Chris and Mirella

Chris and Mirella stood together high on the cliff top with majestic views over the whole valley below. As they looked yonder they could see the slaves of the science paradigm each heaving huge blocks of stone into place, there was a multitude, each with a very specific role in the construction of the pyramids built to honour and preserve the evidence based scientific paradigm. Each slave laying the block of stone that was to become their prison, and each slave learnt to see the pyramid as they had been told to see it by the wise teachers in the schools of learning without realising that they had forgotten how to question.

“¿Why should one question?” declared Mirella and it was true, because engraved on each of the pyramids were the words p=<0,05,  thus it was written from that moment on all knowledge must be p=<0,05 as a testament to it’s objectivity and all other knowledge which does not bear this sign shall be rejected and ridiculed, and so it came to pass.

As Chris and Mirella looked on an old man Kierkegaard came to them and declared “The people still suffer!” “¿Do you not see?” “The people no longer exist, but are lost completely to objectiveness.” Kierkegaard sunk deeper into his cloak and turned mumbling “mark my words!! Objective madness is the worse type of madness because one regards oneself as just another fact. People with objective madness have no soul.”

Chris turned to Mirella and asked “maybe the time has come to be authentic and admit our incoherencies.”

“I am always coherent!!!” cried Mirella, to which Chris answered “That may be so, but isn’t it also true that when we claim to be something we shed responsibility for our actions?”

Chris paused, “we can never just be, we chose and do”.

Mirella sunk deeper into her woollen jacket, for it was beginning to get cold, her voice trembled either from the cold or because it was the first time she felt uncertainty “But if I step outside of the scientific paradigm, what shall become of me?”

Chris wished there was a way to offer certainty but the truth must be told “Life will become meaningless; this is the price one must pay for being a free thinker. To be free means to assume freedom, for it is through our choices that we really become free. Accept the unavoidable, the here and now and assume the responsibility of our choice in every situation. For if we are what we do, then we are nothing but the choices we make.

“Are you suggesting that you and I..my life are all nothing?” despaired Mirella.

“On the contrary, we can only strive to be nothing; nothingness is a state which is never permanent, even if we achieve it, it cannot be maintained; It would be false to believe we are nothing, but striving to be nothing frees us from the restraints of dogma and paradigm.. When we lean on scientific paradigm we flee from our choices and our responsibility, the same as our ancestors relied on religious doctrine to avoid choices and responsibility. Who does evidence based intervention serve? Does it help the patient or does it help free the therapist of responsibility...?”

Chris turned up his collar as the winds began to chill his spine. “In the vain hope of becoming a CBT therapist, we shed our responsibility. The moment we make our bed with any school of thought we are relieved of all choice and responsibility and thus lost”.

Just at that moment the pyramids began to tremble. “You see? A theoretical framework is a fortress that we build for security, but beware for it is built upon the moving sands of uncertainty and change; any feeling of control is at best fleeting”.

“We must embrace freedom, for as much as we try to hide behind dogma and paradigms, we can never be liberated of our responsibility. We do not take an exam, there is no certificate, we cannot become, only strive to become without becoming. Once we become we stop striving and just are, we are safe in the knowledge that never again must we make another decision”.

Mirella shook her head and muttered “But being and becoming makes me feel good, should I reject that?”

“Feeling good is only temporary, it is doing that is important. What is more important to you, to feel good or live well? It is futile to try to be at one with oneself. Anxiously holding onto our theoretical framework enables us to avoid this truth and any thoughts we may have of being “right” are just thoughts and we should abstain from attaching importance to them”.

Mirella once more shook her head and replied “Surely we owe it to our clients to follow those who have gone before and what has proved to work?”

“But if I can’t make a decision free from dogma, what right have I to make decisions for others? Surely we need a committed response to each situation, not just a manual to follow. When we create our own values, we encourage our clients to be the artists of their own lives and not just followers of what has gone before”.

“When our clients come with anxiety, we should encourage them to embrace anxiety as bearer of the ultimate truth, that life is pointless. Temporary avoidance quickly disappears like sand through our fingers and objectivity can never be obtained because to understand something is to interpret it.”

