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Old 09-06-2018, 09:59 AM   #1 (permalink)
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Biology of Desire


I have been reading Biology of Desire , it was brought to my attention on SR, the author Marc Lewis believes addiction is not a disease but learned behaviour. I really do not know where I stand on this but the book is very interesting and informative. However , before I came to sober recovery I believed that addiction was a disease, it was told to me in AA , and actually I believe that when it was determined that alcoholics were sick and diseased , it made it easier for alcoholic's to come forward. It really does not matter to me if it is a disease or learned behaviour, the only way out of it is to stop.However I disagree with the way AA tells us we are doomed forever, I believe there is a lot of negative thought in the AA model. I believe in God , I believed before I was an alcoholic and I firmly believe in him today , I believe he gave me the free will to decide how to conduct my life , and I became alcoholic on my own choices So I do believe that the author Marc Lewis , an addict once, a neuroscience PhD is clearly making progress with his idea that addiction is a choice, why do we , programs like AA and institutions like rehab shun progress, is it because they are making money , not AA but the rehabs of America are. Every time I turn the radio on in my car I hear an advertisement for alcohol and drug rehab. Marc points to statistics in the book that clearly show that the disease model is not working and rehab is very ineffective. It just surprises me that institutions debate what is clearly a failing solution , I think we should be open to all ideas on addiction especially ones with modern science , we know so much more about the brain now compared to when AA and rehabs were developed.
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Old 09-06-2018, 10:12 AM   #2 (permalink)
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I've always felt a little uncomfortable with the disease concept too. I feel I understand the neuroscience behind addiction, and what it does to us chemically. And yes, technically by definition, addiction is a disease (but with that loose of a definition, a lot of things are). It's conceptually how we view the term "disease" too. I have a hard time reconciling that I'm as sick as my dying mother who had pancreatic cancer. I watched this horrid tumor, this other disease, eat the hell out of my mother, with the chemotherapy killing everything else. Watching her take her last breath as I took shots of whisky on the floor. But I'm sick tooooo...

Yeah, it's a delicate subject. I don't think there is a one size fits all for everyone. The disease model has made sense to million of people and educated them in a way that shaming them has not; rehab has worked for many individuals as well. There are weirdos like my grandfather who have never popped open a big book, never been to a therapist or rehab, pondered the meaning of his addiction and just one day up and quit after 42 years of heavy drinking with no spiritual maintenance or second thoughts ever. Everyone is different. I think, like you mentioned, the core of it is, STOP. Cling to whatever you need to, try whatever you need to try, but stop the madness and put the plug in the jug.
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Old 09-06-2018, 10:21 AM   #3 (permalink)
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The question you pose is one that can be applied to a lot of things. Being a change agent and a process guy (kinda hate that label but whatever) hereís a quick take.

Institutions of any kind, generally speaking, run into what I find is a very interesting paradox. On one hand itís important to have controls and processes in place that deliver what you know historically works. On the other hand institutions need to break their own rules and experience a certain degree of chaos in order to evolve and innovate into new and more effective directions.

One side of that spectrum reduces and controls risk, the other side is inherently risky but offers otherwise important learning and potential.

Itís a tension that is necessary and is dynamic. But shift the scale too heavy handed in either way and problems - sometimes big problems - show up.

I suspect many rehab and other programs are faced with typical organizational problems in seeing this and managing it appropriately. The bigger an organization becomes the more explicitly the issue needs to be managed.

A lot of organizations have executive management too invested in working in the business vs on the business. In those conditions itís easy to miss important paradigm shifts, even when they are right in front of your face.

Think Blockbuster video or even Kodak cameras. Giants of market share one day, basically gone the next.

Generally speaking of course.

TLDR; organizations and institutions must adapt to change to thrive, most conventional management processes control or promote status quo vs innovation - especially in lieu of outside market pressure. Itís easy to miss the need for change despite it being in front of your nose.

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Old 09-06-2018, 10:59 AM   #4 (permalink)
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I've always felt a little uncomfortable with the disease concept too. I feel I understand the neuroscience behind addiction, and what it does to us chemically. And yes, technically by definition, addiction is a disease (but with that loose of a definition, a lot of things are). It's conceptually how we view the term "disease" too. I have a hard time reconciling that I'm as sick as my dying mother who had pancreatic cancer. I watched this horrid tumor, this other disease, eat the hell out of my mother, with the chemotherapy killing everything else. Watching her take her last breath as I took shots of whisky on the floor. But I'm sick tooooo...

