Cactus Juice

On Super-Specialing and Self-Sabotage.

Why is it that we so cling to the super-special reasons why each one of us cannot have health, cannot have happiness, and cannot have success?  The appearance of strange notions in current self-help literature is a response to a true problem in our culture.  Basic, obvious, solutions to suffering are routinely rejected out of hand.  To grasp the simplest of solutions to life is seen as unusual and even heroic.  What the heck is going on here?!

One aspect of our current cultural climate is that we wish to make evil spirits our pets.  Ever since Freud, we have been defined by our afflictions.  Affliction, prior to this point, was unwaveringly woeful.  No one thought to meet Achilles on the battlefield and point out that his one area of moral danger was an opportunity for him to fully experience his humanity.  No one suggested to Job that he had been "given a trial" to learn from.  Rather, Job's suffering reveals a character which he has already formed.  These days, Elizabeth Wurtzel revels in her weakness while Anais Nin and Simone de Beauvoir rot on the vine.  Here's a clue:  Weakness is just not that interesting; each of us was issued plenty of it at birth.

In this post-industrial world, we are meant to express ourselves as individuals in a world-wide culture where it is difficult even to get 15 minutes of fame.  Being the crazy cat-lady in no-where, Wisconsin isn't good enough; you have to be the craziest cat lady in the entire world.  Gaining notoriety through rare excellence is unlikely, so we turn to rare affliction.  Wurtzel having her latest drug stash FedEx'ed to her latest writing venue.  Pathetically, these afflictions are quite a bit less than rare.  From addiction to family dysfunction, the same story is repeated a few million times.

To add to all of this, the Western World in 2008 is the most superstitious it has been in at least 200 years, and perhaps one of the most superstitious cultures of all time.  Magical psychology has replaced ordered ethical thought.  Christianity, frequently dismissed as a kind of superstition, has an ordering of the natural and the supernatural which brought about some of the greatest flowerings of human thought and advancement.  However, there are broad trends of Christianity, in America at least, which are drivel that rivals the most backwards back-desert Mullah that they would like to preach against.  The superstition cloaks itself in science- this isn't the Flat Earth Society; this is the radio preacher that gives his listeners exact Prozac dosages to request from the doctor (true story).

The media market reverberates with the echoes of these cultural trends.  A generation after Archie Bunker, on any given night you can select from about a dozen uninteresting family dramas.  In the commercials, we now have "nicotine receptors in the brain" that are responsible for your smoking habit, though you'd be hard-pressed to find such a "receptor" in an actual brain cell.  For a while now the anti-smoking pharmaceuticals have focused on your likelihood of failure more than your opportunities for success.

Re-direction to success is generally not the goal.  Success --practical, reasonable, success-- is dull.  Affliction is dressed up to be much more exciting than it actually is, more exciting than excellence and much more exciting than success.  I fall into this trap as much as anyone else (Obviously- I have a blog which partly revolves around my obesity affliction.)  If I had a normal BMI, I'd just be a slow, dull, distance runner.  One of the few million others that completed a half-marathon this year.  At 232 pounds, I'm something special.  And that's difficult to give up.

Popping in behind this culture of "super-special" affliction, of late I've noticed an explosion in the use of the absurd term "self-sabotage".  It has all the earmarks of a darling of this culture: magical psychology, lack of personal responsibility, and affliction.  It would be easy to dismiss the thought pattern I just identified in myself as "self-sabotage."  I guess the way you explain it is, "I don't really want to lose weight."  But that's only part of the picture, which is one of the problems with the concept of self-sabotage.  Using the term is one way to refuse to think through and take responsibility for one's actual decision making process.  In my case, I have to finish the sentence: "I don't really want to lose weight because I want to be a special fat person rather than an undistinguished thin person."

All rational people, and all irrational people too (such as psychotics), engage in decision making patterns exactly like this; they make decisions designed to make their life better.  There is no evil spirit, no magical psychology.  I have made a choice.  What can I do to make a different choice?

There are lists and lists of techniques to help me make a different choice, and I'd like to put them into two categories: those which focus on affliction and those which do not.  Techniques that do not focus on affliction but rather focus on health, on self-actualization, on successful outcomes, are the best.  Thus the exotic solutions in the current crop of self-help books such a the "law of attraction."  For more sedate acknowledgment of this principle, note that the AA Big Book says, "We ceased to struggle."  The New Testament advises not to "kick against the pricks."

Needless to say, these are not the solutions that are the most popular.  When it comes to controlling eating, rather than act like a healthy eater (such as on a Weight Watchers program), "dieting" systems that interact with, and circle around, and focus on, and make war with disordered eating are the most popular.  There's a whole circle of extremism in Overeater's Anonymous that I would say does the same thing.

Back to the question: What should I do?  To say that I shouldn't engage in self-sabotage is meaningless since I'm in fact not trying to make my life worse, rather, I'm trying to make my life better by having a special accomplishment. I am a healthy animal, a rational person, and I make decisions for a reason.  And not just any reason, but a healthy and completely normal desire to treat myself well and have a good life.  I can take responsibility for my own decisions.

What would it look like to "not engage in self-sabotage"?  I guess it means nothing more than "Just don't overeat!"  In response to that simplistic message, I will quote the Buddha, who said that you cannot "press your tongue to the roof of your mouth and force your brain a certain direction."

Here some different decisions I am going to make:  I am going to focus more on actual success and less on affliction.  Perhaps you will be hearing more about my running accomplishments and less on my eating struggles.  I have set myself up for a potential running failure that will be caused by my obesity, entering a marathon where I may not be able to make the time cut-off. Affliction is a lot less fun when it actually curtails the possibility of accomplishments and the reality of experience beats magical psychology every time.  There are no evil spirits lurking around the corner, there is just the reality of conflicted decision making and the burden of heavy cultural influences toward making the wrong decisions.  My affliction is not going to be my pet.

A Nation and a Culture Without Shame.

America doesn't do shame.  Our continual desire to hammer the Germans over Nazi atrocities juxtaposes badly with our inability to face the slave-holding roots of our own nation.  Presently, national righteousness over Burma stands in embarrassing juxtaposition to our recent bout with Hurricane Katrina.  American sheriffs refused to allow people to leave New Orleans, thereby violating the American constitution.  And yet they have neither been hanged for treason or (more realistically) jailed for civil rights violations.  The failures in Burma are not any different from what is expected out of that government.  America failed to be America, and therefore the shame should be that much greater.  I find Laura Bush's interest in Burma embarrassing in its shamelessness.  A First Lady should have political hobbies, but one of the core hobbies of First Lady is meant to be compassion upon the people of her own nation, and nothing much interesting has happened there.

What do I mean by "shame"?  Dictionary definitions tend to start with "dishonor."  And our repulsion with shame starts there as well.  In our culture, we see ourselves as ethical free agents.  You may have done something dishonorable, but you will never be a dishonorable person.  Brownie failed to manage the response to Katrina and caused untold suffering and death, but he's off managing horses again or something like that and he's whatever he is today.  His actions are things that happened at a point in time, but his essence is not made of those actions.  It's all about "what have you done lately."  Today there is more of a psychologized definition of shame which then creates it's own particular Christian response.  An in depth review of these pscyhologized definitions can be found here.  Since we don't believe that a person can have any action stick with them, "shame" becomes some rootless negativity in the emotionality.  Christians turn it into a psychologicalization of Original Sin and make Jesus the Christ the answer.

