd. Who's doing the talking
(40:13):
if that's a part of yourself? Well, somehow
it works. Yeah. And so you're bringing a
perspective and a mindfulness
together with that urge and saying,
we're gonna actually kind of just
gently re
we're gonna modify the way we get this
feeling, the way it works so that so
that it doesn't kill us, so that it
doesn't hurt us, doesn't get us in horrible
(40:34):
trouble at home with the family, with your
partner, with your bank account, etcetera. Yeah. Right?
And it works. And everything, all the different
parts actually say, yeah.
Please. That would be nice. Well, the the
the thing with addiction is because
so often addiction follows from trauma.
Yeah. And so often there's this undercurrent
(40:56):
of shame
that that's underlying
Mhmm. Any form of addiction. Mhmm. Often when
one
superficially
examines their inner dialogue, there's nothing good going
on inside. That's right. It's it's all, you
know, why you're bad or why you're shameful
or how you're a mess up. So that's
why asking oneself what's wrong with me, which
(41:17):
the medical model almost kind of does.
Kind of. Oh, I I guess it, you
know
Well, I would say I would say Yeah.
We're gonna tell you what's wrong with you.
We're gonna look it up. We've got all
kinds of data on this. We're going to
let you know what's wrong with you. Right.
But it's the paradigm of what's wrong
(41:37):
as opposed to what's the intent.
Well, yeah. Because they're not assuming
any kind of teleological,
any kind of goal oriented
conscious deliberate activity on the part of the
virus.
Right? Yeah. Virus doesn't have questions. Right? Fit
human beings are way more complex than viruses.
Yeah. So but
(41:57):
but anyway, there are parallels with the medical
form of diagnosis and
analysis.
Thank you for listening to How to be
an adult.
This episode, an interview with Mark Lewis, will
be continued in part 2, which will be
released in 2 weeks.
How to be an adult is a production
of the Morpheus Clinic for hypnosis
(42:19):
at www.morphisclinic.com.
When I'm trying to get someone to stop
using alcohol or heroin
to kind of resolve that inner debate or
ambiguity in the climate. Addiction I understand since
I had it myself in my 20s. I
struggled with an opiate addiction. It seems like
we've all accepted the idea that we can't
just be, and we've always gotta do or
consume something, or else we're not Welcome to
(00:22):
How to be an Adult, a podcast created
by the practitioners at the Morpheus Clinic For
Hypnosis in Toronto, Canada. This is a show
for people just like you who've inadvertently become
adults
and don't know what to do about it.
I'm Luke Chao, and today I'm joined by
a very special guest, Mark Lewis,
author of best selling books like the Biology
(00:42):
of Desire.
He's formerly a professor at the University of
Toronto.
He's a cognitive scientist and a neuroscientist and
a psychotherapist in private practice.
He's the author of close to 100 articles
about development of psychology and especially to the
public
the field of addiction.
More specifically,
(01:03):
he advocates
against the medical model of addiction that I
think we can agree disempowers
the people it's supposed to help.
So Mark welcome aboard. Thank you. You're welcome.
Thank you. Let's begin with this. Would you
like you who are me
to try to summarize your views on addiction
in a couple of sentences?
(01:24):
So so generally, what I have been writing
about and arguing for for years now,
almost 10 years,
is the idea that
rather than think of addiction as,
a disease, a a brain disease, a pathology
per se. Think of it as,
a psychological habit, a cognitive habit, a very
(01:47):
strongly emotional habit, a habit which is
motivated by intense emotions and therefore becomes deeply
ingrained, deeply entrenched,
And partly for that reason, it's extremely hard
to break even though you certainly understand at
some level that it's not doing you any
good and in fact might be making your
life into a horrible mess, might become extremely
(02:09):
boring and destructive in in various ways.
And trying to understand what's the value of
substance use or other kinds of addictive practices
that make it,
hard to give up, not only because it's
a habit, but also because it's doing something
for you. Something that you're not able to
do as well,
or as,
(02:30):
reliably in the rest of your life. So
really looking at it from the point of
view of the science, the psychology, but also
from the person's point of view, the person
who is using substances
and having a hard time stopping. Well, all
of us who have even a
light addiction to our phones or to social
media,
let alone something like alcohol or cigarettes or
(02:51):
gambling,
your explanation of addiction seems just simply intuitive.
It matches
so many people's actual lived experience
Mhmm. Of what it's like to to to
find it impossible to put on your phone
or to
tell yourself
erroneously that you need a drink just because
you're going through a breakup when actually what
(03:11):
you need is something like love instead.
