Latest / How to Be an Adult / About Addiction, with Marc Lewis (Ep. 16, pt. 1 of 2)
Transcript
- 0:00When I'm trying to get someone to stop
- 0:02using alcohol or heroin
- 0:04to kind of resolve that inner debate or
- 0:07ambiguity in the climate. Addiction I understand since
- 0:09I had it myself in my 20s. I
- 0:11struggled with an opiate addiction. It seems like
- 0:14we've all accepted the idea that we can't
- 0:16just be, and we've always gotta do or
- 0:19consume something, or else we're not Welcome to
- 0:22How to be an Adult, a podcast created
- 0:24by the practitioners at the Morpheus Clinic For
- 0:26Hypnosis in Toronto, Canada. This is a show
- 0:29for people just like you who've inadvertently become
- 0:31adults
- 0:32and don't know what to do about it.
- 0:34I'm Luke Chao, and today I'm joined by
- 0:36a very special guest, Mark Lewis,
- 0:39author of best selling books like the Biology
- 0:42of Desire.
- 0:43He's formerly a professor at the University of
- 0:46Toronto.
- 0:47He's a cognitive scientist and a neuroscientist and
- 0:49a psychotherapist in private practice.
- 0:51He's the author of close to 100 articles
- 0:55about development of psychology and especially to the
- 0:58public
- 0:59the field of addiction.
- 1:01More specifically,
- 1:03he advocates
- 1:05against the medical model of addiction that I
- 1:08think we can agree disempowers
- 1:10the people it's supposed to help.
- 1:13So Mark welcome aboard. Thank you. You're welcome.
- 1:16Thank you. Let's begin with this. Would you
- 1:18like you who are me
- 1:20to try to summarize your views on addiction
- 1:23in a couple of sentences?
- 1:24So so generally, what I have been writing
- 1:27about and arguing for for years now,
- 1:30almost 10 years,
- 1:32is the idea that
- 1:34rather than think of addiction as,
- 1:37a disease, a a brain disease, a pathology
- 1:40per se. Think of it as,
- 1:43a psychological habit, a cognitive habit, a very
- 1:47strongly emotional habit, a habit which is
- 1:51motivated by intense emotions and therefore becomes deeply
- 1:54ingrained, deeply entrenched,
- 1:57And partly for that reason, it's extremely hard
- 1:59to break even though you certainly understand at
- 2:02some level that it's not doing you any
- 2:04good and in fact might be making your
- 2:06life into a horrible mess, might become extremely
- 2:09boring and destructive in in various ways.
- 2:12And trying to understand what's the value of
- 2:16substance use or other kinds of addictive practices
- 2:19that make it,
- 2:21hard to give up, not only because it's
- 2:22a habit, but also because it's doing something
- 2:24for you. Something that you're not able to
- 2:27do as well,
- 2:28or as,
- 2:30reliably in the rest of your life. So
- 2:32really looking at it from the point of
- 2:33view of the science, the psychology, but also
- 2:36from the person's point of view, the person
- 2:38who is using substances
- 2:40and having a hard time stopping. Well, all
- 2:42of us who have even a
- 2:45light addiction to our phones or to social
- 2:47media,
- 2:48let alone something like alcohol or cigarettes or
- 2:51gambling,
- 2:52your explanation of addiction seems just simply intuitive.
- 2:55It matches
- 2:57so many people's actual lived experience
- 3:00Mhmm. Of what it's like to to to
- 3:03find it impossible to put on your phone
- 3:05or to
- 3:06tell yourself
- 3:07erroneously that you need a drink just because
- 3:10you're going through a breakup when actually what
- 3:11you need is something like love instead.
- 3:14How did it end up being
- 3:16that the predominant
- 3:17model of addiction is a disease model,
- 3:21which is so counterintuitive,
- 3:22not just to me as a hypnotherapist or
- 3:24to you as a psychotherapist and a scientist,
- 3:26but to, I think, even members of the
- 3:29public
- 3:30whose experiences of addiction are are not
- 3:33one where they become some kind of fiend
- 3:35that's controlled by some kind of demon. I
- 3:38would hope not. Yes. No. There was a
- 3:40time in the 19 thirties, forties, fifties when
- 3:43that was in fact the kind of public,
- 3:45vision, the optics, the idea that addiction is
- 3:48like a fiend. Mhmm. And and it it
- 3:51was,
- 3:54represented by, you know,
- 3:56pictures of people doing
- 3:58horrible back things or seeing their shadows in
- 4:01the background where they're playing with needles and
- 4:03so forth. And often in those days, black
- 4:05people. People who had,
- 4:07for whom
- 4:08institutional racism was already making some pretty strong
- 4:11negative points. Mhmm. And here's another thing that
- 4:14they're doing. Yep. So there's all that. But,
- 4:16you know, in answer to your question, I
- 4:18think
- 4:19the idea that addiction's a disease, it wasn't
- 4:22motivated by ill intent. It was motivated by,
- 4:26I think,
- 4:27a positive wish to take the blame, the
- 4:30the the stigma, the responsibility
- 4:32off of the shoulders of addicts
- 4:35and rather to say, hey. It's not really
- 4:37their fault. They don't mean it.
- 4:40Okay. So how do you do that? Well,
- 4:41one way to do it is by saying
- 4:43they've got a real problem. Let's call it
- 4:45a disease because we know the people who
- 4:47have diseases aren't responsible for whatever it is.
- 4:50Mhmm. And so that was a way to
- 4:51try to make it easier
- 4:54to not be
- 4:55cornered and persecuted for the
- 4:58activities that went into addiction. Well, it seems
- 5:00almost like
- 5:02if a kid's got their hand in the
- 5:05cookie jar again
- 5:06Yeah. And by their own free will, they
- 5:09put their hand in the cookie jar and
- 5:11then the very compassionate
- 5:13overly empathic
- 5:15dad or mom says,
- 5:17oh, no, son. It's okay for you to
- 5:20eat all those cookies. It's not your fault.
- 5:23It's my fault, not yours Mhmm. That you
- 5:25got your hand in cookie jar. Doesn't that
- 5:27seem to stunt a person's development?
- 5:30Well, it certainly takes the responsibility
- 5:32away. It does. Yes. So in that respect,
- 5:34yeah.
