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Comment by intellectronica | Hacker News Reader

The addiction label is a useful trick. Before criticising it, consider how labelling behaviours as "addiction" and constructing the 12-step infrastructure and community around them, makes it possible for people who suffer to find support and start improving their lives. Most of them will eventually come to understand that it wasn't "addiction" but a symptom of suffering from complex mental health problems. But without that gateway they might have suffered even more, for longer, and potentially with disastrous results.

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Gabor Maté - a physician who worked with people with serious substance abuse disorders for many years - talks about how addiction is usually a symptom of some other underlying suffering; often trauma. The addictive behaviours act as a way to avoid confronting that pain.

I’ve heard this take a lot in my life. And I definitely struggle with substance abuse addiction. However I’ve looked inside myself many times to find said trauma or suffering and I just don’t really see anything of note. Perhaps the only way to discover this is through some very expensive therapy sessions, or maybe vaping some 5-Meo-DMT.

Trauma only appearing in super-deep going therapy sessions can often be False Memory Syndrome, which is an entirely different can of worms and extremely problematic. If you search really really deeply, you're going to find it, wether it exists or not.

Generally: While suppressed memory of trauma exists, the vast majority of people are aware of trauma and there is no evidence suggesting otherwise. And there is clear evidence that lots of mentally well people get addicted as well, so just claiming "it's always some underlying condition" is probably not a great idea. It can, often even, be, sure. But that doesn't make it mandatory and especially doesn't allow the "I struggle with addiction, so there _must_ have been a problem beforehand" conclusion.

So honestly, I'd just not search any deeper to not risk inducing any false memories.

The idea of repressed memories is very popular with untrained general public, but it’s not a substantiated research topic.

Like the comment above said, many “repressed memories” are actually false memories or, in rare cases, false stories that get constructed and encouraged by a misleading therapist who is convinced that some repressed memory exists and pushes too hard to get the patient to “remember” something. When the only way to satisfy the other party is to come up with a story, many people will eventually come up with a story and even believe it themselves.

The same thing happens with false confessions.

> Trauma only appearing in super-deep going therapy sessions can often be False Memory Syndrome, which is an entirely different can of worms and extremely problematic

It is problematic, but not in the way that you think. While memories can be suggestively altered or created by questioning, the evidence for doing so for traumatic childhood sexual abuse is anecdotal and those anecdotes were pretty heavily cherry picked by the clearly biased FMSF, which was run as a support and advocacy group for parents accused of abuse.

That said, my understanding is that in general, dwelling on traumatizing experiences isn't beneficial to recovery. There are times they may need to be confronted and processed, but generally if it isn't causing a problem, don't go digging it up and spending a lot of time thinking about it unnecessarily.

Exactly. This reeks of snake oil.

I'm addicted to sugar. I have some trauma now? What trauma? My life has been relatively smooth sailing. You're right, this is just a way of creating the "need" for "therapy".

The therapy industrial complex at it again /s

It's all because of Big Help.

You joke, but trauma influencers are a big deal. That’s how they get their followers and their podcast appearances.

Alex Jones, is that you? That's a very poignant insight from you that I'm surprised you're willing to admit. /s

Man, you're being disingenuous as can be. Not all addiction is the same, and some are much easier to break than others. However, sugar addiction can lead to some very traumatic experiences at the dentist.

Why are you minimizing my addiction.

I’ve tried counselling multiple times and I never got that eye opening clarity of what’s wrong with me. Maybe one has to do psychotherapy for that, which is unavailable to most.

IME, there's usually not a moment of absolute clarity where I know what's wrong with me. Instead it's a lot of wandering, digging, and, very occasionally, finding little nuggets of info and wondering, "what the hell do I do with this knowledge?" Gradually, what happens is the process of doing this helps you understand yourself, which, over time, can change perceptions and actions.

The clarity usually comes in retrospect for me.

For me it’s not necessarily trauma or suffering, not beyond the normal expected human “suffering” of doing boring, mundane tasks or feeling sad/frustrated/insecure, but rather feeling these generally uncomfortable feelings and having a habit of detaching from them and developing a low tolerance for handling it in general.