How did it end up being
that the predominant
model of addiction is a disease model,
which is so counterintuitive,
not just to me as a hypnotherapist or
to you as a psychotherapist and a scientist,
but to, I think, even members of the
public
whose experiences of addiction are are not
(03:33):
one where they become some kind of fiend
that's controlled by some kind of demon. I
would hope not. Yes. No. There was a
time in the 19 thirties, forties, fifties when
that was in fact the kind of public,
vision, the optics, the idea that addiction is
like a fiend. Mhmm. And and it it
was,
(03:54):
represented by, you know,
pictures of people doing
horrible back things or seeing their shadows in
the background where they're playing with needles and
so forth. And often in those days, black
people. People who had,
for whom
institutional racism was already making some pretty strong
negative points. Mhmm. And here's another thing that
(04:14):
they're doing. Yep. So there's all that. But,
you know, in answer to your question, I
think
the idea that addiction's a disease, it wasn't
motivated by ill intent. It was motivated by,
I think,
a positive wish to take the blame, the
the the stigma, the responsibility
off of the shoulders of addicts
(04:35):
and rather to say, hey. It's not really
their fault. They don't mean it.
Okay. So how do you do that? Well,
one way to do it is by saying
they've got a real problem. Let's call it
a disease because we know the people who
have diseases aren't responsible for whatever it is.
Mhmm. And so that was a way to
try to make it easier
to not be
(04:55):
cornered and persecuted for the
activities that went into addiction. Well, it seems
almost like
if a kid's got their hand in the
cookie jar again
Yeah. And by their own free will, they
put their hand in the cookie jar and
then the very compassionate
overly empathic
dad or mom says,
(05:17):
oh, no, son. It's okay for you to
eat all those cookies. It's not your fault.
It's my fault, not yours Mhmm. That you
got your hand in cookie jar. Doesn't that
seem to stunt a person's development?
Well, it certainly takes the responsibility
away. It does. Yes. So in that respect,
yeah.
It does. So Which for a 4 year
(05:37):
old is not a bad thing. Because, like,
what we advocate for for kind of, you
know, recognition
that
each of us is the captain of our
own ships.
Right? And it's true. We don't control the
winds or the waves. So later, we're gonna
talk about how, for example, disability or poverty
might impact one's ability
to cope with life and perhaps susceptibility
(05:58):
to to addiction. Mhmm. So we don't control
everything. It's not like we can each independently
just be an island. That's for sure. But
at the same time, it's
the very opposite is not true either. It's
not like we completely lack agency. Right. And
there almost seems to be this implication
in a lot of the discourse around the
disease model of addiction. Mhmm. That
(06:20):
an addict
in a more modern version of the fiend
lacks agency.
Mhmm. Did you perceive the same thing? Or
Yeah. That's pretty close. Yeah. In fact, when
I give talks, I often show a slide
that
presents a billboard on the side of the
highway in Massachusetts. I think it is showing
(06:41):
5 or 6 people who look
moderately
content but not very happy
and the slogan is,
it's a disease. It's not a how does
it go? It's not a choice. It's a
disease.
So what they're saying, you know, the subtext
is clearly that, you know, it's not our
fault. Mhmm. And they're looking kind of like,
(07:01):
well, it's too bad this happens. This is
really a drag, but, hey, it happens.
Well, it's also kind of the view
underlined
by AA
where one of the the 12 steps or
12 tenets is that you have to kind
of,
acknowledge
or admit that you've lost control over the
addiction and that you gotta give yourself up
(07:23):
to a higher power. That's right. And that's
never quite sat well with me because, at
least in my experience, we're working with my
clients to primarily primarily to quit smoking, but
also to, you know, to stop overeating food
or to not drink so much. Right. The
experience seems to be the more I have
my client take agency,
the better the outcomes are. Yeah. Whereas if
(07:43):
they just kinda give themselves up to the
addiction, to the feelings, to the impulses,
that seems very counterproductive
to the goals that they have.
Yeah. How the heck is it that AA
and the disease model
have become such popular models of how addiction
works when we're on the same page. And
I think a lot of our listeners in
(08:03):
their own experiences, even even if they've never,
like, used hard drugs, in their own experiences,
it seems like
they they do have choice and it's detrimental
to deny
that choice that they each have.
So I argue that a lot and I
talk about how a sense of efficacy
of self empowerment can be a very, very
(08:25):
powerful tool in overcoming addiction.
And and to put it simply, it's like,
I'm really sick of this. This this is
a shitty life, you know, life experience. I
don't like this. I don't wanna do this
anymore. I'm gonna make it. I'm gonna stop
it. And how do I do that? Well,
let me see. I could go see a
therapist. I could do this or that. I
could become involved in other activities. I could
make other friends. I could become involved in
(08:47):
in other social,
contexts.
And one way or another, they find a
way. And the statistics show very clearly that
most people who are addicted to anything,
including heroin,
or these days, Fentanyl, I suppose,
do in fact
stop. Mhmm. I was gonna say recover because
that's the coin of the realm, but I
don't like the word recover because it's got
(09:07):
this very strong medical
ring to it. But they do stop and
they stop,
mostly without the help of any kind of
formal treatment. In fact, the conventional
rehab setting, rehab and addiction treatment centers
have a very notorious history of not working
well. Costing a lot of money and the
revolving doors that, you know, means that you're
(09:29):
gonna be back again in 6 months or
a year or 2 years and so sorry,
guy. Mhmm. Wish we wish we could help.
