Wednesday, April 6, 2016

The Fiendish Addict With the "Broken Brain" and Other Unfounded Stereotypes


In her new book, Unbroken Brain: A Revolutionary New Way of Understanding Addiction, neuroscience journalist Maia Szalavitz states ...

“Media portrayals of addiction tend to depict people with addictions as 'fiends' or 'demons' whose debauchery is driven by a ravenous hedonism, not a human or understandable search for safety and comfort. Consequently, the 'addictive personality' is seen as a bad one: weak, unreliable, selfish, and out of control.

“The temperament from which addiction springs is also seen as defective, unable to resist temptation. Even when we laugh about having an addictive personality it’s usually to justify an indulgence or to signal our guilt about pleasure, even if only ironically.

“However, the idea that people with addiction are all alike in these extremely negative ways is inaccurate— based more on the racist history of American drug policy and the criminalization of certain drugs than it is on science. Although addiction was originally framed by both Alcoholics Anonymous and psychiatry as a form of antisocial personality or 'character' disorder, research did not confirm this idea. Despite decades of attempts, no single addictive personality common to everyone with addictions has ever been found."

(Maia Szalavitz. “The Myth of the Addictive Personality.” April 05, 2016.)

Szalavitz believes the addictive personality is multifaceted. In other words, “it doesn't exist as an entity on its own.” She says research finds no universal character traits that are common to all addicted people. An entire range exists despite the stereotypes so commonly presented.

And, here I find perhaps the most useful and insightful part of Szalavitz's argument. She claims it is often possible to tell quite early on which children are at high risk. Szalavitz says, “Children who ultimately develop addictions tend to be 'outliers' in a number of measurable ways.”

Here is what she means:
  • Some stand out because they are antisocial and callous.
  • Others stand out because they are overly moralistic and sensitive.
  • Those who are the most impulsive and eager to try new things are at highest risk.
  • The odds of addiction are also elevated in those who are compulsive and fear novelty.
  • It is extremes of personality and temperament—some of which are associated with talents, not deficits—that elevates risk. Giftedness and high IQ, for instance, are linked with higher rates of illegal drug use than having average intelligence.

Boom! If Szalavitz has done her research correctly, and I suspicion from my own that she has, then the stereotype of an addict has been blown away. The valedictorian and the class slacker may be at equal risk of becoming addicted. And, as we all know, teens are notorious risk takers with high-octane hormones and James Dean inhibitions. With constant peer pressure, the clash of social and antisocial impulses has contributed to the definition of adolescence as a time of attempting to survive in a dangerous minefield.

Speaking of research, Szalavitz says, “The impact of all these factors together can be seen most clearly in studies that follow participants from infancy into adulthood (which are rare because they take so long to conduct and are thus very expensive).” Long term studies reveal the progression of addiction.

And, Szalavitz adds this important caveat ...

“Whether these extreme traits lead to addictions, other compulsive behaviors, developmental differences, mental illnesses, or some mixture depends not just on genetics, but also on the environment, people’s own reactions to it, and those of others to them. Addictions and other neurodevelopmental disorders rely not just on our actual experience but on how we interpret it and how our parents and friends respond to and label the way we behave. They develop in brains designed to change with experience—and that leaves us vulnerable to learning things that create damaging patterns, not just useful habits.”


Szalavitz cites longitudinal studies like Shedler and Block’s. She says they have found three major pathways to problems that involve temperamental traits, all of which can be seen in nascent (developmental) form in young children and all of which involve “a difficulty with self-regulation”:
  1. One, more common in males, involves impulsivity, boldness, and a desire for new experience; it can lead to addiction because it makes it hard for people to control their own behavior.

  2. Another, which tends to be seen more in women, involves being sad, inhibited, and/or anxious. While these negative emotions can also deter experimentation, when they do not do so, people may find themselves on a “self-medicating” path to addiction, where drugs are used to cope with painful feelings.
  1. The third way involves having both kinds of traits, where people alternatively fear and desire novelty and behavior swings from being impulsive and rash to being compulsive, fear driven, and stuck in rigid patterns.
If experiences are aberrant or if those brain regions are wired unusually, they may not learn to work properly. Thus, an “addictive personality” has a huge problem with self-regulation, not technically possessing “a personality disorder.”

Please read the entire article “The Myth of the Addictive Personality” by clicking here:

My View

Who is an addict? I believe the common notion that an addict is simply a weak-willed individual who willingly accepts addiction through a terrible flaw in his or her character is simply not true. I agree with Szalavitz in that those most susceptible to being addicted are impulsive, anxious, and desirous of pleasurable, new experiences. Defining an addict with one set of criteria is impossible. That is not to say we shouldn't look for tendencies that fuel risk.

Few people who stereotype addicts recognize the progression from experimentation to dependency to full-blown addiction, which is a disease that affects the brain. Szalavitz's analysis reveals that addiction is often manifested first as a type of “learning disorder,” more like dyslexia than diabetes. The traits of the disorder may be evidenced early in life. This important information pertinent to treatment.

Szalavitz confirms that addiction is a pattern of learned behavior defined by persistence despite negative consequences, and she writes “that is why punishment — because prison, after all, is just one more negative consequence — doesn't work and can be counterproductive.”

To reduce all addicts to people with “broken brains” is to demonize them as defective, throw-away individuals undeserving of life because of their own evil and defective wills. Yet, isn't it true that a combination of factors leads an individual down the path of addiction? As Szalavitz says, “Timing, history, family, peers, culture and chemicals come together to create both illness and recovery.”

As long as the general understanding of addiction is trapped in unfounded 20th century ideas, most people will deny there is a spectrum of addictive behaviors. Thus, prevention and treatment will be outdated; the public will not realize a single approach does not work for all. And, most sadly, the image of a dirty, worthless addict will be perpetuated in future generations. I ask you, “Who really has 'the broken brain'?”


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