I tend to think of shame as a gap between guilt and reaction.  As the gap, it is somewhere between useless and destructive and almost always should be destroyed.  I have learned that shame feeds addiction.  One thing that was absolutely required in bring my eating problem under control was ending my shame about overeating.  There are doctors and various foolish people who think that can belittle or shame a person into losing weight, and it is an absolutely false concept.  Obesity is a painful and horrible condition.  It is medieval in the experience of punishment that it inflicts.  A person who deserves punishment could find little better than the discomforts of obesity.  I like to say, "No one ever hated themselves to health."

And yet, at the same time that I am rooting shame out of my own life, I do see a place for it.  Consider the following story:  a woman loans a digital camera to a friend.  The camera is about five years old and only takes 2 mega-pixel pictures.  You can't even get a 2 mega-pixel camera anymore, but she's happy with it and hasn't seen a need to buy one of the new 6 or higher mega-pixel cameras.  The friend falls in a lake while carrying the camera.  At first it seems that the camera is fine, and she returns it.  But as the camera dries out it ends up being ruined.  The memory card, which had never been backed up, is also ruined.  The friend is horrified and offers to replace the camera.  The owner of the camera looks up the price on a midrange camera and emails the price to the friend.

The friend is living off savings while she puts herself through college and still puts food on the plate for her two children.  She calls the owner of the camera and says that she'll make payments to make it right, but she should only pay for the replacement value of the camera.  What about half the price of the cheapest camera available?  At this point the owner of the camera is really starting to morn the pictures she lost on the memory card, and she feels insulted that her loss is being undervalued.  She insists that her friend isn't making things right, that she should pay for a midrange camera, since that was what she had bought to start with all those years ago.

I've heard various versions of this story many a time.  Just turn on Judge Judy and you can see it over and over again.  One person insisting on "ma rights," no matter what the hardship imposed upon the other person and no matter how reasonable an accident may have occurred.  I find this recourse to a legalistic form of morality brutish.  The fact is that if you have a camera for a long time, something is going to happen to it.  You might fall in a lake, you might leave it in a restaurant.  It is inevitable.  When you bought the camera, you knew that would happen.  It was probably part of the reason you didn't buy a more expensive camera.  It was also probably part of the reason you didn't trade up earlier: you were waiting for the inevitable day when you would be forced to buy a new one.  When you chose to let someone else use your toy, you passed along the possible risks to the other person.  Perhaps the person was more careless than you would have been, except your level of care included the risk of selecting that particular person.  So you are exactly equal in your level of care.  To think otherwise is absurdly self-righteous.

On that last point, you may decide that what I am actually talking about is humility.  In 12-step, humility is defined as placing yourself equally with others, neither above nor below them.  Laura Bush could possibly, with humility, comment on Burma.  Prince Charles and Camilla Parker-Bowles could have, with humility, chosen their re-marriage to each other.  With shame, Laura Bush must be silent on Burma.  The marriage of Charles and Camilla was accepted partly because of their shame in publicly stating their humility.  And the owner of the camera could use a little shame to step back from what in all legality she perhaps deserves.

When I make this argument, I am at this point told, "Well, what about personal responsibility?"  The point is that the hapless friend should take responsibility for her accident.  And yet, look at the responsibility of this camera owner that I have already outlined, including her economic choices in when and what to buy.  And, let's get real for a moment, do you really want to live in a world where you are going to be held "responsible" for everything you do?  Personal responsibility is a very popular concept... just so long as it's someone else's responsibility.

The addict has to renounce shame because it is about hopelessness.  Shame for the addict is moving into the gap between guilt and reaction permanently.  "Just for today" (a 12-step mantra) pulls him out of the gap and firmly onto the reaction of right here, right now.  And yet, conversely, shame can be a particular holder of hope.  The wisdom of millenia that grappled with Original Sin isn't something to lightly push aside.  The fact of shame and the fact of redemption says that we expect that we will get more than we deserve.  And with that hope, perhaps we can give more than others deserve.

Earlier this week, the CNN headline "Woman opens heart to man who slaughtered her family" captured my attention.  Through a process that involved public confession, a Rwandian Tutsi accepted the confession of a Hutu man who participated in the slaughter of her family.  She does business with his wife.  She told the CNN reporter that despite this man's confession and the importance of the confession process that "reconciliation would not have happened unless she had decided to open her heart and accept his pleas.  She said, "I am a Christian, and I pray a lot."  I cannot even begin to imagine how much prayer such a choice takes.  Because of her choice and the choices of others who have as much hope as she does, Rwanda is becoming an African success story.

It was her choice.  Forgiveness was entirely hers to give.  No human being had the right to demand it of her, only her Christ who shares in her suffering could ask such a thing.  A person, often a misguided Christian, who requires the forgiveness of others is making an evil and self-centered statement and is in danger of putting his own self as idol in the place of God.  I am completely in agreement with commentators such as Ayn Rand on this point: ethically, you do not have to give anything.  The only reason to demand someone give what they do not have to give is to be self-serving, and anyone who makes such demands is to be considered as a serpent.

But her choice certainly has brought me to reconsider the choices I have been making.  How many resentments do I cling to?  One is over a matter of about $200 that a close relative backed me into a corner on when I was destitute.  A "bait and switch" kind of a situation.  As I was forced to spend the money, with various family members peering over my shoulder, I didn't even know if the credit card would go through.  There was no cash, and I was on the last of my credit.  This incident is a decade old.  What makes the resent even more absurd is that the relative has matured in the meantime and would certainly never do such a thing today.  I have even received an apology of sorts.  I don't have to forgive, but a little more shame in realizing that I know I get more than I deserve might help me realize that about now is time to give more than someone else deserves.  I definitely know I don't want to get exactly what I deserve.

When the Journey of Life Means Nothing At All

I have recently read a not terribly good novel.  To protect the guilty, I I won't name the book, but part of the reason for reading it was to distinguish more clearly the particular qualities of Tolstoy Lied (blogged here).  I finished Tolstoy Lied feeling certain, first, that I could never write to that level of quality, and second, that a great novel requires much more than unusually good writing (because Tolstoy Lied, for all its attributes, will never be a great novel).  This recent read left me with the thought, "I could do that!"

I suspect that is what the author thought too, though instead of reaching that conclusion after reading a mediocre novel, she reached it after watching a mediocre action flick.  The novel has become the poor man's cinema: if you don't have access to the capitol and connections to create a movie, you can write a book instead.

The primary feature of these made-for-movies novels is that the climax and resolution of the story are conflated, and both are offered with considerably less detail than the build up.  The reader can envision the credits rolling up as they dump their popcorn on the theater floor and caste a sidelong glance at the sole movie goer who has been brought to tears.  Reality television also conflates climax and resolution, or more accurately it attempts to present climax as resolution.  Resolution is swept under the rug: the B-list career that follows the American Idol appearance will not be televised.  On the front end, a lifetime of artistic development and accomplishment are compressed into a few weeks.

But artists have always been dreamers.  Viewed as more insidious by me and my fat friends is Biggest Loser, where the contestants go from fat to svelte in one season.  They then disappear to that dark corner where the fat grows; 99% of people who lose 75 pounds or more regain it within 5 years even if they lost it on TV.

The peculiar heroism of the action movie, the determined heroism of the artist and the everyday heroism of the successful loser are turned into compressed actions devoid of decision and meaning.  This is not a template for heroism that the reader or viewer can apply to his or her own life.  When it comes to heroism, these dramas and plot lines that anyone could write turn into patterns of heroism that no one can live.

