Dear colleagues, welcome to the third international conference on addiction research and therapy, which is going to be held in Amsterdam, the Netherlands, March 2020.
My name is Sam Vaknin, I am the author of Malignant Self-Love, Narcissism Revisited, and a series of other books about personality disorders. I am a visiting professor of psychology at Southern Federal University in Rostov-on-Don, Russia, and I am a professor of finance and a professor of psychology in SIAS-CIAPS, the Centre for International Advanced and Professional Studies.
Today I would like to discuss with you a potentially new view of addiction.
In our attempts to decipher the human psyche, which in itself we should all admit is a mere construct, not an ontological entity.
When we attempt to decipher the human psyche or soul if you are spiritually inclined, we have come up with two answers.
The first answer is that behaviors, moods, emotions and cognitions are wholly reducible to biochemical reactions and neural pathways in the brain.
And this is the medicalization of what it is to be human. It is inevitably hotly contested by dualists, people who believe that there is a distinction, there is light, daylight between mind and body, and that the mind is not an epiphenomenon or an emergent phenomenon of the body, but kind of a separate entity that somehow is connected to the body, not clear how.
This is the Cartesian view, it is very old.
And the second type of answer that we have come up with is that behaviors, moods, emotions and cognitions can be explained and predicted by the introduction of scientific theories or scientific sounding theories based on primary concepts.
Psychoanalytic is an early and now widely discredited or disregarded example of such an approach to human affairs, the physics of the soul, the physics of the psyche.
The concepts of addiction as the concept of pathological narcissism, the concept of addiction was introduced to account for oft recurring amalgams of behaviors, moods, emotions and cognitions.
Both concepts, addiction and narcissism, are organizing exegetic, hermeneutic principles with some predictive powers. Both constructs hark back to Calvinist and Puritan strands of Protestantism, where excess and compulsion, inner demons, so to speak, were important topics, sometimes exclusive topics.
And so today we perpetuate this Puritan view of addiction. We say that addicts are slaves to their addictions. They are kind of mindless robots controlled by the processes in their brains, by the substances that they consume, or by interaction between the substances that they consume and the processes in their brains.
And in the brain itself, there's another class of substances, neurotransmitters, serotonin, dopamine, acetylcholine and others, and they interact with the consumed substances. They are receptors, special sites, where the consumed substances, addictive substances, bind, dock into.
But in my view, there is no such thing as an addictive personality.
I believe that addiction and addictive behaviors should be cast in a totally new light.
I claim that addictions are the natural state of humanity. They're the baseline.
We start off by getting addicted. We get addicted to mother. We get addicted to her milk.
And we continue to develop addictions throughout life. We relabel them. We don't call them addiction addictions.
But what I have is, if not addictions, what is love, if not a form, an extreme form of addiction, what are automatic thoughts, what are obsessions, compulsions, they are forms of addictions.
Addictions are powerful, organized and explanatory principles. They endow life with meaning, purpose and direction, or misdirection.
Addictions provide boundaries, rituals, timetables and cages of skeleton, of order. Addictions are ways to regulate emotions. Addictions are ways to modulate interpersonal relationships. Addictions are communication protocols. They're communication modes.
Addictions are the scaffolding of life itself.
Indeed, if you look at our brain, our brain is programmed to constantly get addicted. About 40% of brain structures, and much more than that of brain surface, are kind of dedicated to addictions. Big, important parts of the brain revolve around getting addicted, maintaining the addiction, and directing and regulating behaviors and emotions under the addiction, or to somehow conform to the addiction.
A high is the desired permanent outcome, it seems.
Addictive states must serve some evolutionary purpose.
Because we know from evolutionary theory that structures that consume energy do not survive if they have no role, if they have no goal, if they are not functional. Addictive states must have some function, they must serve some evolutionary purpose and therefore there are beneficial adaptations, there are not maladaptations.
In the process of socialization, we internalize inhibitions and introjects, what Freud called the superego. And these inhibitions and introjects usually counter addictions, they are against certain addictions, so as to render us functional and useful in human communities and environments.
In other words, the edicts against the injunctions against addictions are not biological, they don't have anything to do with our psychology, with our brain, or with any realities which are biological and psychological, they are social in nature.
Whenever we counter an addiction, whenever we attack, the morality of an addiction, whenever we, we usually talk in social terms, social acceptability, social conformity, social functioning. Other addictions mediated by our institutions, such as the church or the family, these addictions are encouraged for the same reasons exactly, because they are pro-social.
So we have anti-social addictions and pro-social addictions. Non-conforming and defiant addicts are conditioned to self-destruct and to defeat and loathe themselves. Addictions are individual, their prescription and inhibition is social, they are social.
No wonder that addictions are associated in clinical and abnormal psychology with anti-social law, even psychopathic and sociopathic traits, behaviors and personalities.
The addict seeks to alter his perception of reality. Addictions are both intersubjective theories of mind and of the world.
Many addictions come replete with or in the context of ideologies. Addictions spawn sub-cultures, they provide social reuse and contexts within which to operate.
They have, they spawn codes of conduct. Of a luminous literature notwithstanding, there is little convincing empirical research about the correlation between personality traits and addictive behaviors.
Substance abuse and dependence, alcoholism, drug addiction, is only one form of recurrent and self-defeating patterns of misconduct. People are addicted to all kinds of things. Gambling, shopping, the internet, reckless and life-endangering pursuits and hobbies.
Adrenaline junkies abound.
The connection between chronic anxiety, pathological narcissism, depression, specific compulsive traits and alcoholism and drug abuse, this connection is well-established and is common in clinical practice.
But not all narcissists, compulsives, depressives, psychopaths and anxious people turn to the bottle or to the needle.
Frequent claims of finding a gene complex responsible for alcoholism have been consistently cast in doubt.
In 1993, Berman and Noble suggested that addictive and reckless behaviors are near emergent phenomena and may be linked to other more fundamental traits such as novelty seeking or risk taking.
Psychopaths, patients with antisocial personality disorder or even people who are merely defined. Psychopaths have both qualities in ample quantities, novelty seeking and risk taking.
We would expect them therefore to heavily abuse alcohol and drugs.
Indeed, as Louisa Buckholz convincingly demonstrated in 1991, psychopaths do.
Still, only a negligible minority of alcoholics and drug addicts are psychopaths.
We must reconceive and rethink addiction.
It fulfills some function. It has some role. It is very often antisocial, so society is dead set against addictions.
But addictions have a place. They have a biological presence, a neurological presence, cerebral presence in the brain.
Many people actually looking at the situation objectively, most people are addicts one way or another.
They are eruptive and disruptive addictions such as falling in love. They are chronic addictions. They are pro-social addictions and antisocial addictions.
We need to reconceive of addiction, not in the framework of clinical or normal psychology perhaps, but in the broader context of social psychology or just psychology.
Thank you for listening.