- 5:35It does. So Which for a 4 year
- 5:37old is not a bad thing. Because, like,
- 5:39what we advocate for for kind of, you
- 5:41know, recognition
- 5:43that
- 5:44each of us is the captain of our
- 5:46own ships.
- 5:47Right? And it's true. We don't control the
- 5:49winds or the waves. So later, we're gonna
- 5:51talk about how, for example, disability or poverty
- 5:53might impact one's ability
- 5:55to cope with life and perhaps susceptibility
- 5:58to to addiction. Mhmm. So we don't control
- 6:00everything. It's not like we can each independently
- 6:02just be an island. That's for sure. But
- 6:04at the same time, it's
- 6:06the very opposite is not true either. It's
- 6:08not like we completely lack agency. Right. And
- 6:11there almost seems to be this implication
- 6:14in a lot of the discourse around the
- 6:16disease model of addiction. Mhmm. That
- 6:20an addict
- 6:21in a more modern version of the fiend
- 6:24lacks agency.
- 6:26Mhmm. Did you perceive the same thing? Or
- 6:29Yeah. That's pretty close. Yeah. In fact, when
- 6:32I give talks, I often show a slide
- 6:34that
- 6:36presents a billboard on the side of the
- 6:38highway in Massachusetts. I think it is showing
- 6:415 or 6 people who look
- 6:43moderately
- 6:45content but not very happy
- 6:47and the slogan is,
- 6:49it's a disease. It's not a how does
- 6:51it go? It's not a choice. It's a
- 6:53disease.
- 6:54So what they're saying, you know, the subtext
- 6:56is clearly that, you know, it's not our
- 6:58fault. Mhmm. And they're looking kind of like,
- 7:01well, it's too bad this happens. This is
- 7:03really a drag, but, hey, it happens.
- 7:06Well, it's also kind of the view
- 7:09underlined
- 7:10by AA
- 7:11where one of the the 12 steps or
- 7:1412 tenets is that you have to kind
- 7:16of,
- 7:17acknowledge
- 7:18or admit that you've lost control over the
- 7:21addiction and that you gotta give yourself up
- 7:23to a higher power. That's right. And that's
- 7:25never quite sat well with me because, at
- 7:28least in my experience, we're working with my
- 7:30clients to primarily primarily to quit smoking, but
- 7:33also to, you know, to stop overeating food
- 7:35or to not drink so much. Right. The
- 7:37experience seems to be the more I have
- 7:39my client take agency,
- 7:41the better the outcomes are. Yeah. Whereas if
- 7:43they just kinda give themselves up to the
- 7:45addiction, to the feelings, to the impulses,
- 7:48that seems very counterproductive
- 7:51to the goals that they have.
- 7:53Yeah. How the heck is it that AA
- 7:56and the disease model
- 7:58have become such popular models of how addiction
- 8:01works when we're on the same page. And
- 8:02I think a lot of our listeners in
- 8:03their own experiences, even even if they've never,
- 8:06like, used hard drugs, in their own experiences,
- 8:07it seems like
- 8:11they they do have choice and it's detrimental
- 8:14to deny
- 8:15that choice that they each have.
- 8:17So I argue that a lot and I
- 8:19talk about how a sense of efficacy
- 8:22of self empowerment can be a very, very
- 8:25powerful tool in overcoming addiction.
- 8:27And and to put it simply, it's like,
- 8:29I'm really sick of this. This this is
- 8:31a shitty life, you know, life experience. I
- 8:34don't like this. I don't wanna do this
- 8:35anymore. I'm gonna make it. I'm gonna stop
- 8:38it. And how do I do that? Well,
- 8:39let me see. I could go see a
- 8:41therapist. I could do this or that. I
- 8:42could become involved in other activities. I could
- 8:45make other friends. I could become involved in
- 8:47in other social,
- 8:49contexts.
- 8:50And one way or another, they find a
- 8:52way. And the statistics show very clearly that
- 8:54most people who are addicted to anything,
- 8:56including heroin,
- 8:58or these days, Fentanyl, I suppose,
- 9:00do in fact
- 9:02stop. Mhmm. I was gonna say recover because
- 9:04that's the coin of the realm, but I
- 9:06don't like the word recover because it's got
- 9:07this very strong medical
- 9:09ring to it. But they do stop and
- 9:12they stop,
- 9:13mostly without the help of any kind of
- 9:15formal treatment. In fact, the conventional
- 9:18rehab setting, rehab and addiction treatment centers
- 9:22have a very notorious history of not working
- 9:25well. Costing a lot of money and the
- 9:27revolving doors that, you know, means that you're
- 9:29gonna be back again in 6 months or
- 9:31a year or 2 years and so sorry,
- 9:33guy. Mhmm. Wish we wish we could help.
- 9:36There's almost this cruel irony
- 9:39that
- 9:40the practices, the paradigms, the philosophies
- 9:44that make the most money
- 9:46are the ones that are disseminated most widely
- 9:50and often end up being researched more most
- 9:52completely or at least publicized most completely. Publicized.
- 9:55Yeah.
- 9:57And the practices
- 9:58that are impossible to monetize like quitting cold
- 10:01turkey
- 10:02seem to get no publicity
- 10:04and then no research money.
- 10:06Right. And it can be cold turkey or
- 10:08it can be gradual. There's an awful lot
- 10:10of ways to overcome addiction.
- 10:12Sometimes, you know, it's it's complete abstinence. Sometimes
- 10:15it's not. Sometimes it's controlled use. Sometimes it's
- 10:17gradually decreasing Yep. Tapering use. But I think
- 10:20we have to be careful about,
- 10:22you know, the pointing of the finger here.
- 10:24AA doesn't make any money. AA is
- 10:28famous because it's free. Mhmm. And it's been
- 10:31around since the thirties and,
- 10:34it's extremely
- 10:36useful and attractive to people who can't afford,
- 10:39any kind of formal
- 10:41medically oriented treatment.
- 10:43So that's where they go. And AA does
- 10:46work for some people. I mean, the, you
- 10:48know, the the estimates are anywhere from 5%
- 10:51to 35 or 40%. Mhmm. That's not too
- 10:53terrible.