In the novel, the fatally ill heroine takes a few courageous steps that dramatically change the last days of her life and of the lives of those who she leaved behind.  At one point, she pointedly decides that she doesn't want to know the future effect of one of her decisions.  The reader never knows just why she made that decision to start with.  After her death, nothing has changed that much.  A few pawns have moved here and there on the chessboard, but how they feel and the possibility that in fact everything has been changed isn't communicated. Soft focus and cue the credits.

I'm not requiring all entertainment to be intellectually nuanced; shallow entertainment has existed since time immemorial and the very best entertainment --think Shakespeare-- is so true to life that it can be enjoyed as pure story or as something more.  I do think that the failures that I have highlighted in current entertainment are peculiar to our time.  In contrast, consider The Three Stooges.  Not serious work at all, but work that showed a simplified pattern of stimulus, reaction, and resolution.  Indeed, the extreme simplification was part of the comedy.  On the highbrow side post-modernism played with the link-up of those three items, but you can only play with them if you have their structure to launch off from.  Our current popular art seems to be losing the link-up.  As much as that is failing to tell our society something, it is also telling of something in our society that is failing.

Change a Behavior and Finding God May Follow

The Business Self Help Book That Helped Self

Influencer: The Power to Change Anything isn't deep philosophy.  It isn't say, The Varieties of Religious Experience, where we will end up today.  But it is one of the best books in the self-help / business segment genre that I've read- I'll be adding it my shelf with First, Break All The Rules (a book that every parent should read on behalf of their children and every high school student should read for herself), The Seven Habits of Highly Effective People and Getting Things Done (issue these two books and a good secretarial manual to each new college graduate).

A self-help book must give a prescription for change, preferably in a numerated list.  Influencer offers in the categories of personal, social and structural solutions a prescription each in the motivational and ability categories- six total.  For best results, the authors recommend throwing all six solutions at a problem.  Best of all, the book explains that these methods can be used not only to influence others, but to influence yourself.  The example provided is of a man who lost a large amount of weight; a real person.

Another requirement of the self-help book is that it speak from authority.  Statistics and case histories are presented to illustrate that the author knows more than you do.  Much more.  Your job, therefore, is to not worry about thinking but to simply follow the prescription.  I did, and I've lost eight of the 23 pounds I've gained since my last VFT (Virgin Fat Territory- a lowest number ever seen in a weight loss journey).

The particular lesson that influenced me was told in the history of the fat guy: Influence must be aimed at behaviors.  A goal does not contain within it the elements of influence that will lead to the goal being achieved.  My New Year's Resolution included getting to onederland (a weight starting with a one) this year.  Twenty-three pounds up was not getting me there, but the desire to get 23 pounds down wasn't enough to make it happen. 

What was a behavior that I could change?  Overeating is so complicated.  There are so many different reasons I overeat.  I recently saw a study that claimed the average adult made more than 1,000 decisions per day about eating.  I've spent more than a decade now with therapists and overeating comrades analyzing my eating.  All I needed was one behavior.

I decided not to eat food the minute it was in my possession.  Specifically, I decided to wait five minutes from having food until eating it.  For the most part I haven't waited five entire minutes, but I have broken the cycle of grabbing food and stuffing it in my mouth.  While I wait, I "write-before-bite", another important behavior in controlling eating but not the primary goal.  I also do general journal writing, which has been missing from my life because I "don't have time" for that.  I've lost those eight pounds.  But most importantly, I feel in control of my eating again for the first time in more than six months.  One behavior.

Where God Comes In

I have been meaning to write a post about the limiting nature of happiness, to go with the post on the limiting nature of strength.  You know the old footprints poem: God is rarely seen in happy times.  For an addict having the time of her life with good health, a great job, and fabulous friendships, getting one inch past Step One into that God stuff is difficult.  I'm a proclaimed theist of the Christian variety, but my sense of spiritual connection has been at an all time low.

And yet notice what happened when I started pausing before my food.  My selected behavior was not prayer, which would be more directed toward God and would be another means of pausing, and yet the behavior of pausing just for the sake of the space caused me to start writing in my journal again.  Not in itself prayer or intended meditation, but a space for a spiritual experience.

William James considered this space to be important.  On a separate page I offer a lengthy excerpt (pp. 395 - 398) from The Varieties of Religious Experience for those who wish to read it.   It is an excellent defense of creating space for spirituality through practices of asceticism.  Waiting a few moments before eating is a tiny asceticism, but an effective one in a life that is just too easy.  James, referencing the ease of 1902, wrote:

...it is certain that the prevalent fear of poverty amongst the educated classes is the worst moral disease from which our civilization suffers. (p. 403)

Poverty isn't just a matter of zip code, it's a matter of separation from ease.  It is an asceticism enforced or chosen by interactions with the outside world.  Avoidance of poverty at all costs includes the willingness to sell one's soul at any cost; this is what makes it a moral disease.  Single-minded devotion to the things of this world is what makes it a spiritual disease.

Many years ago I read an a book of existentialist psychology.  There is no possibility I could recall the identity of this book, but it made the argument that addiction is a kind of necrophilia- a chasing after death.  When I mentioned this to my therapist he was so startled that it ended the conversation immediately.  Reading James, I realize that the concept was wrong.  Addiction is a maladaptive chasing after life.  One thing that the fat on my body says is that I have provided life for myself.  One thing that choosing food before anything else says is that I choose nourishment and life.

American culture has made an idol worship of not dieing- we don't spend a quarter-million dollars on the last few days of life on accident (the cost of the typical American dieing process); it is the final sign of respect to the idol.  According to James, asceticism is about increasing life through an acceptance of death.  The final paragraph from the excerpt mentioned above:

The metaphysical mystery, thus recognized by common sense, that he who feeds on death that feeds on men possesses life supereminently and excellently, and meets best the secret demands of the universe, is the truth of which asceticism has been the faithful champion.  The folly of the cross, so inexplicable by the intellect, has yet its indestructible vital meaning. (pp. 397-398)

I happened to finish reading  The Varieties of Religious Experience this week.  Much of it is relevant to  my spiritual struggles, and I shall surely be devoting a post just to wrapping up my interaction with the book.  The book is wide and souring and exactly the kind of philosophy that is central to my existence as a human being, but I know that this specific topic required changing a behavior first and letting the meaning follow.  As I mentioned in a previous post, without any experience of life the book was meaningless.  With the experience of one tiny, very tiny, behavior a "metaphysical mystery" became clear.

The Addict as Object: trapped between moral condemnation and biological determinism

The cover of 03 March 2008 issue of Newsweek displayed the headline: "The Hunt for an Addiction Vaccine."  Inside, a more ominous title: "What Addicts Need."

"Addicts," author Jeneen Interlandi tells us, "like the rest of the public, need to recognize the fact that we are entering a new era in addiction treatment."  This comes near the end of the article, after a prim "...most people reading this article probably can think of someone they know who owes his or her life to it [AA, and by implication NA, OA, etc.].  Some readers themselves have surely benefited." (emphasis mine) The article may be about what addicts need, but it is written to the rest of the public.  Indeed, drawing a line between addict and non-addict is the focus of the article.

