Understanding Addiction

Happy New Year! Yes, I’m still here

Written by

Marc

in

Hello readers,

Some of you have noticed that I haven’t posted much in the last few months. The last post published, by Hildur Jónsdóttir, was I thought very beautiful and meaningful. So…not a bad place to end for the season. Please take a look if you haven’t read it yet.

Blogging has been an incredibly enriching experience for me. I have made many friends through the blog, and I feel a strong emotional and intellectual connection with all who have read our posts, responded or not, and remained connected over the years. This is a fabulous blogging community, totally unlike any other in the addiction field, mostly because of the sensitivity, compassion, intelligence, expertise and openness of my readers.

Sound like I’m about to say goodbye? Well, no, not yet.

I have posted less because I’m thinking about other things, trying to write that novel, and mainly because I’m not sure what to focus on in the addiction world that’s new and interesting. Please, please, send me suggestions for topics in the world of addiction — the science, experience, policy, politics, and/or treatment aspects — that either I or colleagues (including readers!) could write about.

My own news. I’ve been in Toronto for nearly two weeks with my family — our annual vacation visit with family and friends. Everyone in my immediate family is well. My boys are now 11 and still delightful. Their experiments with preadolescence remain benign. My girl (from my previous marriage) is almost 30 and getting more interesting and sophisticated by the year. We’re flying (boys, Isabel and I) back to the Netherlands later today. From minus-15 in Toronto to plus-10 in Arnhem. Of course it will be raining when we get there. That’s a given. But I’ll trade that for the cold.

My exciting news to do with addiction: This coming Tuesday evening I will have a public debate with Nora Volkow, head of NIDA and staunch spokesperson for the brain-disease model of addiction. I’ve been wanting to debate Nora for years. I came close a couple of years ago, as I wrote about here. This time it’s a direct hit. The event will be put on by the University of Amsterdam, as part of the hoopla of awarding Nora an honorary PhD. I have a lot of respect for that woman, but we have obvious differences of opinion. I look forward to crossing swords but also finding common ground and directions for connecting brain models with social-developmental “non-disease” models of addiction — and moving toward a framework that may be less contentious and more effective for policy and care efforts all over the world.

I’ll let you know how it goes in my next post. Meanwhile, here’s the poster:

Debate with Volkow

 

Wish us luck in connecting with each other in a meaningful way. And please do send me suggestions for the blog. A huge number of people are still suffering from addiction or misguided efforts to curtail it. This is no time to stop thinking, exploring, and hoping.

 

 

 

Comments

34 responses to “Happy New Year! Yes, I’m still here”

  1. Peter Sheath

    Happy new year to you and yours my friend, I’m really looking forward to hearing about you crossing swords with Nora. We must catch up soon, over the past year working with the guys I’m currently working with, it feels like I’ve fell into a whole new world of substance use/addiction which, I feel, has deepened my understanding and, hopefully, enriched my wisdom. This, in turn, has led to me having some serious reflections on my practice and challenged some of the long held paradigms and values I had developed over the many years I’ve worked in this field. I would love to talk about this further with you at some point because I believe it’s got the potential to be really important. Anyway, for now, take care my friend safe journey back to Europe and, hopefully, speak soon.

    Reply
  2. Mark

    I too, look forward to hearing / seeing the exchanges with Nora. I expect you’ll both “come away with a different point of view.” Let us know if/when it hits the Youtube.

    As for creative areas of addiction to wire together, I’d love to see ACEs (Adverse Childhood Experiences) and Polyvagal Theory introduced into the addiction literature more. Steve Porges has recently published an very readable account of his theory in this “Pocket Guide to Polyvagal Theory: The Transformative Power of Feeling Safe.” Transformative indeed. I have something highlighted on every page. http://books.wwnorton.com/books/The-Pocket-Guide-to-the-Polyvagal-Theory/

    Reply
    1. Beth

      Seconded! It’s a little late for me (pushing 60), but in the last year, learning about attachment/development trauma has been eye opening in my recovery (currently working with my therapist on trauma reenactment as it relates to my issues).

      I haven’t read it yet (have it ordered), but I’m finding the preview of Laurence Heller’s book Healing Developmental Trauma and his NeuroAffective Relational Model to be intriguing.

      Reply
    2. Terry

      Hi all – just a small question – why do we always look on drug use as abnormal and those who use drugs as somehow deficient, diseased, unwell whatever – might drug use, or at least the undertaking of repetitive behaviours, be normal ?? given that most of the population in some way or another seeks stress relief in some external form or other. My new way of thinking would be that we turn 360 degrees. we seem to be continuing to get more and more confused chasing the abnormal line and getting no where in helping those who cannot manage their drug use. Happy new year from Australia where its a little warm this week

      Reply
    3. matt

      Thirded.