- 10:54Mhmm. But 5% is not very good. I
- 10:56mean, a lot depends on context. The the
- 10:59nature of the group, the makeup of the
- 11:00group, the relationship with the sponsor, the kind
- 11:03of drug, the kind of other societal,
- 11:07factors that you alluded to,
- 11:10you know, which might might include economic and
- 11:12social and prejudicial and race racism and all
- 11:15kinds of things.
- 11:16But anyway, long story short, AA
- 11:19sometimes works. And
- 11:21AA doesn't fit with a disease model perfectly
- 11:23either. It was kind of a strange marriage.
- 11:26So AA came came along the idea that
- 11:29you can't make it go away. You can't
- 11:31make it stop. That is that you have
- 11:33to admit that from the, you know, from
- 11:35the get go. However, you can control it
- 11:37and you need to control it and you
- 11:39must control it. Like if you're a diabetic,
- 11:41you need to take your insulin. Mhmm. Okay?
- 11:43So there's that.
- 11:45But
- 11:46but also the disease model, you know, the
- 11:49implication that this is something that needs to
- 11:51be treated
- 11:52by a medical establishment
- 11:54and can be addressed with certain drugs, with
- 11:56certain pharmaceuticals, for methadone and Suboxone, and so
- 12:00on and so forth. Naltrexone
- 12:02is now a big deal. So, you know,
- 12:03that doesn't fit with the philosophy of AA
- 12:05very well at all. Mhmm. And a lot
- 12:07of what treatment centers do and have done
- 12:09for the last 50 or 75 years or
- 12:11so have been to kind of merge the
- 12:142. The 12 step approach on the one
- 12:16hand, cognitively, behaviorally,
- 12:19and also the idea of being in a
- 12:21group, the idea of fellowship.
- 12:23Really important.
- 12:24Fellowship. It's got nothing to do with the
- 12:26disease model. You're not gonna do any better
- 12:28if you're with a group of fellow diabetics.
- 12:30Mhmm. Right? I can take your insulin. Yeah.
- 12:33But but AA, the fellowship idea in AA
- 12:36is really fundamental. It's really intrinsic to how
- 12:38it works. So so somehow, this kind of
- 12:40forced marriage took place in in
- 12:45rehab centers that sprang up all over the
- 12:47US, especially in the fifties sixties seventies,
- 12:50merge these two models together
- 12:52and tried to make a kind of coherent
- 12:56integration between the 2. Right. Well, my my
- 12:59read of AA
- 13:01is that
- 13:02it works
- 13:03despite
- 13:05each member having to kind of deny responsibility
- 13:08or give up agency. Mhmm. It doesn't work
- 13:10because of that. It works because of the
- 13:12fellowship that you mentioned Mhmm. And the social
- 13:14support.
- 13:15Mhmm. One kind of mental model of addiction
- 13:17I'm kinda playing around with inside my head
- 13:20is that whatever it is that gives people
- 13:22that that kind of dopamine hit, which I'm
- 13:24sure is oversimplified, but whatever gives them that
- 13:26nice feeling. Mhmm.
- 13:28It's it's a poor substitute
- 13:31for
- 13:32the authentic
- 13:33kind of connection and camaraderie,
- 13:35even affection and love Yeah. That we get
- 13:38socially. This is why the opioid crisis in
- 13:40the US is so oftenly found
- 13:42among lonely rural men. Mhmm. It it's because
- 13:46if if they had loving families, if they
- 13:48had lots of of friends Mhmm. They'd be
- 13:51less susceptible to addiction. Yeah. And AA kinda
- 13:55gives people that sense of community and fellowship
- 13:59and camaraderie
- 14:01that, well, unfortunately, methadone does not. Right. And
- 14:04then methadone kind of, you know, hits the
- 14:06neurotransmitters
- 14:07correctly.
- 14:08Yeah. And the fellowship, you know, just kinda
- 14:11might do that obliquely.
- 14:13Yes. So that's I don't know how educated
- 14:15that reading of AA is, but, you know,
- 14:17at least from my perspective, that's kind of
- 14:19how I interpret how how it works.
- 14:22I think that's a big part of it.
- 14:23Yeah. I think that's not a bad way
- 14:25of putting it. And the idea of fellowship,
- 14:27camaraderie,
- 14:28and,
- 14:29feeling cared for, feeling that sense of belonging
- 14:32really is fundamental. Yeah. And for any form
- 14:35of addiction,
- 14:37you know, I think it was put very
- 14:38simply by Johann Hari. Do you know who
- 14:41Johann Hari wrote a book called Chasing the
- 14:43Scream, which is a wonderful book,
- 14:45about the war on drugs. Mhmm. And Chasing
- 14:48the Scream
- 14:49pertains to,
- 14:51what was his name? The the first guy
- 14:53who was the head of the DEA, the
- 14:55drug enforcement agency in the US, heard some
- 14:58woman screaming down the hall. She was a
- 14:59morphine addict and I suppose she was coming
- 15:01off morphine and she was screaming and he
- 15:03was chasing the scream. He was going to
- 15:05put a stop to this this kind of
- 15:06stuff. Right?
- 15:08Anyway, whatever. It's a wonderful book. It's a
- 15:10beautiful narrative, and what Yohan Hari says and
- 15:13this is,
- 15:15this is highlighted in his TED talk. So
- 15:17if you don't have time for the book,
- 15:18you should go get to the TED talk.
- 15:20Johann Hari, j o h a n n
- 15:24h a r I. And what he says
- 15:26is the opposite of addiction is not sobriety.
- 15:29The opposite of addiction is connection.
- 15:32So there it is. I'm completely in agreement.
- 15:35Yeah.
- 15:36So, yeah, in a way, most addictions
- 15:39and even addictions,
- 15:40you know, we can sort of understand with
- 15:42opioids and alcohol,
- 15:44they do connect with opioid receptors and help
- 15:47us to feel more relaxed and more comfy
- 15:49and cozy. That's an addiction I understand since
- 15:52I had it myself in my twenties. I
- 15:53struggled with an opioid addiction for years.
