Friday, July 25, 2014

On Being Addicted


Addiction can be cured, so long as we know what addiction is and what cure means. Once we understand those two factors cure is not far off. Oh yes, there is one more item: need. It is need that that is responding to drugs, and it is need that makes us addicted. Now we have a problem because, after all, what is need? Need is whatever we required to normalize the system. We need water and food and we need love and touching and hugging. I am listing these needs after seeing patients reliving them, so I don’t have to guess what they are, something therapists in history may not have done. And we see the pain when those need are not met.

Needs form a hierarchy from the earliest the latest, from the most remote to the most recent; this means from the most live saving/ endangering to the least endangering. Reduced oxygen in the womb during gestation can be catastrophic and life-endangering. A mother taking drugs can also shut down the fetal system. These are what I call the first line needs, first to arrive in our lives and the last to relive in our therapy. For our therapy is neurosis in reverse; first in, last out: last in, first out. And the pains that accompany the first line match the valence of the need. This may not be obvious but it will become more apparent in a moment or two. For the urgency of fulfillment grows as we descend down the evolutionary chain of brain development. The earlier the deprivation, the stronger addiction and the need for drugs will be. And that is exactly the attention that is missing when we try to treat it. For if we neglect the greatest cause of pain and therefore the time and place for the greatest need for drugs we cannot possibly hope to cure it.

So a hug is very nice when the child is twelve, but crucial just after birth when touch is critical. That period of time has to do with the critical window, when certain needs must be met. For afterwards, no matter how hard we try, the pain remains intact, engraved in the brain and biologic system, for a lifetime.

As I have written, there are similar or the same feelings, say, of hopelessness, that compound the earlier imprint. Reliving those higher level traumas can be achieved but until the wounds during the critical period are addressed and re-experienced we cannot resolve addiction.

What is it, addiction? It is the need to normalize the system that has been deregulated due to early deprivation. The system is then askew as the brain circuits are rerouted and the biochemistry derailed. In brief, the wholes system is out of whack, and will stay that way so long as the early traumas are left imprinted. So if the mother took downers during pregnancy, which also suppressed the baby’s system, then he grows up needing speed or stimulants of one kind or another. He needs to normalize. This is true for what happens to so many addicts. We can be addicted to sweets, cigarettes or alcohol, depending on the early deprivation. Or how the system was rendered unbalanced. A “wired” mother already sets part of the physiology in her offspring; he has been over-activated in the womb. We don’t see it and it is never mentioned but therein lies the soil for later addiction. He may need tranquilizers constantly to calm his system. Yes, there are current stressors but they lie above the prototype set down very early in life. The person may shake and act nervous, be afraid of so much, yet we cannot imagine the genesis of it all; and by the way, it is called epigenesis. Things that occur to sway our genetic evolution. Those early traumas, a mother taking alcohol, make for a new system, a neurotic one. A system that “needs” drugs. So ordinarily we need to eat and drink what makes us normal and balanced, but when pain arrives we have a new set of needs; to undo damage and try to establish a normal system again. Now we know why the majority of men entering prison have drugs in their system. Their needs were not met early on; in brief, they were not loved. Love means, inter alia, filling the child’s needs. “My child knows I love him. I just can’t show it.” Oh no he doesn’t know. His is a deprived system no matter what the excuses. “ I know my child is hungry but I just can’t feed him.” His belly tells him what he really needs to know. He is being deprived and he hurts.

So how do you try to normalize when you cannot shut down anxiety? You take pain-killers which often contain the same molecules that were depleted at the time of the trauma. The supply from inside was exhausted in every sense of the term,. And so he goes to another pharmacy, around the block, one has more supplies, and orders more painkillers. He feels better; he is normalized for a time. Isn’t that what most of us do? Find the missing part of us; we do that even when choosing a life partner. We marry someone who breathes life into us when we were severely deprived of oxygen early on. That deprivation can turn us into parasympaths; passive souls that have no get-up-and-go in us. We tend to get involved with those get-up-and- goers. Or, maybe more efficient, drugs that help us get up and go.

So what is the choice of drugs? Whatever it was originally. A depressed carrying mother may force the child into a coke habit. His system was down-regulated early on. Again, we become addicted to need; that is the hook that forces us into drug habits. Those needs and deprivation are so early as to be unperceived and neglected. Later on, someone who was not loved in infancy can be “bought” for a few kind and laudatory words — “you are wonderful, so talented and so good.” Done. The hook is in.