There's almost this cruel irony
that
the practices, the paradigms, the philosophies
that make the most money
are the ones that are disseminated most widely
(09:50):
and often end up being researched more most
completely or at least publicized most completely. Publicized.
Yeah.
And the practices
that are impossible to monetize like quitting cold
turkey
seem to get no publicity
and then no research money.
Right. And it can be cold turkey or
it can be gradual. There's an awful lot
(10:10):
of ways to overcome addiction.
Sometimes, you know, it's it's complete abstinence. Sometimes
it's not. Sometimes it's controlled use. Sometimes it's
gradually decreasing Yep. Tapering use. But I think
we have to be careful about,
you know, the pointing of the finger here.
AA doesn't make any money. AA is
famous because it's free. Mhmm. And it's been
(10:31):
around since the thirties and,
it's extremely
useful and attractive to people who can't afford,
any kind of formal
medically oriented treatment.
So that's where they go. And AA does
work for some people. I mean, the, you
know, the the estimates are anywhere from 5%
to 35 or 40%. Mhmm. That's not too
(10:53):
terrible.
Mhmm. But 5% is not very good. I
mean, a lot depends on context. The the
nature of the group, the makeup of the
group, the relationship with the sponsor, the kind
of drug, the kind of other societal,
factors that you alluded to,
you know, which might might include economic and
social and prejudicial and race racism and all
(11:15):
kinds of things.
But anyway, long story short, AA
sometimes works. And
AA doesn't fit with a disease model perfectly
either. It was kind of a strange marriage.
So AA came came along the idea that
you can't make it go away. You can't
make it stop. That is that you have
to admit that from the, you know, from
the get go. However, you can control it
(11:37):
and you need to control it and you
must control it. Like if you're a diabetic,
you need to take your insulin. Mhmm. Okay?
So there's that.
But
but also the disease model, you know, the
implication that this is something that needs to
be treated
by a medical establishment
and can be addressed with certain drugs, with
certain pharmaceuticals, for methadone and Suboxone, and so
(12:00):
on and so forth. Naltrexone
is now a big deal. So, you know,
that doesn't fit with the philosophy of AA
very well at all. Mhmm. And a lot
of what treatment centers do and have done
for the last 50 or 75 years or
so have been to kind of merge the
2. The 12 step approach on the one
hand, cognitively, behaviorally,
and also the idea of being in a
(12:21):
group, the idea of fellowship.
Really important.
Fellowship. It's got nothing to do with the
disease model. You're not gonna do any better
if you're with a group of fellow diabetics.
Mhmm. Right? I can take your insulin. Yeah.
But but AA, the fellowship idea in AA
is really fundamental. It's really intrinsic to how
it works. So so somehow, this kind of
forced marriage took place in in
(12:45):
rehab centers that sprang up all over the
US, especially in the fifties sixties seventies,
merge these two models together
and tried to make a kind of coherent
integration between the 2. Right. Well, my my
read of AA
is that
it works
despite
each member having to kind of deny responsibility
(13:08):
or give up agency. Mhmm. It doesn't work
because of that. It works because of the
fellowship that you mentioned Mhmm. And the social
support.
Mhmm. One kind of mental model of addiction
I'm kinda playing around with inside my head
is that whatever it is that gives people
that that kind of dopamine hit, which I'm
sure is oversimplified, but whatever gives them that
nice feeling. Mhmm.
It's it's a poor substitute
(13:31):
for
the authentic
kind of connection and camaraderie,
even affection and love Yeah. That we get
socially. This is why the opioid crisis in
the US is so oftenly found
among lonely rural men. Mhmm. It it's because
if if they had loving families, if they
had lots of of friends Mhmm. They'd be
less susceptible to addiction. Yeah. And AA kinda
(13:55):
gives people that sense of community and fellowship
and camaraderie
that, well, unfortunately, methadone does not. Right. And
then methadone kind of, you know, hits the
neurotransmitters
correctly.
Yeah. And the fellowship, you know, just kinda
might do that obliquely.
Yes. So that's I don't know how educated
(14:15):
that reading of AA is, but, you know,
at least from my perspective, that's kind of
how I interpret how how it works.
I think that's a big part of it.
Yeah. I think that's not a bad way
of putting it. And the idea of fellowship,
camaraderie,
and,
feeling cared for, feeling that sense of belonging
really is fundamental. Yeah. And for any form
of addiction,
(14:37):
you know, I think it was put very
simply by Johann Hari. Do you know who
Johann Hari wrote a book called Chasing the
Scream, which is a wonderful book,
about the war on drugs. Mhmm. And Chasing
the Scream
pertains to,
what was his name? The the first guy
who was the head of the DEA, the
drug enforcement agency in the US, heard some
(14:58):
woman screaming down the hall. She was a
morphine addict and I suppose she was coming
off morphine and she was screaming and he
was chasing the scream. He was going to
put a stop to this this kind of
stuff. Right?