- 15:57But even people who are addicted to cigarettes,
- 16:00to tobacco, or psycho stimulants, cocaine, or methamphetamine,
- 16:05Although it's not cozy and comforting per se,
- 16:08it does make you feel that you belong
- 16:10with or to
- 16:12a a drug, really. This is my familiar
- 16:15experience. This is my world which I can
- 16:18go into whenever I want and feel taken
- 16:20care of and feel safe, you know, and
- 16:22that's a big deal.
- 16:23And, of course, that is indeed,
- 16:26an alternative. It's a substitute for feeling cared
- 16:29for or feeling like you belong with a
- 16:31social or familial. And it's always a poor
- 16:34substitute because cigarettes can never love you. No.
- 16:37Even a even a dog, a cat can
- 16:40love you. Yes. Right? And, of course, a
- 16:42friend, a partner, a child by the way.
- 16:44I don't know about cats. No. No. I
- 16:45I definitely do know about cats.
- 16:48But but, like, even like a hamster. Right?
- 16:50Even a hamster
- 16:51can like cozy up next to you Yes.
- 16:53And cuddling. Yeah. And a hamster therefore is
- 16:56superior to a cigarette.
- 16:58Yeah. I mean, I know what you're saying.
- 17:00Yeah. Yeah. Well, so I I work with
- 17:02a lot of smokers. At this point, I'm
- 17:04not even surprised if it's over a1000.
- 17:06And so frequently,
- 17:08I hear that cigarettes give companionship. Uh-huh. Cigarettes
- 17:12give
- 17:13my client a sense that
- 17:15they have a friend and then quitting smoking
- 17:19almost feels like they're betraying a friend or
- 17:22abandoning a friend. Or abandoning. Yes. That's why
- 17:25I really have to make the point that
- 17:27your friends are not trying to kill you.
- 17:30But cigarettes aren't trying to kill you.
- 17:33Well, I mean,
- 17:35the the the the the We anthropomorphize it
- 17:38and say, yeah. Well, in fact, yeah, they're
- 17:40really bad for you, and they are going
- 17:41to increase your chances of dying from various
- 17:43diseases for sure, but they're not trying to
- 17:46get So it's fair to to give all
- 17:48the agency
- 17:49to the human being Yeah. In the equation.
- 17:51I know you agree with that. And yeah.
- 17:53Yeah. So you're right. I am anthropomorphizing cigarettes,
- 17:56but when my client
- 17:57anthropomorphize
- 17:58a cigarette Yeah. But describe them by describing
- 18:01them as a friend. I mean, we must
- 18:03further that analogy
- 18:04For sure. By painting,
- 18:06you know, the the feelings that they get
- 18:09from tobacco as a treacherous,
- 18:12traitorous kind of friendship and not actually the
- 18:15real thing.
- 18:16Yeah. I know. You and I have talked
- 18:18about this before a few times, and I
- 18:20think we agree,
- 18:21in a lot of ways. I think there's
- 18:23an awful lot of overlap between our perspectives,
- 18:25but it's not total overlap because I think
- 18:28you feel much more absolute about that than
- 18:30I do.
- 18:31And I think, for example, of
- 18:33a good friend of mine named Sean Shelley.
- 18:35He,
- 18:36he struggled with his own addiction in Cape
- 18:39Town, South Africa,
- 18:41and he's fine with me saying that. He
- 18:43he talks about it all the time. He
- 18:45after he gave up, on crystal meth, he
- 18:49got his PhD, became, involved in all kinds
- 18:52of,
- 18:53agencies and bodies that were trying to help
- 18:55people who had addiction problems throughout Africa. He
- 18:58actually served on the United Nations, Committee For
- 19:00Drug Reform. Mhmm. He's done a lot of
- 19:03wonderful work and, you know, came a long
- 19:04way, so to speak. However, he he talks
- 19:07about what, for example, smoking heroin does for
- 19:11young black men in Cape Town, and it's
- 19:13not evil, and it's not, you know, it's
- 19:16not,
- 19:17what's the word, malicious or malevolent.
- 19:20It's rather it's a social habit that does
- 19:23involve a chemical influx, but it's also something
- 19:26they do together
- 19:27makes them feel
- 19:30like, well, we talk about alcohol as being
- 19:32a social lubricant.
- 19:34Like, there's something to that. Right? Yeah. And
- 19:36opioids are also a social lubricant. In fact,
- 19:39opioids, when you give opioids to rats and
- 19:41mice, they,
- 19:43they have more fun together. They play more.
- 19:46They really do. Yeah. So, you know, opioids
- 19:48soften edges. Yes. Okay. So let me explain
- 19:51the absolutism.
- 19:52It's actually more in language than it is
- 19:55in thought. Okay. Because
- 19:57I'm not a prohibitionist. Yeah. I I actually
- 20:00have
- 20:00no,
- 20:02disdain for and
- 20:05I don't think that drugs are all bad.
- 20:08In fact, I think that the resurgence of
- 20:11psychedelics recently,
- 20:12as a possible treatment for PTSD, for example,
- 20:15is a very good thing. Mhmm. And Ketamine,
- 20:18for example, could be used recreationally or it
- 20:20could be used therapeutically. Right. And, of course,
- 20:23cocaine and heroin originally had therapeutic uses.
- 20:26So, like, I'm not I'm not one to,
- 20:28like, demonize drugs. Right. The reason for for
- 20:31the
- 20:32absolutest speech is because for better or for
- 20:35worse,
- 20:36the less room you'll leave for doubt when
- 20:38you're communicating,
- 20:39the stronger the point you make. So I
- 20:41guess,
- 20:42you know, for this kind of academic conversation,
- 20:44you know, I'll just add in the asterisk
- 20:47Yeah. That, you know, I'm not I'm not,
- 20:49like, against
- 20:52the
- 20:53responsible and informed
- 20:55use of drugs in a way that's legal
- 20:57for your jurisdiction. Mhmm.
- 20:59Okay.
- 21:00But yeah. When I'm when I'm trying to
- 21:02get someone to quit smoking,
- 21:05then I do have to speak in an
- 21:07absolutest way. I believe that. Or when I'm
- 21:09trying to get someone to stop using alcohol
- 21:12or heroin
- 21:13to kind of resolve the inner debate or
- 21:16ambiguity in the client's mind. Mhmm. You know,
- 21:18I'd as a hypnotherapist,
- 21:19I kind of had to give one clear,
- 21:21unambiguous,
- 21:22neatly packaged idea Mhmm. As simplistic as the
- 21:25idea would be if we kind of try
- 21:27to unpack it in more of a
- 21:30scholarly kind of context. I can see that.
