Mate reminds us that as beings we want to be in stable caring mutual environments, not aggressive hostile ones. Of course, the latter is what we too often help create. But if what is normal—all the traumas of life from those hostile environments--is assumed to be just natural, then the norm will continue. And throughout history we develop myths in order to sustain what is normal when who really benefits are those in power. This is one of the insights from systems thinking: to see how maintaining dysfunction easily becomes the status quo in lives, families, and larger groups.
What are some of the markers that Mate plants to point us on the right way of recovery? He quotes Bessel van der Kolk’s “our culture teaches us to focus on our personal uniqueness, but at a deeper level we barely exist as individual organisms.” This is one of those recovery maxims too, calling us out of our fixation on our “terminal uniqueness.” This moving out of our “separation from self” is one of the cultural character traits or markers to use in guiding us through recovery. Or as is said in 12 step groups, the opposite of addiction is community, healthy self-differentiating attached in an authentic way community. Other markers he points to are our culture’s consumption hunger (we never are enough or have enough in our lives, be it security, comfort, material things) and the way we react to our sense of inner and external scarcity with lives given over to “hypnotic passivity.” All of this is a breeding ground for addictions.
In a particularly helpful section, Mate puts our myths of addiction into perspective. We used to “normally” think addictions were only the result of bad choices made by individuals. Then more recently we “normally” thought of addiction as a disease model. He finds in his experience that both are too limited.
About bad choices: He is clear that just telling people to say no won’t work, and just saying no doesn’t work. People tell themselves no all the time every day but go right on choosing yes. Do they choose to stay hooked? From the outside it looks like an easy answer. But not when on the inside of the addict’s life. He quotes Dr. Nora Volkow, head of the U.S. National Institute on Drug Abuse on recent studies showing that repeated drug use leads to long lasting changes in the brain that undermine voluntary control. Mate says brains of addicts are already impaired by life experiences that set the stage for addiction to take hold, before they even start with their drug or behavior of choice.
About the disease model. It is a step in right direction, he says; it is a more compassionate response and takes in the study of the brain. But he says it lacks the brain-mind-body-culture connection. It misses the human element. Disease is more useful as a metaphorical tool than a literal fact. Addictions are rooted in coping mechanisms. People seeking to cope with life’s pains. Experiences are a main ingredient of the drug of choice.
The Two new essential questions: 1. Don’t just ask an addict what is wrong with their addiction, and what wrong led to it, but rather, what is right about it for them? What benefit is the person deriving from it? Benefits such as social connection, feelings of power, confidence (the saecrecy of separateness and comfort and no conflict, see an earlier blog post). Or perhaps temporary peace. Or that they won’t disappoint anyone during the time of acting out. They won’t feel inadequate. If it is a way of escape, why would you feel the need for escape? 2. Ask not about the addiction why, but about the originating pain why.
His definition of addiction is now that “Addiction is a complex psychological, emotional, physiological, neurobiological, social, and spiritual process. It manifests through any behavior in which a person finds temporary relief or pleasure, and therefore craves, but that in the long term causes them or others negative consequences, and yet the person refuses or is unable to give it up. Accordingly, the three main hallmarks of addiction are: short-term relief or pleasure and therefore craving; long-term suffering for oneself or others; and an inability to stop.”
He maintains that no drug (substance or behavior) is in and of itself alone addictive. The question is not is something addictive, yes or no? The right answer is exactly that: “yes or no.” Depends on the degree of pain one needs to soothe. Environmental factors turn on or off genes, and stress in the womb can even predispose the brain to addiction, he says, adding that porn watching for example induces repeated dopamine spikes and is engineered to do so. I would add to that it is more than the dopamine surge of watching, but also the added dopamine from orgasms during the viewing, and for some there is a combination at play of dopamine from porn and drug use and orgasm all at the same time.
In his Part four, he concludes with his pathways to wholeness. About that Mate said: “The essential first step is what I call being disillusioned. Now, people usually think of disillusionment as discouraging and somewhat negative. No. Would we rather be illusioned or disillusioned? Would we rather see the world through rose-colored glasses, not seeing what’s in front of us, or would we rather deal with reality the way it is? In the final chapter, I quote James Baldwin, the great, great James Baldwin, who said that not everything that’s faced can be healed, but nothing that’s not faced can be healed.”
His pathways are called the 4A’s of stressing authenticity, agency, anger, and acceptance. His 5C’s of compassionate inquiry into our selves come in: Ordinary human compassion, Compassion of curiosity and understanding, Compassion of recognition, Compassion of truth, and Compassion of possibility.
All of this includes the important distinction between the healthy Self compassion as opposed to the unhealthy self-pity. This has been one of the arcs of my own life struggle. Especially after prison and public shame and a deep sense of guilt and remorse, it is hard to feel compassionate about yourself; it is so easy for the lingering addict in your mind to feed you a steady dose of self-pity instead. And there is always the risk you will try to live in a make-believe world of forgetting past harms in order to make yourself feel better. Human impulse is for psychic survival. But the middle path is learning to treat yourself wholly and compassionately so that you do have the resources and motivation to look honestly on your faults and your strengths and use all of yourself to help grow and help others grow. Self-compassion is a daily recovery task.
Mate promotes Compassionate Inquiry: to ask ourselves what in my life’s important areas am I not saying no to? How does my inability to say no impact my life? What bodily signals have I been overlooking? What symptoms have I been ignoring that could be warning signs were I to pay conscious attention? What is the hidden story behind my inability to say no? where did I learn these stories? Where have I ignored or denied the yes that wanted to be said? These are key questions especially for anyone in recovery or in need of recovery.
He offers these action responses:
Relabel self-limiting thought as a thought (hence something within our control, not reflective of an absolute reality.)
Reattribute the thought to the brain sending old messages.
Refocus. Buy time. Do something else. Physical if possible, or give yourself positive thoughts on what is loving in your life, what you can be grateful for.
Revalue. Explore, talk back to the urge, the thought. Remember consequences.
Re-create. Imagine yourself differently, who you want to be. Be intentional.
These steps are best carried out, of course, in communities of accountability and grace. They also remind me of the important steps discussed a few decades ago in “Brain Lock” a book focused on OCD which has been helpful, as I have written in other posts, for my own compulsions and impulses.
The book concludes by asking: ‘What will it take to unmake the myth of normal?” He answers that it will take some key changes or shifts to create those conditions which foster health and not toxicity. These shifts, he says, all derive from the core principles of this book: 1. biopsychosocial medicine, 2. disease as teacher, 3. the primacy of holding together both attachment to others and authenticity of self, and above all, 4. fearless self-inquiry, especially on a social scale we have for too long ignored or minimalized.
I encourage reading and journaling one’s way through this book. It is a large one. It will take some time. In today’s particularly toxic culture, that is all the more reason to do so.