In order to enter the new era in addiction treatment, the biological determinism of addiction must be accepted.  Just like it was for depression.  Steven Paul, head of research for drug maker Eli Lilly (developer of Prozac), is quoted as saying, "There used to be a stigma attached to depression, too, but the development of Prozac put an end to that."

Yes and no.  The marketing of Prozac did indeed shift the stigma.  There is no longer moral condemnation for having depression.  Indeed, having depression and seeking treatment is now considered somewhat laudable.  What is not morally acceptable is being depressed; the stigma has shifted, not been obliterated.  If you are depressed, it is because you aren't willing to consume the pills offered.  Marketing depression as a biological disease has created the assumption that it is "highly treatable."  Many recipients of the message would probably be surprised to learn that only about half of patients treated with antidepressants report improvement of any kind (and so do about half of subject treated with a placebo), and fewer than that show a high level of improvement.  But a consequence of the message is that if you are depressed there is only one possible explanation: you haven't taken the treatment. And that is unacceptably irresponsible behavior.  Indeed, the tolerance for people exhibiting depression as a natural response to loss or grief seems to be on the decline.  College students upset over romantic breakups report being pressured by parents and peers to take antidepressant medication.  Widows reports being advised to, "See your doctor."

The article concludes, "...there's hope that science may some day help put that power [as opposed to the "powerlessness" that is Step One of the 12-Steps] within the reach of anyone who needs it.  And then who would choose not to grasp it, and begin the long war for sobriety-- a war without end, but one worth the fighting."

Once addiction is sold as biologically determined there will no longer be a stigma associated with being an addict, but there will always be a stigma associated with addiction.  That stigma will be wider than the stigma associated with powerlessness; it will be the moral condemnation of the irresponsible behavior of not grasping, of refusing to be treated (nevermind whether the treatment works or not), or not fighting.  The depressed addict will be double stigmatized.

Biological determinism is a metaphysical concept, not a scientific fact.  Concepts are presented and tested as scientific theorems.  The testing of the theorem is the scientific process; the conclusions are the scientific facts.  Needs and desires outside of science prompt the creation of the theorem; Edison wanted to provide light without the use of fire.  What needs and desires prompt this theorem, and why is it being prematurely sold as fact?  One reason is to reinforce the moral condemnation that biological determinism supposedly squelches.  Just as the Puritans could watch for who tripped on the church steps in order to determine who was most loved by God, moderns can determine with satisfaction that they are not-addicts.

There is no scientific dividing line between the addict and the not-addict as they are observed.  Addict to not-addict, like most things in nature, run on a continuum.  Efforts at line drawing are moral statements.  Therefore, the line between addict and not-addict is not an argument about what is, but an argument about what should be.  As scientific terminology, it has no meaning.

To set up the line-drawing fundamental to the biological determinist case, the author draws on the field of neuroscience.  "Neurological scientists don't talk about 'will-power,' which is a philosophical concept..." but rather "three kinds of self-control".  Note the line-drawing the author finds in neuroscience (emphasis mine):

• Addicts always take the immediate reward.
• Addicts typically act without processing all the available information.
• ...addicts were much less able to ["consciously stop a behavior that has become automatic"]

These three points are meant to make the biological determinist's case.  An "always" statement is always suspect.  In this case the article itself provides the exception.  From earlier in the article:

It has been years since the pleasure of drinking outweighed the pain it caused Fuller.  Looked a that way, the "social" and "spiritual" aspects of her problem seem insignificant compared with the contribution of biology.  If you weigh advances in neuroscience over the last few decades against social and spiritual progress, it's clear which field is more likely to produce the next break-through in treatments.

The paragraph is meant to support the argument that the biological determinism of addiction is so extreme that it will cause the addict to behave irrationally, against their own interests by every definition including the interest of taking an immediate reward.  Addiction, in other words, can shift fundamental laws of psychology that are not even shifted by severe mental illness such as schizophrenia or suicidal depression.

Addicts "typically"- and yet this information Interlandi gleaned from Thomas McLellan, a psychologist from the University of Pennsylvania, elsewhere in the article:

Addicts are by no means unique in their propensity to relapse.  In a study comparing alcoholics and drug addicts to patients with diabetes, asthma and hypertension, McLellan found nearly identical rates of noncompliance and relapse; between 30 and 40 percent of each group failed to follow even half their doctors' guidelines.

"Much less able" refers to a test with a clicker and a computer screen.  I'm inclined to respond that if you put a clicker and a computer screen in front of me and used it to measure my will power, at least my hands would be full and I couldn't eat.  Meanwhile, if you have a scientific definition for "typically" or "much less able," let me know.

Another reason to promote the hypothesis of biological determinism is to increase money and power.  The scientist out to make a name for herself in her field; the pharmaceutical executives out to make a profit; the government agency out to create a constituency and a block of support.  The support is required from the non-addict and the addict alike.  To get support from the non-addict, aside from appealing to his elevated standing, one can also appeal to his fear that drugs really do alter the laws of psychology.  This magical view of drug use, countered in the book The Cult of Pharmacology and discussed in an earlier Cactus Juice entry, is trotted out for the article.

The appeal to the addict is simple:  this problem, this enormous problem that you have been cursed with, can be solved with no input from you.  And it can be solved with a pill.  Addicts are resistant to that message for a variety of reasons.  One is that after being offered opium and cocaine as treatments for addictions to substance such as alcohol addicts know that drugs get pushed on them premature to science.  Heroin addicts are simply switched to methadone, a synthetic heroin available through the legal drug market.  The author acknowledges all of that, but also describes a heroin-turned-methadone addict as being "in recovery for 20 years."  The addict states "some people feel recovery from addiction should not be easy or convenient."  I don't know about that, but I do know it should involve recovery.  Most addicts know that their addiction isn't a separate part of them but, for better or worse, integral to their place in the world and their experience of it.

Despite the appeal of the biological model, the director of the pharmacotherapies division of the National Institute of Drug Abuse, Frank Vocci, is quoted expressing caution:

The idea that we can restore "self-control" or "free will" with medication is a very, very exciting one.  It could be paradigm shifting.  But we need more studies to see how consistently that impacts recovery.

The author continues on about biology: discussing the difficulties in shifting the biochemistry of the brain.  But that isn't what Vocci's quote is about; the question is how does shifting biochemistry impact recovery.  It is possible that biological determinism is false; that even with perfect brain chemistry the psychosocial elements of addiction will prevail.

Injection drug studies and an actual real word event (where what amounted to placebo heroine was released onto American streets) have shown that addiction to injection drug use can be shifted to addiction to the injection ritual itself (with more innocuous drugs such as caffeine or without any drug at all).  Chemistry isn't everything.

Following Ms. Interlandi's article, is a one-page rebuttal by Mitchell S. Rosenthal, M.D., writing in opposition to biological determinism.  His statement includes the following line, which I read with an amusement that was probably unintended:

...we should recognize that drugs alone are not the answer to addiction.

His conclusion is that treatment "can be empowering" and "...it is hope, grounded in self-awareness, that is the best safeguard for recovery we now have."

There is no line between the addict and the not-addict.  The motivations that put science in the place of ethics must be recognized, and cheap efforts to simplify both science and ethics must be avoided.

Gaia and the Sweet Girl

To describe what I've learned about the "sweet girl" it is necessary to go back to the beginning... of time!

To a Mother Earth that birthed us all, to a Goddess Gaia that fed us on her bounty.  And then onward to a Hebrew God that killed the Goddess to become the judge of all, but took human form and in infancy was nursed by a simple woman of Judea, the Mary to whom many still appeal to make merciful intersession on their behalf.