- 21:34I mean, as a clinical psychologist, I often,
- 21:37you know, will use words and ideas also
- 21:39in a way that's intended to help people
- 21:42think and feel a little bit differently about
- 21:44whatever it is they're engaged in that seems
- 21:46to be harming them or blocking them. And,
- 21:49no, you're right. It's not an academic,
- 21:51you know, point that you're making. You're not
- 21:52trying to make a foolproof argument proof point.
- 21:56So it's a different yeah. Well, I kinda
- 21:57feel like keeping in mind that, you know,
- 21:59some of our listeners are are kind of,
- 22:01they're kinda tuning in because they they can't
- 22:03afford,
- 22:04hypnotherapy or psychotherapy. Right. They they can't, like,
- 22:07afford rehab for sure. Mhmm.
- 22:10So, yeah. To kind of see,
- 22:12let's say, tobacco Mhmm. As
- 22:14a trader and not a friend is gonna
- 22:17help in one's journey to to quit smoking.
- 22:19Yeah. I can do that. Yeah. So that
- 22:21that that that I'm not actually as black
- 22:23and white of a thinker as to what
- 22:24I communicate. That's true. Yeah.
- 22:27Yeah. And, certainly, I'm not anti drug. I
- 22:29mean, there's, like, uses for almost every drug.
- 22:32And I wouldn't I don't even draw a
- 22:33line between what you might call recreational and
- 22:36therapeutic use
- 22:38because
- 22:38there is no clear line Mhmm. And especially
- 22:40with psychedelics.
- 22:42I mean, psychedelics, if you wanna think of
- 22:43it as treatment, think of it as a
- 22:44treatment for life in our current right?
- 22:48The cosmo follows an age because psychedelics help
- 22:51you connect with nature and think about your
- 22:54role in the universe. And Mhmm. Do you
- 22:55wanna call that treatment or it's not treatment
- 22:58or, recreational, it's something else. Something's hard to
- 23:01define. Yeah. Well, in previous episodes, we we
- 23:04we've kind of
- 23:05spoken against the mind body dichotomy Mhmm. Where
- 23:09it's kind of this artificial
- 23:11divide
- 23:12to say we can, like, just treat the
- 23:14mind Mhmm. Or we treat the body independently
- 23:16of the mind. Well, no. Yeah.
- 23:18You know, like, anything that you put in
- 23:20the body, it's gonna affect your mind. And
- 23:23if you think in certain ways, it's gonna
- 23:25affect the body too. Yes.
- 23:27So yeah. We're,
- 23:29you know, each one individual organism
- 23:31at its, you know, kind of a fictitious
- 23:34concept
- 23:34to divide mind and body. Yeah. I agree.
- 23:37Yeah. It's way too neat. Yes. It doesn't
- 23:40really make much sense if you think about
- 23:41it a little bit more. Yeah. So
- 23:44you've been, kind of trying to challenge the
- 23:47the medical model of addiction Mhmm. And with
- 23:49some success, considering how many books you've sold,
- 23:52Mhmm.
- 23:53I'm sure that along the way you've gotten
- 23:55some pushback. I'm sure along the way you've
- 23:57kinda rubbed people with a profit motive in
- 23:59the wrong way.
- 24:01So how's this journey been like? How successful
- 24:03have you been in kind of like helping
- 24:05others to overcome the the the the stigma
- 24:07of drug use or the idea that it
- 24:10is a disease as opposed to a learned
- 24:13habit? Mhmm.
- 24:15There's been certainly pushback.
- 24:18Generally speaking, I think my
- 24:20my argument, my view, my perspective has been
- 24:23taken well. And a lot of a lot
- 24:25of people are saying, yeah, that makes sense.
- 24:27Okay. Got it. I'm not the only one
- 24:30who takes this position. There's there's quite a
- 24:32number of other people who sort of addiction
- 24:35scholars or addiction,
- 24:37might might be doing research in addiction or
- 24:39might be doing clinical practice related to addiction
- 24:42who also feel that the medical model has
- 24:44gone in the wrong direction.
- 24:46And
- 24:47so the pushback that we have gotten, some
- 24:50of that come it comes from all different
- 24:51sources. For example, whenever you kind of perturb
- 24:54a societal habit, you know, you're gonna get
- 24:56some kind of crap from somewhere, from maybe
- 24:58from many places. So one source of that
- 25:01for me was in the US, especially where
- 25:04I give talks sometimes,
- 25:06it's like people say,
- 25:07if we don't call it a disease, then
- 25:09we can't get medical insurance to cover the
- 25:11cost of treatment.
- 25:13Yeah.
- 25:14Sorry about that. That's actually
- 25:16a political and economic issue. It is not
- 25:19a psychological issue. It's certainly not a scientific
- 25:22issue or a biological issue. You wanna talk
- 25:24about your health care system? Yeah. It's pretty
- 25:27stuff. The, American health care system obviously epitomizes
- 25:30certain real problems where profit and,
- 25:33healthcare,
- 25:34you know, meet head to head, not in
- 25:37a very satisfactory way.
- 25:39So, yeah,
- 25:40Sorry about that. You need a name for
- 25:42this, so then you can throw money at
- 25:45it or get the insurance companies to throw
- 25:47money at it. Same thing for a lot
- 25:49of other things by the way,
- 25:50racism.
- 25:51Now, we have anti racism. So now, we
- 25:54can support
- 25:56research dollars for anti racism or clinical or
- 25:59institutional practices
- 26:01for anti racism because we've given it a
- 26:03title. Terrific.
- 26:04Bullying. Again, anti bullying programs.
- 26:07Domestic abuse. Right? Child abuse, all kinds of
- 26:10abuse has now gotten very much highlighted and
- 26:13entitled and now it sorry. I don't mean
- 26:16entitled. I mean, given a title, given a
- 26:19category
- 26:19heading label
- 26:21makes it easier to pinpoint it and to
- 26:23say, okay. This is how we need to
- 26:26deal with it. Whether it comes from a
- 26:28source of contributions, whether it's monetary, whether it's
- 26:31governmental, institutional, legal, whatever it is. It helps
- 26:34you, you know, focus on the problem and
- 26:36try to do something. But so in that
- 26:38respect, I see the argument.