Anyway, whatever. It's a wonderful book. It's a
beautiful narrative, and what Yohan Hari says and
this is,
this is highlighted in his TED talk. So
if you don't have time for the book,
(15:18):
you should go get to the TED talk.
Johann Hari, j o h a n n
h a r I. And what he says
is the opposite of addiction is not sobriety.
The opposite of addiction is connection.
So there it is. I'm completely in agreement.
Yeah.
So, yeah, in a way, most addictions
(15:39):
and even addictions,
you know, we can sort of understand with
opioids and alcohol,
they do connect with opioid receptors and help
us to feel more relaxed and more comfy
and cozy. That's an addiction I understand since
I had it myself in my twenties. I
struggled with an opioid addiction for years.
But even people who are addicted to cigarettes,
(16:00):
to tobacco, or psycho stimulants, cocaine, or methamphetamine,
Although it's not cozy and comforting per se,
it does make you feel that you belong
with or to
a a drug, really. This is my familiar
experience. This is my world which I can
go into whenever I want and feel taken
(16:20):
care of and feel safe, you know, and
that's a big deal.
And, of course, that is indeed,
an alternative. It's a substitute for feeling cared
for or feeling like you belong with a
social or familial. And it's always a poor
substitute because cigarettes can never love you. No.
Even a even a dog, a cat can
love you. Yes. Right? And, of course, a
(16:42):
friend, a partner, a child by the way.
I don't know about cats. No. No. I
I definitely do know about cats.
But but, like, even like a hamster. Right?
Even a hamster
can like cozy up next to you Yes.
And cuddling. Yeah. And a hamster therefore is
superior to a cigarette.
Yeah. I mean, I know what you're saying.
Yeah. Yeah. Well, so I I work with
a lot of smokers. At this point, I'm
(17:04):
not even surprised if it's over a1000.
And so frequently,
I hear that cigarettes give companionship. Uh-huh. Cigarettes
give
my client a sense that
they have a friend and then quitting smoking
almost feels like they're betraying a friend or
abandoning a friend. Or abandoning. Yes. That's why
(17:25):
I really have to make the point that
your friends are not trying to kill you.
But cigarettes aren't trying to kill you.
Well, I mean,
the the the the the We anthropomorphize it
and say, yeah. Well, in fact, yeah, they're
really bad for you, and they are going
to increase your chances of dying from various
diseases for sure, but they're not trying to
(17:46):
get So it's fair to to give all
the agency
to the human being Yeah. In the equation.
I know you agree with that. And yeah.
Yeah. So you're right. I am anthropomorphizing cigarettes,
but when my client
anthropomorphize
a cigarette Yeah. But describe them by describing
them as a friend. I mean, we must
further that analogy
For sure. By painting,
(18:06):
you know, the the feelings that they get
from tobacco as a treacherous,
traitorous kind of friendship and not actually the
real thing.
Yeah. I know. You and I have talked
about this before a few times, and I
think we agree,
in a lot of ways. I think there's
an awful lot of overlap between our perspectives,
but it's not total overlap because I think
(18:28):
you feel much more absolute about that than
I do.
And I think, for example, of
a good friend of mine named Sean Shelley.
He,
he struggled with his own addiction in Cape
Town, South Africa,
and he's fine with me saying that. He
he talks about it all the time. He
after he gave up, on crystal meth, he
(18:49):
got his PhD, became, involved in all kinds
of,
agencies and bodies that were trying to help
people who had addiction problems throughout Africa. He
actually served on the United Nations, Committee For
Drug Reform. Mhmm. He's done a lot of
wonderful work and, you know, came a long
way, so to speak. However, he he talks
about what, for example, smoking heroin does for
(19:11):
young black men in Cape Town, and it's
not evil, and it's not, you know, it's
not,
what's the word, malicious or malevolent.
It's rather it's a social habit that does
involve a chemical influx, but it's also something
they do together
makes them feel
like, well, we talk about alcohol as being
(19:32):
a social lubricant.
Like, there's something to that. Right? Yeah. And
opioids are also a social lubricant. In fact,
opioids, when you give opioids to rats and
mice, they,
they have more fun together. They play more.
They really do. Yeah. So, you know, opioids
soften edges. Yes. Okay. So let me explain
the absolutism.
(19:52):
It's actually more in language than it is
in thought. Okay. Because
I'm not a prohibitionist. Yeah. I I actually
have
no,
disdain for and
I don't think that drugs are all bad.
In fact, I think that the resurgence of
psychedelics recently,
(20:12):
as a possible treatment for PTSD, for example,
is a very good thing. Mhmm. And Ketamine,
for example, could be used recreationally or it
could be used therapeutically. Right. And, of course,
cocaine and heroin originally had therapeutic uses.
