It’s Hard to Get Enough of What Almost Works
I just finished Dr. Gabor Maté’s In the Realm of Hungry Ghosts, the most humane, scientific and, dare I say, Jungian-without-Jungian-terminology foray into addiction I’ve read. This is high praise from someone who has read more than 200 books on addiction, listened to hundreds of hours of podcasts and audiobooks, read maybe another one hundred research papers on the topic. Several times since the 2008 publication, I’ve heard the author interviewed, and made a mental note to read the book.
Yet, Dr. Maté’s earlier interviews had never addressed the damage that addicts do to those around them, which I felt deeply ambivalent about. He seemed so okay with active addicts being, well, active addicts. Yet, I remembered that I’d left an utterly unrepentant addict and was in no frame of mind to issue get-out-of-jail-free cards to addicts. Nope, I was holding addicts accountable as I was struggling to identify and process what I had been dealt. Wondering Why didn’t he just bloody stop? haunted me.
Early this summer I heard a podcast interview with Dr. Maté, coincidentally, while in a bookstore, and left the store with the book. Hungry ghosts is a Buddhist notion for intensely unconscious and instinctually driven beings, no longer fully alive due to their compulsive behavior. Ghosts may crave intensely and seek incessantly, but their ability to be nourished is long absent.
The Jungian therapist David Schoen depicted addiction as an archetype in The War of the Gods in Addiction. Anyone who has observed an addict over time probably sees the addict’s behavior very much like an archetypal possession. Attempted communion with the archetypical destroys mere humans, overwhelming the ego with too-potent energies. But we humans persist. Sometimes we so desperately want to transcend distress that no risk—psychic, spiritual or physical—seems too great. Maté calls all addiction “a flight from distress.”
While reading Maté’s patients’ evocative stories, one senses their addictions as an archetypical presence. This well-written volume weaves the reality of addiction with the vanguard of science. Peppered with the neuroscience of our brains’ dual cravings—both the opiate attachment-reward and the dopamine incentive-reward systems that dictate some of our behavior with nary a frontal cortex neuron’s involvement—Hungry Ghosts goes onto explain that our earliest experiences “set” these two systems.
An imbalance created early in life in one or both reward systems foreshadows our future cravings/compulsions and, perhaps, addictions. Early trauma, abuse, neglect and injury can affect how our brains function for the whole of our lives. Although brains can recover to surprising degrees upon cessation of active addictions (both substance and process addictions), the addicted brain is ever-susceptible to its pre-established imbalances.
Without knowing the powerful dictates of maladapted brain chemistry and its resultant cravings, Jung posited that it would take either a spiritual transformation or a strong human community to overcome addiction. Writing of one his former patients, Roland H., who had shared Jung’s adumbrations about addiction with Bill Wilson (co-founder of Alcoholics Anonymous), just before Wilson became sober and started AA in this now-famous letter, Jung stated:
“…his (Roland W.’s) craving for alcohol was the low-level equivalent of the spiritual thirst of our being for wholeness, expressed in medieval language: the union with God.
…you might be led to that goal (of sobriety) by an act of grace or through a personal and honest contact with friends…
…the evil principle prevailing in this world, leads the unrecognized spiritual need into perdition, if it is not counteracted either by a real religious insight or by the protective wall of human community. An ordinary man, not protected by an action from above and isolated in society cannot resist the power of evil…you see, alcohol in Latin is spiritus and you use the same word for the highest religious experience as well as for the most depraving poison. The helpful formula therefore is: spiritus contra spiritum.”
Jung also realized that both substances and processes were addictive:
“Every form of addiction is bad, no matter whether the narcotic be alcohol, morphine or idealism.”
Maté writes of his own work addiction. And his compulsion to own classical music CDs, most of which he admits are never played once purchased. He writes plainly that he has lied to his wife about compulsive CD purchases. On many occasions. That he has hid purchases, or parts of purchases, to manage his wife’s reactions to his latest music acquisitions. Just like an addict. He describes dulling the painful, empty place inside of him by planning and obsessing about owning various recordings and the ultimate high and release of his inner anxieties when he succumbs to the purchases. Followed by shame and deception. Oh, addiction, you are predictable.