I generally engage more in my own flavor of addictions (caffeine, social media, workaholism) when I am more overwhelmed, understanding that I do this and why… was helpful.

> However I’ve looked inside myself many times to find said trauma or suffering and I just don’t really see anything of note.

Don't worry about it. The trauma diagnosis has been ludicrously poor at treating addiction.

From what I've read, it performs worse than placebos, random chance, etc.

For treatment of substance abuse, therapy is literally at the bottom of the performance chart, below things like hypnotism, alternative medicines and plain old prayer.

Trauma is far too vague and far too appealing to be as useful as people believe. Everyone thinks they have some sort of trauma, and that everything can be boiled down to trauma. Some people are more inclined to addiction and this is not necessarily related to trauma.

Yes, but trauma is a useful framework to help an individual recover from addiction. While some individuals will struggle more than others, everyone has a path to avoiding addiction, and one of the best ways to do this is to build an environment for people that compensates for trauma. It’s much easier to confront things that were done to you, than to mistakes that you yourself committed.

I don't think it's a good framework, because trauma is about the past. Whereas for addiction or other avoidant or self-destructive behavior, the tigers are often still around.

But what if the addiction isn't rooted in trauma? My mom smoked a few cigs when she was pregnant, which probably caused some mild ADHD symptoms, so when high school rolled around and I began experimenting with drugs to quell those symptoms, the ADHD medication felt best. If that medication felt good, I wondered what the others would feel like, so it started me down the path of addictive behavior during my formative years.

Where is the trauma in that scenario? The brain damage from the cigs? I can hardly get over that 'trauma' since I've never known a world without it. The trauma of repeatedly getting addicted to things? I DON'T hold that against myself, I just like how they feel. Where is the trauma in that scenario?

This tends to be a really frustrating conversation because it's different for different people. Some find the trauma framework as useful in recovering, other find it useful because it allows them to blame other people and sink deeper into addiction. Others yet find that it doesn't really apply to them.

It’s actually not very helpful, because it entirely externalizes the problem.

It can get people started on therapy because it uses therapy speak and therefore feels like therapy is an obvious solution. However, it also makes the person into a victim of external trauma while minimizing their own role in the choices that led to the addiction.

It’s really appealing for people who need something external to blame, but it’s less helpful in getting at the root of behavioral issues that aren’t really external.

For the narrow slice of patients who actually have severe trauma response issues, it can be helpful. For everyone else it’s becoming a big distraction.

Most people probably do have some sort of trauma, whether or not it causes ongoing problems is a different story

That may apply to things like serious substance abuse, but what about things like smartphone, social media addiction? I seriously doubt everyone glued to their phone has a trauma. Some things are simply engineered to be addictive.

I guess one could argue that modern life in industrialized world is deeply understimulating, and the phones just provide an escape from that, but that's just living conditions, not a trauma.

I think the reality is that no matter how manipulative these devices are, they really aren’t comparable to addictions in the sense of drug or alcohol addiction. They are essentially just learned behaviors which are reinforced constantly by peers and society.

Yes, I think "trauma" is a little too specific and gives the wrong associations. The point is, there was something about our situation that made it appealing to escape into the "addiction" for a moment. And depending on what the "addiction" is, it could more or less self-reinforcing.

You're right. For substance additions the cause could be something like a toxic relationship or job stress.

As soon as I put my smartphone away I realise I'm confronted with challenging feelings: the fear of engaging with the people around me, worrying what they're thinking, looking stupid if I'm not doing anything, or just plain boredom. So it's "avoiding psychological difficulty" that is the fundamental factor.

I was addicted for years (to the flow state, to which by the way I've never seen or heard a report of anyone else's being addicted).

I also wasted too much time, thousands of hours, reading and writing on the newsgroups and on the web.

There are similarities between these 2 things. For example, both reduce the amount of motivation and drive available in a life. But they feel very different, and in my experience, avoiding the former is extremely important whereas avoiding the latter is merely one more important thing in a life full of important considerations.

In an ideal world, there would be a word or short phrase for the second thing so that "addiction" could be reserved for the first thing. "Insufficient vigilance against superstimuli" is the shortest phrase I can think of right now. (I'm sad that I cannot use the word "vices" without provoking an immediate negative reaction: "vices" is shorter than "superstimuli".)

