Different Perspectives on Addiction

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Different Perspectives on Addiction

“What is addiction, really? 

It is a sign, a signal,

a symptom of distress. 

It is a language that tells us about a

plight that must be understood.” 

-Swiss psychologist Alice Miller

 

 

Healers of all perspectives have sought to comprehend and create the conditions that manifest beneficial change; seeking to aid in the cessation of suffering.  Suffering arrives in various ways: relationships, transitions, anxiety, depression, stress, confusion.  It is endemic to human experience.  Intrinsically, humans desire to suffer less and be happier.  This certainly is the case with psychotherapy.  People enter therapy to “feel better,” to “feel happier,” and certainly not to “feel worse.”  The lure of better happiness has been clutched by corporate America.  Advertisements and marketing promise a better life: if you take this medicine for depression you will “be happier,” if you use this toothpaste your teeth will “be whiter,” if you drink this beer you will “be popular.”  Obviously, nobody desires to feel “less happy,” but might it be the case that humans have become addicted to wanting more happiness?  If addiction is viewed along a continuum—at one end residing the intravenous drug user dependent upon their habit, in the middle someone who abuses alcohol but is not dependent, and at the other end the privileged workaholic or daily television watcher—all destructive habits appear to be driven toward avoiding suffering and wanting happiness.  What are these addictions really attempting to communicate?

The phenomenon of addiction has been investigated for centuries.  In America alone, personal and institutional responses to alcoholism and other addictions have ranged from Alcoholics Anonymous, inebriate asylums, luxury inpatient treatments, electric shock therapy, water cures, mandatory sterilization, aversion therapies, and methadone maintenance (White, 1998).  Through these various responses to addiction, relapse continues to intervene in abstinence.  Let’s take a closer look…

Traditional allopathic medicine, the dominant form of medicine practiced in Western nations, including the United States, focuses on treating symptoms by accurately diagnosing their cause.  As such, healing is viewed as ridding oneself of something that is problematic, such as recovering from a physical disease, affliction, or confused mental state.  The Diagnostic and Statistical Manual, for example, “draws a line between what is viewed as ‘normal’ and what is not” (Whitaker, 2010, p. 10).  That is, Western theory views healing as getting rid of something unwanted or abnormal.

Quite contrary to Western theory, Buddhist psychology tends to view healing as the process in which, by understanding the human condition more clearly, one uncovers their own true nature.  There is no “problem” per se of which to rid oneself; rather health resides in the unfolding of one’s natural true state which is always present and therefore need not be regained.  This unfolding of one’s true state consists of relating more closely to the experience of destructive emotions with unconditional friendliness (Wegela, 2011).  Within this view, a component of healing thus takes place through the development of compassion for ourselves, others, and the world.

The philosophical question, “Which came first, the chicken or the egg?” might be of value here.  My goal is not to distinguish whether the Western or Buddhist perspective on problem verses no problem came first or is a better approach to healing and recovery.  Alternatively, my objective is to integrate and elucidate the distinctions in how emotions are conceived in Western and Buddhist thought.  Author and physician, Dr. Gabor Matē (2008) proclaims, “the constellation of behaviors we call addiction is provoked by a complex set of neurological and emotional mechanisms that develop inside a person” (p. 157).  The key word in that sentence is, “complex”.  Human behavior is complex, meaning it is created through a myriad of circumstances, genetics, memories, food, sleep, relationships, and overall environment.

 

Western Perspective

Traditional allopathic medicine terms addiction as a chronic disease.  If an individual meets certain criterion, a diagnosis is given—so a problem is identified—and pharmacological interventions are often provided to rid the unwanted problem.  Dr. Nora Volkow, director of the National Institute on Drug Abuse and Dr. Ting-Kai Li (2004), director at the National Institute on Alcohol Abuse and Alcoholism states, “Drug addiction is a disease of the brain, and the associated abnormal behavior is the result of dysfunction of brain tissue, just as cardiac insufficiency is a disease of the heart” (p. 963).  Drug and alcohol use changes the brain’s “chemical structure, its anatomy, and its physiological functioning” (Matē, 2008, p. 154).  In essence, our brain is a major component to how we react and relate to the world and drugs influence our brain.  It is these brain dynamics that I believe the disease-based model of Western theory is of importance to addiction recovery.

 

Eastern Perspective

Buddhist philosophy does not emphasize problem solving, but rather views healing holistically as a mind-body connection emphasizing the whole person including the spiritual aspects of human experience.  In Buddhist psychology the mind does not exist in the brain alone, rather includes the entire physical body.  The mind receives the impressions from the world through the body’s five senses of sound, sight, smell, touch, and taste, and then interprets these perceptions through the brain, which is known as the sixth sense in Buddhist psychology.  The senses are used to identify danger verses safety; they are the root of emotion.  The confusion of human experience begins with emotion from this perspective; it is not that emotions are negative or should be avoided however (Holecek, 2009).  It is that they disguise the natural true state that each human is born with.

