The following is an excerpt from The Biology of Desire: Why Addiction is not a Disease by Marc Lewis, PhD. The book is an argument against the notion that addiction should be classified under the same category as cancer, multiple sclerosis, and dementia. If you consider the history of how and why addiction became a disease as opposed to being classified as anything else, combined with the neuroscience of how addiction impacts the brain vs. how something like dementia does, you’ll realize the power of this argument, especially considering the fact that while someone with dementia can’t decide to stop having dementia, a person with an addiction needs to first decide they no longer want to continue with their addiction before they seek the right therapy and support. Disease requires a combination of drug treatment and possibly immune system actions, whereas addiction requires personal will and therapy. What I really liked about this book is how Lewis intertwined narratives of former addicts with how their addiction habits were affecting their brains’ structure and function (Lewis happens to also have been an addict and wrote about this in a previous work titled Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs). Lewis is almost poetic in how he narrates the stories of real life people who battled with addiction, which he also does with such authenticity given that he himself was a former addict and can relate to these stories at a personal level. The book also does a very nice and smooth job layering on top of these narratives how the brain responds to changing habits, and how addiction is really the brain doing what it’s meant to do but taken to an extreme end. It was quite an enjoyable and enlightening read.
Her therapist wanted to hear the whole story.
The urge to delete her inner world had emerged long before her drug-taking days. The equation that guided her life was that she must hide her feelings of need and vulnerability, her disappointment, her anger, in order to be accepted, tolerated, loved. First as a child, in a family configured around her father’s fragility. Then, years later, as a young woman, enmeshed in relationships with abusive men, one after another. She remembers one particularly horrific relationship in which she allowed herself to be tied up with a gun to her head, in order to satisfy the man she was with. Sacrifice was the key to acceptance. As she put it, there was “the moment where my self just left.”
Now she sees the similarity between abusive relationships and drug addiction, at least as it played out in her own life. In both cases, she had to give up a lot if she wanted to get something. She says she “would walk out of relationships physically broken, just like people who walk into rehab.” But the impulse to repeat these disastrous encounters, with men or with drugs, was exactly the same. In between relationships, she would starve herself, not eat for long periods. The important thing was to deny her actual needs, to suffer that deprivation, until she could no longer stand the emptiness.
After her neck injury had healed almost completely, Donna discovered that Vicodin offered something besides pain relief: a sense of being cocooned in warmth — without having to cut off her feelings, without having to hide from herself. But of course she could not share this discovery. Hiding her new obsession from others wasn’t easy, but it was not nearly as hurtful as hiding her needs from herself. In fact, the hiding itself became satisfying; it released flaring sunspots of defiance, moments of triumph, in a life otherwise ruled by compromise. It worked, as long as she got the intimacy she needed from her drugs. For Donna, as for Natalie, a certain fusion took place — not the result of the drug itself, but the result of a collage of historical and present wounds, and the fit between what was missing and what was gained.
With her therapist, Donna replayed the messages she’d recorded as a child. “So much was done with silence in my family. Which is what I repeated with other people. I was very withholding with Michael, then defiant through the secrecy.” Her therapist held up the mirror, and Donna realized she’d been biting back depression for nearly her whole life. This shocked her. She’d never seen herself as depressed, but now it was obvious. She had denied so much of her pain and chosen self-control and self-abuse instead, with her parents, with men, and with drugs. The important thing had always been to stay hidden. That was the one rule she’d never broken. Until now, sitting in this room with someone she hardly knew.