Romantically, blind justice is portrayed in female form.  But realistically, judgment in the Western world is masculine.  Certain parts of the east may cut off a woman's genitals or prevent her feet from forming, but in the West we cut off her reason.

Gaia is harsh on mankind; we must work for our bread, and even then we may well starve.  She does not suffer fools gladly: they die; or they are maimed and then they die.  This is the warm embrace we seek??

The JudeoChristian God is more rational.  He judges us on our thoughts and on the intent of our actions.  If we suffer, it is for our own good, or it is the creation of Satan.  Or so the story goes.  It is to this kind of judgment that the Western world submits.

And yet, despite the masculanization of judgment, it is the judgment of women that is sought out.  It is commonly recognized that women respond to the judgments of women- they dress, eat, drive and date that which other women will approve.

It is less commonly recognized that men respond to the judgments of women.  Certainly the image of the man dressing for work each morning, living for the validation from his wife that he is a good provider is common enough.  But there are some others: Think of the man who asks/encourages his female co-workers to comment on his outfit.  Think of the drunken husband who begs his wife to tell him he's a good man anyway.  I have male friends who call me to confess (their word) various indiscretions: a one-night stand, a rant in an airport, driving home drunk.

What makes me the proper recipient of a confession?  It is that I am female.  I am meant not to apply any (masculine) reasonable judgment.  I am meant to embrace.

Not as Gaia embraces.  Everyone knows that the Goddess isn't as kind as we've made her out to be.  The opposite of justice may be mercy, but there is logic that makes mercy feminine.  The opposite of reason, which has been made masculine, is chaos, and chaos has been left to the feminine.  Who would subject themselves to a judgment rooted in chaos?!  Only someone who thought the feminine had been subdued millenia ago.  Only someone who wanted to lay in a field of daisies under the sunshine.  Only someone who felt certain that a woman could be counted on to be "sweet."

That which the Goddess has wrought is not so sweet.  Poverty, disease, disorder- of course, all of these are meant to be absorbed by a sweet woman.  Woman is chaos; woman is the barrier to contain chaos.  The woman who fails to be sweet fails to be feminine- and there will be no shortage of enraged men and censorious women who will tell her so.

A few sociological studies to call upon:  A woman who is equally assertive as a male peer is seen as gruff and abrasive, even aggressive.  I recall one time having an issue at a gas station (I don't recall the specifics) and very calmly and evenly stating to the attendant what the problem was and the solution I expected.  He was beside himself telling me to calm down.  It was, in a word, insane.  I work well with others, so I rarely have this interaction, I know that as a woman flirting is required first, then business.

To continue with the sociology:  Obese women are supposed to be "jolly;" those of average temperament are seen as unhappy or ill-tempered.  Ah, the obese woman.  We are, quite often, "sweet."  I believe that there is a correlation between sweetness and obesity, but it is different from the BBC image of the cheerful rotund woman.  The sweet girl has been asked to personify an insanity, and she has done it.  But she cannot tolerate the assault on her humanity, and so she eats.

Regaining full humanity as a rational equal is not easy.  It comes in fits and stutters, sometimes with outbursts of aggression as assertiveness is sought and overshot.  Sometimes with bizarre apologies for assertiveness.  And sometimes insanity lingers- when a women finds it necessary to explain how assertive or aggressive she is, it is almost certain that she is neither.

This last point is of most concern.  If a woman thinks she has been assertive or aggressive, and yet nothing about her world has changed, it is a confusion.  Should she just eat?  Should she just be "sweet"?  It is of vital importance that women support other women, first, in sanity.  We should not label something assertive that isn't- "I'm sorry dear, you did what you could but it had no effect."  No!!  Assertiveness is like prayer- it always changes something even if that something is you.  An assertive woman is a hopeful woman, ready to face the world as it really is.

P.S.

*Everything I've said about assertiveness of course also applies to men.  But a mousy man is much more like to be called out with a dose of reality.  It is women who are fed insanity and thrown in the "sweet girl" brier patch.

*Hugo Schwyzer, gender studies professor,  recently wrote a blog post titled "'I'm not like the others': Nice Guys, self-flattery, and the myth of uniqueness" which was the second in a set of two posts on the topic.  One aspect of his review of the topic is the nice guy that seeks female approval of his uniqueness in the form of romantic love, and the rage that follows when he is not give it.  Hugo isn't talking about men seeking out women as judges, but it's right there.

And then this post on asking his female student to keep a list of when the say "yes" when perhaps they should have said "no."  He calls it "people pleasing," but isn't that just all about the Sweet Girl?

Commitment to Reality: The Drought, Lévy's book on Sartre, and Mourning Addiction

The Drought

The hysteria over the drought in North Carolina reached (I hope!) the zenith of it's absurdity when the News & Observer published the latest of their water saving tips: hair styles for non-daily washing.  This is the same paper that analyzed the water use of a normal responsible family and found that it was almost within the governor's "request" of 25 gallons per person per day.  I know someone who dutifully collects shower water to flush the toilet, and whose daily mood is partially influenced by whether or not it has rained.

Meanwhile, it has been pointed out that the water bills in most of the municipalities are impossible to read.  It doesn't matter what they say anyway, because at least one municipality has decided to put a flat surcharge on all bills (regardless of use, regardless of size of household) to cover the shortfall in revenue due to (this is so great!) people conserving.

In actuality, the State of North Carolina and it's municipalities are failing to respond to water limitation issues.  Instead, politicians are using the responsible sense of conservation and the individual social/political action of environmentalism to cover for their failure to provide leadership and, more importantly, policy.  Disorganized job and housing growth can continue one more election cycle, if only you will wear your hair in an oily ponytail for a week.  This is not stealing from the poor to give to the rich, it is stealing from the willing to give to the unwilling.  It is exactly the kind of cynical and warped appeal to altruism that so inflamed Ayn Rand.

Meanwhile, our communities go further and further down the road to unsustainability, and there will be serious pain we run into a reality that not amount of stealing from one group of the community to give to another can resolve.  This "drought" is a blip, currently of about 20% variation from the recorded mean.  If it were a serious natural anomaly, you would see changes in the environment such as the die-off of deciduous plants.  Look around- the natural world expected this kind of variability in rainfall.  We're the only ones who failed to account for it.  Look at that failure to respond map- it isn't about climate zones, it is about uncontrolled grown.  We cannot continue to cover for politicians who continue to fail to make a real response.

So live your life, wash your hair.  Heck, put an extra 10 gallons down the drain, the fish will thank you.*  Instead of carrying buckets to the toilet, put those politicians against the wall and make them face reality.

Lévy's Book

This week I started reading: Sartre: The Philosopher of the Twentieth Century by Bernard-Henri Lévy (trans. Andrew Brown).  Lévy is apparently an odd sort of figure, and the Publishers' Weekly review called the book a "haze of grandiloquent verbiage" ("grandiloquent" is an amusingly self-referential word, isn't it?).  I'm enjoying the book very much, to me it reads like a road trip: you just sit and watch the scenery go by.  How much of it is Sartre and how much of it is Lévy, I have no idea.  The books is an enthusiastic response to Sartre (the review called it a "love letter"), which is really the most a philosopher could ever hope for.  As a blogger, I write responses, riffs off whatever strikes me (I am now), so that is fine with me.