Buddhist meditation master and author, Chögyam Trungpa Rinpoche (2005) insists that the “Mind cannot exist without emotions” (p. 65).  Further, Buddhist teacher and author Dr. Andrew Holecek (2009) suggests that, “Emotions are the electricity of life.  Emotions make us human; we never want to get rid of them.  Emotional problems…on the other hand, are when the electricity burns us up.  It is when we don’t relate to the energy properly” (p. 192).  Confusion, such as addiction, thus proceeds with a misidentification with emotions or the self.  In Buddhism, this self is known as the ego and it is a clinging to the identity of self.  Recovery or healing begins with a closer relationship with the mind and body, which is a component of emotional intelligence.  This relationship begins with mindful-awareness of how the ego is continually being solidified through a disconnection with emotions.  Trungpa (2005) suggests that, ” If a person regards sickness as an enemy, then his body has no working basis to be well.  He thinks his body is invaded by enemies and he goes to the doctor to get rid of these foreigners occupying his castle.   And once that’s taken care of, it’s all over.  So no relationship is established.  Sickness is a message, and it can be cured if the right situation is created” (p. 163).

The aspiration for health, from a Buddhist perspective, then resides in listening very closely to these messages of emotions; the emphasis is no longer on the problems themselves but rather on direct experience in the present moment.  So even if an individual is repeatedly relapsing on drugs with the knowledge of tragic consequences, such as death or losing custody of children, there is a message of sanity to be uncovered; there is no problem to rid, but rather a shift of focus is essential.

 

Integrating the West and the East

In The Complete Tail’s of Winnie-the-Pooh, A.A. Milne (1994) begins the children’s book with a paragraph that may parallel the experiences while in the clasps of addiction: “Here is Edward Bear coming downstairs now, bump, bump, bump, on the back of his head…sometimes he feels that there really is another way…if only he could stop bumping for a moment and think of it!” (p. 1).  Both Western and Buddhist perspectives on healing seek the same thing: the cessation of suffering or as Edward Bear might attest, a better way down the stairs.  The convergence of Western science and Eastern philosophies are particularly fertile in psychology today as the world becomes ever-more interconnected.  In illuminating the different perspectives on emotions from both allopathic medicine and Buddhist psychology, my hope is that clinicians and clients alike may begin to relate to their emotions with more clarity and, simultaneously, intelligence.

“The Dzogchen Ponlop Rinpoche says that fundamentally emotions don’t bother us—we bother them” (Holecek, 2009, p. 205).  In my experience, if allopathic medicine is integrated with philosophy—a deeper relation with emotion itself, not just the trigger—both healing modalities bestow emotional intelligence.  In this view, there is no reason for either the clinician or the client to beat oneself up for being emotional; in fact, this may be celebrated with loving-kindness, a mark that one is alive and fundamentally healthy.  A letting go, however, of how one thinks things should be or could have been is essential.  Trungpa (2003) maintains that, “Egolessness is having the trust to not rebuild again at all and experiencing the psychological healthiness and freshness that goes with not rebuilding” (p. 545).  The challenges of life may not be as solid and monotonous as conceived, if the focus of healing is directed to the immediacy and fullness of this very moment.

 References

Holecek, A. (2009). The power and the pain: Transforming spiritual hardship into joy. Ithaca, NY: Snow Lion.

Matē, G. (2008). In the realm of hungry ghost: Close encounters with addiction. Berkeley, CA: North Atlantic Books.

Milne, A. A. (1994). The complete tales of winnie-the-pooh. New York, NY: Dutton Children’s Books.

Trungpa, C. (2003). The meeting of buddhist and western psychology: Experience and theory. In C.R. Gimian (Ed.), The collected works of chogyam trungpa, vol 2. Boston, MA: Shambhala.

Trungpa, C. (2005). The sanity we are born with: a Buddhist approach to psychology. Boston, MA: Shambhala.

Volkow, N.D., & Li, T.K. (2004). Drug addiction: The neurobiology of behavior gone awry. Nature Reviews Neuroscience, 5, 963-970.

Wegela, K.K. (2011). The courage to be present: Buddhism, psychotherapy, and the awakening of natural wisdom. Boston, MA: Shambhala.

Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. New York, NY: Broadway Paperbacks.

White, W. (1998). Slaying the dragon: the history of addiction treatment and recovery in America. Bloomington, IL: Chestnut Health Systems/Lighthouse Institute.