You are not alone! I used programming flow state as pain management for a decade.

Its one of those "paid for your mental disorder" situations that are a lot more common than people realize.

Whoa. I've never heard anyone put the flow state in this category.

On the one hand, it sounds preposterous - a bit like saying you're addicted to consciousness, or meditation. On the other, I can relate to how my enjoyment and pursuit of it strains my relationships with others.

It's a fascinating suggestion. I'd like to hear more about why you feel that way.

Most things that are highly pleasurable or that provide relief can become the focus of an addiction.

I had chronically-high cortisol. The flow state provided a profound but temporary relief from the cortisol. There are better responses to high cortisol.

DHEA (which is available over-the-counter in the US) is a better response because it allows me to dispense with the hour or 2 of intense concentration necessary to get into the flow state (freeing up the time and the mental energy for more productive uses).

Starting a friendship with a person who gets me and doesn't trigger my trauma triggers was a better response because the cortisol-lowering effect of such a friendship has lasted for years whereas the effect of being in the flow state ends as soon as the flow state ends.

Are you rich at least?

Not at all. But I'm no longer addicted to anything, which is more important.

I think it's a bit of both. The worse ones mental health, the harder it is to stop addictions from forming.

I don't think it's the glued-to-the-phone that indicates trauma/addiction - it's when they have the option not to be and still choose to stay. E.g. if I'm spending time with my friends, I have no interest in my phone. When I'm on my own, it's easy to spend hours on it.

> I seriously doubt everyone glued to their phone has a trauma.

The “trauma explains everything” meme has become more of a way to get people to accept therapy than a real explanation.

It transforms the problem from a personal failing (I can’t control my addiction) to a situation where the person is a victim of something external (Trauma inflicted on me has forced me to become addicted). People find it easier to accept treatment when they think they’re a victim of something external.

Gabor Mate (the trauma influencer mentioned in the comment above) uses trauma as the basis of his therapy, so he finds a “trauma” for everyone. If he can’t find something with the patient, he believes being born is their trauma, because the childbirth process is painful. Everyone was born, so he has a fallback trauma to assign to everyone.

That sounds like basic woo-science.

Okay, but the therapy industry is also a total grift. So I guess the trick is to reinforce your external locus of control by blaming your trauma, so that you go to a pseudoscience practitioner who will fix the problems that were created for you? That way they've got a lifelong customer!

People who suffer from mental health difficulties tend to be psychologically inflexible. And it is that inflexibility, which can manifest in so many different ways, that is preventing them from growing and healing.

For some it can be consuming the same psychoactive substance over and over again. For others it may be compulsion to repeat a limited set of rituals and behaviours.

The first thing they need help with is accepting that they will not be able to exercise control over everything. There are many ways to get there, but for many, labelling this pattern as "addiction" and getting help and support in this context, is easier than other options.

I distinctly remember english speakers being less annoying before this guy filled everyone full of relating absolutely everything to trauma. It just seems like a massively reductionist point of view in a world of people more complex than that

My initial.reactiom to his book on ADHD was similar, I couldn't believe that it could all be reduced to trauma.

I've really come around to that theory though and I think he's very wise.

We need to take a close look at the way we are living our lives under capitalism, the decisions we're forced to.make, and the way we treat our children.

Gabor Maté is popular, but he’s an example of an influencer who has one tool (trauma treatment) and applies it to everything. His approach is extremely reductive. Many people get addicted to drugs simply because they like taking the drugs and have poor self control, not because they’re avoiding trauma.

It’s another example of something that isn’t really correct for everyone but can be useful to get people to go to a therapist and get treatment.

He also believes that he can remember full memories from when he was 3 months old. There is no evidence that this is possible.

Do you have a reference for that?

As someone with an incredibly "addictive personality", I've always seen it much more simply. I become addicted to things when there's nothing else I'd rather be doing that is incompatible with the addictive behavior. Like if I'm sitting on the couch scrolling on my phone, if there was something else I'd rather do (not something that I'd "ought to" rather be doing but don't actually want to) then I would be doing that instead.