So, like, I'm not I'm not one to,
like, demonize drugs. Right. The reason for for
the
absolutest speech is because for better or for
(20:35):
worse,
the less room you'll leave for doubt when
you're communicating,
the stronger the point you make. So I
guess,
you know, for this kind of academic conversation,
you know, I'll just add in the asterisk
Yeah. That, you know, I'm not I'm not,
like, against
the
responsible and informed
use of drugs in a way that's legal
(20:57):
for your jurisdiction. Mhmm.
Okay.
But yeah. When I'm when I'm trying to
get someone to quit smoking,
then I do have to speak in an
absolutest way. I believe that. Or when I'm
trying to get someone to stop using alcohol
or heroin
to kind of resolve the inner debate or
ambiguity in the client's mind. Mhmm. You know,
(21:18):
I'd as a hypnotherapist,
I kind of had to give one clear,
unambiguous,
neatly packaged idea Mhmm. As simplistic as the
idea would be if we kind of try
to unpack it in more of a
scholarly kind of context. I can see that.
I mean, as a clinical psychologist, I often,
you know, will use words and ideas also
(21:39):
in a way that's intended to help people
think and feel a little bit differently about
whatever it is they're engaged in that seems
to be harming them or blocking them. And,
no, you're right. It's not an academic,
you know, point that you're making. You're not
trying to make a foolproof argument proof point.
So it's a different yeah. Well, I kinda
feel like keeping in mind that, you know,
some of our listeners are are kind of,
(22:01):
they're kinda tuning in because they they can't
afford,
hypnotherapy or psychotherapy. Right. They they can't, like,
afford rehab for sure. Mhmm.
So, yeah. To kind of see,
let's say, tobacco Mhmm. As
a trader and not a friend is gonna
help in one's journey to to quit smoking.
Yeah. I can do that. Yeah. So that
(22:21):
that that that I'm not actually as black
and white of a thinker as to what
I communicate. That's true. Yeah.
Yeah. And, certainly, I'm not anti drug. I
mean, there's, like, uses for almost every drug.
And I wouldn't I don't even draw a
line between what you might call recreational and
therapeutic use
because
there is no clear line Mhmm. And especially
with psychedelics.
(22:42):
I mean, psychedelics, if you wanna think of
it as treatment, think of it as a
treatment for life in our current right?
The cosmo follows an age because psychedelics help
you connect with nature and think about your
role in the universe. And Mhmm. Do you
wanna call that treatment or it's not treatment
or, recreational, it's something else. Something's hard to
define. Yeah. Well, in previous episodes, we we
(23:04):
we've kind of
spoken against the mind body dichotomy Mhmm. Where
it's kind of this artificial
divide
to say we can, like, just treat the
mind Mhmm. Or we treat the body independently
of the mind. Well, no. Yeah.
You know, like, anything that you put in
the body, it's gonna affect your mind. And
if you think in certain ways, it's gonna
(23:25):
affect the body too. Yes.
So yeah. We're,
you know, each one individual organism
at its, you know, kind of a fictitious
concept
to divide mind and body. Yeah. I agree.
Yeah. It's way too neat. Yes. It doesn't
really make much sense if you think about
it a little bit more. Yeah. So
you've been, kind of trying to challenge the
(23:47):
the medical model of addiction Mhmm. And with
some success, considering how many books you've sold,
Mhmm.
I'm sure that along the way you've gotten
some pushback. I'm sure along the way you've
kinda rubbed people with a profit motive in
the wrong way.
So how's this journey been like? How successful
have you been in kind of like helping
others to overcome the the the the stigma
(24:07):
of drug use or the idea that it
is a disease as opposed to a learned
habit? Mhmm.
There's been certainly pushback.
Generally speaking, I think my
my argument, my view, my perspective has been
taken well. And a lot of a lot
of people are saying, yeah, that makes sense.
(24:27):
Okay. Got it. I'm not the only one
who takes this position. There's there's quite a
number of other people who sort of addiction
scholars or addiction,
might might be doing research in addiction or
might be doing clinical practice related to addiction
who also feel that the medical model has
gone in the wrong direction.
And
so the pushback that we have gotten, some
(24:50):
of that come it comes from all different
sources. For example, whenever you kind of perturb
a societal habit, you know, you're gonna get
some kind of crap from somewhere, from maybe
from many places. So one source of that
for me was in the US, especially where
I give talks sometimes,
it's like people say,
if we don't call it a disease, then
we can't get medical insurance to cover the
(25:11):
cost of treatment.
Yeah.
Sorry about that. That's actually
a political and economic issue. It is not
a psychological issue. It's certainly not a scientific
issue or a biological issue. You wanna talk
about your health care system? Yeah. It's pretty
stuff. The, American health care system obviously epitomizes
certain real problems where profit and,
(25:33):
healthcare,
you know, meet head to head, not in
a very satisfactory way.