Lévy's response to Sartre's essay "What is Literature?" (pp. 60-69) focuses on the the idea of "commitment."  What is a writer committing to?  Ultimately, to reality.  The writer writes out of his time and place, for his time and place and (Sartre urges) to as wide of an audience as possible.  When it comes to this commitment to humanity, the journalist is no less of a writer than the philosopher and perhaps even more of one.  Lévy calls this last commitment on the part of Sartre "a real generosity, a superabundance of being, a prodigality -- and hence a form of courage." (p. 69)

The common criticism of existentialism is that it can descend into solipsism.  The idea that you control your life and the ways in which you do actually control your environment can turn into the wishfulness which (interesting because of it's core solipsistic nature) is best expressed by the "prosperity preachers" of today's popular Christianity.  It appears that what holds solipsism back is commitment.  Commitment to reality.  Just think of that in terms of the issues with the drought and personal and societal/politic response discussed above.

Mourning Addiction

With all of that in mind, someone from my Weight Watcher's group recently hit that moment of mourning addiction.  This experience I have found best described in Existential Psychotherapy by Irvin D. Yalom, a book I read many years ago.  There is a point in overcoming addiction when one looks back at the wreckage of previous failures with horror.  Along with the realization that you can control your life today comes the realization that you were in control of your life yesterday.  That the meaning of addiction is to have played a game with reality, a game where you made the rules and the rules said that you lose.  For some that realization is too harsh and a decision is made to simply stay in addiction, stay out of contact with reality.  For others, all you can do is hold their hand while they weep, and then turn attention toward the promise of the future.

The only thing that makes the promise of the future possible is a profound attachment to reality.  After considering the hopelessness of the entangled motivations in response to the drought, after reading this idea of the writer's commitment to reality, I'm realizing that commitment to reality has a broader meaning than I had previously considered.  It isn't just about untangling motivations- which the games of politics would prefer remain tangled. It isn't just about honest and authentic interaction with the world and the things in it- what the addiction meaning game undoes.  It is about burrowing into reality with dedication, not just accepting reality, but choosing.  Not just being there because you've found the limits of your self-definition, but committing to being in that place.

I know that my accepting phase is well; I am fairly sane and not given to the delusions of wishfulness outside of it's proper place.  Only this week did I start to understand what commitment means, and how far I have to go.

P.S.

*We use surface water here; this is not the wildly destructive act it would be in a place where pumped water is used.  If you live in one of those places and just have to do something, wash your hair and dress it nice and go protest in front of town hall instead.

H-France review of Lévy's book.

The War for Drugs, Addiction, and The Fight For Meaning

The War for Drugs

After reading The Cult of Pharmacology by Richard DeGrandpre, I'm reminded of an issue with gun manufacturers brought up in Michael Moore's movie Bowling for Columbine.  The fact is that most crime guns can be traced to a small number of retailers.  What if the FBI were to provide this information to gun manufacturers, and they could refuse to sell their product to these retailers?  If it were to reduce gun crime and improve public perception of guns, it would ultimately be in the manufacturer's interest to do so.  But gun manufacturers don't want to touch this, partly because they want to keep their industry totally separate from what people choose to do with their product.

Psychoactive drugs are not so different.  The synthesized drugs of the modern world, starting with cocaine, are not created and introduced to the public by the criminal gangs that now manage some of the biggest cash cows (like cocaine).  Rather, while pharmaceutical companies are trying to beat the patent cycle to get their investment out of new compounds before they go to generic, another kind of "natural" sociological patent cycle is happening with the criminal world.  Psychoactive drugs are introduced and popularized in the scientific, medicalized world, and then if they are profitable enough they go "generic" to the criminal world.

The end result of this is a real war, with real bullets, and real shattered communities, families and individuals.  We gasp at the absurdities of the sugar wars of centuries past, and are incensed by whatever economic motives, real or surmised, motivates more recent battles.  But in the economic war for drugs, "bad" people die to preserve the prosperity of pharmaceutical companies as they develop products for the "good" people.  It is a battle between good and evil for angel and demon compounds (p. 139) where the AMA is the Vatican, the FDA is the Office of the Inquisition, and the DIA, CIA, etc. are the executioners.

Illegal or legal, America is the most lucrative market for drugs in the world.  A rising tide lifts all boats, and Americans truly believe that drugs work- that certain chemicals will not only bring us back into balance or resist illness, but actually cause health, cause us to be "better than well."  We believe it so strongly that the illegal use of drugs is much higher now than it was prior to the era of concern over drugs (p. 128).  Additionally, the illegal drug trade directly feeds an industry built around treating addiction.  Concepts of dependence and addiction, mythologies of the magical essence of drugs that can take over the soul, feed both the drug addiction and the "need" for drugs and a medicalized process to escape the addiction.  The same concept of addiction that sells more cigarettes also sells more stop-smoking products.  The war against drugs is a mislabeling; the war is for drugs and for which kinds of drugs will be used. Your therapist is no more likely that your crack dealer to support you in leaving the church of pharmacology.

How The War Was Won

While The Cult of Pharmacology elegantly lays out the meaning of drugs and how the battle lines were created, Generation Rx by Greg Crister recounts the history of one particular battle- selling a patriotism to pharmacology, that is, getting the public to stand behind the "right" side of the line with vigor.  On it's own it presents a fascinating history that carefully weaves in the subtle intellectual shifts that arrived at the present day.  However it also engages in lame sniveling attacks at pharma that pander to a public that wants to blame someone else for the distressing reality that drugs aren't angels or demons- they are merely chemicals, which many different effects on the mind and the body.

According to Crister, the turning point in modern Direct to Consumer (rather than filtered through doctors) marketing came in response to a book by Ivan Illich called Medical Nemesis.  Illich was a philosopher who had written several other books about systems of modernity and he wrote sharply about the reductionism of modern medicine:

Before sickness came to be perceived primarily as an organic or behavioral abnormality, he who got sick could still find in the eyes of the doctor a reflection of his own anguish and some recognition of the uniqueness of his suffering.  Now, what he meets is the gaze of a biological accountant engaged in input/output calculations.  His sickness is taken from him and turned into the raw material for an institutional enterprise.  His condition is interpreted according to a set of abstract rules in a language he cannot understand...  Language is taken over by the doctors: the sick person is deprived of meaningful words for his anguish, which is thus further increased by linguistic mystification.  (quote secondary from p. 41 of Generation Rx)

Illich was criticizing the message of the mass of the Cult of Pharmacology.  Joe David, a high-flying advertising executive specializing in drug ads read it and saw a criticism of the mass being in Latin.  According to Crister, this was the turning point which, after creative advertising and a few law suits, lead to the current Direct to Consumer age.

It is hard to argue against the idea that disease and drug information should be provided to consumers in plain English.  The author tries to present sound arguments about why consumers should be protected from focused advertising, but most arguments are easily countered by the protection the consumer has in their ever increasing education.  At one point he even criticizes the idea of creating one-a-day or combo drugs simply because they are more convenient. (pp. 124 - 125)  But I've used one of medications he attacks and it is easier to use one product once a day than two different products twice a day (four uses per day). Eventually he ends up sounding nearly incensed (pp. 159 - 162) that consumers might be making their own drug choices.