      Reply
      1. matt

        MAT (Modern Attachment Theory) Allan Schore is worth a look too. He doesn’t talk much about addiction, but makes the case for sustained anxiety and other developmental issues that are precursors

        Reply
  3. Dawn

    ACE data? Let’s not get carried away. ACE (adverse childhood experiences) data is based on subjective responses drawn from memory. The meaningfulness of the data, if one is interested in maintaining a rational perspective, must take into account what we know about memory: ” . . . what we know about memory is that it’s totally creative and faulty. When we remember our childhood, we leave out a lot and we make up a lot. Not because we’re trying to, but because that’s the way memory works.” Robert Waldinger, Zen priest and leader of the longest-running study of human happiness.

    Reply
    1. Marc

      The types of experiences reported on in the ACE questionnaires are mostly very concrete: e.g., physcial, sexual, or psychological abuse, mother treated violently, parental separation or divorce, parental substance abuse, household mental illness, family member incarcerated etc.. Granted, some categories such as “emotional neglect” are fuzzy, but most are not.

      Also, this isn’t rocket science. While self-report is obviously subjective and biased, I have talked with or heard from literally thousands of people who’ve been through addiction. A very high percentage of them (of us) have gone through some form of early emotional trauma that is not considered normative for our culture.

      Reply
      1. LouAnn Jones

        Amen Mark!!! It was very Real and still IS very vivid in my mind. And I am 61 years young.

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      2. matt

        Thanks Marc and Dawn

        The question here seems to be the validity of the relationship between ACEs and later addiction, given the (obviously true) reconstructive and unpredictable vagaries of memory. I’m not a scientist, but I’d like to raise a point based on my experience running many recovery groups. If we limit ourselves to cases in which there is empirical evidence of the ACEs, not subject to memory’s reconstruction, would we still find the relationship to hold? Based on my experience, I think we would. In my groups there are so many people who have childhood experiences of parents being incarcerated, of parents being addicted, of parents involved in violence, childhood neglect—these would all constitute ACEs. I understand that there may now be people with addictions who learn of the ACE addiction relationship, and do begin to reconstruct an explanatory ACE after the fact. Some or many of these may be dubious evidence. But can the hypothesis be based on exploration of the cases where there is evidence beyond memory reconstruction?

        n my own experience, I think Mood Congruence Theory (which no one talks about anymore in that way) makes sense. If I am anxious and depressed, I’m gonna remember the bad stuff more than the positive. Maybe it was an adaptation to risk avoidance evolutionarily. But in the reality of my subjective experience(is that an oxymoron?) I got tired of feeling that way. Instead of Waldinger’s path to happiness, I took the quick fix.

        It seems to me Porges, Bessel Van Der Kolk, Alllan Schore, Judson Brewer, and other developmental researchers, plus all the people looking directly at addiction (Marc, Maya, Maté, et al) all seem to be coming to this in one way or another

        Dawn, thanks so much for this important question. We don’t want to throw the baby out with the bathwater, but we don’t want to go on a wild goose chase either. Thanks for keeping us on the rails around this. 🙂
        I

        Dawn.

        Reply
  4. Eric Nada

    Happy New Year to you and yours, Marc. I look forward to what I’m sure will be a mature and necessary discussion with Nora Volkow. I also look forward to hearing about the various talking points that you guys discuss, and hope there will be video available. Here’s to the preadolescence in your life staying benign (without being boring) and leading into an equally benign (without being boring) adolescence.

    Reply
    1. Marc

      That would sure be nice. We have so far filled their days with activities which they appreciate (e.g., music, coding, yoga or meditation) and then reward them with limited “screen time” when they’ve done everything they’re supposed to do. Seems to be working extremely well.

      Reply
  5. Paul du Buf

    Hi Marc, happy new year to you. As a fellow dutchman and working as a nurse with people with addictions for many years in the UK and the Netherlands I am now learning with a passion about, in my experience, a major gap in addiction treatment which is working with the intelligence of the body. Being curious and listening to its narratives. Inviting a focusing relationship specially has my interest currently. I would love to have the intelligence of the body come more into the picture. Coming to the Netherlands myself end of January from Vancouver, where I’ll continue to live and work, maybe like to meet and explore over a cup of coffee?

    Reply
    1. Marc

      Sure, Paul. Let’s try to meet up. I think that information and ideas about the “intelligence” of the body could be very interesting. Perhaps you could consider writing something yourself!

      Reply
  6. Joanna “Nicci Tina” Free

    Marc – I look forward to seeing the video – there’ll be one, right? – of your talk/debate with Nora Volkow. Glad to hear you’re not leaving off blogging. I enjoy reading, even if I don’t always comment in response.

    I feel so glad and excited for the evolution happening in the field of addiction. Thankful for your voice in that.

    Happy New Year to you and yours!

    Reply
    1. Marc

      And to you, Joanna. Maybe you’d consider doing a guest post summarizing the evolution you mention. Some people feel that the field is stagnating, but I can also see ways in which it’s evolving. A summary piece would be very welcome.