- 26:40Right. If I take away the label, what
- 26:41are we gonna call it? How are we
- 26:43gonna deal with it? Well,
- 26:45like you and I have been talking about,
- 26:47it's a much broader issue than just a
- 26:49person's
- 26:50relationship to particular substances or activities.
- 26:54Whether it's booze, whether it's drugs, whether it's
- 26:56gambling,
- 26:57whether it's porn, whether it's phone use, whether
- 27:00it's Internet use.
- 27:01There are so many kinds of addictive activities
- 27:04and,
- 27:06it's completely intermingled with the rest of our
- 27:08psychological and social lives. Mhmm. It isn't a
- 27:11distinct phenomenon or a distinct category. So don't
- 27:14even try. Mhmm. There's better ways to understand
- 27:17it. Yep.
- 27:19One pattern I've noticed
- 27:21among people So, you know, you you mentioned
- 27:23porn. There's alcohol. There's all sorts of drugs.
- 27:26One pattern I've noticed 2 patterns, actually.
- 27:29One of them is that
- 27:31it seems like we've all accepted the idea
- 27:34that we can't just be, and we've always
- 27:36gotta do or consume something or else we're
- 27:39not good enough. Yeah. That's part of it.
- 27:41Yeah. And that's tied in
- 27:43with this idea that
- 27:45we shan't love ourselves because it's arrogant
- 27:48or because it's gonna,
- 27:50I guess, divide up a finite amount of
- 27:53love as though we don't generate more of
- 27:54it ourselves. Mhmm.
- 27:56But it's almost like
- 27:57this, at least these two views
- 28:01Mhmm. Seem to exist in every client I
- 28:04have
- 28:05who
- 28:06smokes cigarettes or drinks alcohol. It's where, like,
- 28:09they can't just sit alone with their own
- 28:11thoughts like a monk on a mountain top
- 28:14feeling their hearts and feeling loving kindness. Yeah.
- 28:17And you might say I'm overly simplifying things,
- 28:20and I I would admit in some ways
- 28:21I I am. Mhmm.
- 28:24To to say that if only we all
- 28:26learned how
- 28:27to quietly sit with our own thoughts. Yeah.
- 28:30But but being a monk on a mountain
- 28:32top is not gonna be the way for
- 28:34most people. But here's the cool thing. We
- 28:36don't actually have to seclude ourselves with civilization.
- 28:40Mhmm. When we each have private homes or
- 28:43at least bedrooms,
- 28:45we can all retreat into it. Even in
- 28:47a city, we can put on our, you
- 28:48know, noise cancelling headphones. Yeah. We could close
- 28:51our eyes. We could pretend we're on a
- 28:53mountaintop. So I'm just kinda painting an image
- 28:55with a mountain top, but the idea is
- 28:57wherever we find seclusion,
- 28:59wherever we find privacy and quiet, is our
- 29:02mountaintop.
- 29:04And, you know, so it's no excuse that
- 29:06there's no mountain in sight in downtown Toronto.
- 29:09We're like, even in in like, we're in
- 29:11the downtown core right now. We're actually not
- 29:14far from one of the busiest intersections in
- 29:16the city. Mhmm. It's actually also very quiet
- 29:19in here because we boarded up the windows.
- 29:21Right. So this is like a an example
- 29:23of a mountain top in here. Yeah. Now
- 29:27let's say here
- 29:29I'm breathing deeply enough.
- 29:31Mhmm. I'm looking to wear the glass is
- 29:34half full in life. Mhmm. I'm thinking of
- 29:37those I care about.
- 29:40I'm generating within myself
- 29:42nice, warm, and fuzzy
- 29:44feelings. Mhmm.
- 29:46Right? Now, I'm I'm kind of losing my
- 29:47desire to go play a video game. Mhmm.
- 29:49I'm losing my desire to catch up on
- 29:51the latest episode of the show I might
- 29:53be watching on Amazon Video. Right. Right?
- 29:56I I I try to introspect
- 29:59to understand humanity.
- 30:00It's under the idea we have more in
- 30:02common than we have differences, and I, you
- 30:04know, can examine myself way better than anyone
- 30:06else. So, you know, if I ascertain that
- 30:10a practice seems to help me, then
- 30:12plausibly it could help another.
- 30:14Yeah. So I kind of imagining that if
- 30:17I only were to teach people how to
- 30:20find their version of a mountain top,
- 30:22to be with
- 30:24wear the glass is half full for them,
- 30:26to breathe deeply enough, to think of those
- 30:29they do care about, then they're gonna start
- 30:31losing their desire to have to consume, to
- 30:33have to do, to have to to, you
- 30:36know, fill in the void because the void's
- 30:38being filled in with the the good things
- 30:40I'm having them think about.
- 30:42Do do do do do you think that
- 30:43love is an adequate solution?
- 30:45That's the question.
- 30:46I I think there's an awful lot of
- 30:48stuff that
- 30:49compiled together
- 30:51in in your perspective there. And I I
- 30:53think in many ways, I do agree.
- 30:57Well, the two main things are, I would
- 30:59say, sort of mindfulness capacity to reflect and
- 31:03to have some silence so you can reflect
- 31:06on your own thoughts and not take everything
- 31:08as a given and not just rush into
- 31:11rush along with capitalist enterprise and be a
- 31:14cog in the machine or a brick in
- 31:15the wall as Pink Floyd Mhmm. Put it.
- 31:17Right? So, yes, that kind of mindfulness is
- 31:20super important.
- 31:22That's a little bit different than the sort
- 31:24of practice of love and kindness and goodness,
- 31:27which, yeah, that's another way of fulfilling
- 31:30our potential as people.
- 31:33Both of them can help us not require
- 31:36other kinds of input and other kinds of
- 31:38busyness.
- 31:39The busyness thing, you know I mean, back
- 31:42when I was when I was being,
- 31:44supervised as a grad student in psychotherapy techniques,
- 31:47I studied psychoanalysis
- 31:48and stuff. They called it the manic defense.