So, yeah,
Sorry about that. You need a name for
this, so then you can throw money at
it or get the insurance companies to throw
money at it. Same thing for a lot
of other things by the way,
racism.
Now, we have anti racism. So now, we
(25:54):
can support
research dollars for anti racism or clinical or
institutional practices
for anti racism because we've given it a
title. Terrific.
Bullying. Again, anti bullying programs.
Domestic abuse. Right? Child abuse, all kinds of
abuse has now gotten very much highlighted and
entitled and now it sorry. I don't mean
(26:16):
entitled. I mean, given a title, given a
category
heading label
makes it easier to pinpoint it and to
say, okay. This is how we need to
deal with it. Whether it comes from a
source of contributions, whether it's monetary, whether it's
governmental, institutional, legal, whatever it is. It helps
you, you know, focus on the problem and
(26:36):
try to do something. But so in that
respect, I see the argument.
Right. If I take away the label, what
are we gonna call it? How are we
gonna deal with it? Well,
like you and I have been talking about,
it's a much broader issue than just a
person's
relationship to particular substances or activities.
Whether it's booze, whether it's drugs, whether it's
(26:56):
gambling,
whether it's porn, whether it's phone use, whether
it's Internet use.
There are so many kinds of addictive activities
and,
it's completely intermingled with the rest of our
psychological and social lives. Mhmm. It isn't a
distinct phenomenon or a distinct category. So don't
even try. Mhmm. There's better ways to understand
(27:17):
it. Yep.
One pattern I've noticed
among people So, you know, you you mentioned
porn. There's alcohol. There's all sorts of drugs.
One pattern I've noticed 2 patterns, actually.
One of them is that
it seems like we've all accepted the idea
that we can't just be, and we've always
gotta do or consume something or else we're
(27:39):
not good enough. Yeah. That's part of it.
Yeah. And that's tied in
with this idea that
we shan't love ourselves because it's arrogant
or because it's gonna,
I guess, divide up a finite amount of
love as though we don't generate more of
it ourselves. Mhmm.
But it's almost like
this, at least these two views
(28:01):
Mhmm. Seem to exist in every client I
have
who
smokes cigarettes or drinks alcohol. It's where, like,
they can't just sit alone with their own
thoughts like a monk on a mountain top
feeling their hearts and feeling loving kindness. Yeah.
And you might say I'm overly simplifying things,
and I I would admit in some ways
(28:21):
I I am. Mhmm.
To to say that if only we all
learned how
to quietly sit with our own thoughts. Yeah.
But but being a monk on a mountain
top is not gonna be the way for
most people. But here's the cool thing. We
don't actually have to seclude ourselves with civilization.
Mhmm. When we each have private homes or
(28:43):
at least bedrooms,
we can all retreat into it. Even in
a city, we can put on our, you
know, noise cancelling headphones. Yeah. We could close
our eyes. We could pretend we're on a
mountaintop. So I'm just kinda painting an image
with a mountain top, but the idea is
wherever we find seclusion,
wherever we find privacy and quiet, is our
mountaintop.
(29:04):
And, you know, so it's no excuse that
there's no mountain in sight in downtown Toronto.
We're like, even in in like, we're in
the downtown core right now. We're actually not
far from one of the busiest intersections in
the city. Mhmm. It's actually also very quiet
in here because we boarded up the windows.
Right. So this is like a an example
of a mountain top in here. Yeah. Now
(29:27):
let's say here
I'm breathing deeply enough.
Mhmm. I'm looking to wear the glass is
half full in life. Mhmm. I'm thinking of
those I care about.
I'm generating within myself
nice, warm, and fuzzy
feelings. Mhmm.
Right? Now, I'm I'm kind of losing my
(29:47):
desire to go play a video game. Mhmm.
I'm losing my desire to catch up on
the latest episode of the show I might
be watching on Amazon Video. Right. Right?
I I I try to introspect
to understand humanity.
It's under the idea we have more in
common than we have differences, and I, you
know, can examine myself way better than anyone
else. So, you know, if I ascertain that
(30:10):
a practice seems to help me, then
plausibly it could help another.
Yeah. So I kind of imagining that if
I only were to teach people how to
find their version of a mountain top,
to be with
wear the glass is half full for them,
to breathe deeply enough, to think of those
they do care about, then they're gonna start
(30:31):
losing their desire to have to consume, to
have to do, to have to to, you
know, fill in the void because the void's
being filled in with the the good things
I'm having them think about.
Do do do do do you think that
love is an adequate solution?
That's the question.
I I think there's an awful lot of
stuff that
compiled together
in in your perspective there. And I I
(30:53):
think in many ways, I do agree.
Well, the two main things are, I would
say, sort of mindfulness capacity to reflect and
to have some silence so you can reflect
on your own thoughts and not take everything
as a given and not just rush into
rush along with capitalist enterprise and be a
(31:14):
cog in the machine or a brick in
the wall as Pink Floyd Mhmm. Put it.
Right? So, yes, that kind of mindfulness is
super important.