And that is what drugs do: they create a signal in the brain that all is well, you are confident, and more aggressive. It does without words what approval does, make us feel better. Cocaine is ideal for this, if it weren’t for those pesky heart attacks and strokes that follow. So whether it is cocaine or praise the effect is to make up for deprivation of need. The person becomes a seeker … of applause and praise as a performer, or seeks out a drug that does the same thing. When these drugs normalize for a moment it changes personality; one is more calm, less aggressive (except for cocaine which produces aggressivity). The problem is that the addict suffers from pains that have no name, pains that were imprinted long before words came on the scene to define them.

Cocaine can take care of a gestation where a mother was depressed and down, together with a childhood of suppression and lack of love. It makes the person “up” and assertive. Pain that has no name is often the worse kind because it is nearly always about life-and- death. A carrying mother who is on constant tranquilizers is helping to shut down the fetal system. He cannot be normal unless he can counteract that suppression with other drugs that stimulate; and cocaine does that. It enhances dopamine which energizes the system. Why a stimulant? Because somewhere her system is down-regulated and “needs” it. The person can go from “can’t do” to “can do.” Moreover, it calms the pain; cocaine, after all, has been used in surgery.

Even though we are discussing a lack of love, it would seem that more love would help. Nope. More love can’t get in. What can get in is feeling there is no love, feeling the pains which finally opens up the system to feel again and to feel loved. Early love normalizes the system and makes it feel OK, loved. When that is missing later on, we need artificial help with drugs that boost supplies of such chemicals as serotonin that help block pain. The point is that the person needs it constantly, and it never completely satisfies like early love does. In fact, any ritual we have to do over and over again, whether a mantra or drugs is to overcome what has been missing inside of us. These are stop-gaps, not cures. It can never make up for the lack of hugs and kisses by one’s mother very early in life; never make up for a carrying mother who drinks alcohol.

I have seen suicide cases where the person was so agitated by pain that handfuls of painkillers could not kill. He is trying to kill a lifetime of deprivation and that pain is so great that it is almost unstoppable.

So what do many of these addicting drugs do? The most addicting are those that manage to suppress brainstem, first-line pains from very early in our lives—those pains with no name. They are the most powerful, visited upon a naïve, vulnerable soul who has no defenses. This makes for hard-core addicts that are considered untreatable only because these pains are so deep and remote as to be considered nonexistent.

So what does it matter if I can calm myself by a bit of drugs every morning and every night? And yes, if you need drugs to calm yourself during the day, you no doubt will need them at night to sleep.

It’s the difference between normalizing a symptom and normalizing the system. Vitamins or tranquilizers can help us feel better but underneath the system is still warped, and in areas we don’t even know about. Far better to right the system so that compensatory therapies will no longer be necessary. We can only right the system by going after what “un-righted” it. Lack of love and deprivation of need. So long as the system is warped, I believe there will be a shorter life span. It is akin to a false positive in blood examinations. We feel better, sleep better, with our pills of course, but we are not really better. In fact, there is no “better”; there is only normal or abnormal. It is the difference between a holistic approach (not holistic new age therapy) and a narrowly focused one. It means to right the entire system not just the symptom such as high blood pressure. It can be kept under control with beta blockers, that in effect will block the message of pain to the blood system, but one is still not normal and won’t be until the generating sources are addressed. Being kept normal or appearing normal by artificial means is not the same as being normal. Blocking pain is by no means the same as not being in pain.

Blocking pain means a daily ritual of some kind or another; a bit of drugs, some coffee, a couple of cigarettes and a coke or two. Then we can get out of bed. It is the parasympath, the down-regulated one that has trouble getting up and getting going. Conversely, it is the up-regulated that cannot stay in bed and has to get going immediately. He needs to be calmed before facing the world. Sometimes just moving from one appointment to another can help. So long as he can keep moving. It discharges some tension or anxiety inside. That alone can calm. Being held still, unable to move, as in being sick and in bed can produce more anxiety (an analogue of the birth trauma, unable to move and get out).

So when we consider our behavior we need to think about how our personality tendencies were stamped in, for our behavior, like taking drugs, is usually done to normalize ourselves. We are constantly seeking balance without even knowing that we had been unbalanced. To stop addiction we need to back to our starting blocks and see how we were sent off; then we will know what to do.

9 comments:

