by Maia Szalavitz (2016) @maiasz
[also co author to the boy who was raised by a dog]
can’t remember how i got intro to this..
addictive behavior is back (from 80s just say no) in the media spotlight, though these days it’s not crack but internet .. sex… food.. gaming.. addictions .. and the tragic drumbeat of prescription overdose deaths .. that get the most attention.. overdoses are now in fact, the number one cause of accidental death, surpassing even auto fatalities..
today.. more people than ever before see themselves as addicted or recovering from substance addiction: 1 in 10 american adults – more than 23 mn people – said they’d kicked some type of drug or alcohol addiction in their lifetime in a large national survey in 2012.. at least another 23 mn. suffer from some type of substance use disorder.. that doesn’ even count the million s who consider themselves addicted to or recovering from behaviors like sex, gambling, or online activities.. nor.. food related disorders.. the 2013 declaration by the american med assoc that obesity, like addiction, is a disease, up to one in three americans may now qualify due to their body weight..
at same time, big pharma, big food, big tobacco , big alcohol and big business in generall a ll seem to intimately understand addiction and how to manipulate it.. however most of the american public.. do not..
as this book will demo, addiction is not a sin or a choice, but it’s not a chronic, progressive brain disease like alzheimer’s either.. instead, addiction is a developmental disorder – a problem involving timing and learning more similar to autism, add and dyslexia that it is to mumps or cancer..
like autism, addiction involved difficulties in connecting w others.. like adhd it can also be outgrown in a surprisingly large number of cases
in all these conditions.. the boundaries between normal and problem behavior are fuzzy
early life trauma also can play an important role in addiction whereas it plays no role in autism..
in all these conditions – including autism itself – repetitive, vigilant or destructive behaviors are not usually the primary problem. instead they are typically a coping mech, a way to try to manage an environ that frequently feels threatening and overwhelming..
the behavior is often search for safety rather than an attempt to rebel or a selfish turn inward
90% of all drug addictions start in adolescence and most illegal drug addictions end by age 30
understanding the role of learning illuminates what’s really going on and what to do about it… properly understood, the addicted brain isn’t broken – it’s simply undergone a diff course of development.. people actually have increased odds of recovery as they age..
so.. let’s get back to not yet scrambled ness..
moreover, as parents and teachers everywhere know well, it’s almost impossible to force or coerce learning – esp to alter behavior that has already become habitual.. fear and threat also literally shunt energy away from the areas of the brain involved in self control and abstract reasoning.. exact opposite of what you want when trying to *teach new ways of thinking and acting ..
or.. *free up
sadly, cancer rarely disappears when someone falls in love and marries – but alcoholism and other addictions can and often do remit
though my specific story is undoubtedly unusual, its particulars illustrate the universality of learning in the addiction process and why its singular nature in all cases is critical to understanding the larger problem..
1 – needle point
heroin was the only thing that really worked, the only thing that stopped him scampering around in a hamster’s wheel of unanswerable questions. – edward st aubyn
to do better we need to understand what addiction really is.. and how our misguided attempts to define it have actually caused great harm
this was my first personal encounter w supposedly professional ‘help’ for addiction: a system that calls you ‘dirty’ if you relapse; on that assumes you are a liar, a thief, or worse and responds to increasing symptoms of addiction not by offering more help but by punishment or expulsions.. the fact that i exhibited symptoms fo addiction was basically why i was expelled from treatment for it..
2 – a history of addiction
drug ed programs tend to avoid publicizing these stats, the expert consensus is that serious addiction only affects a minority of those who try even the most highly addictive drugs, and even among this group recovery w/o treatment is the rule rather than the exception..
word addiction referred to a social relationship of bondage: latin root means ‘enslaved by’ or bound to’..
the idea that addiction was a form of chemical slavery became increasingly popular a few decades later .. mid 19th cent. it may not be a coincidence that during the same period. the us was also consumed by debates over race and the actual slave trade. blatant racism and ideas about bondage have played a role in concept s of addiction and drug policy right from the start..
physician and dec of independence signer benjamin rush.. was among first to call alcoholism a ‘disease of the will’
rush was also a leading abolitionist: he found the first anti slavery society in the us.. however, as w addiction, he saw being black as a disease.. he called this illness ‘negritude’ and thought it could only be cured by becoming white..
when particular drugs weren’t associated w ‘the dangerous classes’ however addiction tended to be seen as a medical problem..
today, many experts argue that, in fact, junk food is at least as addictive as coke and the comparison is no longer shocking in light of the high prevalence of obesity – then, however, it was genuinely seen as both absurd and beyond the pale
3 – the nature of addiction
what makes drug withdrawal hard to take is the anxiety, the insomnia, and the sense of losing the only thing you have that makes life bearable and worth living, no the puking and the shaking. it’s the mental and emotional symptoms – the learned connection between drugs and relief and between lack of drugs and pain – that matter
studies find that people who believe a particular type of pain means that worse is to come actually rate it as more severe.. that if they have exact same physical experience ut can be reassured it’s nothing to fear..
it was her analysis of what the pain meant that had tormented her
no matter whether the source of pain is obviously ‘physical’ or ‘just psychological’ the unpleasant aspect is processed by many of the same parts of the brain. not coincidentally, these regions are rich in opioid receptors
w/o heroin, my receptors were screaming for relief, the addiction having reduced or otherwise disabled my natural supply of endorphins and enkephalins, which are the brain’s heroin-like neurotransmitters. mostly, i felt utterly stripped of safety and love. and so, what tormented me most.. the recurring fear that i’d never have lasting comfort or joy again. i needed to understand what drugs had given men and what addiction had taken away
gabor‘s first question – what did the addiction give you
many people think this definitional debate is only seen around addition. but the sam is true in schizo, bipolar, autism, depression, and all the other conditions in psychiatry’s diagnostic manual. in none of these diagnoses has a single pathology, present in all affected people and absent in others, been found. in fact, once a specific genetic profile or a unique physiology can be detected reliably, it may be redefined as ‘neurological’ rather than psychiatric and removed from the manual, which leaves psychiatric diagnosis open to ongoing controversy
some characteristics that seem necessary to addiction actually aren’t.. take withdrawal symptoms.. cocaine and meth produce few such signs.. conversely.. there are blood pressure meds that have potentially fatal withdrawal syndromes – if miss dose .. can kill you.. sounds like ultimate addiction.. but people don’t crave these drugs.. fail to urgently seek them and even forget to take them.. also.. because these hypertension meds improve health.. difficult to see patients who rely on them as addicted
similarly, some antidepressants can produce wicked withdrawal.. people often forget to take antidepressants – but no addict ever forgets to take her heroin.. if addiction is simply needing something to function, we are all food, water, and air addicts and the term is pretty well meaningless..
our society doesn’t deal well w conditions that cross boundaries between mind and body, med and ed, psychology and psychiatry, psychiatry and neurology..
if you manage to make it thru adolescence and young adulthood w/o developing an addictive coping style, your odds of developing one later, while not nonexistent, are dramatically reduced..
addiction then, is a coping style that becomes maladaptive when the behavior persists despite ongoing negative consequences..this persistence occurs because ‘overlearning’ or reduced brain plasticity makes the behavior extremely resistant to change.. plasticity is the brain’s ability to learn or change w experience. lowered plasticity means this ability is compromised, and when a pattern of activity is locked in, it is ‘overlearned’
where had the seeds of addiction been planted for me..