That's a little bit different than the sort
of practice of love and kindness and goodness,
which, yeah, that's another way of fulfilling
our potential as people.
Both of them can help us not require
(31:36):
other kinds of input and other kinds of
busyness.
The busyness thing, you know I mean, back
when I was when I was being,
supervised as a grad student in psychotherapy techniques,
I studied psychoanalysis
and stuff. They called it the manic defense.
There There's something called the manic defense. It's
really simple idea that of all the defense
mechanisms,
(31:57):
being manic
is kind of like the default. It's the
basic one.
Because by going after goals and doing,
you know, achieving,
whatever it is that you're going after and
moving towards or away from
very particular things in the world,
you are feeling,
(32:19):
feelings of connection, involvement, and utility that are
really good to feel.
So what about that? Well,
we don't necessarily wanna get rid of that
because, you know what, every
baby needs to feel that in order to
pull away from mom and dad and to
go reaching across the room, and learn to
crawl, and grab at things, and pull them
(32:39):
off the shelf, and suck on them, or
play with them. And all of cognitive development
requires that kind of manic is a strong
word, but it requires going after goals. Mhmm.
So how is addiction different?
It's somehow it is like a white noise
machine. It's kind of it
it blocks out other forms of connection.
(33:01):
Mhmm. That's that's what I would say. Right?
So
yeah. So the kind of connection you get
by pursuing normal goals, so to speak, like
good goals, goals that are interesting and novel
enough to be, you know, worth thinking about,
gets replaced by going after the same thing
day after day or hour after hour or
month after month or year after year. That's
(33:23):
a whole different kind of enterprise. That's not
just being too involved in activity and not
having enough time to reflect. That's there's a
kind of intrinsic
boringness to that.
Repetition numbs you. Right? It turns off a
lot of aspects of having a well functioning
mind, brain, and heart.
(33:44):
But as for the role of love, I
mean, you and I agree about that.
Feeling love for other people, feeling that connection,
concern,
care, respect,
and for oneself,
fundamental practices,
practices,
strange word, fundamental way of connecting,
with other people that is tremendously fulfilling that
indeed feels really good. And by the way,
(34:05):
yes, it does actually stimulate opioid receptors.
In fact, mother's milk has opioids
in it. So,
when I use the word love,
I'm not talking about like romantic love, which
is highs and downs. Right? It's it's
it's a little artificial,
and it's seldomly lasting.
So I took a Vipassana meditation course,
(34:28):
one of the 10 day Goenkara retreats Okay.
Many, many years ago. In fact, 2 weeks
before I opened the board of his clinic
for hypnosis, and I got back and I
opened up. I rent out this office, which
is now our studio Yeah. And I opened
it up 2 weeks after I got back
from that retreat. Right. But,
the term is loving kindness,
which is an English translation of of the
word meta,
m e t t a. So what when
(34:50):
I mean when I talk about, like, sitting
quietly
with your own
thoughts Mhmm. And feeling your own heart and
causing your own good feelings that way, I'm
not really talking about, like, pursuing romantic love
or even, like, parental love or love for
a child or even love for, like, a
cat or a dog. Right. I'm talking about
loving kindness that's for all human beings. Right.
(35:13):
And that one can feel when he's he
or she is on their own. Yeah. And
I would say also that that kind of
love, and yes, it meta, that Buddhist term
covers it. It's
there is something that is intrinsically connects that
with mindfulness.
Because to love in that way, whether it's
someone else or yourself, you need to get
them. You need to actually think about what
(35:34):
it's like to be that person. What's it
like for you? I don't know what it's
like for you. You have a very different
life than I do, of course.
And what's it like for people of other
genders or races or economic conditions and all
that stuff requires a certain amount of reflection
and thoughtfulness,
which to me is pretty close to mindfulness.
It's like, you know, what's it like? And
(35:55):
also when we are loving ourselves, caring for
ourselves,
I use a kind of psychotherapy now in
in my psychology practice called, internal family systems,
which is getting quite popular these days. It's
IFS is the acronym. IFS,
Internal Family Systems.
First thing I always tell people, it's not
family therapy.
No. That's a misnomer.
(36:17):
The internal family is this, the family of
parts or voices, they call them parts of
ourselves.
The part that is craving
fulfillment,
like the addictive part, give me more. The
part that is critical,
you're being an idiot. I can't believe you're
doing that again. What a jerk. You know,
the part that whatever. There's a number of
(36:38):
different parts of us that just pure needy.
I feel alone. I need to be cared
for. The part that, you know, all that.
Okay. So what about that?
It's kind
of analogous
to the way we need to understand other
people is to really consider them. What's it
like to be you?
What's it and then in IFS, it's it's
(37:00):
it's astounding the way it works. In IFS,
you kind of look at your parts very,
you know, very, deliberately
and say, what's it like for you internal
critic to be this
critical mean, you know, accusatory
part of me? What's that like for you?