Mirella turned to go as now it was getting dark, Chris thought he heard “You’re out of your fucking mind” but the wind carried it away

Globalization of Addiction

To get the full picture on addiction we have to look, not only at the ways in which it is bad for us, but also the way that substances provide something that is lacking in our lives. Something that family or society has been unable to provide, for whatever reasons.

We can consider addiction as the act of constantly seeking something outside ourselves to curb an insatiable yearning for relief or fulfillment. The aching emptiness is perpetual because the substances, objects or pursuits we hope will soothe it are not what we really need, although they did work for a while and gave temporary relief.  

Addiction is a dysfunctional way of attempting to escape from disconnection and an overwhelming feeling of fear and despair. Manifesting in a variety of shapes and forms, shopaholics, workaholics, gambling, internet, all are to a lesser or greater degree on the same continuum of dysfunctional lifestyles and an attempt to soothe something that is inside with something from the outside. It’s a form of self-harming and a failed attempt at taking back control, not dissimilar to the way an anorexic believes that the only thing they have control over in their life is the food that they ingest.

Some people are prepared to risk their lives for a brief moment of fulfilled life and a sense of connection to something.

The basis of all addiction lies in the central nervous system and neurochemicals known as neurotransmitters and their corresponding receptors. Although the Central nervous system and neurotransmitters exist, they do not exist in isolation and it’s essential for any real, in-depth understanding of addiction that we take into account the person in their entirety, that is to say in a holistic manner. The physiology of someone’s brain does not develop in isolation of an emotional and social context. On the contrary, it is very much influenced by and influences on the social and the emotional.

The false promise that substance or behaviour will make all the planets line up and everything will somehow fall into place makes them the false prophet of a distress free life. It would be wrong to label addictive behaviours as just a bad habit or a lack of willpower and falls short of understanding that all addiction is functional.

All addiction has its origins in emotional pain, whether conscious or unconscious. Powerful narcotics such as Heroin and Cocaine are anaesthetics and are extremely good at relieving pain.

A high percentage of people who engage in addictive behaviours have suffered trauma in childhood, although not all. Trauma is not a requirement for engaging in destructive behaviours, but in my clinical experience, there has been hurt, be it through a particular parenting style that cannot be called abuse, or through a deep-rooted feeling of disconnection with loved ones or the world. One thing that advances in neuropsychology show us is that stress through adversity in childhood has an enormous effect on the physiology of the central nervous system.

But its not just childhood trauma that creates an aching hole in our soul. The way society is constructed in a Neo-liberal market is enough to make my Conservative grandfather turn in his grave.

Modern market culture promotes a feeling of emptiness as we all strive to be the best we can. The fabricated Facebook shopfront of other people’s lives and successes can leave us reflecting on our own failures.  We all feel emptiness; dissatisfaction and frustration in an ever-globalizing world, but many of us have found tactics for keeping them at bay through distraction, be it through professional success, riches, sex, substances or addictive behaviour. But I know through personal experience that the moment this distraction stops, a void of emptiness can open up before us producing a continual white noise of anxiety buzzing away in the background that gets louder and louder as the years go by.

Drugs can offer relief to the lost and you only have to look at the way indigenous communities have dealt with the destruction of their way of life. When the glue of society’s fabric fails, substances are always there to step up the challenge.

It is not a coincidence that drug abuse is on the rise. In 2016, 20 million Americans suffered from a substance disorder, with 2 million addicted to opiates. The social fabric that held societies together is being ripped apart. The Market demands that we are a mobile, fluid workforce, uprooted and disconnected from society and from any ideology that may interfere with the globalised market forces, such as a sense of community, patriotism or religion. Certainty in the job market no longer exists making planning for the future a source of anxiety and worry.

Modern day addiction is neither a disease or a moral failure, it is a maladaptive means of survival. One where the drug user tries to buffer himself from a feeling of complete disconnection from society. It is a form of adaption that is never going to work and one can never feel whole through drug use, which will not only affect the health of the drug user, but also leave them feeling hollow, empty and craving for more.

Traditional drug care has always been based on the individual, but without a caring, inclusive and egalitarian society, recovery will always be against the odds.