4 – intense world
that drive to return to the past isn’t an innocent one. it’s about stopping your passage to the future, it’s a symptom of fear of death, and the love of predictable experience. and the love of predictable experience, not the drug itself, is the major damage done to users.. – ann marlowe.. t
henry markram – research.. on attempts to deal w overload.. calling it ‘intense world’
a barrage of chaotic, indecipherable input, a cacophony of raw, unfilterable data..just to survive you’d need to be excellent at detecting any pattern you could find in the frightful and oppressive noise.. to stay sane, you’d have to control as much as possible, developing a rigid focus on detail, routine, and repetitions.. systems in which specific inputs produce predictable outputs would be far more attractive than human beings, with their mystifying and inconsistent demands and their haphazard behavior..
this.. the markrams argue, is what it’s like to be autistic.. rather than being oblivious, autistic people take in too much and learn too fast.. while they may appear bereft of emotion, the markrams insist that people w autism are actually overwhelmed not only by their own emotions but by the emotions of others.. not caused by problems w empathy.. instead.. social difficulties and odd behavior result from trying to cope w a world that’s just too much
i spent a lot of time trying to foresee and control what would happen next, attempting to manage my responses in advance.. unfortunately that meant that i had few attentional resources left over to consider the thoughts and feelings of other people..
it was as thought the volume knob on all of my senses was turned up
i found songs in minor keys so upsetting, i would cry just because a melody seemed sad; i generally refused to wear anything confining.. i lived on bland foods like p butter and pizza crusts.. i had a difficult relationship w touch: i often longed to be held and comforted, but i hated feeling out of control and some types of pressure made me feel like i was going to suffocate.. so i resisted and pulled away from many hugs.. my family members learned not to touch me unless i initiated it or otherwise indicated that it was ok. paradoxically, this sometimes made me feel rejected because i couldn’t understand why i was so diff
pete townshend (the who): most people for whom alcohol becomes a problem are running away from something.. usually, what they are running away from is feelings and the inability to deal w the intensity of their feelings
in reading and listening to hundreds of these stories over the years, i’ve found that many include a sense of being fundamentally diff and uncomfortable in their own skin.. ‘always at odd w entire world’. codeine.. made me feel right for the first time in my life..i ever felt right from as far back as i can remember and i was always trying diff ways to change how i felt’
the particular symptoms that people use drugs to cope w may be infinitely varied, but the desire to feel accepted and secure when you typically feel alienated, unloved, anxious, and in danger is common.. alternatively.. some people’s temperaments make them feel understimulated.. here a sense of exploration, a desire to push limits.. and a love of risk and adventure may underlie addiction.. either way, the temperaments that make people stand out begin affecting them from birth..
as a learning disorder, addiction results from a *dysfunctional coping style, in a wy that is profoundly affected b development
or their only functional way thru trauma.. no?
the sensitive period for developing addiction – as w schizo – is adolescence.. not early childhood.
? what..? i’m thinking it’s more early childhood’s missing of maté basic needs..
the idea that simple childhood exposure to a potentially addictive drug will automatically produce addiction is not supported by the ritalin data – or, for that matter, by research on therapeutic use of other potentially addictive drugs like opioid pain relievers in children
oh my.. to the ritalin
sadly, the idea that early therapy fo adhd will help prevent negative consequences like addictions isn’t supported either.. the theory is that stimulants will help kids w adhd by allowing them to do better academically and socially. this in turn will reduce the risk of self meds w illegal drugs or alcohol to cope w such difficulties during the teen years.. unfortunately, it doesn’t seem to work that way: most studies find the risk is the same..
of course.. ie: doing better academically.. not the problem
5 – the myth of the addictive personality
addicts are just like everyone else – only more so.. – anonymous
(on standing out) – and i couldn’t do anything about it other than start looking for ways to escape
fundamentally, the idea of a general addictive personality is a myth
children who ultimately develop addictions tend to be outliers in a number o measurable ways
giftedness and high iq.. are linked w higher rates of illegal drug use than have avg intelligence
oy.. perhaps it’s the labels.. that are driving us to intoxication.. ie: outlier.. gifted..
addictions and other neurodevelopmental disorders rely not just on our actual experience but on how we interpret it and how our parents and friends respond to and label the way we behave
ie: disorder, gifted, outlier..
difficulties w self regulation lay the groundwork for learning addiction and for creating a condition that is hard to understand. the brain regions that allow self reg need experience and practice in order to develop..if that experience is aberant (departing from an accepted standard) or if those brain regions are wired unusually, they may not learn to work properly
it seems the same regions that gave me my intense curiosity, obsessive focus and ability to learn and memorize quickly also made me vulnerable to discovering potential bad habits and then rapidly getting locked into them
for many, if not most, people w addiction, trauma is perhaps the critical factor that causes the problem.. t
per gabor – for all.. trauma law
ie’s of trauma
explains why she’s saying many/most.. her defn of trauma seems (at this point) to be extreme/visible trauma – something bad done to you.. leaving out the other piece from gabor – something good not done/given to you
this doesn’t mean that all addiction comes from trauma: in my own case and perhaps one third of others, there is no significant trauma history..
basically, epigenetics involves changes to molecules that determine which genes will be turned on and which will remain silent.. these changes don’t alter the dna that transmits genetic info itself. instead, they affect the structures around the dna that determine how it will be read.
studies of the offspring of holocaust survivors suggest that our parents’ experiences may be written in our genes
changes in sperm and egg cells, however are not the only way epigenetics can influence development overwhelming stress and trauma can deeply influence how parents interact w infants..
nurture or lack of nurture itself is what determine the epigenetic outcome here: *good parents literally activate a more optimal set of genes for their children..