Well, I do that because you get in
so much trouble all the time. You're always,
you know,
(37:21):
screwing up and, you know, banging your head
against the wall and I just can't have
that anymore. I need to get you under
control.
Oh, that's different. Mhmm. How do you know?
How do you get that? Well, you really
have to look inside. So it is a
kind of mindfulness
Yeah. Involved in understanding what's going on inside
or in other people. Well, it kind of
raises the idea that the questions you ask
(37:44):
yourself
are going to evoke
certain
answers or even certain
domains of answer. Yeah. So asking the question
of one's inner critic,
what's it like for you? Mhmm. Evokes 4
higher quality answers Mhmm. Than asking the inner
critic, could you please shut up? Yes. Right?
Exactly. Yes. So That's the main point. Yeah.
(38:06):
Yeah. Well, often the questions we ask ourselves
are just simply not very good questions. You're
right. So a common question is, what's wrong
with me? Well, anytime you ask the question,
what's wrong with me? You're setting it up.
You're setting, like it's a leading question. You
gotta come up with everything bad bad about
you. Yes. It's a leading question. Exactly. And
with the addict self, the famous addict self,
which, you know, in AA is doing push
(38:27):
ups in the parking lot. They actually have
this expression. You know, your addict self
your addiction is doing push up push ups,
strengthening itself while you're in here trying to
be a good boy or girl.
Sorry. But, you know, that doesn't quite wash.
So, like, what is this addictive part actually
trying to do? The craving part. I want
more. I want to drink. I want to
drink tonight. I don't want to be sober.
(38:49):
I don't want to, you know, abstain.
What's that like for you? Well,
I know that this helps you. It soothes
you. It makes you feel better.
I want us to feel better so to
speak. I mean, it's kinda strange to put
that in language, but I want us to
feel better. So that's what I do for
us.
In any kind of good communication,
(39:09):
you want to assume good
faith. Yes. So in your inner dialogue, you
want to assume good faith. That's pretty much
the idea. And in fact, Richard Schwartz, the
founder, his latest book is called No Bad
Parts.
Precisely that. Yes. All kind of on your
side one way or another.
Yep.
Yep. And even the part that wants you
to use heroin or go on a bender
(39:32):
has some kind of positive intention. And when
you're asking the right questions,
you arrive at that positive intention and then
you can meet that positive intention
in some more
holistically
appropriate or beneficial way. Yeah. Yeah. Pretty much
so. And so when you really get into
conversation with these parts of oneself,
(39:53):
the addict self being the most prevalent,
is like,
okay. I wanted to instead of, like, trying
to get rid of you and toss you
in the trash and, you know,
talk you and tell you're whatever, until you
give up on me, I'm gonna I'm going
to accept what you need, what you want,
and we're gonna work together,
which sounds really odd. Who's doing the talking
(40:13):
if that's a part of yourself? Well, somehow
it works. Yeah. And so you're bringing a
perspective and a mindfulness
together with that urge and saying,
we're gonna actually kind of just
gently re
we're gonna modify the way we get this
feeling, the way it works so that so
that it doesn't kill us, so that it
doesn't hurt us, doesn't get us in horrible
(40:34):
trouble at home with the family, with your
partner, with your bank account, etcetera. Yeah. Right?
And it works. And everything, all the different
parts actually say, yeah.
Please. That would be nice. Well, the the
the thing with addiction is because
so often addiction follows from trauma.
Yeah. And so often there's this undercurrent
(40:56):
of shame
that that's underlying
Mhmm. Any form of addiction. Mhmm. Often when
one
superficially
examines their inner dialogue, there's nothing good going
on inside. That's right. It's it's all, you
know, why you're bad or why you're shameful
or how you're a mess up. So that's
why asking oneself what's wrong with me, which
(41:17):
the medical model almost kind of does.
Kind of. Oh, I I guess it, you
know
Well, I would say I would say Yeah.
We're gonna tell you what's wrong with you.
We're gonna look it up. We've got all
kinds of data on this. We're going to
let you know what's wrong with you. Right.
But it's the paradigm of what's wrong
(41:37):
as opposed to what's the intent.
Well, yeah. Because they're not assuming
any kind of teleological,
any kind of goal oriented
conscious deliberate activity on the part of the
virus.
Right? Yeah. Virus doesn't have questions. Right? Fit
human beings are way more complex than viruses.
Yeah. So but
(41:57):
but anyway, there are parallels with the medical
form of diagnosis and
analysis.
Thank you for listening to How to be
an adult.
This episode, an interview with Mark Lewis, will
be continued in part 2, which will be
released in 2 weeks.
How to be an adult is a production
of the Morpheus Clinic for hypnosis
(42:19):
at www.morphisclinic.com.
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Ridiculous History
History is beautiful, brutal and, often, ridiculous. Join Ben Bowlin and Noel Brown as they dive into some of the weirdest stories from across the span of human civilization in Ridiculous History, a podcast by iHeartRadio.