- 31:51There There's something called the manic defense. It's
- 31:53really simple idea that of all the defense
- 31:55mechanisms,
- 31:57being manic
- 31:58is kind of like the default. It's the
- 32:01basic one.
- 32:03Because by going after goals and doing,
- 32:06you know, achieving,
- 32:08whatever it is that you're going after and
- 32:11moving towards or away from
- 32:14very particular things in the world,
- 32:16you are feeling,
- 32:19feelings of connection, involvement, and utility that are
- 32:23really good to feel.
- 32:24So what about that? Well,
- 32:26we don't necessarily wanna get rid of that
- 32:28because, you know what, every
- 32:30baby needs to feel that in order to
- 32:32pull away from mom and dad and to
- 32:34go reaching across the room, and learn to
- 32:37crawl, and grab at things, and pull them
- 32:39off the shelf, and suck on them, or
- 32:41play with them. And all of cognitive development
- 32:44requires that kind of manic is a strong
- 32:47word, but it requires going after goals. Mhmm.
- 32:50So how is addiction different?
- 32:53It's somehow it is like a white noise
- 32:56machine. It's kind of it
- 32:59it blocks out other forms of connection.
- 33:01Mhmm. That's that's what I would say. Right?
- 33:03So
- 33:04yeah. So the kind of connection you get
- 33:06by pursuing normal goals, so to speak, like
- 33:09good goals, goals that are interesting and novel
- 33:12enough to be, you know, worth thinking about,
- 33:16gets replaced by going after the same thing
- 33:19day after day or hour after hour or
- 33:21month after month or year after year. That's
- 33:23a whole different kind of enterprise. That's not
- 33:26just being too involved in activity and not
- 33:28having enough time to reflect. That's there's a
- 33:30kind of intrinsic
- 33:32boringness to that.
- 33:34Repetition numbs you. Right? It turns off a
- 33:37lot of aspects of having a well functioning
- 33:40mind, brain, and heart.
- 33:44But as for the role of love, I
- 33:45mean, you and I agree about that.
- 33:47Feeling love for other people, feeling that connection,
- 33:50concern,
- 33:51care, respect,
- 33:52and for oneself,
- 33:54fundamental practices,
- 33:55practices,
- 33:56strange word, fundamental way of connecting,
- 33:59with other people that is tremendously fulfilling that
- 34:03indeed feels really good. And by the way,
- 34:05yes, it does actually stimulate opioid receptors.
- 34:09In fact, mother's milk has opioids
- 34:12in it. So,
- 34:13when I use the word love,
- 34:15I'm not talking about like romantic love, which
- 34:18is highs and downs. Right? It's it's
- 34:21it's a little artificial,
- 34:22and it's seldomly lasting.
- 34:25So I took a Vipassana meditation course,
- 34:28one of the 10 day Goenkara retreats Okay.
- 34:31Many, many years ago. In fact, 2 weeks
- 34:32before I opened the board of his clinic
- 34:34for hypnosis, and I got back and I
- 34:35opened up. I rent out this office, which
- 34:37is now our studio Yeah. And I opened
- 34:39it up 2 weeks after I got back
- 34:41from that retreat. Right. But,
- 34:43the term is loving kindness,
- 34:45which is an English translation of of the
- 34:47word meta,
- 34:48m e t t a. So what when
- 34:50I mean when I talk about, like, sitting
- 34:52quietly
- 34:53with your own
- 34:54thoughts Mhmm. And feeling your own heart and
- 34:58causing your own good feelings that way, I'm
- 35:00not really talking about, like, pursuing romantic love
- 35:03or even, like, parental love or love for
- 35:05a child or even love for, like, a
- 35:07cat or a dog. Right. I'm talking about
- 35:09loving kindness that's for all human beings. Right.
- 35:13And that one can feel when he's he
- 35:15or she is on their own. Yeah. And
- 35:17I would say also that that kind of
- 35:19love, and yes, it meta, that Buddhist term
- 35:22covers it. It's
- 35:24there is something that is intrinsically connects that
- 35:26with mindfulness.
- 35:28Because to love in that way, whether it's
- 35:30someone else or yourself, you need to get
- 35:32them. You need to actually think about what
- 35:34it's like to be that person. What's it
- 35:36like for you? I don't know what it's
- 35:37like for you. You have a very different
- 35:39life than I do, of course.
- 35:42And what's it like for people of other
- 35:45genders or races or economic conditions and all
- 35:47that stuff requires a certain amount of reflection
- 35:50and thoughtfulness,
- 35:51which to me is pretty close to mindfulness.
- 35:53It's like, you know, what's it like? And
- 35:55also when we are loving ourselves, caring for
- 35:57ourselves,
- 35:59I use a kind of psychotherapy now in
- 36:01in my psychology practice called, internal family systems,
- 36:05which is getting quite popular these days. It's
- 36:07IFS is the acronym. IFS,
- 36:10Internal Family Systems.
- 36:12First thing I always tell people, it's not
- 36:14family therapy.
- 36:15No. That's a misnomer.
- 36:17The internal family is this, the family of
- 36:20parts or voices, they call them parts of
- 36:22ourselves.
- 36:23The part that is craving
- 36:26fulfillment,
- 36:27like the addictive part, give me more. The
- 36:30part that is critical,
- 36:32you're being an idiot. I can't believe you're
- 36:34doing that again. What a jerk. You know,
- 36:36the part that whatever. There's a number of
- 36:38different parts of us that just pure needy.
- 36:41I feel alone. I need to be cared
- 36:43for. The part that, you know, all that.
- 36:45Okay. So what about that?
- 36:47It's kind
- 36:49of analogous
- 36:51to the way we need to understand other
- 36:53people is to really consider them. What's it
- 36:56like to be you?
- 36:57What's it and then in IFS, it's it's
- 37:00it's astounding the way it works. In IFS,
- 37:03you kind of look at your parts very,
- 37:06you know, very, deliberately
- 37:08and say, what's it like for you internal
- 37:10critic to be this
- 37:12critical mean, you know, accusatory
- 37:14part of me? What's that like for you?