importantly, however, the changes that result from being raised in a stressful environ aren’t al negative. the reason that early environ affects later development is to allow organism to prepare for the life they expect to experience by turn on or off certain genes.. *this is nature’s way of adapting children to the environ they are most likely to face.. given the genes they have.. so if a child is brought into a wildly stressful harsh world, genes that will help him thrive in such situation as are turned on.. while those that would be best in a calmer ,safer place are muted..
in an uncertain world, it’s rational not to count on anything to far in the future,.. however this type of short term thinking can lead to impulsive choices like eating one marshmallow now rather than waiting for tow later or taking drugs rather than going to school
as a child i would lie awake at night, overcome w fear about the end.. i would try to pry, hoping there was some sort of afterlife, but the judaism i was being raise w was conspicuously silent on this issue..
silence as your trauma.. no..? nothing really to do w say.. judaism.. but to do with the fact that you were wrestling w something in isolation.. no one to talk to
mother undergoing treatment for cancer during preschool yrs.. she had always been haunted by her own mother’s death from that disease.. and while i wasn’t told what she had, i did know something was wrong..father holocaust survivor
silence again.. to curiosities.. trauma
same fears my father had.. he never talked about it.. but seems to have somehow transmitted his terror to me..
further because i was ashamed of my compulsions.. i hid them as much as possible.. this shame itself .. is also symptomatic of compulsive behavior.. because of visible loss of control or marked by powerful feelings of self-loathing. either way, the mental and physical ritual i engaged in on the swings at my elementary school was far from my only unusual routine..
u less anxious will actually make you more so, you don’t believe it. you feel compelled to repeat it, even when you are utterly sure it will not help. this is the heart of why addiction.. are learning disorders..
people don’t develop drug addiction by just taking drugs. pre existing difference in temperament and in *negative experiences are what drives the learning of addiction..
*and absence of positive ones
seeing addiction as ’caused’ by the availability of specific substance blinds us to what drives it more generally. it creates instead a serial focus on an ever expanding list of potentially dangerous compulsions, from new drugs sold online to the internet itself, from mobile phone use to gaming and porn. the problem isn’t the existence of activities and substances that offer escape; it’s the need for relief and the learned pattern of seeking it that matters..t
nicely put.. spot on
as a result, the behavior will either be hidden or replaced by a substitute action if the real driver of the behavior isn’t addressed..t
indeed, many autistic adults describe being traumatized by therapies aimed at suppressing their self soothing and self stimulating behavior because this left them exhausted, upset and w/o alternative means of coping
same for drugs: banning new ones or cracking down on old ones may make policy makers feel like they are ‘doing something’ but it ignores the real problem.. which is the distress that makes people seek escape..
6 – labels
the reason diagnostic labels are so important.. is that w/o those labels, we only have the labels we got in the streets, which are hateful – john elder robison
that was obvious to me in how much i stood out from other children.. the idea that i was somehow born bad and could never change played a big role in how my mental health problems grew over the course of development
while much has been said about dangers of psych labeling/meds.. w/o a label, children may come up w their own ideas about ‘what’s wrong’ w them.. because it’s plain from how other people react that something is
so – label daily curiosity.. because this is deeper than having labels/language.. it’s about *a nother way to live.. ie: those acting like something is wrong.. have just as much ‘wrong’ w them.. ie: are in need of just as much.. or even more.. detox..
it was typically years before our experiences and our damaged sense of self led us to start drugs – and then at least months of repeated, daily use before we thoroughly learned addiction. but the condition originated in the way we learned to frame ourselves and the world and the way we learned that drugs could alleviate the resulting distress
gabor – not why the addiction… but why the pain
drugs alone do not hijack the brain. instead what matters is what people learn – both before and after trying them
one of the reasons that addiction is best seen as a learning disorder is that it simply cannot take place if someone doesn’t learn over time to associate a drug w pleasure and/or relief (only small minority of those who try any rec drug become addicted)
after those in hospital treated for pain w opioid drugs for several weeks.. goes home.. they never realize the nausea vomiting cramps sleepless ness… this ‘hospital flu’ is actually opioid withdrawal.. they haven’t learned that lack of drugs is the source of their symptoms.. haven’t id’d drugs as source of comfort.. or as best way to cope..
if you haven’t learned tha t a drug ‘fixes’ you, you cannot be addicted to it.. even if our body is dependent on it..
the idea that physical dependence was ‘real’ addiction but psych dependence was mere trifle led people to ignore the role of learning.. the mind/body distinction is a false one..psych needs and desire drive addiction and these change w learning and development physical dependence does make quitting drugs harder – bit if it were the real problem, addiction could be cure simply by being forced to wait out withdrawal..
the failure to distinguish between physical dependence and the learning that creates addiction is also why, contrary to claims .. babies can’t actually be ‘born addicted’.. infants can be born w physical dependence on drug.. but sence they don’t learn .. take drug to feel better.. they can’t crave it.. don’t know what to crave..
often what actually happens in childrens’ lives is less important than how those children interpret their experience..
7 – hell is jr high school
in many cases, addiction is learned as bullies confirm children’s worst social fears and anxieties about themselves..
8 – transitive nightfall
it took an artificial sensation for me to feel my relationships were real..t
hari lost connections
getting high broke down the wall of fear that kept me from reaching others or accepting myself; it sees to solve my lifelong problem of being both wildly curious about new experience and terrified of it.
i dove into the lit .. and decided there were two classes of drugs: they psychedelics (including pot) which enhanced growth and awareness and the powders (coke and heroin) along w alcohol, which shut that down and were about mere pleasure and escape
the teenage brain is not just an immature adult brain.. it is undergoing a transition comparable in magnitude only to its explosive development in the first few years fo life.. this stage is critical for understanding addiction: most learning disorders appear during a specific time during development..
as noted earlier 90% of all addiction begin during adolescence.. a child’s elementary school years are a relatively quiescent time in terms of brain development.. however, before that, between birth and the end of kindergarten.. the brain has already grown to a stunning 95% of adult size
all these %’s et al.. and marking years by school years.. we really have no idea what we would be like w/o that.. our natural state.. kids and adults.. and adults affecting kids .. et al.. ie: science of people ness
moving from childhood to adolescence isn’t linear.. from puberty until around age 25, brain undergoes a remodeling almost as extensive as period in first 5 yrs.. both marked not only by growth but also by pruning.. during childhood the brain grows billions of connections and then prunes away nearly half of them.. (smaller or shrinking structure aren’t alway a sign of pathology.. sometimes a sign of efficiency)
curious if this happened before we became civilized.. ie: h g child
i’m thinking there’s a diff in which cells are pruned..