      Reply
      1. Carlton

        Yes, a Summery, or a Point-of-View of the evolution in the field of Addiction up to this point, could prove insightful…. especially from a reader of this blog.

        And perhaps the content Marc’s upcoming talk/debate with Nora could be considered a reference point of some sort.

        Marc, the website uses the words “published by”, so does that mean this debate will only be available as text, and if so, when will it be available to the public?

        Looking forward,
        Carlton

        Reply
  7. William Abbott

    great to hear from you – and you taking on Nora, Remembering your encounter at the Dalai Lama session warms my cockles . Hope its to be recorded so we all get to see/hear it later

    Sendng you sharp sabers and strong armor lol

    Reply
  8. Marc

    Thanks, Bill. I hope I won’t need the sword and armor, and maybe the glow of truth will suffice. But it’ll be good to have just in case. (although the Dalai Lama would not approve!)

    Reply
  9. Cheryk

    Marc, I’d like information on other ways to beat addiction. Other than AA 12 steps.

    Reply
    1. Marc

      There are literally thousands of books and tens of thousands of articles, blogposts and so forth out there. The consensus in this community seems to be that 12 steps have limited effectiveness…but there are many different strokes for many different folks.

      Reply
  10. Joe S.

    Looking forward to your discussion with Prof. Volkov. Will it be recorded? Please let us know where we might find it.

    Reply
    1. Marc

      Hi Joe. I’ll let you know as soon as I find out.

      Reply
  11. Gina

    Hi Marc! I’ve long enjoyed your blog, even if I don’t comment often. I think it’s one of the most thoughtful, intelligent, open-minded and non-judgmental forums anywhere online for discussing the very complex and sensitive topic of addiction and I recommend it often. I’m also REALLY looking forward to your debate with Nora Volkow. I know it’s a long-time coming. Is there a way to stream it online either live or will it be available for download somewhere after the event?

    Reply
    1. Marc

      Probably it will be posted to YouTube. I’ll let you know.

      And glad that you are so taken with the blog. So am I!

      Reply
  12. Michele Wilson

    Will this debate with Dr. Volkow perhaps be filmed to post on YouTube?

    Reply
    1. Marc

      I’ll find out and let you know…

      Reply
  13. Mark

    Here’s an idea for beating addiction – a brain implant. What could possibly go wrong?
    http://www.euronews.com/2018/01/05/scientists-say-brain-implant-may-be-key-beating-addiction-ncna835051

    Reply
  14. Don

    Hey Marc how was the debate? I know you will post something soon but was just curious if it was productive?

    Reply
  15. HouTex

    Happy New Year Marc! Would love to see the debate with Nora Volkow. As you said differing viewpoint but hopefully some common ground was found … disease or compulsion, hereditary or learned whatever the differing viewpoints on addiction are one thing I think people can universally agree upon is how destructive it is … to the addict and those around the addict.

    Suggestions or thoughts for the blog … I would like to see the process addictions discussed … food, sex/porn and gambling, etc. Do they affect the brain in the same way as substance addictions? Can someone addicted to food recover naturally, the way you talked about in The Biology of Desire, when the focus of the addiction food (or sex or shopping) is not something than can be removed from the addict’s life but rather the addict must learn a new way of relating to food?

    Reply
    1. Jackie

      I would also like to see the process addictions discussed, particularly food and overeating. Also excessive internet and phone use. It’s impossible to live without eating, and very difficult to function in contemporary life without the internet and a mobile phone.

      Whilst these addictions may not have such extreme effects as substance addictions, and they may not have such obviously destructive consequences on others, the necessity of eating and human interaction may make them extremely difficult to overcome.

      Reply
  16. Donnie Mac

    Hey Marc , Happy New year .
    I think your answer Cherylk “There are literally thousands of books and tens of thousands of articles, blogposts and so forth out there.” is a bit of a “Cop out ” , I know the 70’s called and they want there sayings back . I’m not a super big fan of Eckhart Tolle but he did say something that was interesting . He talked about problems and how most of them are just signs to another place . He used the metephor of a stop sign , that generally just means stop and carry on . But instead we use magnifying glass’s to look at evrey inch of the stop sign and miss the message . I think that’s where we are at , anyone that has read your book agrees that “OK” heres the problem but how do we change the “Rut” in ower heads ? To write here’s the problem with no solution , or , find your own solution from these 30,000 options is well , lacking . Please don’t get me wrong I have more than enjoyed meeting you and reading everything you have written but I think most of your blog fans are here for treatment not for “This is why you might be addicted ” Love all ways . Dam/18

    Reply
    1. Carl

      I’ll take what your’e having 🙂 I think you make a very good point. You have made me think about this stop sign idea.

      Reply
  17. meshack

    Happy new year 2018 ..Why do some people become addicted to drugs while others don’t?is it biological .

    Reply

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