When I sit and observe my thoughts and feelings I find a complex mix of desires. Some that are immediate/basic/short-term vs some that are conceptual/nuanced/long-term. The eventual course of action is a delicate compromise. A lot of the time I'd rather just veg out than - say - go for a run or do some writing. But I might do the latter anyway because I recognise that it'll usually help me feel much better in 2 hours time.

I guess the upshot is that "I'd rather be doing..." is not actually very simple at all IMO.

It’s important to understand that all 12 step programs(all of which are based on AA) approach addiction as a spiritual disease, and the program offers a spiritual solution. 12 step programs also teach that addiction is a progressive disease, and there is no permanent ‘fix’, but rather a daily reprieve contingent on the maintenance of one’s spiritual condition. Here is a concise summarization of the 12 step design for living: ‘reverse selfishness, get out and help others’. According to 12 step programs, if you stop working the program, addiction will come back in full force.

Its also important to understand the most of the successes sang by 12 step evangalists are coming from the <5% it works on.

Im not against it but it simply is not the only cure for addiction. In fact its provenly a very bad program for the 95% that cant hang.

Much better CBT and medical interventions out there and millions of people are told every year to ignore them because of 12 step evangalist.

If the west had the answer to addiction in the form of 12 step, we probably wouldnt have the highest rates of addiction in the world and is probably a sign of societal trauma that no amount of meetings is going to help.

The only thing that worked for me is 'trying to do better than I did the previous day' with the understanding it's not a linear curve, but a spiky graph that trends upwards.

That's awesome, just please don't tell other people that its the only way. Which has been my experience with 12 step people.

Its the most unscientific method of treating addiction we have, one of the least effective, yet the government literally uses it as its ONLY tool (in a lot towns) to fight addiction in their communities, partly because propagandists of the 12 step methods have ingrained the idea that its the only thing that works into society (USA), when in fact, it is the opposite. My guess is, they like or don't care about recidivism also.

I think the decentralized community-based nature of 12 steps programs is cool though, and we do need more stuff like that.

AA specifically suggests to only come when all other measures have failed, and if you can do it without AA ‘our hats are off to you’ quote from their ‘big book’ which is their main piece of literature. I truly believe and have seen first hand hundreds of thousands of dollars spent on rehab and counseling and medications and therapy and only AA ever brought those individuals into true long term recovery. I don’t like the AA is forced by folks who haven’t already tried, or had the privilege to try ‘all other measures’.

I agree. It shouldn't be the only tool in the box

We could also stop gerrymandering the use/abuse line and just make a call as a society: we use drugs (most people most places most of history) or we don't fuck with drugs (most of the Islamic world, certain subcultures).

America is a Puritan origin society with a temperance faction that has been everything from writing the Constitution to largely ignored, standards for alcohol, cannabis, scripts fluctuate like hemlines: a typical adulthood will see multiple incompatible regimes of acceptable use vs unacceptable abuse.

None of that is anything to do with compassionate provision of high-quality medical care to vulnerable people (a strict ethical and practical good). Compassionate provision of high quality support is both expensive and leaves no room for insider/outsider lizard brain shit, i.e. not a very American thing to do in the 21st century.

Our society needs to get its shit together on this, not further weaponize it.

I will ask AI to come up with the 12-step plan....

It leaves a bad taste in my mouth when people "lie" about psychological terms because they feel it enables a greater good.

I see the point you're making. But we as a society do this a lot, and it hasn't always historically been good for the people who are actually affected by the disorders.

Historically, this has been done by therapists who aren't well connected to the research world. They think they find a framework that works for their patients and promote it. Sometimes it becomes a fad despite not being backed by evidence. It's not always clear what the consequences are, but a common consequence is that many people miss out on actually figuring out what's going on with them and getting evidence-based treatment.

I'm not saying that there is no AI addiction. I'll leave that to the professionals. But I do want to gently push back on the idea that we should raise something to the level of pathology because it seems useful.

And as the parent of kids, there are a lot of habits that become compulsions and where you experience withdrawal if you stop. Reading is one in my family. Exercise is something that's rewarding and you feel bad if you stop. But exercise addiction is a very specific disorder. Just some stuff to keep in mind.

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