failure to remove some cells.. can actually lead to disabilities.. one of most consistent findings in autism,, ie, is early brain overgrowth w some regions being ‘hyperconnected’ or simply having too many cells and too many links between them..
one recent study of brain tissue from the temporal lobes of autistic and typical teens found that while typical adolescents had 41% fewer synapses than typical toddlers, in the autistic teens the percent reduction was only 16%, compared to younger children w autism.. though this excess might have some potentially positive effects – like improved memory ro enhance perceptions – it may also lead to sensory overload or overlearning
? seems a strange comparison..
because the brain is in flux, it is particularly vulnerable during this period: what is learned during the teen years will shape both the brain itself and the psych coping skills people rely on for the rest of their lives
so we do middle school.. nice
successful adolescent development requires a drive for novelty and social contact w same age peers to pull teens away from family and toward friends and potential partners..
the prize looms large.. far out of proportion to thoughts of future and potential risks.. if adolescents think that … will win social approval – *the biggest prize of all at this age – this ca blot out most considerations..
? we created that.. with ie: school.. maté trump law… via pushing them away at age 5
a brain can either be highly responsive or packed w knowledge: expertise comes at the cost of flexibility, to some extent.. brain primed for learning is also brain primed for addiction
9 – on dope and dopamine
they (connections between dopamine in addition and in parkinson’s) suggest that dopamine may be required for the fundamental expression of drives and desires – in other words, free will..
oliver sacks was amount first to explore the philosoph and psych implications of this aspect of dopamine.. connecting it to will and willingness in his 1973 account of patients w severe form of parkinson’s caused by a 1920s encephalitis outbreak: find themselves hurried against their will.. other extreme.. sit for hours.. not only motionless ..lacked will
repeating the experiments.. while dopamine is involved in motivation or pleasures of the hunt.. that’s not the only way we can feel good. dopamine is noo necessary, it seems, for enjoying sweetness, comfort, satiation, and calmness .. research suggests that these pleasure are more strongly linked to the brain’s natural opioids, or heroin like chemicals, instead of to dopamine.. and that has implications for the broader understanding of addiction..
these diff types of pleasure are also important in understanding the role of learn ing in addiction, because wanting is critical to learning while liking is less so.. if you are curious, feel capable, and have a goal in mind – ie; you want something – you will be highly motivated to learn whatever will help you achieve it.. and those lessons will really sink in. in contrast, being calm, content, and satisfied is less directly motivating.. liking can make experience memorable. . but if you don’t also want to repeat it, it won’t change your behavior
in addiction this means that because being addicted escalates wanting more than liking.. the drug experience gets deeply carved into your memory.. as a result when you try to quit.. everything from a spoon.. to a street.. to stress.. can come to driving craving.. desire fuels learning..
habituation or tolerance is the opposite type of learning
addiction is a learning disorder in part because of the way it affects both the habituation and sensitization processes and also skews them
10 – set and setting
norman zinberg’s classic, drug, set, and setting.. found people who took heroin only on weekends for decades w/o neg consequences.. also did firs study showing that although nearly half of american soldiers in nam took drugs like opium and heroin.. 88% of those who had been addicted while overseas did not become readdicted upon returning home.. those how relapses.. around 1% were mainly those who had had drug problems before the war
so why did set (mental state) and setting (environ) matter so much
on skinner and variable reinforcement.. unpredictable reward.. working better than regularity
often, it later turns out that these folks took the drug in a new environ or social setting, not as part of their typical habit. sometimes, a new source of stress is involved – ie: a lost job or breakup. in these cases, the unconscious cues that normally activate tolerance don’t do so – and w/o tolerance, the normal dose becomes an overdose.. sometimes context alone can change a safe dose into a lethal dose..
it is much harder to create tolerance w a drug that imitates the pleasures of desire than it is with one that simulates the experience of satisfaction..
alcohol, incidentally , also (like opioids) does not work for maintenance . unlike opioid tolerance, alcohol tolerance doesn’t completely eliminate impairment, even if drug is given in steady regular doses.. opioids produce complete tolerance in steady state dosing, while alcohol does not..
on environ – 77 – bruce alexander’s rat park.. might they take drugs excessively in the classic experiments not because the drugs are so good – but because the rest of their lives are so bad..t
drugs are powerful primarily when the rest of your life is broken
providing a running wheel reduces cocaine use by 22% in male rats and 71% in females..
interestingly, offering large amounts of sugar also cuts cocaine use..
brains did not evolve in order to allow us to become addicted.. we get addicted only in certain context.. by itself nothing is addictive..
11 – love and addiction
heroin gave me the comfort that all the other drugs had only teased me with, a sense of well being that ended all worries.. the high wasn’t delicate; it couldn’t detour into darkness like marijuana, psychedelics, and even cocaine might.. soaring on heroin, i felt safe, wrapped in a cozy, protective blanket.. for what seemed like the first time ever i felt truly safe and loved
ever since addiction as first described, people have compared it to love..
nearly every behavior seen in addiction is also found in romantic love.. obsession .. craving.. uncharacteristic, and even immoral behavior to ensure access.. withdrawal prompts anxiety and fear… only the drug/loved-one can relive these pains.. both conditions profoundly alter people’s priorities..
importantly, like addiction, misguided love is a problem of learning. i love, people learn powerful association between their lovers and nearly everything about/around them.. in addiction.. these connections are made w the drug.. soon relevant cues.. will spur relapses.. stress often leads to relapse..
in both.. the stress relief system has become wired to the object of the addiction.. you need the drug/person to feel at ease.. in same way that young children need their parents..
w/o oxytocin, ice cannot tell friends or family from strangers and mothers do not learn to nurture their young.. . the specific geography of these receptors allows the memory of special partner to be wired into a vole’s brain, making him or her ‘the one and only’ ..this happens during mating … linking the scent of the partner w the pleasure of sex and the comforts of hume..later, when that partner is present, the stress system will be calmed and dopamine and opioid levels rise.. in contrast.. when partner is absent, stress rises and withdrawal symptoms insure..
montane voles, in contrast, are not wired for monogamy. sex feels good to them of course, but the particular partner doesn’t matter.. they don’t have enough receptors for oxytocin or vasopressin in their pleasure regions – so they never link the memory of a specific mate w the joy of sex.. for a montane vole, any attractive member of the opposite sex will do.. only sexual novelty, not familiarity, brings pleasure in this species..
