I watched Johann Hari’s impressive July 2015 Ted Talk, Everything You Think You Know About Addiction Is Wrong, which I recommend to anyone involved with an addict. The talk is compassionate, insightful, and somewhat controversial. If you don’t want to watch, you can listen to his short youtube video that gets across the same information about how we ought to respond to addiction in our society.
Hari’s video on Addiction has been seen by millions of viewers worldwide. It propelled his book on drugs and addiction, Chasing the Scream, to the New York Times Bestseller list. But it is really making a very simple point: Our current attempts to curb addiction and, specifically, drug use, have been futile. He says that most of us (including himself at one time, he admits) don’t understand how addiction works. He argues that addiction is a result of the pain in an individual’s life that makes his reality unbearable, and it can be overcome only through increased social connectivity and a more positive environment. “The opposite of addiction is not sobriety,” he says. “The opposite of addiction is connection.”
I love this message for many reasons, among which is the essential truth that if we want to help addicts overcome addiction we need to stop ostracising them, locking them up, and shaming them. What extraordinary arrogance I used to have when I heard the word “addiction”. After all, nobody in my family was an addict; I would never be involved with an addict. Addicts were just weak, weren’t they?
And then I found out I was married to an addict. And while he certainly has weaknesses, he is also hard-working, intelligent, resourceful, caring, sensitive, artistic, nurturing, fair-minded, compassionate and kind.
Most of us already know that addicts often start using drugs to dull their response to unbearable circumstances. Some of us imagine that if we were in those same circumstances we would have the presence of mind to forgo drug use and improve our situations, but that is easy to say and unlikely to ever be tested.
As a society we shame and punish addicts. Even in the United States, with all its information and pockets of enlightenment surrounding substance abuse disorders, addicts are looked down upon as breed of untouchables. Hari says, “In Arizona, I went out with a group of women who were made to wear t-shirts saying, ‘I was a drug addict,’ and go out on chain gangs and dig graves while members of the public jeer at them, and when those women get out of prison, they’re going to have criminal records that mean they’ll never work in the legal economy again.”
What did such a declaration emblazoned on their clothes accomplish other than to shame them? And who benefits from shaming them?
What we may not know (and I certainly did not know) is that addicts have a better chance of beating addiction when their physical environment and circumstances change for the better. Rats in studies in which there was nothing but a cage and a water bottle— no toys or other rats—became heroin addicts when heroin was available.
However, in a different study, rats that were placed in an enriched environment did not become cocaine and heroin addicts even when the drug was available. The scientist in running the experiment, Bruce Alexander, concluded that rats only become addicted to drugs when they are socially isolated and/or their circumstances are unbearable for them. I know that isn’t the only conclusion we could draw, but it is an interesting one. And it rather flies in the face of those who perceive drugs as chemicals we become hooked on. Essentially, it asks the question is addiction really addiction as we have understood it up to now?
This question is particularly relevant to those of us with spouses with sex addiction as we have been scrambling to prove pornography has a drug-like effect on the brain. By proving pornography has a drug-like effect, we then are able to understand the problem as an addictive disorder rather than plain bad behavior.
But now I have a dilemma. If my husband’s reality is rather pleasant (after all, he is married with a family in a peaceable conditions) then why were there so many years of struggle with addiction? Why does he have to go to meetings twice weekly, make daily phone calls and all sorts of other efforts to maintain his sexual sobriety?
I will answer this shortly, but for now let’s return to chemical drugs. Hari brings up the well-documented fact that drug use was high among soldiers in Vietnam, but that many soldiers gave up heroin entirely upon their exit from service. In fact, of the 20% of American serving in Vietnam who self-identified as heroin addicts (and for all this information on Vietnam I am relying on Alix Seigel’s 2012 article written for NPR) most stopped using the drug upon returning to their homes in America.
Well, most of one set stopped. The relapse rate among those who returned home having already “dried out” while living outside the United States was very low, about 5%. So, if they gave up heroin before returning to America they had a 95% chance of staying sober.
However the relapse rate among this who returned home still addicted to the drug was very high. They arrived in America addicts and even if they then tried to give up the drug, they often stayed addicts or relapsed frequently.
Confusing? Yes. But the reasons have been explained by scientists who demonstrate how addictive behaviours are somehow reinforced by our physical setting.
The Vietnam soldiers who successfully stayed off heroin went through whatever process of rehabilitation was available in Vietnam (I dare not think what it was) and were then returned to their homes in America, to environments that resembled nothing of the jungles and mountains, the living conditions, military roles and hierarchy, the fear, and constant threat of death in Vietnam. This new environment was clean of drug-associated behavior.
The Vietnam soldiers who did not successful stay off heroin arrived as addicts to America and continued in their addiction there. By doing so, they began associating their life in America with using the drug. Apparently, this matters. For some reason, the setting itself reinforces the addiction, and this appears to be the case in established addiction even if the environment is non-hostile. Moving from one place to another when addicted will not help defeat the addiction. As every sex addict will tell you, a dramatic change in intentions and goals will not easily shift it.
I’ve heard my husband state that he hates pornography, hates prostitution, can’t stand the thought he’d ever been involved in cyber-sex, and yet the behaviors have been repeated. Good intentions do not alter the addiction.
I’ve also seen him work furiously to curtail the addiction through therapy and 12-Step programs, prayer, spiritual teachings, and physical activity. Even with all that cyclical acting out persisted for years.
I have read enough literature on addiction and recovery to know that a change in environment, on its own, does not help end addiction. Doing what the 12-Step programs call “a geographical” will not alter the addiction if the addiction is in evidence. In other words, if you were a sex addict in New York, you’ll likely be a sex addict in London.
However, I keep thinking about those Vietnam veterans. I don’t want to make too big a statement here, but it seems possible that if you recover in one place, you have a better hope of maintaining your sobriety if you move your environment to a new place, one in which your normal behaviours (of whatever sort) are disrupted. The environment that somehow reinforced the addiction no longer fires off all those subliminal messages that put your back into auto-pilot and into addiction. How radical a change you need (Vietnam to a house in suburbs in the USA is very radical), we don’t know. But being aware that addictive behaviours are somehow linked to our environment may be a useful bit of information to use in recovery.
We don’t have great statistics on sex addiction but it is currently being understood as a lifelong condition with chronic relapses. The frequency of relapses vary from very frequent, even daily, to every few months or so. In many regards sex addiction does not follow the addiction patterns we see in alcohol or drugs, but the question of environment has struck me.
What is the environment that triggers a sex addict? Perhaps it is one of social isolation, which is one of the conditions that Hari suggests brings upon addiction. It may also be one of feeling shame, which is a very big trigger for many sex addicts. Does it make matters worse that in our society we endure the constant hard-sell of sex on every billboard, store front, magazine, internet page, and tv series? If a sex addict can get some distance from the craving, if he can manage to interrupt the patterns of thinking that move him into “the bubble” can he help himself further by doing an inventory of his environment and the conditions of his life that create a propensity toward patterns of acting out? Can he shift enough of his environment so that it no longer “speaks” addiction to him?
I asked my husband and he wasn’t so sure. “The problem is we carry around the environment in our heads,” he said. “We make it all up.”
He means the shame, the social isolation, the self-loathing. And if that is what brings upon addiction then Hari’s argument, though tenuous in some areas, is the one that makes the most sense in fighting sex addiction. Let’s forget the notion of “enabling” for a moment and try an experiment in which we embrace, sit with, love, accept, and care for our men and women in sex addiction. At least, until some better idea comes along.
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