So day 2 of looking at the brilliance that is the book ‘Chasing the Scream’ by Johann Hari.
The other element of the book that I found fascinating and left me scratching my head is the notion of a chemical hook with addiction. This has been the perceived wisdom for as long as I can remember – but you only have to look at behaviour addictions, such as gambling to know that in this case there is no substance and therefore external chemical hook. So his exploration of this felt pertinent to here too. Yes with alcohol if you drink enough often enough you will become physically addicted but that is the end of the journey and there is a great deal of road before that happens.
He looked at nicotine addiction and the evidence. We can do this easily thanks to Nicotine Replacement Therapies where people trying to stop smoking use pharmaceutical products impregnated with the addictive substance, nicotine, to allow them to wean themselves off over time. US research found that only 17.7 of nicotine patch wearers were able to stop smoking even though their need for the addictive substance had been met by the patch and therefore removed. Which leads us to look at the thorny subject of physical dependence and addiction. If you are physically addicted there is an external chemical hook that you have become addicted too. To quote Johann:
Addiction is different. Addiction is the psychological state of feeling you need the drug to give you the sensation of feeling calmer, or manic, or numbed, or whatever it does for you. My coffee withdrawal pains will have totally passed in two days – but two weeks from now, I might feel the urgent need to get my mind focused again, and I will convince myself I can’t do it without caffeine.. That’s not dependence; that’s not a chemical hook; that’s an addiction. This is a crucial difference. And what goes for a mild and fairly harmless addiction like caffeine goes for a hard-core addiction like meth. That’s why you can nurse addicts through their withdrawal pains for weeks and see the chemical hooks slowly pass, only for them to relapse months or years later, even though any chemical cravings in the body has long since gone. They are no longer physically dependent – but they are addicted. As a culture, for one hundred years, we have convinced ourselves that a real but fairly small aspect of addiction – physical dependence is the whole show.
“It’s really like” Gabor (Mate) told me one night, “we’re still operating out of Newtonian physics in an age of quantum physics. Newtonian physics is very valuable, of course. It deals with a lot of things – but it doesn’t deal with the heart of things.” (page 184)
Further on in the book when visiting Portugal where all drugs have been decriminalised since 2001, and where they had radically adjusted how they deal with addiction, there were some valuable insights into how you deal with and heal the addiction element.
The program here, I am told, is built on Joao’s belief that “using drugs is only a symptom of some suffering, and we have to reach the reasons” that make addicts to want to out of their heads much of the time. “You can stop using drugs for a while, but if you don’t solve the problems you have in your mind, things will come back. We have to work [on] the trauma in your life, and only then can you change the way you deal with it”.
So this institution is here, as he puts it, to help addicts “to increase their insight, to analyze themselves – helping them to understand themselves [and] the way they react.” Over your year and a half being treated here for addiction, the team will try to build a safe, trusting environment where you can do something you have been running away from for years – express your emotions, and tell your story truthfully.
This often starts with basic steps. The recovering addicts play a game based on Pictionary, where they have to make a face that expresses an emotion, such as anger or sadness. At first, many of them refuse to: it is too frightening. They can’t bear to let these emotions show, even in a game, for a moment. This is one of the reason why they have needed to be intoxicated for so long: to escape the terror and lack of control that comes with emotions like these. (Page 242)
So physical dependence is an external chemical hook and addiction is an internal psychological hook to looking away from difficult emotions. I often wonder why I’ve ended up studying Child and Adolescent Psychotherapeutic Counselling but it makes perfect sense in light of this. I’m re-parenting myself to understand these emotions as I recover from my alcohol addiction. I’m a wounded healer …….