in both men and women oxytocin is copiously released at orgasm..it also spikes during childbirth and nursing, causing uterine contractions during labor and later.. the letdown of breast milk.. it helps bind parents to their particular babies.. .. oxytocin has become known as the ‘love hormone’ or ‘cuddle chemical’
oxytocin apparently teaches us who is friendly or at least familiar.. and who is not.. can do same for memory of drugs..
studies have shown that oxytocin elevates trust and helps autistic people to more accurately detect other people’s’ emotions.. not entirely benign though: while it strengthen bonds and encourages altruism among ‘us’ it also elevate hostility toward ‘them’..
you many also compulsively seek drugs because you discover that they provide a sense of being truly loved that you can’t find elsewhere.. if bonding system s are miswired for any reason – genetic, environ, or both – you as may not be able to feel the love other people actually do have for you and may also look for relief in drugs..
oxytocin wiring is basically designed to addict us to each other..
love really is a drug – or rather, it’s the template for addictive behavior
because addiction was defined as a disease, codependency became one as well.. the problem of codependency was soon combined w the idea of ‘tough love’ which diagnosed nearly any caring behavior toward people w addiction as ‘enabling’ their drug use to continue..as a result.. codependency counselor and al anon members recommend withholding love and material support. add this to an individualistic culture where any type of dependence on others is seen as weakness and you have a recipe for pathologizing normal human needs while increasing the pain and stigma associated w addiction..
w/o repeated, loving care by the same few people, infants are at high risk for lifelong psychiatric and behavioral problems..
rene spitz – 1940s – prisoners allowed to keep children.. thrived.. supposed safer hospital.. w rotating rarely touching nurses.. 1/3 died
while a romantic relationship isn’t necessary for health, having at least some close relationships is.. loneliness can be as dangerous to health as smoking and more harmful than obesity..
in 80s.. any need for others was suspect.. esp someone who was already an addict
there is no co dependent personality no brain disease of codependence…
i figured scraps (or relationships) were better tha nothing at all.. love is real when it expands and enhances your lief.. and troubling and problematic when it contracts or impairs it.. whether you love a person/drug/intellectual-interest, it if is spurring creativity, connection, and kindness, it’s not an addiction – but if it ‘s making you isolated, dull and mean, it is..
obsessions can get out of hand, bu love is inherently obsessive and needs to be that way to keep us bound to each other.. the obsession itself doesn’t make love and addiction
dependence itself is pathologized… dependence isn’t the real problem in addiction: compulsive and destructive behavior is
love can’t always cure addiction – but lack of it or inability to perceive it often helps cause addiction.. compassion is part of the cure, not the disease.. out societal belief that toughness is what works instead is a huge part of why our drug policy is so disastrously inept and harmful…
addiction and love are both deeply culturally constructed.. this means not that they aren’t real but, rather, that they can’t be defined in some generic context, that they must be understood where and when they occur specifically…
part of the function of emotions themselves is to carve important experiences into memory, so learning love or addiction is visceral… not just stored like other memories.. the changes are deeper, longer lasting and more pronounced..
love and addiction change who we are and what we value – not just what we know
12 – risky business
i consistently chose what felt better now..
if the world is unpredictable and people are unreliable, an available reward now is more valuable than an uncertain gain later.. children who eat the one marshmallow in front of them rather than waiting for two later are actually making the right choice, given the environ constraints they typically face
if the prisoner does not know that the possibility of escape exists.. via the trapdoor, she is not ‘free’ to choose it.. even though another prisoner who does have that info can easily liberate himself.. while addicted there are alt behaviors available… you sometimes even recognize they exist.. but you simply can’t enable them or believe w enough conviction that they will genuinely help to power yourself thru the necessary changes..
i literally couldn’t take in love that was actually present, no matter how clearly expressed. it didn’t reach me.. perhaps because depression had lowered my ability to feel the pleasure of relationships..
my father.. unaware of this deficit, he often blamed his poor moods on flaws in the work or in those who couldn’t figure out how to please him..
exploring the learning involved in parenting (role of endogenous opioids in the maternal/offspring bond).. offers yet roe insight on the learning processes of addiction and their compulsive nature..
even normal parenting, for ie, involves a touch of ocd.. obsessed w safety et al
nothing is actually ‘instantly addictive’ because learning takes actual, not just planned or wanted, repetition
13 – busted
while there are many experiences that are not common to all addictions, the compulsion to continue using no matter what ..is its essence..
in this light .. the idea that other sorts of threats or painful experience will stop addiction makes no sense.. addiction is an attempt to manage distress that becomes a learned and nearly automatic program.. adding increased distress doesn’t override this programming; in fact, it tends to engage it even further.. if learning were occurring normally during addiction , addicted people would soon learn not to take drugs because the consequences are so bad.. the fact that they do not is the crux of the problem..
students have found reduced brain activation during punishment (typically monetary loss) in people addicted to cocaine and meth
so why then do so many believe that addiction ends when people hit bottom.. and that criminalizing drug use helps people bottom out..
to understand how we came to use punishment to ‘treat’ a condition that is literally defined by its resistance to punishment.. we have to return briefly to the history of ideas about addiction and how this influenced our laws related to drugs..
america’s first drug laws were born in a climate of overt racism, during the jim crow years.. the rhetoric used to win their passage was explicitly racist.. and supporters played on white mens’ fears of .. losing power..
this unfortunate use of drug policy in support of racism did not end w prohibition; it simply went underground.. reemerging in 71 w nixon’s declaration of war on drugs.. expanded further by reagan.. using code words like ‘crime/drugs/urban’ to signal to racist voters tha republicans would ‘crack down’ and be ‘tough’ in dealing w black people..
as michelle alexander points out in her bestseller the new jim crow, selective enforcement of harsh drug laws created a new – and apparently legal – way to segregate, control and incarcerate black people..
but this is only one part of why america remains addicted to a punitive – and failed – drug policy
14 – the problem w bottom
shame and guilt didn’t provide any new tools that would allow me to change. w/o a clue as to alt ways of coping.. i could’t see ay way out..
because we do not understand addiction as a learning disorder – one that is actually define by its resistance to punishment – these ideas are particularly pernicious.. (punitive approach)
study of over 100 000 american children arrested between 1990 and 2005.. mainly for drug crimes or assault – found that those who receive custodial sentences were 3x more likely to be incarcerated as adults.. regardless of the severity of initial crime.. as compared to those given al sentences in the community or to those who had their charges dropped.. this means that for youth, prison is essentially 3x worse than doing nothing at all..t
a canadian study followed nearly 800 low income youth from age 10 to adulthood.. found an even bigger effect.. it included kids who didn’t get caught.. found to be 7x higher.. if teen was actually locked up in a reform school or juvenile prison..
america which lead the world w its incarceration rate, also tops the charts in marijuana addiction and cocaine addiction… suggesting again that the criminal justice system is not an effective way to reduce drug related harm
and what countries have world’s worst rates of heroin and opium addiction? not the us.. although we do lead world in painkiller misuses.. but hard line countries like russia, afghanistan and iran – some of which have the death penalty for drug offenses – have higher rates of illegal opioid misuse..
funding for drug war.. went from 200 mn a year i 70 to more than 15 bn a yr in 2010.. during that same time, addiction rates either remained flat or rose..
until people understand exactly why punishment isn’t a cure for addiction – and why we still secretly think that it is – it’s hard to argue effectively for alts.. addiction frightens.. and angers.. family and public..
so what does keep us so attached to punishment and so resistant to actually changing our practices..? in addition to politics and racism.. misinterpreted ideas taken from 12 step rehabs.. quietly upholds current policies.. their support for a moral approach under the guise of medicine has taken us in the wrong direction…
this concept of rock bottom.. using punishment to fight addition..
these notions originated in 12 step programs which are not a required curriculum in at least 80% of american addiction treatment programs.. langue like ‘enabling’ and ‘bottoming out’ has entered the vernacular and the idea that addiction is a ‘disease’ of ‘powerlessness’ is pervasive in rehab and beyond..
ideas may have been far less troublesome if 12 step remained voluntary and weren’t integrate into coercive treatment and criminal justice system..
one of the groups foundational texts (started by aa in 1935).. lays out why its creator believed that recovery could not begin unless an addicted person is first forced to feel completely defeated (ie: the avg alcoholic, self centered in the extreme, doesn’t care for this prospect – unless he has to do these things in order to stay alive himself)
by 2000 – 90% of all addition treatment was 12 step based.. by early 90s.. rehab had become almost glamorous
people said to have ‘high bottom’ which allows them to see the logic of quitting before they lose that two car garage.. for this lucky group, no addiction al consequences are needed.. for rest who have low bottoms.. recovery is still framed as impossible until so many bad things have happened..
so.. more punitive.. more likely to recover.. more kindness and support.. less likely..
the evidence on what makes for successful recovery contradicts the bottom story: people are actually more likely to recover when they still have jobs, family and greater ties to mainstream society, not less..
even today, virtually every publicly funded inpatient addiction program in the us that calls itself a ‘therapeutic community’ has its roots in synanon (founder said aa is based on love, we are based on hate.. made all these claims.. which weren’t true.. but no one paid heed.. because they loved him for supposedly curing ie: heroin addicts .. he himself arrested for trying to kill a judge who ruled against him.. as an ‘ex alcoholic’ wh had found a ‘cure’ for addiction .. was drunk) – ie: pheonix house and daytop
for decades these programs used sleep/food deprivation, isolation, attack therapy, sex humiliation.. to get addicts to realize they’d hit bottom..
the tough love approach for parents and partners of addicted people is also deeply reliant on the idea of bottom..
a further outgrowth of the forcing bottom idea is the ‘intervention’ ..typically in a big meeting.. threaten to cut off all emotional and financial support.. harshly attack addict.. trying to break thru.. serious potential to backfire: there have been suicides immediately after interventions.. most notoriously.. kurt cobain..
in this context. . not surprising that the criminal justice system is seen as the appropriate tool to fight addiction.. few better ways to make people feel powerless tha n locking them up and controlling every aspect of their lives.. there’s not conflict between viewing addiction as a disease and as a crime if you believe punishment is the cure for the disease..
in fact.. powerless ness and helpless ness is fundamental in determining whether a horrific experience will cause ptsd.. and having ptsd increases relapse and actually doubles and quadruple risk of being addicted in first place..
over four decades of research ,.. not a single study has supported the confrontational approach as superior to kinder and less potentially harmful treatments..
this leave the poor and those who buy int tough love ideology incredibly vulnerable..
15 – antisocial behavior
children w cd (conduct disorder – spiteful.. cruel) tend to lack fear. because they aren’t motivated by pleasing other people, they are also don’t respond w the dismay that ordinary children have about social rejection when they disappoint parents/teachers.. so both social and physical punishments have little effect..
for those who don’t grow out of cd.. 40-75%.. go onto to develop aspd in adulthood.. far end known as psychopathy and sociopathy.. complete lack of conscience.. for others .. ie: serial killers.. but more commonly.. nonviolent con artists and white collar criminals..
so.. unfair to claim addicts are aspd.. ie: liars
addiction is not a personality disorder.. no set of traits seen in all people w addictions..
aspd also extremely diff from ie: autism..w autistic.. problem is not being sure how to act.. rather than being uncaring or indifferent to the social world, autistic people have a hard time understanding the rules of interaction and emotional expression.. in cd and aspd, however this concern for other people is missing
aspd has to have reasons too.. we have to let go of saying.. accept these people.. but not these extreme people.. no either or.. just all of us.. assume good.. assume i know you ness.. and work from there..
fortunately only around 4% of the population has aspd. among addicted people, however, that figure is indeed much higher.. with 18% of those who have some type of illegal drug use disorder also affected by aspd.. and 9% of those w alcoholism affected.. may be as high as 37% w opioid users… but vast majority of addiction s do not fall int it.. and the majority of people w aspd – 60-70% don’t have alcohol or other drug addiction either..
impact of the family circle therapy – w 2 other families
16 – the 12 step conundrum
when i thought the universe was friendly and that pain could lead to insight or at least sometimes had some meaning, bearing it made sense. if however, i believed that ‘life sucks and then you die’ i needed anesthesia and felt there was nothing wrong w seeking it.. i needed to have a reason to suffer; otherwise wy not get high.. in heroin i’d found something to protect me from life’s ups and downs – to quit, i’d need good reason to endure them..
the program seemed to offer what i had been looking for all along: a way of seeing theat would give mea community and in identity, and a way to make sense of the distress in the world..
popular culture at time was 12 step… indeed if anyone dared (support any other approach), the backlash was often vicious.. as i’d soon find out for myself when i started writing about the conflicting da. but before i read the research, i had no idea how far away the positive media portrayal of 12 step programs was from the data collected by scientists..
the trick is disconnecting self help from professional treatment and recognizing the strengths and weaknesses of both..
not to say aa is useless.. when you look at people who voluntarily continue..
given the 12 step programs do provide social support.. and are essentially free.. makes them a resource..
all that said, it is also clearly true that great harms ahs been inflicted by trying to force 12 step morality into a medical and criminal justice system.. teaching it’s their only hope (involving the addict become disempowered et al)
our brains are embodied – much of the problem with debate over addiction and psychiatry more generally is a refusal to accept this and our ongoing need to see physical, neurological and psychological as completely distinct
17 – harm reduction
a 2003 analysis.. black people 10x more likely to get arrested for drug crimes .. 2009 – also 10x more likely to be sent to prison for these offenses.. in fed prison, on avg blacks server early as long for drug offenses as whites do on avg of violent ones.. and 82% of people sentenced under the harsh fed mandatory min for crack cocaine are black..
first time drug offenders often served more time than rapists and killers..
the % of new yorkers in state prison for drug crimes more than tripled between 1973 and 1994.. more than 80% of those sentenced.. who had to serve many years w no possibility of parole – had no history of violence..
same w marijuana – starting in 73.. new yorkers unlucky enough to be caught selling two or holding four oz of weed were looking at a 15 yrs in prison.. but give how likely such laws were to enmesh white kids, marijuana wasn’t included for long..
by 2008.. more than 90% of ny state’s drug prisoners were minorities..
between 85 and 92.. the number of nyc residents sent to state prison annually for drug crimes quintupled.. from 2000 to 10 000 .. similar nationally..
we are now world’s largest jailer.. w 5% of population but 25% of prisoners
although press claims that heroin use is now a white thing for the first time, in fact the majority of heroin users have been white since the 70s..rates of heroin addiction in people making less than 20 000 per year are triple those for people who earn 50 000 or more.. addiction disproportionately kicks people who are already down
alt to war on drugs – 80s.. harm reduction.. recognizes crucial role of learning in addiction and failure of punishment to solve drug problems.. also based on idea that even during active addiction, people can learn and change..
teaching how to use safe needles
in essence.. harm reduction is the idea that the goal of drug policy should be to minimize negative effects of drug use, not use itself.. by 87.. because clear that the biggest danger associated w illegal drugs was hiv..
they argued for two critical weapons: needle exchange programs and he expansion of meth maintenance..
at the time.. us and uk had policies that facilitated the spread of aids: some laws made clean needles hard to get.. and meth programs had restrictions that prevent people from getting or staying in treatment
88 british harm reductionists convince thatcher govt of their logic.. endorsing easier access to meth and clean needles.. saying ‘the spread of hiv is greater danger to individual and public health than drug misuse..
this was harm reduction’s essential insight: drug use and even addiction aren’t necessarily the worst that can happen
harm reduction: don’t focus on trying to fight drug use.. don’t focus on whether getting high is morally or socially acceptable.. people will take drugs.. this doesn’t make them irrational or subhuman.. most use isn’t linked to addiction.. find out what plagues those whose drug use is harmful.. and teach and empower them to make changes..
in alcohol policy.. harm reduction .. designated driver.. work to cut drunk driving, not drinking..
but unlike the uk.. the us fought tooth and nail against harm reduction for drugs other than alcohol.. as a result.. 90s.. uk 1%.. us 60%.. a 1000 babies a year testing positive.. ny adds harm reduction and by 2012 – 3%. . the state now calls syringe exchange ‘the one intervention which could be described as the gold standard of hiv prevention’.. because of both needle exchange an antiviral drugs.. ny no longer has an ‘aids babies’
far beyond needle distribution.. human interactions that take place in harm reduction programs show its deeper, but hidden, benefits and how it helps *teach change..
*perhaps rather.. allow/welcome/free-up change
before exchange was legal.. (and activists did it anyway).. most amazing.. climate.. crowds felt benign.. many were obviously moved that anyone cared at all.. let alone enough to risk arrest to try to help them. it was as though they couldn’t believe their eyes and for at least a moment, their masks of distress and pain would lift..
most of first needle exchange clients were people hardened by years of addiction and stigma.. primarily folks that ‘respectable’ people walked on other ride of street to avoid.. the experience of having someone give anything to them freely, w/o strings, petty bureaucratic rules, or moralizing.. was almost completely alien to them.. virtually ever other encounter they had w mainstream culture – drs, counselors, charities, govt, even stores – came w a big dose of shame like a lecture.. pitch, urine test, or some other potent reminder of their low status..
not so w needle exchange.. free needles.. even to those who do not have used ones to return… encouraged to return.. so needles aren’t potentially infectious waste..
but nothing officially required.. people must simple be what they already are: iv drug users..turns out .. the unexpected kindness of bein helped w/o expectation si itself a potent psych intervention.. someone sees you as both being able to behave responsibly. and worthy of a chance to live.. opens doors to hope in surprising ways..
critics who say that such programs ‘send the wrong message’ could not be more wrong.. it’s.. opposite of tough love.. it’s unconditional kindness and imbues what looks to outsiders like irredeemable ugliness w startling moment of transcendent beauty..
this (taking meds for depression in 7th yr) led to a startling conclusion: i now saw that a crucial part of my depression was complete inability to feel good in any way.. w/o that, i was just as far from being able to change as i’d been when i was completely numb and overwhelmed by my addiction.. this pain hadn’t led to growth -0 but to stagnation..
the fact that depression is joyless.. not shocking.. but.. that i hadn’t even noticed the loss of so many diff types of pleasure/reassurance..
this reframed my perspective on recovery, forcing me again to recognize how physiological psychology can be.. (zooloft made me less sensitive)
the wide range of responses to antidepressants probably has to do w the huge variety of natural human wiring.. which can make same drug into a poison, a panacea, or a placebo, depending on the dose, timing, and patient..
diff pathways lead to diff types of addiction; diff wiring and diff needs require diff treatments.. discriminating against people merely because they have a particular chemical in their bloodstream – regardless of how it actually affects them – is just as irrational as doing so on the basis of other physical characteristics.. like race or gender.. what matters is what works best for each individual..
what all this adds up to is that addiction is driven by learning.. not just exposure to a particular substance, having certain genetic traits or being traumatized.. dependence on a substance, person or experience to function isn’t its essence – a learned compulsion that continues despite punishment is what matters… so need to recognized the enormous variety.
however.. similarities people overcome learning when: treated w compassion and respect.. connections.. ; when treated .. as they are.. and doesn’t try to remove person’s primary coping mech *until others are in place.. waiting rather than controlling/forcing; calming rather than threatening; sees the not as bad people.. *but as those who are lacking info and skills that teachers can share; ..