Central to his argument is his buy-in that drugs are either angels or demons (although in his world they are all demons, "poisons").  Any safety issue could label the product a "harmful drug". (p. 191).  But drugs are simply chemicals that have many effects on the body.  (In his book, DeGrandpre comments on the strange fact that, when it comes to drugs, you find yourself repeating the obvious.)  Users, and their advisors (doctors), select whether or what drug to use based on what risk they are willing to tolerate for relief from what symptom.  That's medicine.  The FDA regulates how much certainty we want to have in our knowledge of drug effects, and at what cost.  Making that determination is politics.  Absolutely nothing in the universe will make a drug equal health, no amount of kind spiritedness on the part of pharmaceutical stock-holders, no amount of regulation, nothing.  A drug is just a chemical.

Dependence and Addiction in Context

Where The Cult of Pharmacology really shines is in discussion of exactly what drug dependence and addiction means.  The author discusses a seven-level scale of drug use (abstinence, experimental, circumstantial, casual, regular, dependence, addiction) (pp. 94-95) and the complexities of drug effects on the body.  He discusses the "placebo text", that is, the myth that tells an individual what will happen to their body when they consume a particular drug. (p. 120)  The voluminous information about placebos is clear enough evidence the use of a drug is about much more than interactions of chemical. DeGrandpre presents a host of animal, human, and sociological studies that show drug effects to be infinitely more complicated than just the issue of chemical placebo hints at.  The following is perhaps the heart of the book:

In fact, at the center of the new scientific wisdom remains a firm belief in the magicalism of millennia past.  As a drug ideology derived from the eternal notion that psychoactive compounds contain a unique spirit or essence, the cult of pharmacology legitimized the belief that these spirits bypass all social conditioning of the mind and by themselves transform human thought and action.  Unlike other worldly modes of influence on mind and human experience, and despite many real advances in the pharmacological sciences in the twentieth century, psychoactive substances continued to be treated in the main as spirits that could enter into the body and take possession of it.  Yes, soul was translated into mind, and spirit was translated into biochemistry, giving the appearance that science and medicine had done away with the myths surrounding what had come to be understood as "drugs."  Drugs were not demythologized, however, by rather remythologized.  Psychobabble and biobabble replaced magical explanations of drug action, creating what had become by the end of the century a new, molecular pharmacologicalism.  These modes of explanation were then used to forge a modern pseudoscience of good and bad drugs, enforced via a differential prohibition of angels (Like Ritalin) and demons (like cocaine).  The "rational" science of drugs, in other words, carried myth along with it; it was itself framed and motivated by myth--a myth of angels and demons.(pp. 104 - 105)

Our belief in drugs is truly magical.  Consider this: patients who are given a placebo and told that it is a placebo nonetheless frequently get better. (p. 60)  We kill people at home and abroad over cocaine ("No doubt the war on drugs will one day rank amongst the most shameful periods in American history." -p. 174), but we give our children the virtually identical compound Ritalin. (p. 28)  The placebo text tells us that one in a dangerous drug used by degenerates, and the other helps our children cope with the modern knowledge economy.  The author notes:

Drugs contain potentialities that lie within the drug's chemical structure, pharmacologism posits, and when taken into the body, these potentialities take hold of and transform both brain and behavior.  This way of understanding drug outcomes has great efficiency, for it affords society with the opportunity to classify drugs once and for all as angels and demons, independent of time, person, or place.  Accordingly, the evil that some drugs pose is determined not by societal conditions or attitudes about these drugs--by experience--but by the drug's essence.  A century of angels falling from grace did not diminish the popularity of this theory, moreover, since the notion of pharmacological determinism was never judged to be in error; instead, each fallen angel was declared, one after another, to have been inadequately assessed pharmacologically.  (pp. 209-210)

I do think that the author goes a bit off in his argument against the negative effects of drug addiction.  For example, he suggests that smoking mostly only reaches the level of dependence, not addiction, where addiction is defined as "an activity so all-consuming that it disrupts the normal functioning of a person's life." (p. 95)  Risking a painful and early death cannot possibly be mere "dependence".  Risking severe life disruption because of possible criminal persecution, even if an artificially created outcome, cannot possibly be mere "dependence."  I see fellow food addicts trying to split this hair quite frequently.  They want to say that they aren't addicted to food because they haven't done anything irrational to get food, or pursued food in an irrational way.  True, but they are willing to endure the prison of obesity, and possible suffering and death as well, for the food.  That rational error is addiction.

On the other hand, the war on drugs model mirrors a puritanical world-view where life is a series of tests by God.  If you are not capable of passing the test, you are not welcome to participate in our society.  It is very plausibly argued that the drugs test is not administered on a level playing field.  And of course the law has in a certain sense caught up with this as the differential sentencing between powder and crack cocaine is being struck down.  But beyond that it is a matter of presenting people of different social experiences and enrichments with an alienated drug alternative, blessing those who take the alternative one way (sanctioned drugs) and striking with lightening those who take it another way (street drugs).  While it is not completely irrational for social ideals about drug use to be encoded into law, and especially not irrational for protections from irresponsible users (e.g. drunk drivers) to be legally encoded, there is a problem with the legal and scientific encoding of the irrational.

Personal Response to the Story of Addiction and the Demythologizing of the Angels

In discussion addiction as being about more than a simple chemical reaction, the author produces a description of opiate withdrawal that I can more than identify with as a food addict:

If and when the opiate user identifies opiate withdrawal as such, still another step must be taken for drug dependence to emerge.  Specifically, he or she must complete a ritual activity that is partly physiological, partly cognitive, and partly behavioral.  That is to say, the opiate user must experience withdrawal (a physical phenomenon), he or she must develop a concern over the withdrawal experience as such (a physical phenomenon), and then he or she must engage in drug use, take opiates repeatedly to eliminate or avoid opiate withdrawal (a behavioral phenomenon).  A breakdown in any part of this biopsychosocial circuit can prevent a pattern of dependent opiate use from emerging.  For example, an individual may experience little physical withdrawal following repeated opiate use, or, as found in Scharse's study of Mexican Americans, a person might interpret withdrawal as a sign of impending drug dependence and subsequently reduce or quit his or her drug habit.  If, on the other hand, a withdrawal experience causes an individual to become obsessed with the prospect and experience of withdrawal--and to continually use in order to avoid it--the circuit will be completed, with the learning process now occurring repeatedly, thus reinforcing the drug habit at all three levels: physiological, cognitive, and behavioral. (pp. 119-120)

The consequences of food withdrawal are the simple experience of hunger and the re-emergence of the stress of everyday life.  Hunger is not that dramatic, and the stress of life is not as overwhelming as it once was.  However, I am capable of ending up in a pattern of obsession over the boogie-man of hunger.  It takes a period of time where I can remove myself from everyday life and re-learn to experience and tolerate hunger before I can return to a normal pattern of eating, at which point it seems absurd that my fear of hunger could have ever been that extreme.

One study particularly caught my eye, which was the number of studies involving cocaine at different titrations vs. sucrose at different titrations (p. 200).  All of this is meant to demonstrate that cocaine is not chemically addictive, and no attention seems to be paid to another possible interpretation, which is that sucrose is as addictive as cocaine.

An additional point is that ritual itself is not the problem.  Every activity engaged in, every response to stimulus, has a psychosocial component.  The goal is to create psychosocial experiences which are present and whole.  Mal-adaptive drug (and food) rituals are the problem, where the experience is fragmented and alienated.  It doesn't even take a substance to encourage the maladaptive ritual.  Gambling addiction is commonly understood, and at different times and places street drugs become near placebos, such as the use of heroin nationwide in 1973 when a national storage drove the purity of street product as low as 0.5% (p. 203) meaning that this was no longer a maladaptive drug culture but a maladaptive injection ritual culture.