The orbitofrontal cortex (OFC) and addiction are interrelated. These bilateral structures of the brain are rich in opiate and dopamine receptors and have an a plenitude of connections to the limbic (emotional) system. Additionally, the OFCs receive sensory inputs from all five senses while maintaining vast connections with both the implicit and explicit memory systems. Both substance and process addicts’ OFCs do not function normally.
Why does that matter? The OFC’s purpose is to evaluate diverse stimuli and make a story for the frontal cortex. To tell a story to the frontal cortex for final decision-making. According to PET scans, the OFC has made decisions up to ten seconds before subjects report that a thought has occurred, with muscles already taking action well before the moment that the decision had been made. Although sometimes overridden by the frontal cortex, the OFC determines much of our behavior, emotional lives and decisions by acting as a hub for many portions of the brain to cohere into a story.
I am awed that Jung seemed to know that senses, feelings, imagery and story-making were connected decades before there was a shard of evidence. The OFC findings point to a wiring and chemical connection.
Addicts of all stripes report a nearly identical addictive process: a fantasy/preoccupation, intense craving, using, anxiety reduction followed by shame and increasing anxieties, which loops back to preoccupation. The short biochemical description of addiction is that all addicts are addicted to their own brain’s chemical surges. The variety of ways that addicts jolt their brains into overproducing shows a remarkable and telling creativity on the part of the addicts. So that begs the question of why one person is drawn to a work addiction and another to alcohol? Why heroin? Or sex? Or methamphetamine? Or collecting classical CDs? Or information avarice?
To address that, Maté quotes Dr. Vincent Felitti: “It is hard to get enough of something that almost works.”
It was music that soothed Maté during a traumatic infancy in a Nazi-controlled Budapest ghetto. His father had been taken to a concentration camp, leaving his mother with the baby Gabor. Sometimes she spent 18 hours a day outside the home getting subsistence-level food for herself and her baby. When Gabor cried, no one came to soothe him. Both parents were utterly non-responsive to his crying. His mother left music playing while she was away obtaining food. Music was not the closeness to his mother that he really wanted, but it almost soothed him. Now, Dr. Maté finds that he will employ identical behaviors that he sees in his substance abuse patients to own yet another recording of Don Giovanni.
And his wife inquires: “Gabor, don’t you already have eight of that one already?”
Reading of Maté’s curious compulsion, it occurs to me: information almost works for me. Copious information almost makes the the world make sense. It almost bolsters me to face life courageously. Almost. My history offered knowledge-gathering as a substitute for parental bonding. Doesn’t the word almost conjure the image of hungry ghosts? Always grasping, yet ever empty?
Any particular addiction (or combination of addictions) almost works for that addict. Whatever combination each particular addict crafts is indicative of whatever it is that s/he is trying to resolve/staunch/sooth and what is available to relieve that. Again, Jung’s reach into patients’ histories for personal narrative in cultural context seems like current neuroscience.
Would a PET scan of my brain taken after a research binge reveal similarities to an alcoholic after a drinking binge? I do not know. I only know that I crave information. There I said it. If I could, I would inject sentences, thoughts and concepts into my veins to keep the information coming in. Information almost works for me.
Yes, clearly an addiction to information lives within me. Books are my first choice, followed by podcasts, audiobooks, lectures, workshops, classes, documentaries, research papers…and ad infinitum. Even though I have read piles of wonderful books, an identical anxiety looms in the last paragraphs of every one of them. An understood world is not a safe world, just a less anxious one for me. Hungry ghosts, indeed.
Like many addicts, I have been rather self-justified about my addiction, smug rather than ashamed of my imbalances. Because isn’t being uninformed just the worst of all possible fates? Isn’t not knowing like being an slack-jawed imbecile? I’ve certainly thought so. Years ago, I remember my son watching the DVD, Gladiator, and perhaps, in passing, I muttered something about conflating Roman emperors and movies with poor historical foundations. Perhaps.
“Oh stop, Mom, go argue with the History Channel.” my son protested, annoyed that I was questioning the veracity of the movie he found enthralling.
I am sure I shot something right back at him, which I am equally certain he ignored.
Now my son’s words sound uncannily like“Gabor, don’t you already have eight of that one already?” and Why didn’t he just bloody stop?
Why didn’t he just bloody stop? Because it almost works, that’s why. Was that the gem I have long been reading and listening for? Maybe, just maybe. Addiction is the repetition of what almost works, including my own.
And where does this take me, this new realization? I simply do not know and that is finally and incredibly satisfying.