I must say, and what wrangles me is that the NY Times refuses to carry any of my articles. They tell me and I quote: “You guys think you have all the answers and none of you do “.
Gee, I thought I did. So here is what they publish on the front page of their SCIENCE section. “Rehab Rooted in Science.” (see http://www.nytimes.com/2016/02/23/science/mark-willenbring-addiction-substance-abuse-treatment.html) I will discuss what they write so I remain true to their proposition. It is about Dr, Willenbring, a psychiatrist who has found a novel way to treat addiction. He was treating someone formerly addicted to heroin and tried some twenty faith-based and abstinence notions of therapy. None worked.
The patient’s brother died of Oxycontin overdose. He also tried suicide with drugs. Ayayay.
First step: explaining the neuroscience of alcohol and drug abuse. Ok, good idea. Convince them it is bad for you. Then the doctor adds, “it is genetic.” Exactly how does he know? Has he ever heard of science and epigenetics? Now, he should know better since he was formerly director of the National Institute for Alcohol Abuse and Alcoholism. Surely, the notion of methylation has reached him.
The person is immediately relieved that it is not all his fault. This in contrast to the usual blah blah, booga booga speech where they are exhorted to believe that they have a spiritual defect. It is, they say, all the patient’s fault. They are put on an abstention program: no drugs, and then they count days off drugs as the beginning of the cure. And all attendees applaud. Good for the ego and less good for cure.
After five years on the job our doctor returned to his hometown to open a private clinic, with his own ideas, treating drug abuse and alcoholism. He advises, first, to plan on a long-term therapy. And now I quote: “His treatment plans can involve anti-depressants, medication for anxiety, and anti-relapse medication; i.e, pain killers. He also includes psychotherapy. This is new? He doesn’t get people off drugs; he gets them on them. And he treats for traumatic stress disorder. He states that medication is necessary to reduce alcohol craving. Whey are they craving? Duh; Pain. “I don’t want anyone to have to go through the crap I went through,” the doctor insists. He credits the pain killer suboxone for his getting off opioids for three years. So he credits one drug for helping him get off other drugs. He believes that the main target is the craving; so it is ok to use drugs to reduce the craving. And where does the craving come from? Ah! Another mystery. There is no recognition of a deep inner life; of embedded imprinted memory that endures and causes cravings. The focus is on inhibiting the desire for drugs; that is, for relief from pain, only the cause of all that is pain, which is rarely mentioned. Oh yes, did I mention breathing exercises? They have added that to the mix. And they accept weed in moderate doses.
Wait a minute. Is this a clinic for addiction? Sadly, it touts itself as an improvement on other approaches. So explain to me how and why? I could go on but that is enough; it is not enough to use drugs to cure drugs. That is an oxymoron. What is needed is the really new approaches, an awareness of a deep inner life; an imprint down into the antipodes of the brain which creates havoc and unrelenting need. It is unrelenting because it results from a memory imprint that is imprinted into the genes of the system and endures perhaps for a lifetime. You do not conquer need. Need is essential for fulfillment and development. It cannot be denied or avoided. It is an immovable object. Above all we need to understand how personal evolution gets detoured; we need to examine epigenetics and methylation. We need to understand what lies below addiction and why it exists.
Let me start with one truism. We are addicted to need not any substance. And that behavior or drug has to block need and the pain it engenders. Are we addicted to sex or are we addicted to the need for touch, for caresses and hugs and kisses; all of which we missed early in our lives but never leaves the memory centers whether in the limbic system or in the brainstem. Those alterations become part of our systems and drive behavior. They have the importuning quality of life and death because they derive from deep and life endangering pain.
So let’s see what Dr. Willenbring brings to us: suboxone, which has elements of an opioid in it, joined with naloxone which blocks the effects of an opioid. This latter helps undo a bit of repression. It is basically an opioid antagonist.
Why that? Because they have also offered a wee bit of the drug they are trying to detox. Many years ago we used it for a time for depression. So here we have drugs to stop drug addiction? And this is revolutionary? Is there ever going to be a realization of why we need that? A description of inner life and above all, of our early history. Or are we changing chairs on the Titanic? Because down below there really is a catastrophe lurking; the boat is sinking. And what is being treated? What we can see in the present, on top: behavior.
We too see behavior but of very different sort: the behavior of those who address and relive their history with all of its agony. We don’t have to confine ourselves to what is obvious, taking drugs. We reach the bottom layers of the brain which contain feelings, needs and pain so that we are not limited to the evident. Aah. What a relief, just because our good doctor brings relief but no resolution, a big difference. But if you have no way to observe deep into the nervous system then you are confined to the superficial. This is what Primal Therapy offers: a deep look at the changes in the brain, so that we understand the importance of the new neurology: epigenetics and methylation. We can now measure the pain and measure its resolution; that is science at work, no surmise nor guesswork. Neurology has opened up a whole new dimension to us. Let us not neglect it. If we do, it is at the patient’s peril.
Allow me to add another caveat: it is a pain that ends, a pain that feels good because it is out of the system and becomes a relief. A pain that feels good.
Can we imagine the lifetime effects of never reaching the pain and leaving that deleterious force to do its damage over the decades? No one escapes; no one who has unaddressed pain stays untreated with impunity; repression will take its toll. Caveat emptor.