- 37:17Well, I do that because you get in
- 37:18so much trouble all the time. You're always,
- 37:20you know,
- 37:21screwing up and, you know, banging your head
- 37:24against the wall and I just can't have
- 37:25that anymore. I need to get you under
- 37:27control.
- 37:28Oh, that's different. Mhmm. How do you know?
- 37:30How do you get that? Well, you really
- 37:32have to look inside. So it is a
- 37:34kind of mindfulness
- 37:35Yeah. Involved in understanding what's going on inside
- 37:38or in other people. Well, it kind of
- 37:41raises the idea that the questions you ask
- 37:44yourself
- 37:45are going to evoke
- 37:47certain
- 37:48answers or even certain
- 37:50domains of answer. Yeah. So asking the question
- 37:53of one's inner critic,
- 37:54what's it like for you? Mhmm. Evokes 4
- 37:57higher quality answers Mhmm. Than asking the inner
- 38:01critic, could you please shut up? Yes. Right?
- 38:03Exactly. Yes. So That's the main point. Yeah.
- 38:06Yeah. Well, often the questions we ask ourselves
- 38:08are just simply not very good questions. You're
- 38:10right. So a common question is, what's wrong
- 38:13with me? Well, anytime you ask the question,
- 38:15what's wrong with me? You're setting it up.
- 38:16You're setting, like it's a leading question. You
- 38:18gotta come up with everything bad bad about
- 38:20you. Yes. It's a leading question. Exactly. And
- 38:23with the addict self, the famous addict self,
- 38:25which, you know, in AA is doing push
- 38:27ups in the parking lot. They actually have
- 38:29this expression. You know, your addict self
- 38:31your addiction is doing push up push ups,
- 38:33strengthening itself while you're in here trying to
- 38:35be a good boy or girl.
- 38:37Sorry. But, you know, that doesn't quite wash.
- 38:40So, like, what is this addictive part actually
- 38:43trying to do? The craving part. I want
- 38:45more. I want to drink. I want to
- 38:47drink tonight. I don't want to be sober.
- 38:49I don't want to, you know, abstain.
- 38:52What's that like for you? Well,
- 38:55I know that this helps you. It soothes
- 38:57you. It makes you feel better.
- 38:59I want us to feel better so to
- 39:00speak. I mean, it's kinda strange to put
- 39:02that in language, but I want us to
- 39:04feel better. So that's what I do for
- 39:06us.
- 39:07In any kind of good communication,
- 39:09you want to assume good
- 39:11faith. Yes. So in your inner dialogue, you
- 39:14want to assume good faith. That's pretty much
- 39:16the idea. And in fact, Richard Schwartz, the
- 39:18founder, his latest book is called No Bad
- 39:21Parts.
- 39:22Precisely that. Yes. All kind of on your
- 39:24side one way or another.
- 39:26Yep.
- 39:27Yep. And even the part that wants you
- 39:29to use heroin or go on a bender
- 39:32has some kind of positive intention. And when
- 39:35you're asking the right questions,
- 39:37you arrive at that positive intention and then
- 39:39you can meet that positive intention
- 39:41in some more
- 39:43holistically
- 39:45appropriate or beneficial way. Yeah. Yeah. Pretty much
- 39:48so. And so when you really get into
- 39:50conversation with these parts of oneself,
- 39:53the addict self being the most prevalent,
- 39:56is like,
- 39:57okay. I wanted to instead of, like, trying
- 39:58to get rid of you and toss you
- 40:00in the trash and, you know,
- 40:02talk you and tell you're whatever, until you
- 40:04give up on me, I'm gonna I'm going
- 40:06to accept what you need, what you want,
- 40:09and we're gonna work together,
- 40:11which sounds really odd. Who's doing the talking
- 40:13if that's a part of yourself? Well, somehow
- 40:15it works. Yeah. And so you're bringing a
- 40:17perspective and a mindfulness
- 40:19together with that urge and saying,
- 40:22we're gonna actually kind of just
- 40:25gently re
- 40:26we're gonna modify the way we get this
- 40:29feeling, the way it works so that so
- 40:31that it doesn't kill us, so that it
- 40:32doesn't hurt us, doesn't get us in horrible
- 40:34trouble at home with the family, with your
- 40:36partner, with your bank account, etcetera. Yeah. Right?
- 40:39And it works. And everything, all the different
- 40:41parts actually say, yeah.
- 40:43Please. That would be nice. Well, the the
- 40:46the thing with addiction is because
- 40:50so often addiction follows from trauma.
- 40:53Yeah. And so often there's this undercurrent
- 40:56of shame
- 40:57that that's underlying
- 40:59Mhmm. Any form of addiction. Mhmm. Often when
- 41:02one
- 41:02superficially
- 41:03examines their inner dialogue, there's nothing good going
- 41:06on inside. That's right. It's it's all, you
- 41:08know, why you're bad or why you're shameful
- 41:11or how you're a mess up. So that's
- 41:13why asking oneself what's wrong with me, which
- 41:17the medical model almost kind of does.
- 41:21Kind of. Oh, I I guess it, you
- 41:23know
- 41:25Well, I would say I would say Yeah.
- 41:27We're gonna tell you what's wrong with you.
- 41:29We're gonna look it up. We've got all
- 41:30kinds of data on this. We're going to
- 41:32let you know what's wrong with you. Right.
- 41:34But it's the paradigm of what's wrong
- 41:37as opposed to what's the intent.
- 41:40Well, yeah. Because they're not assuming
- 41:43any kind of teleological,
- 41:44any kind of goal oriented
- 41:47conscious deliberate activity on the part of the
- 41:49virus.
- 41:50Right? Yeah. Virus doesn't have questions. Right? Fit
- 41:53human beings are way more complex than viruses.
- 41:55Yeah. So but
- 41:57but anyway, there are parallels with the medical
- 42:00form of diagnosis and
- 42:03analysis.
- 42:04Thank you for listening to How to be
- 42:05an adult.
- 42:07This episode, an interview with Mark Lewis, will
- 42:09be continued in part 2, which will be
- 42:12released in 2 weeks.
- 42:14How to be an adult is a production
- 42:16of the Morpheus Clinic for hypnosis
- 42:19at www.morphisclinic.com.