Yeah, it's a delicate subject. I don't think there is a one size fits all for everyone. The disease model has made sense to million of people and educated them in a way that shaming them has not; rehab has worked for many individuals as well. There are weirdos like my grandfather who have never popped open a big book, never been to a therapist or rehab, pondered the meaning of his addiction and just one day up and quit after 42 years of heavy drinking with no spiritual maintenance or second thoughts ever. Everyone is different. I think, like you mentioned, the core of it is, STOP. Cling to whatever you need to, try whatever you need to try, but stop the madness and put the plug in the jug.
Hawking 22,
My mom passed away the same thing horrible pancreatic cancer , the only good thing was she passed quickly but I was neck deep in Budweiser the night she passed I saw her in the afternoon at my drunken convenience, because I knew I was going to get drunk I went and saw her, I missed her bedside passing , it kills me everyday thinking about that it is my biggest regret about drinking , I will never forgive myself for that . I had two wonderful loving parents , a good middle class upbringing, and I became an alcoholic on my own , and I am choosing to stop on my own, I think back on my mother's death and it reinforces to me that alcoholism is a selfish choice, the brain does change as you continue to drink , and it does cause cravings , anxiety , depression , and apathy , but if it was truly a disease like cancer , you would not be able to stop by choice. The power of the mind chooses to stop and you can change your brain back to normal over time.I wish I did before my mom passed.
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Old 09-06-2018, 11:09 AM   #5 (permalink)
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I'm very certain science does know quite a bit more about addiction from a biological standpoint now than was known back when AA was developed. The problem is, (IMHO) that human beings aren't strictly biological creatures. We also have psychological and spiritual components that are all interconnected, and what one does effects the others. Can addiction be arrested strictly thu manipulation of a biological mechanism? Perhaps. But addressing the underlying issues that cause addiction in some cases may go far deeper than mere biology. Like one of the other posters mentioned, arresting addiction will probably never be a one size fits all solution. Different people will respond to different methods.
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Old 09-06-2018, 01:15 PM   #6 (permalink)
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Here's my two cents: it's both a disorder AND a choice.

The disorder part is that when an alcoholic is triggered and gets the idea to drink, the craving starts and if you don't satisfy that craving, then all kinds of negative emotions pile on: anxiety, irritability, anger, resentment, entitlement, and depression. That doesn't happen in non-addicted people. If someone isn't addicted and you say "on second thought, let's not have that beer after all" they're like "okay, fine with me." And they don't experience distress.

But we do experience distress, so severe that drinking seems like the most reasonable way to feel better. Normal brains don't create that kind of intense emotion when a craving goes unfulfilled. Addicted brains do.

But it's also definitely a choice, because to drink is always a choice. just because you have uncomfortable emotions doesn't mean you're literally powerless to not drink. Obtaining the alcohol and going about drinking it are complex behaviors that are under our voluntary control. We don't lose control of our muscles like in a seizure, we don't lose the ability to control our arms and legs. Drinking is always a choice.

And for me, that points the way to recovery: recognizing that it is a choice, that we do have the power to say "no" to the urges. We can choose to sit with the uncomfortable emotions and tolerate them, or distract ourselves, or deal with the feelings in some way other than drinking.

So that's how I see it. The exaggerated distress that cravings cause is the "disease," but what we do with those feelings (including drinking) is a choice.
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Old 09-07-2018, 07:04 AM   #7 (permalink)
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If it is a learned behaviour, then I must be the worlds fastest learner, lost control the first time I drank at age 10, and drunk everytime there after until I was almost on the grave at age 22.

AA calls it an illness BTW, and fundamental to AA experience is the loss of control and choice. One can run into problems with alcohol without losing either control or choice, and if one is lucky enough to be in that camp, it is pretty straight forward to just make a choice to stay sober, nothing else required.

In fact, reading about Towns Hospital and its policy regarding AA, they were quite selective in who they referred, sending only those they thought could recover on a spiritual basis. There seems to have been a great number of others that were helped by the then available therapy and treatment and were able to recover on a non-spiritual basis.

At the time this book was published I attended a talk on this very subject by the head of a research team based at the Otago Medical School. The talk cited findings that Alcoholism was a brain disease which could be seen on an MRI. Its causes were partly genetic, but also it needed an environmental element to kick it off, which explained why it sometimes skipped a generation.

The talk was about alcholism, and the word addiction was not mentioned as far as I can recall. The two things may be different. In my own case I suffered from alcoholism and nicotine addiction. The disorders were completely different in my experience, as was the recovery process.

It was an interesting talk not least because it introduced the concept of alcohol use disorder, which has a wide range of severity, there being specific and effective solutions available across most of the range, excepting the very severe chronic cases, which were a small minority.
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Old 09-07-2018, 07:33 AM   #8 (permalink)
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As for amends, I had one that I had to do. It was a woman that I behaved badly toward, and I owed it to her. Others I have not done, for various reasons.

As for disease, I feel alcoholism is mental, hereditary, and of course biological. The physical addiction is terrifying. Once that is dealt with, the mental issues have to be confronted. Relapse prevention is the goal. And if alcoholism runs in your family, I believe you are more likely to suffer from it. My two cents.
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Old 09-07-2018, 08:58 AM   #9 (permalink)
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Hawking 22,
My mom passed away the same thing horrible pancreatic cancer , the only good thing was she passed quickly but I was neck deep in Budweiser the night she passed I saw her in the afternoon at my drunken convenience, because I knew I was going to get drunk I went and saw her, I missed her bedside passing , it kills me everyday thinking about that it is my biggest regret about drinking , I will never forgive myself for that . I had two wonderful loving parents , a good middle class upbringing, and I became an alcoholic on my own , and I am choosing to stop on my own, I think back on my mother's death and it reinforces to me that alcoholism is a selfish choice, the brain does change as you continue to drink , and it does cause cravings , anxiety , depression , and apathy , but if it was truly a disease like cancer , you would not be able to stop by choice. The power of the mind chooses to stop and you can change your brain back to normal over time.I wish I did before my mom passed.
I'm so sorry for your loss; I know your pain. I know you're guilt and anguish too. Thank you for posting this thread.
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"It wasn't how far I'd gone, it was where I was headed"
"When I am willing to do the right thing, I am rewarded with an inner peace no amount of liquor could ever provide"
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