**ugh.. rather.. those who are lacking a safe place..
being a student is more empowering role than being a patient..
not so empowering.. we can do better..
one ie that was tweeted just when i closed book for a reading break.. many other ie’s:
Students had prepared their own mini-lessons 2 teach in small groups this wk. Another tchr walks in & says 2 stdnt, ‘John,why don’t u work this hard in my class?” John replies, “I’m a tchr here.”Tchr asks 2 meet w/ me 2 learn how 2 use peer teaching
Original Tweet: https://twitter.com/Larryferlazzo/status/951810961563779072
but truly recognizing the role of learning in addiction requires far greater transformation of our systems for dealing w it that this.. the rise of harm reduction is only a start..
indeed.. go deeper.. into all the systems.. to the root of healing
18 – the kiwi approach
until 2013 – no nation had ever even tried to create such a system for nonmedical drugs that alter consciousness, despite their widespread use..
n o sane policy maker.. for ie.. could justify allowing commercial sales of a drug like tobacco, which cuts life expectancy by 10 yrs on av.. while using incarceration to punish those who take marijuana, which is not associated w increased mortality at all.. our policies are not based on rationality, risk assessment or logic.. just history..
alt to illegal highs.. ie: red bull; bzp (reduce meth habits)
bowden argued best way to cut harm was to come up w safer drugs
then overuse.. market et al.. then banned.. so then.. cycle of one banned.. another .. worse.. comes about..
banning ness becomes ridiculous.. and back to bowden’s thinking: allow drugs to be sold, but only the safest ones..
when is it ok to value pleasure over health? why is potentially fatal skydiving ok but not lsd.. a drug that is not linked w addiction, mental illness or overdose death?.. new zealand is first country to try to face these questions..
cannabis has been used by millions of humans for thousands of years and a us govt agency has spent decades .. and over 100 mn between 2008 and 2014 alone – trying to prove it a high risk drug, with little luck.. legal highs, in contrast, are brand new substances w no history of human use and some already linked w fatalities..
but at time new zealand began its regulatory journey, considering marijuana as a possible legal high was politically impossible.. – may even be internationally illegal what we’re doing in ie: co, wa, et al..
so how to do it safely.. w/o ie: punishment..
19 – teach recovery
howard josepher founded arrive.. addiction understood primarily as a learning disorder..
the creators of what became arrive kenw th amanhy people leaving prison were at high risk of erelapse to iv drug use – and that the only way to prevent the spread of aids in this groups was to reach those who had no desire to quit.
that means that any program they designed would have to be, literally, user friendly, and it could not require abstinence as a condition of participation
no training or prep..
josepher: ‘in treatment the focus is on individual pathology. you’re looking at what’s wrong w the person and how you go about fixing them. but to engage someone in a teaching dynamic, they’re a student and their only job is to be open, to be receptive. you’re not telling the person there’s something wrong w them.’
um.. yeah you are..
for some participants, graduating from arrive is the first time they have successfully completeed any educational program..
ugh.. that mindset.. and that for some reason they didn’t fit/feel-belonging in Ed system.. is a huge part of our addiction problem.. all of us..
in arrive, you define recovery for yourself – and everyone’s path..is accepted.. all that is asked is that you show up ready to learn ..
so.. you don’t really define it for yourself..
because no one was mandated into arrive, it had to make itself as appealing as possible, initially paying participant s $10 to attend each class and participate in the research
perhaps we try something that everyone already craves.. cure ios city
(on.. but now people clamor to join).. josepher himself is an inspiring and charismatic speaker.. overall org – exponent – now includes more traditional outpatient drug treatment.. as well as services like trauma groups, nutritional aid, ged classes..
howard and exponent:
(lead – law enforcement program based on harm reduction in seattle) participants tend to be moved by the simple fact of being valued unconditionally precisely when they expect to be rejected or shamed, and by being seen as capable of changing for themselves..
imagine i f7 bn people felt that way.. all at once.. we wouldn’t have the trauma/stress/addiction in the first place.. let’s try that
key idea is not to force people into abstinence and punish them if they fail, but rather, to connect them up w services that can help them meet their own goals – like finding a house or a job….
in washing ton state.. abg arrest.. 3100.. cost for a month by lead 240
imagine not cost.. imagine no money.. it’s easy if you try..
lead can be seen as a tentative move toward decriminalization..
the existing system that most closely approaches this strategy is that of portugal.. which removed criminal penalties for all personal level drug possession in 2001..
i often wondered how diff my life would have been if.. as a child or teen, i ‘d known ways of defeating depressive thoughts..before they became engrained in my brain..
working on that.. patricia conrod.. kings college.. adventure.. preventure.. or co venture.. ei: working w adolescents aged 13-16 ideas to target those w temperaments that increase risk for both addiction and mental illness..
‘a mental health approach to alcohol and drug prevention looks like it’s much more effective and promising than simple drug or alcohol ed’ conrad told me
to avoid issues related to labeling children as ‘high risk’ or as having personalities outside the *norm.. conrod and her colleagues devised a clever, innovative strategy.. kids take a test.. don’t know why.. don’t know results.. ones w high scores offered two 90 min seminars.. described as teaching skills for **success.. rather than being labeled as deviant.. told they are ***selected by lottery to be permitted to enroll.. nearly all kids who are selected opt in
ugh.. what is *norm.. who’s deciding what **success is.. and ***why deceive.. isn’t that a red flag
impulsive kids are educated about this trait and taught cog skills for managing it..
let’s go deeper guys.. we’re teaching people to manage themselves in a sick world..
20 – neurodiversity and the future of addiction
we need a system that actual is a system.. one that starts by *evaluating people’s needs
(on reducing stigma and learning earlier.. and neurodiversity).. in the autism community where the idea developed, these activist view autism itself not as a disability but as a way of being
people aren’t to *blame for they way they are wired.. we can either accept neurodiversity and create a society where many types flourish or ignore it and make associated disabilities worse..
the same brain that is vulnerable to overload in wrong conditions can be superior to ordinary brains in the right ones..
yeah. let’s facil that..
we should focus on people’s *abilities, not their disabilities.. and help them find their **strengths rather than stigmatize them for their weaknesses
although the neurodiversity movement calls people who aren’t autistic and don’t have other brain realted diagnoses ‘neurotypical’ there really is no such thing.. every brain is unique..t
in acknowledgements: carl hart
so far no mention of gabor.. hari follows her on twitter
tweet while reading
Sometimes the sheer cruelty of the American way of dealing with addiction and mental health overwhelms me… we are losing so many kind, talented people for no good reason at all.
Original Tweet: https://twitter.com/maiasz/status/948658861002641410
addiction et al