  1. Hmmm. My main first line feeling is anxiety; a feeling that I will be or have already been physically harmed. My neurotic interpretation of this feeling is that I must avoid anything that could harm me, including drugs. I am always in self-protection mode... I need to be careful every time I move in case I will stumble toward a new hazard. I sit still at home for very long periods - never feel any desire to get out. I am always tired and always stay in bed when my alarm clock starts ringing. I try to talk fast because no one has the patience to listen, but my tongue is too slow and so I fumble my words. My heart is always racing. Sometimes I drink alcohol because it makes me feel calm and confident and more feeling..... but sometimes it makes me slide into despair. I limit my drinking to about once every three months and never to the point of slurred speech because I don't want to dissolve the protective fat in my brain. I drink to keep in touch with reality -- I don't want to stay away from myself for so long that I begin to forget who I am. I am self-centred and selfish. The world revolves around ME.
    So what am I Art? - an anxious sympath who is too afraid to move? Or a parasympath who uses the wrong drug? I hate caffeinated coffee - it makes me feel trembly - it makes my arms feel like they are about to move involuntarily - but that is similar to my nightmares in which I lose control of my limbs.
    Sometimes when I exert even the slightest amount of energy, such as reaching up to turn my computer screen off - I actually get a very bad feeling... my body tells me I am making too much effort..... just the slightest tensing of a muscle feels like hard work... it feels terribly 'wrong' and 'bad' like my body is demanding that I just stay totally relaxed.
    My flatmate gave me a nickname; "limp noodle". You will often find me slouched on a sofa, utterly motionless. I always find the easiest way to accomplish a physical task - always using swinging and 'floppy' motions to minimise physical effort. As a result, my arms are very weak and skinny.... however...I feel good when I am walking fast... my legs are muscular -- my brother used to say I had the body of a dinosaur (T-Rex).
    What am I, Art? Let's talk about me for a change.

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    Replies
    1. You can talk about you but I never make long distance diagnoses. This is not Ann Landry. Art

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  2. Richard: You are welcome to talk about you but you know I never make long distance diagnoses. art

    ReplyDelete
  3. An email comment (part 1):
    Art thanks for writing this....

    I would agree, that addiction is all about primal pain... and primal therapy cured me of addiction... so I am not complaining, but I also think that addiction, is a little more complicated than that...


    Heres Something I posted on a a forum at Mad in America

    I have a long clinical history of working with drug involved clients, both as a clinical director on the west coast of an output drug treatment program, running diversion groups for Los Angeles County, and also directing a Detox unit. I have also worked with drug involved clients with DCFS in Los Angeles county, and in private practice. That being said I also have a long and at times tumultuous history of working with institutional medicine. My clinical career has been varied and I have literally worked with thousands of drug users.

    In addition to that I also have personal experience of involvement with drugs, starting at the age of 12. However at this point in my life I have many decades of sobriety. I am not only sober I am cured completely and totally. Something very few people in the recovery community believes is possible. I don't go to meetings, and I don't have a sponsor...

    My reason for writing this blog, is my growing frustration at how drug users are treated in this country and the growing death grip of psychiatry on drug treatment, despite its abysmal failure in treating drug users. Despite the fact that psychiatrists, themselves have no clue as why and how to treat drug users, they continue to dominate the treatment approaches of this country. Quite simply psychiatry, and most psychiatrists have nothing to offer. There may be .001 percent of psychiatrists who have something to offer somewhere but I have not met any. But, if you are a psychiatrist, don’t go thinking your part of the . 001% who have something to offer until you read what I have to say…

    Now a few facts. Drug treatment in this country, has about a 1% success rate, that means that of 100 people who quit due to treatment 1 will remain sober after a year. 12 step approaches. have a much better rate, its claimed at about 18 to 20%, although its difficult to say just how accurate this figures are because, 12 step groups are anonymous. Finally people who quit on their own have a documented success rate of about 5%.

    I am sure there are arguments against what I am saying however, it cannot be argued that institutional treatment is better than 12 step approaches, or even quitting on your own, it is clear that institutional medicine is a failure when treating addiction.

    ReplyDelete
  4. Part 2:

    Psychiatry doesn’t have anything to offer in treatment, that’s why most addiction treatment centers offer 12 step meetings. Another reason is those meetings are free, and they don’t cost hospitals anything, that increases their profits.

    Psychiatry, fails for several reasons. First it prescribes drugs to treat drug addiction. This is completely wrong headed. Prescribing drugs only creates more problems for the drug user. And also because it doesn’t offer a long term plan of recovery, something 12 step groups excel at. Its simply too expensive, for hospitals to do. Finally psychiatry fails because it really doesn’t understand what causes addiction.

    Just as psychiatry has been looking for decades for biological causes for mental illness, its done the same for addition. This has been going on since morphine was the drug of choice for soldiers in this country, It was once called the soldiers disease. Heroin, was to be its cure. Then came Methadone, and now Suboxone. All abysmal failures, all abused in turm. Add suboxone to the growing list, its readily abused by addicts, and causing a rise in drug OD’s, even though thats not supposed to happen. And add Fentanyl to the list, addicts readily chew it. In recent years there have also been the drugs Oxycontin, Oxycodone, Roxcet and others. It is obvious that psychiatry in league with the pharmaceutical companies have created millions of more drug users. Prescription drug over doses now out number street drug OD’s.