The author tries to make the point that making pharmacologism (as addiction) part of the study of pharmacology is like making sun worship part of  astronomy (and cites the book Ceremonial Chemistry by Thomas Szasz in making this argument). (p. 221)  But pharmacologism, the psychosocial relationship with the meaning of the drug, in inherent in the use of the drug.  The author further tries to argue that drugs are only a kind of a stimulus, "...the core myth underlying the cult of pharmacology is that drugs are unique from other, traditional modes of experience..." (p. 240)  Of course this is absurd; drug use will always be part of a wider story.  Really, every stimulus is.  Meaning can be imparted in a whole way:  I once knew a breast cancer survivor on tamoxophin who kept notes about the success of tamoxophin all around her environment.  Similarly, I've realized that my food withdrawal obsession focuses on certain symptoms.  Would it not be reasonable to use the most simple and safest compounds, such as bicarbonate to prevent stomach pain, to reduce my concern about those symptoms?  (I have to admit I find myself drawn to the scientific magic of ranitidine instead, and in fact in giving my food addiction a good smack down this weekend resorted to taking it rather than the bicarbonate that I had planned on.  It was an illogical "pharmacologism" decision.)

The other side of withdrawal obsession is craving obsession.  Interestingly, it seems that craving symptoms and actual drug use do not correlate. (p. 232)  That is definitely true in my experience with food- cravings are just information.  Sometimes they are information that the devil is knocking on the door and there is no way he should be invited in, literally, to supper.  Other times it means I should feed him right away so that he'll go away and let me get back to the rest of my life.

As a last note, it is an interesting slap in the face to the addiction industry that it doesn't own the pathway to ending addiction- there are many pathways, and an individual is as likely to use the tools of the industry (medications, therapy, etc.) as not.  (pp. 117-118, citation: Waldorf and Biernacki, The natural remission from opiate addiction: Some preliminary findings, Journal of Drug Issues II (1981): 61-74)   "Recovery," whatever that means, is an individual process with an individual definition of attainment.

Meta-pharmacologism: The Hope Before Drugs

Ultimately reading these books has reinforced for me the idea that we need existentialism now more than ever.  Critler, by no means writing a philosophical work, comes to the same conclusion which he couches in the term "notion of independence."  (p. 250)  He is talking from a behavioral and policy standpoint- as individuals, as patients, as doctors, as regulators, as a society, we each need to be approaching our decisions about drugs from a place of independence.  We are not the unwashed worshiping at the alter of pharmacologism; we each can determine the meaning and experience of a drug for ourselves, appropriate for the particular role we fill.

Pharmacologism as a psychosocial story or myth, and pharmacology as a science, have both created reductionist beliefs about what a human "is".  I view this reductionism as heretical.  Reductionist concepts of addiction are the opposite of certainty about another person's choices in that it is certainty about their lack of choice.  In this addiction concept, only other people can experience pure addiction.  You yourself cannot, because your experience of your own complexity does not allow it.  Where you have been convinced to ignore your own experience of your complexity and believe a reductionist theory of addiction, something evil has been done to you and it wasn't done by a chemical.

I am perhaps fortunate in that food does not lend itself to reductionist theories of addiction, though there are plenty hot on the efforts to shoehorn it into one.  I did at one time think that there was nothing I could change about my relationship with food, that it's "just how I am."  There are people who take set-point theories about body weight and try to sell them to the obese- how absurd is it to claim that my body wanted to be 300 lbs.?  But that is the sale that is underway.  In losing weight, I've proven more than that I can manage addiction, or that I have it in me to do things that I'm proud of doing.  I've proven that as a human being, I can set the meaning of my own life.  Meaning comes before direction and action, before chemicals and other things of the physical world, and is perhaps the most important thing that a human being creates.

P.S.

Another interesting looking book about the shaping of drug and medical information and meaning: Selling Sickness

Also by Greg Critser: Fat Land: How Americans Became the Fattest People in the World

Also by Richard DeGrandpre: Ritalin Nation: Rapid-Fire Culture and the Transformation of Human Consciousness

New Year's Day

New Year's Day is the special holiday for hope.  I'm not sure how much can enter into the boundaries of hope-  was Queen Elizabeth hopeful when she spoke of leaving her annus horribilis behind her, or was she merely wishful?  I'm not sure.  The power of hope is not in wishfulness, and neither is the power of faith for that matter; a topic I intend to write more about in this coming year.

In the local paper this morning was a report on First Night.  Apparently the Raleigh version of the event included a Resolution Oak Tree, where you could hang your resolution.  Considering how unfortunate it is to have your resolutions revealed with your name on the front page of a newspaper section, I'll be fair and reveal mine later.  This is what The News & Observer reported:

     Amid resolutions to lose weight and get organized were promises to "Make NC a Better Place," "Give Back to Others" and "Be More Green."
     Julie and Michael Massey of Raleigh made resolutions meant to start the new year off fresh.  Hers: "To love and forgive like a child."  His: "To be a better person."

I am someone who has over almost two year lost nearly 100 lbs. and kept off 75, so I know a thing or two about the Most Popular New Year's Resolution in America.  Those things probably apply pretty well to New Year's Resolutions in general.  The more I think about it, the more I believe that Fromm's four requirements for love (I looked it up this time) also apply to hope.  The union is so clear that it brings up the question of whether hope can be defined as an act of love; perhaps it can.  Fromm's requirements for love are: care, responsibility, respect and knowledge. (The Art of Loving, p. 24)

Ultimately, a hope with no bearing on reality is just as wish.  It takes care and responsibility to bring a wish to reality, and a plan is the only way I know to do that.  A wish with no respect and knowledge is a flimsy thing that has no connection with the power of hope (or of faith or of love). My New Year's Resolutions come into my mind already in a format that falls somewhere between wish and action:

• Onederland. (A body weight that starts with a one.)
• Forty miles of training per week. (A minimum goal that I was already meeting through 2007.)
• Six hours with the French language per week. (A couple of days ago I was claiming 9 as the commitment, but let's call 9 the "reach" goal.)
• Return to a cash-based lifestyle. (After several years of living on cash, I had drifted over to my credit card with poor results.)
• Remove from my house the things that are not useful, beautiful or meaningful. (These categories are based on David Allen's Getting Things Done, but at the moment I cannot find his specific list of things one should have vs. not have.)

As a fairly concrete thinker, it takes effort for me to backtrack from hope to wish.  I am suspicious of any New Year's Resolution that is termed in wishfulness, and I give low marks to the likelihood of such resolutions ever reaching reality.  However, reviewing my list, I can see some value in wishfulness, perhaps the ultimate "why" of my activities.  Wishfulness backs up a step, presents some other alternatives.  I suppose if someone starts at wishfulness it might not be so bad, but after starting there hope and action do have to come back to earth in their proper stages.

Hope hovers just above where the rubber meets the road.  In making a New Year's Resolution I am the kid that has wound up the car and is just about to set it down, in whichever direction I choose to go.  Perhaps that choice of direction is nothing more than wishfulness.  Hope says that it won't sputter and stop, the gears won't spring apart when confronted by tall carpeting, the dog won't grab my toys and drop them in the bushes.  From where I have had success, I say make a plan- smooth out the path, where possible tie up the dog, and let those New Year's Hopes roll.