    This situation, parallels the problems we are having with psychiatric medications. And I believe its caused for the same reasons. Psychiatry does not understand what causes, psychiatric issues, in people. Which means that treatment is based on a false belief system, and is bound to fail with cataclysmic implications to those that look to psychiatry for help.

    Psychiatrists, even so-called addictionologists, know very little about addictions. I am sure they are experts, some of the time on anatomy, and medicine, but from a practical point of view, they now very little about how to help someone get clean. Because they prescribe more drugs. They are not as good as a sponsor, who has been there themselves, or even a paraprofessional. Because often they ares so intellectually oriented that they can’t relate to drug users, nor can drug users relate to them. This is also why I do not favor cognitive approaches to drug treatment.

    ReplyDelete
  5. Part 3:

    I have witnessed first hand the uselessness of psychiatric medicine when dealing with drug users. Its very disheartening. People are symbolized on the idea of going to rehab, or residential treatment to cure their addiction. But residential treatment, is expensive, and doesn’t offer much in the way of help. The same is true for Detox.


    People are given medication to help them through withdrawal, but although withdrawal can be complicated, and sometimes life threatening, the use of strong medications, although given to provide relief and comfort to drug involved individuals, often starts the addition cycle all over again. Acupuncture is cheaper, and more effective in the long run, but of course because of that its ignored by the medical community.

    Here’s why… The brain, produces all the chemicals someone needs to deal with pain and stress. Emotional distress, and physical distress cause the brain to produce natural pain killers. These natural pain killers are hundreds of times stronger than prescription medications and street drugs.

    When someone is given a drug, it alters brain chemistry, and the way the brain responds, causing the brains pain killers to shut down. This is done simply as a protective mechanism, to prevent overload, and sedation. At the same time the body begins to produce enzymes to more quickly break down drugs in the system, to prevent overdose. This is what tolerance is all about. What happens next is that dosage levels of drugs need to be increased to over come tolerance. This starts an addictive cycle. However, whats not understood, is that the brains natural pain killers, and stress relieving system is also further shut down; drugs from the outside have taken its place.

    At some point addicts get to a place where they only use to keep from getting sick, when their tolerance becomes quite high. So in order to get high again, they know they need to quit, to lower their tolerance.

    Once users get through withdrawal, they have only dealt with the physical aspects of their addiction however their brain chemistry is still off. The brain is slow to heal, and its internal pain killing mechanisms are still shut down.

    So now the normal stress that’s happening to us all, traffic jams, a broken glass, an imagined insult, become overwhelming, because the are open, too open without the brains internal pain killing mechanism to protect them. This is known as an opiate affect. They only thing Addicts know that works to make them feel betters is more drugs.

    Well meaning psychiatrists, who have been taught never to allow anyone to feel, are willing to prescribe at this point. But unfortunately, this keeps the brains internal pain killing system shut down. Prescribing any medications, will not allow a person to experience pain. And only through experiencing pain without drugs, will cause the brains internal pain killers to start functioning again.

    This is why prescribing drugs to addicts never works.

    Acupuncture is much better because it stimulates the brains internal endorphins.

    This is something that A.A., and 12 step groups know intuitively… it can take a long time for the brain to come back because it heals slowly.. the first 2 years are the hardest…

    Feeling pain, unhappiness, sadness, and frustration, stimulates the brains pain response system to function again.... Getting prescription medications, or street drugs, keeps in shut down.....

    As someone once said, feeling feelings hurts, but not feeling kills.

    ReplyDelete
  6. Hi Art,
    I really never ever felt to be addicted to all those peky sleeping "devices (cd, pills et,c. in the sense as I surmise those luck/unlucky users ot alcohol tobacco, and the like are to their relievers
    I often guessed what was worse to be in a state of comatose-like heavines in my brain as the atermath of pills, or that of lack of sleeping pills...1

    By the way I am quite unsure whether I was a parasympath ..to those effects or a sympath
    as now I feel very alert after a good nights sleep( with all that turmoil od deacades as an insomniac in the background of my min...
    Yours emanuel

    ReplyDelete
    Replies
    1. Emanuel: If your vital signs are on the low side chances are you are probably a parasympath. art

      Delete
  7. we can regulate the pluses and the minuses. but how to regulate the pain? how regulate the reality? by deciding what is real?

    what is depersonalization? is it over activation of third line as a reaction to leaky gates? person cant stay in intensive first line so "chooses" the third. but then panic is so close. why panic? because we are sooo far from ourselves that that system only knows that there is a big danger but cant see it (outside). the human in panic is human without context. decontextualized and depersonalized.
    how to regain the context, the person, the reality? normalizing, balancing is not enough. we need reference and connection.
    just thinking....

    ReplyDelete

Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
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Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
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Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

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Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
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His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
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In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor