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Can Addiction Be Helped? (Mexico City Lecture)

Uploaded 1/31/2024, approx. 1 hour 17 minute read

Ladies and gentlemen, I've been asked by the translator to speak slowly and to make many pauses.

That means I have to talk like Joe Biden, not like Donald Trump.

So I will do my best.


Okay.

Today I'm going to introduce to you a new view of addiction.

I'm not a coach, I'm not a relationship advisor, I am not a therapist.

I teach clinical psychology.

So what I'll be able to do today is present to you an alternative way to look at addiction.

Once my party's over, you can ask me questions.

You can ask me questions about anything you want.

You can ask me questions about narcissism, about codependency, about victimhood, about politics, no, not politics, but everything else.

Okay.

Also, feel free to laugh when I make a joke.

It makes me feel good.

Thank you.

Okay.

Let's start with the way we see addiction.

How do we regard addiction?

There are five metaphors, five narratives.

The first one is that addiction is some form of slavery.

The addict is a slave to the substance, to the habit.

There's a form of slavery here.

The addict is not free in his choices.

If he is addicted to substances, the substance dictates the addict's life.

If he is addicted to some activity, this is known as process addiction, then the activity dictates the addict's life.

But at any rate, he's some kind of slave.

And this is the puritan view of addiction.

It's as if the addict has some inner demons, is possessed, and it requires purification.

This is the religious view of addiction, essentially.

The addict is dependent on the addiction.

The second way to look at addiction is the addict is some kind of robot.

The substance takes over the brain and the substance compromises the brain.

And then the addict becomes robotic.

The behaviors of the addict, choices, decisions, they're all dictated by the substance.

There's a process of automation.

It is as if the addict's personality has vanished, has been taken over, has been replaced by the substance.

The third way to look at addiction is morality play.

Morality play means good versus evil.

So today, for example, in psychology, in clinical psychology, we have this perception of morality play.

We keep saying and we keep teaching in universities that addicts are dark personalities. They are narcissists. They are antisocial or even psychopaths. They are mentally ill. They have mood disorders. They have anxiety disorders.

So addicts are not good people. And society is trying to restore good over evil.

This is the morality play version of the perception of addiction.

The next way to look at addiction is victimhood.

The addict is a double victim. He is a victim of his background, of his circumstances, bad neighborhood, poverty, abandonment, neglect, abuse in childhood, we call it adverse childhood experiences.

All these victimize the addict, precondition the addict, predispose the addict to become an addict.

So he's a victim.

And then the addict becomes a victim of the substance or the habit.

And so it's double or dual victimhood.

And the last way to look at addiction, these are all ways in which we look at addiction, all narratives, the stories we tell ourselves about addiction.

And the last way is to regard addiction as a medical condition, a brain disorder, or even a brain disease.

Addiction is medicalized. It becomes the equivalent of tuberculosis or cancer.

And therefore, there is a presumption that because addiction is a medical condition, it can also be cured the same way we cure other medical conditions.

These are the five ways we look at addiction.

All five ways are probably wrong.

And to understand why, and this is exactly the topic of the lecture, to understand why we need to go deep into the human body and have a look at the brain.

Most people have brains, not everyone, but most people.

So we have a look at the brain.

The brain is an addiction machine.

About 30 to 40 percent of the structures of the brain are concerned, preoccupied with addiction.

That means almost half the brain is dedicated to creating addictions, sustaining or maintaining addictions, increasing addictions.

The main output of the brain is addictions, actually.

A single structure in the brain, the dopaminergic pathway, comprises 20 percent of the brain's surface and depth.

There's a single structure, and it is dedicated 100 percent to addiction.

It does this particular structure, does nothing else but addiction.

So the brain is an addiction machine.

It would therefore be accurate to say that addiction is a natural state, not an abnormal state, not a disease, not a sickness, not a pathology.

The normal state of the brain is addiction.

And so if it is the normal state of the brain, and if about 30, 40 percent of the brain is dedicated to addiction, it means that addiction is a positive adaptation as far as evolution.

Evolution wanted us to become addicts.

So evolution gave us a brain that encourages addiction.

Why do we become addicted to substances?

How?

How does this happen that we become addicted to substances?

Because our brain has receptors, has special sites dedicated to interacting with the substances that create addiction.

Our bodies generate drugs all the time, cannabinoids, endorphins. They're all generated inside the body, in the gut and in the brain.

And they are drugs, absolutely drugs.

We are on drugs all the time.

Even healthy people who never touch a drug, they're on drugs all the time.

So addiction is a positive evolutionary adaptation and has taken over a big part of the brain.

Just to give you a comparison.

30 to 40 percent of the brain deals with addiction.

Three percent of the brain deals with language, procause area.

It means that the brain dedicates ten times more resources to addiction than to language.

Now if this is true, an addiction is normal, not a disease, not a problem.

On the very contrary, something encouraged by evolution, something good for us.

If this is the case, we should find many addictive behaviors, many addictions in everyday life.

And this is exactly the case.

What are habits?

We all have habits, yes?

We are habituated.

We develop habits.

Habits are addictions.

What about love?

Love is an addiction, biochemical addiction, definitely.

What about, for example, obsessions, compulsions, their addiction?

What about experiencing pleasure?

It's addictive.

Addiction is an underlying organizing principle in psychology and in biology.

Now I'm not telling you that it's good to be addicted, I don't know, to heroin or to fentanyl.

That's not what I'm saying.

Like everything else in human psychology, even the most healthy thing can become pathological and malignant.

There is a healthy, benign form of love and there is a pathological, malignant form of love.

There is a healthy, benign form of self-love and there is a pathological, malignant form of self-love known as narcissism.

This is narcissism.

There is a healthy, benign form of addiction and there is a malignant form of addiction.

Everything healthy has the equivalent, the pathological equivalent, everything in human psychology.

So what are the psychological functions of addiction?

Why did evolution give us, why did it give us this gift?

Why our brains are designed to create addiction on the right?

The first thing is that addiction reduces anxiety.

Addiction is anxiolytic.

When we feel anxious, when we have an inner conflict, it is known as dissonance, addiction changes all that.

It is a kind of medicine, it is a form of self-medication.

The next thing is that addiction prevents many psychological, psychological processes such as dysregulation and so on.

But of course, when you carry addiction to extremes, when you are too addicted, when addiction is malignant, then of course it is self-destructive, it is self-defeating.

Addiction that is malignant, addiction that is sick, addiction that is pathological, is not the same as healthy addiction.

And this is what I am trying to teach you or to convey to you today.

There is such a thing as healthy addiction and there is such a thing as pathological addiction.

It is not true that all addictions are pathological, completely untrue.

Some addictions are bad, some addictions are pathological, some addictions are malignant.

By no means all addictions.

Addictions are necessary.

They are good for us.

Addictions in general are good for us.

They help us to regulate our internal space.

They help us to love.

They help us to form habits, to get used to routine, to daily life.

We could never do any of this without addictions.

The baby gets addicted to his mother.

The mother gets addicted to her baby.

The relationship between mother and baby is addiction, the form of addiction.

But of course, some addictions are bad.

And the addictions that are bad involve grandiosity.

Grandiosity is a fantastic, inflated self-perception, self-image that you are god-like.

And in fact, you are just a human being.

But you feel like you are god.

That's grandiosity.

Defiance, rage, negative effects, negative emotions, for example, hatred, envy, anger, rage.

These are all associated intimately with bad addictions, sick addictions, pathological addictions, delusions, delusionality, anxiety.

Bad addictions increase anxiety.

Good addictions reduce anxiety.

That is a major test, by the way.

Ask yourself, does my addiction increase my anxiety?

If it does, it's a bad addiction, pathological addiction.

If it reduces your anxiety, it's a good addiction.


As a baby, if you love your mother, your anxiety goes down.

Your anxiety is reduced.

That's why the baby's addiction to his mother is a good addiction.

And of course, the major thing in pathological addictions is that addiction, these kind of addictions destroy your ability to perceive reality properly.

We call it impaired reality testing.

You are no longer able to perceive the world as it is, but you perceive the world through the substance, through the addictive activity.

You perceive the world filtered through your addiction.

And that is one of the signs of a bad addiction.

It drives you away from reality.

It constricts your life.

It narrows your life.

While a good addiction drives you towards reality, to be in touch with reality and expands your life, makes you grow and develop.

Now there have been studies that linked malignant or bad addictions or pathological addictions to psychopathy and to behaviors which are reckless or novelty seeking or risk taking.

These behaviors are common in psychopathy.

So we have studies by Berman and Noble, Lewis and Buckholz and others.

And these studies, especially in the '90s, demonstrated a clear and very strong link between developing pathological addictions and having some kind of psychopathy.

And I'm saying psychopathy, not narcissism.

There's a difference between psychopathy and narcissism.

Both psychopaths and narcissists, they have something in common.

It is known as grandiosity.

The narcissist is grandiose.

The psychopath is grandiose.

Both of them perceive themselves as perfect, as all powerful, omnipotent, as all knowing, omniscient, as brilliant geniuses.

Both the narcissist and the psychopath are grandiose.

But narcissists are not psychopaths.

And addiction actually has not been linked to narcissism, at least not in academic studies.

Addiction has been linked mostly to psychopathy and later on to what we call dark personalities, dark triad or dark tetrad personality.

These are personalities which are a bit narcissistic, a bit psychopathic and a lot Machiavellian, manipulative.

So the two elements in pathological addictions are psychopathy and manipulativeness, manipulating other people.

These are the two major elements.

Addiction has many, many dimensions as you know better than I do.

Many dimensions.

Not only biological.

Not only medical.

Not only chemical.

Addictions have psychological dimensions.

Addictions have social dimensions.

Addictions have cultural dimensions.

Addiction is a way to organize your life.

This is known as organizing principle.

It's a way to put your life together.

The addiction creates for you a schedule, a timetable, a goal, gives you a goal, gives you direction, gives you purpose, gives you life meaning, makes sense of the world.

And you organize your life around the addiction.

It becomes like an axis or a pivot and everything revolves around the addiction.

You're beginning to see the resemblance between addiction and falling in love.

When you fall in love, exactly this happens.

All your life revolves around the new love.

Everything the new love gives your life purpose and meaning and direction.

The new love is the center of your attention, your focus.

Everything is the new love, around the new love.

Addiction is the same.

Addiction is falling in love with a substance.

It's falling in love with an activity like gambling or shopping or working, workaholism.

Workaholism is a form of addiction.

But it's about falling in love.

When you become an addict, you fall in love.

This process is known in psychology as cathaxis.

You become emotionally invested in your addiction.

You develop a relationship with your addiction.

And I will come to it a bit later because the relationship between you and your substance, between you and your activity, between you and your addiction is exactly the relationship between, for example, a narcissist and his intimate partner or a friend, a psychopath and his friend, the same.

So it's the same like interpersonal relationship.

But we'll come to it a bit later.

So the addiction gives your life structure, introduces order into your life.

There are specific activities that you must repeat.

And these activities dictate your timetables and how you organize your day.

Addiction gives you purpose, gives you boundaries.

And in other words, it's the equivalent of a religion, a private religion, because it involves rituals and ceremonies, exactly like religion.

And the rituals in addiction are in time and in space and social.

So the typical addict has a timetable, what he's going to do through the day, he or she is going to do through the day, has a group of people with whom he does it, typically a close-knit group of people, social unit, within which he enacts the addiction, ritually, a form of ceremony or ritual, and he has a space where he does all these things.

Therefore, we can pretty safely say that there are strong similarities between addiction, religion, love and their interpersonal aspect in narcissism, but not narcissism, generally speaking.

Again, I will come to it a bit later.

What about the social dimension?

I mentioned that addiction is a social dimension.

Addiction is not an individual activity.

It's a common mistake to say this.

Of course, when you consume a substance, very frequently you're alone.

When you drink, you're alone. You do drugs, you're alone sometimes.

Although statistically speaking, most addicts consume substances in groups, not alone, statistically.

But you could do it alone.

But even when you do it alone, it's not an individual activity.

It's a social activity.

Inhibition requires you to overcome, destroy, fight against, resist inhibition.

Inhibition is a voice in your head that tells you, "Don't do this. It's not okay to do this. It's wrong of you to do this."

This is called inhibition.

And the addict overcomes the inhibition.

The addict becomes disinhibited.

But what is this voice?

Where does it come from?

It comes from mother. It comes from father. It comes from a teacher, an influential peer. It comes, in other words, this voice in your head comes from other people.

It's not your voice.

It's a voice that you received, that you acquired from the outside, from other people.

So this voice is a social voice.

The process of acquiring this voice in your head is known as socialization.

Inhibitions are socialized.

If you have a voice in your head that says, "To consume heroin is wrong. It's bad." Or even, maybe, "It's a crime." This voice doesn't belong to you. It's not your voice. It's the voice of society.

So even when you're completely alone in a room, you in the bottle, the bottle in you, there is always a third party with you, society.

An addiction is a rebellion, an act of defiance against society.

And that's precisely why society gets involved. Society gets involved because addicts sometimes hurt and harm other people.

But society also gets involved when the addict does not harm other people.

Why is that?

Because it's a social act.

Addiction is a social act. Consumption is a social act. It's an in-your-face act. It's a poking the eye of society.

The society must respond in order to restore authority and order. We call this kind of behavior "contumaciousness," rejection of authority.

Now, society, of course, encourages some types of addiction. For example, in the United States, they encourage workaholism, addiction to work. They literally encourage you. They give you money, more money, and so on. They encourage you to work 80 hours a week, 100 hours a week, to neglect your family, to not have a family.

Social media is addictive. It is based on conditioning. So these are examples of addictions that society encourages. They want you to become an addict to, for example, work or to having a family or to being in love or, on the contrary, to being single, to not have a relationship because you need to consume, to be in social media and so on.

All these are addictions that society pushes on you, and they are known as sublimated addictions, addictions which are socially acceptable.

But there's a series of addictions that society rejects. So addicts are punished. Addicts are doomed. Whenever they engage in addictions, the society frowns upon, the society discourages.

And addicts are rewarded. They're promoted. They are awarded. When they engage in addictions, the society wants them to engage in. It's unfair. It's unfair because society tells you what you should be addicted to, what you can be addicted to, and what you cannot be addicted to. It's a social dictate.

Consumerism is an addiction. Workaholism is an addiction. Falling in love is an addiction. Singlehood is becoming an addiction because singlehood is self-sufficiency, and it's very empowering. Many, many behaviors and traits and characteristics of modern society are highly addictive.

One could say that postmodern society is founded on addictions. Addiction to entertainment, addiction to money, addiction to work, addiction to sex, addiction to substances. It's founded on addictions. Addictions are encouraged. But when you engage in an addiction, the society did not dictate to you. The society did not encourage.

In that point, society labels you antisocial, criminal. Society decides that if you are the one who chooses your addiction, if you don't let society dictate to you what would be your addiction, but you choose your addiction, then you're criminal. Then you're antisocial. You want to be an addict? We want you to be an addict, but our way, our addictions, you want to be an addict and you want to have your addiction? You're sick. You're crazy. You're criminal. You should be punished somehow. You should be treated somehow. Something's wrong with you.

So addiction is a form of social control. Society uses addictions to control you, to control you positively. This is called positive reinforcement. Society uses addiction in order to get you addicted to society. Society gives you addictions so that you become dependent on society, so that you dissociate, you forget how bad society can be, how wrong society often is.

So addiction is used to make you forget.

This is known as dissociation.

And society uses addiction to control you, to own you, to manipulate you, to tell you what to do, to dictate to you, to shape you, and then to shape shift you, to change you.

As long as you are addicted according to the book, if you become too individualistic, too independent, too personally autonomous, too agentic, society will punish you and will call you a psychopath or a criminal.

Now the reason we often say wrongly that most addicts are narcissists is because narcissism is an addiction.

The narcissist is addicted to attention.

It's a highly structured attention.

It's known as narcissistic supply.

The narcissist is addicted to this supply, is addicted to this attention.

So all narcissists are addicts, but not all addicts are narcissists.

Narcissists and psychopaths and borderlines also tend to abuse substances much more than the general population.

So it's difficult to tell them apart.

If you come across a narcissist, there's a 40, 50% chance that he's abusing some substance, anywhere from alcohol to crack, you name it, or opioid, opioids or whatever.

If you come across a psychopath, it's much higher than 60 or 70%.

So these people abuse substances all the time.

And this creates a huge confusion.

But the fact is that the majority of addicts are not narcissists.

Many of them are almost psychopathic.

This is known as subclinical psychopathy.

Now one social dimension of addiction is when you're an addict, you automatically belong.

People want to belong.

People are very lonely.

Narcissists is the pandemic of our time.

It's a much bigger threat than any addiction or combination of addictions.

It's a normal threat to the existence of a species because people don't have sex anymore.

They don't meet anymore.

They don't date anymore.

These are the facts, by the way.

Loneliness, atomization is the curse of the postmodern era.

Now when you develop any kind of activity, collecting stamps, building model airplanes, any activity that you develop, you automatically belong to a group.

If you collect stamps, you belong to a group of all the people who collect stamps.

If you build model airplanes, you belong to the group of people who build model airplanes.

And if you do heroin, you belong to the group of all the people who do heroin.

Addiction is a pathway to social belonging.

The minute you become an addict, and it's not only substances, it's shopaholism, workaholism, gambling, if you're a gambler, for example.

Basically, when you're a gambler, a pathological gambler.

Not a professional gambler, but a pathological gambler.

Automatically, you begin to have gambling friends, you go to casinos, these are gambling spaces, you get a life.

The addiction becomes your life.

Before you develop the addiction, you have no life.

The minute you develop the addiction, you belong to a subculture.

You belong to a group, there are people around you who are like you, they're like-minded.

They do the same things as you do.

And you belong.

You can talk to them, you can share experiences.

You know, it's a very good sense, good feeling, in effect.

Even if the members of the group are hostile, psychopathic, dangerous, criminalized, you still belong.

And the belonging is much more important to human beings than any risk and any danger.

Human beings will go to great lengths and will assume huge risks and put themselves adventurously in big danger just to belong.

Just to belong.

An addiction provides belonging.

That's a very important point.

There's a subculture of addicts for each type of addiction, of course.

There's a specific subculture.

And this subculture is global.

So if you are a user in the United States, you immediately find common language with a user in Mexico, and the user in Mexico has identical language as the user in Israel.

You don't need Google Translate.

All you need is the needle or the bottle or the gat in the casino.

That's all you need.

That's the language of addicts.

And you belong.

That's very crucial.

And finally, addiction is an alibi.

Addiction allows you to blame the outside, to blame the world.

So if you ended up having promiscuous sex with a stranger, you can say, "It wasn't my fault.

I shouldn't feel ashamed.

I shouldn't feel guilty.

The drink made me do it.

The alcohol made me do it." If you steal your mother's money from her purse, the drug made you do it.

Alloplastic defenses.

It's never my fault.

It's the substance fault.

It's the alcohol fault.

It's the drugs fault.

My gambling fault.

It's always someone else's fault.

The bad people around me influence me.

I am never guilty.

I am blameless.

This is known as alloplastic defense.

So addiction provides you with an alibi, a justification.

It exonerates you, absorbs you, redeems you.

It's like a religious experience.

I am angelic.

I am pure.

I'm unadulterated.

Everything that has happened to me, all my misbehavior, misconduct, bad choices, horrible decisions, harm, the way I hurt people, the way I damage things, objects, society, other people, everything I did, all this evil and wickedness.

All of it is my fault.

I was under the influence.

That's why you have a law, driving under the influence.

I never understood this law.

What do you mean under the influence?

You chose to be under the influence.

It's a choice.

What do you mean under the influence?

It sounds as if something came from outer space.

It's a choice.

Addiction is a choice.

Everyone who tells you it's a brain disease and a brain disorder and you can't help it is bullshitting you.

It's a choice.

You are choosing to be addicts.

Because it's your choice, it's 100% reversible.

And yes, before you ask, I know what I'm talking about.

I was consulting to rehab in two countries for well over a decade.

So I know it's a choice.

And you know it's a choice.

Now addiction has highly specific dynamics.

It's important to understand that, and you know it of course, again, better than I do, that the addict seeks to alter, to change the perception of reality.

The addict rejects reality, rejects life.

The rejection of life was first described by a scholar named Harvey Kleckle in the 1940s.

The addict rejects reality.

He doesn't feel comfortable with life and with reality.

Something doesn't fit.

Something doesn't work.

There's friction.

It's like being with a very bad partner in a marriage or in a, you know, being married to the wrong person.

Imagine.

The marriage between the addict and reality is a marriage between the addict and a very bad incompatible partner.

And the addict rejects reality and rejects life.

And the best way to do this is of course by creating a fantasy.

When you're in a fantasy, you're not in reality.

When you're in a fantasy, you're God.

You're the God of the fantasy.

And within the fantasy, you can create a new life, an alternative to reality, a life of your choosing, of your design, a life that fits you like a glove.

This is the power of fantasy.

That's why the fantasy defense sometimes takes over the individual.

For example, in narcissism.

The narcissist has an overdeveloped fantasy defense.

These people reject reality.

But in order to reject reality efficaciously, it's not easy to reject reality.

Reality fights back.

Reality pushes back.

You're rejecting reality.

Reality pushes back.

Reality intrudes.

Reality invades.

There are all kinds of information and data and events and people that challenge you undermine your fantasy, mock you, criticize you, disagree with you.

It's not easy to maintain a cohesive fantasy in the face of reality because reality is always bigger and stronger and all pervasive.

So how do you do that?

In order to change reality into a fantasy, in order to transition into a fantasy, and by the way, the clinical term is parakosa, in order to transition into a parakosa, which is virtual reality, kind of virtual reality, you need to reject not only reality, but you need to reject yourself.

So you need to change the way you see reality, not only reality, but the way you see reality.

And how would you change the way you see reality?

By becoming not you.

The only way for you to see reality in a wrong light, to see reality inaccurately, to change reality into a fantasy, the only way is to not be you anymore, to be someone you.

So addiction is misperceived as a transformative experience, like a mystical experience.

When you talk to first time users and so on, they describe this as a mystical experience, a transformation, they say my ego died, I was able to introspect, I became much more empathic.

This is typical with psychedelics, but not only.

I was thinking much more clearly.

I saw so many amazing lights and colors.

They describe the interaction with the substance as transformative.

So people who drink would tell you that when they drink, they are much less socially shy.

They're much less socially anxious.

They're improved.

The alcohol improves them, makes them more outgoing, more sociable, more daring, more, not less, more.

In order to live in fantasy, in order to develop a fantasy and then inhabit the fantasy, you need to reject not reality.

You need to reject yourself because you are the one who is perceiving reality.

Change yourself and your perception of reality changes.

So addiction is a rejection of oneself.

Why would you reject yourself?

Because you don't feel good in reality.

But why don't you feel good in reality?

Because there is something inside you that tells you that you are not good for reality.

This something is known as the bed object.

The bed object inside a human being, inside a person, is a group of voices.

We call them clinically introjects.

A group of voices that keep telling you you're no good, you're ugly, you're stupid, you're not attractive, you're failure, you will never amount to anything.

You're unworthy, you're bad, you're evil, and so on.

These voices put you down.

These voices degrade you, criticize you.

It's called harsh inner critic.

These voices are sadistic.

These voices are your enemies.

They want you dead.

They want you dead.

Where do these voices come from?

They come from bed parents mostly.

Not only.

They can come from teachers, they can come from peers, influential peers.

They can come from role models, even in the mass media, even in social media.

But in the vast majority of cases, these voices come from your mother and father, mainly mother.

Mainly mother, also to some extent much later in life, father.

So here you are, and you have a bed object inside you, and it feels like an emptiness.

It feels like a black hole.

This black hole is about to consume you because it tells you that you're inadequate, that you're incompetent, that you are no good in reality and will never amount to much.

How do you silence these voices?

You need to silence these voices because they are ego-distonic.

They make you feel bad.

They make you feel uncomfortable with yourself.

How to silence them?

The way to silence them is to not be you.

If you are not you any longer, then whatever these voices say does not apply to you because they are not you.

How to not be you anymore?

Fantasy.

The fantasy defense is a defense against the bed object, against these voices inside you that want you to fail, want you to die, these enemies from within, this fifth column, the Trojan horse.

The only way out is fantasy.

But some people, the only way for them to get to fantasy land is through substances or through habits.

If you are a workaholic, your job and your workplace become your fantasy space.

If you are a gambler, the casino is your fantasy space.

And if you drink, the alcohol and what the alcohol does to you is your fantasy space.

Don't forget, for example, that alcohol has two impacts.

One is known as alcohol myopia.

Alcohol makes you grandiose.

Alcohol makes you feel that you are invincible, that you are immune to the consequences of your actions, that you can dare, you can do anything you want.

This is the first impact.

And the second impact of alcohol, it reduces your ability to form long term memories.

Alcohol is impact on the hippocampus.

So you cannot form long term memories.

In other words, alcohol is dissociative, helps you forget.

These are the elements of fantasy, by the way.

Fantasy helps you forget reality.

And within fantasy, you're godlike.

So alcohol is a fantasy in a bottle.

Simply.

When you drink, you imbibe or you drink fantasy.

The addictive self state that is generated in the fantasy is disinhibited.

There's no inhibitions.

Not a booze.

It is selectively, selectively, disempathic.

In other words, there's a reduction in empathy.

It's a very interesting phenomenon here.

Empathy goes down for people you love and goes up for strangers, by the way.

This is an interesting fact.

The addictive self state is grandiose.

It is impulsive.

There's no delayed gratification.

You want everything instantly and now.

There is splitting.

You tend to see people as all bad or all good.

You tend to see situations as all black or all white.

You tend to see realities all wrong or right.

This is called dichotomous thinking.

You tend to split the world.

There's poor judgment.

It impairs judgment and other executive functions.

There's recklessness.

No fear of consequences.

No fear of risktaking on dangerous activities and dangerous decisions and choices as if they are not dangerous.

But there are other aspects of addiction which are much neglected in the literature.

For example, addiction is regressive.

It pushes you back to a baby state, to infancy.

The more you engage in addictive activity, consuming substances, behaving in certain ways like gambling, the more you engage with your addiction, which you remember, your addiction is a fantasy.

The more you engage with your fantastic addiction, and all addictions are fantastic, the more childish you become, the more you regress, the more infantile you become.

Why?

Because our first and most powerful fantasy, a fantasy which remains with us for life, is the fantasy that we have as a baby with mother.

That's the mother of all fantasies.

That's the proto-fantasy.

Whenever we engage in a fantastic state, whenever we transition to fantasy, we go back to mommy.

We go back to the womb.

We become children again.

That's why when people play games and so on and so forth, they become very childlike.

Did you ever see people play games?

Even chess.

Two people playing chess. One is 80 years old, one is 90 years old. They both become children as they play chess.

This is a fantastic space.

And all fantasies are maternal, and in all fantasies, you're a child.

A child again.

So addiction regresses you.

Finally addiction makes you aggressive.

The aggression is externalized.

In other words, you are aggressive towards other people, towards situations.

But sometimes you could be aggressive towards yourself.

Addiction generally involves aggression.

Addiction is a way to dysregulate aggression.

I mentioned much earlier when we were all younger, I mentioned that the relationship between the addict and his or her addiction is a love affair.

It's exactly like falling in love.

Now medically speaking and psychologically speaking, falling in love is an addiction, biochemical addiction.

It's chemical addiction like any other.

It's a substance, addiction to substances.

And the substances are produced in your brain, but you become addicted to them.

And that is the feeling of falling in love, or limerence, or infatuation.

Any addiction is falling in love with the subject or object of the addiction.

If you're an alcoholic, you're in love with alcohol.

If you're an opiate, you're in love with opioids.

If you do heroin, snort, or whatever, if you do coke, you're in love with heroin, with coke.

You're in love with the substance or with the activity that constitutes the addiction.

And now this love is within a fantasy space because we also said that addiction is a fantasy.

So there is a fantasy.

And this fantasy, there is the addict and the object of the addiction, like alcohol or whatever.

And the two of them fall in love with each other within the fantasy.


Now starting in 1989, a psychologist by the name of Sander studied love relationships within fantasies, not in reality, not when you fall in love with someone in reality.

What happens to you when you fall in love with someone within a fantasy?

And this is known as shared fantasy.

What happens then?

And he made a few discoveries about, and I developed his work much more.

And today we discuss love relationships within fantasies, for example, in the case of narcissism.

But the addict has a love relationship with the object of addiction within a fantasy.

So for example, the addict idealizes the object of addiction.

The addict would idealize his drug.

He would say, the drug makes me much more creative.

When I'm consuming the drug, I'm much more creative.

Or when I'm consuming the drug, I'm a much nicer person.

I'm more empathic.

Or when I'm consuming the drug, I can do anything.

I have a lot more energy, and I'm decisive, and I'm ambitious.

So the addict idealizes the substance the same way a narcissist idealizes his intimate partner.

The substance is the addict's intimate partner, in effect.

So there's idealization.

And gradually, a relationship develops between the addict and the substance, or the addict and the activity.

And when you listen to addicts, they discuss substances and activities as if they were people.

A typical addict would discuss the alcohol or the fentanyl or whatever it is, would discuss it as if he was talking about another person.

Because the relationship is really interpersonal.

The substance or the activity become anthropomorphized.

They become human-like.

You know, when we discuss animals in fables, or we give the animals human qualities, we say that the foxes lie, and the scorpion is wicked.

We give the animals all kinds of human qualities.

This is called anthropomorphism.

We do the same.

Adicts do the same with their drug of choice, with their substance, with their activity.

It becomes human-like.

And their relationship is like the relationship they would have with another person.

Now, addiction is traumatic.

The process of addiction involves multiple traumas.

Many of these traumas are small.

Some of these traumas are very big.

But there's always trauma.

Within a fantasy space, the addict keeps generating self-directed, self-administered traumas.

You could say, therefore, that addiction is self-punitive, self-trashing, self-destructive, self-defeating.

There's hatred, self-hatred, self-loathing.

The desire to destroy oneself, to annihilate oneself, to punish oneself is at the core of addiction.

Because remember, the addict has a bad object.

The addict has these voices that keep telling him, "You're no good. You're unworthy. You're not lovable. You're a zero.

You're a failure." So, these voices.

And the addict wants to validate them.

He hates himself.

He comes to loathe himself.

He uses addiction to punish himself.

And this involves a lot of trauma.

So, gradually, the addict becomes used to the trauma.

The addict becomes addicted to the trauma.

Actually, what happens in addiction, there are two phases.

The first phase is getting addicted to the substance, getting addicted to the habit, to sub-activity.

That's the first phase.

But then there's the second phase, addiction to the consequences, addiction to the trauma.

I start to drink.

I develop a relationship with the alcohol. A love relationship with the alcohol, within a fantasy. I idealize the alcohol. But then I'm beginning to have accidents. I end up in prison for drunk driving.

So I'm beginning to suffer trauma. And I'm getting addicted to these traumas, no longer to the alcohol, but to what the alcohol does to me.

This is secondary addiction.

Because I hate myself, I want to punish myself, I want to destroy myself, the alcohol becomes my best friend. The alcohol allows me to do all this, to accomplish all this.

So he becomes my best friend. I can no longer live without the alcohol, but not because I'm addicted to the alcohol. I'm addicted to the consequences of alcoholism.

Trauma becomes my comfort zone. I feel good with trauma. I feel comfortable with trauma. I develop what is called egosyntony. I want, I seek the trauma. Because when I punish myself, when I destroy myself, when I defeat myself, it is then that the voices inside me are satisfied. They're happy now. They told me that I deserve to die. And here I am committing slow suicide, suicide in slow motion. And this silences them. I no longer have an active bed object because I am now validating the bed object. I am now obeying the bed object. I am now complying with the bed object. I am now the ally of the bed object against myself.

The attempt to change myself within a fantasy is a desperate attempt to escape this dynamic. And so this creates a mega conflict in the psyche, in the psychology of the addict.

There's a mega conflict.

Half of the addict, half of the addict wants to kill the addict, wants to destroy the addict by using the addiction. Half of the addict is comfortable with the trauma, seeks the trauma, because it's the only way to self punish and self destroy and self trash and self defeat.

The other half of the addict wants to change, to become not you, to create a fantasy and to escape into the fantasy.

Because there's fear, fear of death, fear of self destruction. It's terrifying to know that something inside you pushes you to die, pushes you to self destroy.

So you need to defend against this.

And the defense is, I am no longer going to be me. I'm going to be someone else in a fantasy.

And this creates what is called dissonance.

The two parts of fighting, of fighting.

Now this would explain for example, post rehab recidivism.

In rehab, in rehab, we have about 90 plus percent success. People come to rehab, they stay in rehab one month, two months, three months typically. And within this one month, two months, three months, they don't consume drugs, they don't drink, they have no addictions, they're cured, no? They're wonderful. They leave the rehab and within one year, between 80 and 90 percent of them go back to the addiction.

How can we explain this? How do you explain this?

In the rehab, it's a fantasy space. Within the rehab, the addict feels that he is changing. He is no longer himself. He is in a fantasy so he can give up on the addiction.

The minute he leaves the rehab, the bad object voices wake up again.

The conflict re-eracts, re-emerges and addiction resumes.

Addiction therefore is a form of self-harm, self-abuse.

It's exactly like in borderline personality disorder, people cut, people self-mutilate, they cut themselves, they burn themselves, or they have promiscuous sex with a dozen strangers in a single night.

These are all forms of self-harm and addiction is of course a form of self-harm.

And the addict becomes bonded with the trauma, this trauma bonding.

The addict has an abusive relationship with the addiction.

The alcoholic has an abusive relationship with the alcohol.

The alcohol abuses the alcoholic.

The drug addict

has an abusive relationship with the drug.

The drug abuses the drug addict.

There's an abuser there.

And the abuser is the substance or the activity that constitute the addiction, give rise to the addiction.

These are the abusers.

And the addict is the abused party, the victim of abuse, the survivor of abuse.

The dynamic is identical, absolutely identical to an abusive interpersonal relationship.

So there's a lot of trauma bonding, what is called the Stockholm Syndrome.

The addict becomes dependent on the addiction for self-regulation.

The addict uses the addiction to somehow regulate himself or herself.

There's an illusion of self-control.

Nine out of ten addicts will tell you I can stop any minute I want.

I'm totally in control.

The substance doesn't control me, I control the substance.

And they have this elaborate accounting or mathematics.

Yesterday I drank half a glass, today it was less than half a glass.

They have all these numbers and because they want to feel that they are in control, it is a form of self-deception.

They want to feel that they maintain discipline.

They want to feel that the addiction is at the service of the addict.

But that's not true.

The addiction rules the addict because the addiction is the abuser.

The addict is the victim and the victim is bonded with the abuser through trauma bonding.

It's exactly like in a typical relationship.

So what do I suggest?

To cut a long story short, I gave you a headache with all these analyses.

What?

I'm addicted to coffee.

So what do I suggest?

If it were up to me, how would I have treated addictions of all kinds?

By the way, all addictions are identical psychodynamically.

There is no point to try to say alcoholism is one thing, drug addiction is another, work alcoholism is another, gambling is another.

It's not true.

All addictions have identical structure, identical reasons, identical etiology, identical outcome, they're all the same.

So if we were successful in developing a treatment modality for addiction, it would apply to all addiction.

Process addictions, these are addictions that are comprised of an activity or a habit.

These are known as process addictions or chemical addictions, substances.

So I've noted that recidivism is high.

In other words, our current methods of treating addiction suck.

They don't work.

None of them.

There is no treatment for addiction nowadays.

Anyone who tells you otherwise is lying to you in a self-interested way because people make tens of billions of dollars of treatments of addiction.

None of these treatments work.

The only treatment I know for addiction is when the addict decides to stop.

That works.

12 steps provide a supportive environment for the addict to decide to stop.

So 12 steps is a way to push the addict to reach this conclusion.

But strictly speaking, 12 steps is not a treatment modality.

It's an environment.

It's an environment which triggers.

Environment with incentives.

Environment with philosophy, with an ideology.

But it's not a treatment.

All the chemical treatments are temporary and they don't treat the core issue of addiction.

All the psychological treatments, and we have quite a few, none of them work.

They work wonderfully in rehab.

The minute the addict exits the closed simulation of reality that is rehab, the addict relapses.

Relapse is universal.

Period.

So it's not working.

There's another problem which you are more aware of than I am, and that is substitutive addiction.

If you treat an alcoholic and he stops to drink, he will develop a love addiction.

He will become addicted to love.

And if he stops drinking and does not develop a love addiction, he will begin to do drugs, or begin to spend a lot of money shopping or begin to work 150 hours a week.

Addictions are substitutive.

When you get rid of one of them, the addictive behavior erupts like a volcano in some other way.

That's why until recently we used to believe that there is something called addictive personality.

We no longer believe in this.

This is no longer acceptable.

But we used to, because we saw that an addict is an addict is an addict.

Whether he's addicted to weed, whether he's addicted to opioids, whether he's addicted to alcohol, it's all interchangeable.

He gets rid of one addiction, he develops another.

So there is this problem to consider as well.

Remember how I opened my lecture a long, long time ago?

I said that addiction is a healthy thing.

It's a good thing.

There are good addictions.

And it's a mistake to say that all addictions are bad, because we are built for addiction.

Our brains are constructed to encourage addiction.

So I think we should encourage healthy addictions.

We should encourage good addictions, disciplined, sublimated, socially acceptable addictions, goal-oriented or goal-focused addictions, rewarding addictions, self-nurturing addictions.

We should even design addictions, invent new addictions, and offer them to addicts, to people with bad addictions.

We should substitute, we should leverage, we should use the substitutive nature of addiction by substituting good addictions for bad addictions.

What's happening today is that the typical addict exchanges one bad addiction for another bad addiction.

Many of them are not even aware that they are good addictions.

Now the addict, I am completely against forcing the addict to give up on the addiction.

I think it's the core mistake in all the treatments of addiction.

When you go to an alcoholic and say you are now entering rehab and now you cannot drink anything whatsoever, I think it's a serious mistake.

It's a serious mistake because it provokes psychopathic defenses, because when you tell this the addiction becomes even more attractive, more alluring, the forbidden is always much more attractive, because it will never work.

It will never work.

There are changes in the brain when you consume substances and so on.

And because there's essentially nothing wrong in drinking alcohol if it is done in socially acceptable ways, environments, and subject to discipline and rules.

When we demonize drinking alcohol, when we treat alcoholics, it's as if we say you are bad people.

We amplify their bad object.

When the alcoholic comes to a rehab, what we are telling the alcoholic is you are a bad person.

You did a bad thing and now you should stop.

What are we doing?

We are collaborating with a bad object against the addict and this pushes the addict to addiction, which is the only solution he knows how to escape from reality and from the bad object.

We're doing everything wrong.

We're doing everything completely opposite what we should do, in my view.

So I would allow addicts to continue to consume substances.

Now of course I know the famous maxim, which is nothing more than a theory, by the way, that if you give an alcoholic one drink, he will end up drinking the whole bottle.

In other words, that alcoholics have poor impulse control and that if they start to drink, they cannot stop.

There's cravings.

There are cravings and they cannot stop.

Same with drug addicts.

Same with anything else, pathologically gambling, shopaholism, workaholism.

If you introduce the addiction, the addict is not capable on his own or her own to stop the behaviour.

She cannot stop the behaviour.

That is unfortunately not supported by any study that I'm aware of.

None that I know of.

It is a law.

It is a kind of a myth or kind of a story, or I don't know how to call it.

It's kind of an urban legend.

It is true.

The phenomenon of cravings and so on is very true.

Impulse control is a serious problem.

It's all very true.

But it is not true that loss of control is guaranteed in all cases.

It depends crucially on the environment, on the circumstances, on the incentives, on the messaging, on the social milieu, people around the addict, on the addict's collaboration, whether the addict is committed to an agenda, through a poetic alliance, and million other factors.

You cannot generalise and say if you give an alcoholic a single shot, he's going to drink the whole vodka bottle.

It's sometimes true, but not necessarily always.

So what I would do if I were in charge of a rehab, for example, I would allow the convict, I would allow the inmates to continue to consume the substances.

Of course, in a regulated manner, not out of control, but in a controlled manner, I would allow them and of course gradually I would move them to substitutes, the classical methods, but I would definitely not cut them off the addiction.

That's a serious mistake.

I would allow them to continue with the, now this is known as exposure therapy.

In exposure therapy, what we do, we expose the person to what the person fears most.

If you're afraid of spiders, in exposure therapy you will be exposed to spiders.

The addict is traumatised by the addiction.

The only way, in my view, is to expose the addict to the addiction, the same way you expose the arachnophobe to a spider, to in other words to crystallise the trauma, to make it clear to the addict that he's traumatised and this is the source of the trauma, this is what you should be afraid of.

Here it is, here it is, you want to drink, drink, you want to do drugs, do drugs, they're all on the table, but you should know this is the source of your trauma, this is the source of your self-destruction and so on and so forth.

So, we need to teach the addict not to give up on the addiction, that is impossible to accomplish, period.

We need to teach the addict to control the addiction, to manage it, to regulate it, to switch to other addictions, which are good addictions, to modify the addiction, to teach the addict to engage in selection, choices, decisions, to help the addict reassume control of his or her own life and to get rid of the bad object.

Now, all this is done with all this.

For example, in borderline personality disorder, you could describe borderline personality disorder as an addiction.

The borderline personality disorder person is addicted to self-harm, addicted to self-harm, addicted to some antisocial behaviour, addicted to emotional dysregulation.

Borderline personality disorder is an addiction, narcissism is an addiction to narcissistic supply and yet we have treatments, for example, in borderline, dialectical behaviour therapy.

We teach the borderline to not be addicted anymore to her impulsivity, to her recklessness, to her self-hatred, to her self-mutilation and cutting.

We teach her.

Dialectical behaviour therapy is the most successful therapy in history.

We teach the borderline to not be addicted anymore and we are very successful.

Why is that?

Because we don't tell the borderline you are bad.

We don't encourage the borderline's bad object.

We don't make her feel even worse and we don't take away from her her freedom.

We don't limit her.

We don't tell them in Dibiti we don't take away from the borderline sharp objects like a life.

We don't do that even though we know that the pressure of the Dibiti, the stress, would encourage her to cut, to self-harm, lead.

But we show her that we respect her and we trust her.

It's a collaboration.

It's a work together and we make her understand that her borderline personality disorder is the enemy.

It is a source of trauma.

It is an amplification of the bad object inside her.

It is not a friend.

It should not be idealized.

You shouldn't say that your addiction makes you better in some way, more creative or more I don't know what.

You know that mentally ill people are invested in their mental illness.

Do you know what is the most common resistance to treatment among mentally ill people?

They say if I get better, if I lose my mental illness, I will not be creative anymore.

That's the most common objection to treatment.

And yet we teach them.

It's done.

It's doable.

Everything is an addiction that we insist that only some things are addictions.

This is what is misleading us.

That's why we don't think the right way.

Everything is an addiction.

We are addicted to everything.

Addiction is the way we relate to the world.

Period.

Starting as babies.

So we need to teach the alcoholic how to drink, not how to not drink.

We need to teach the alcoholic how to drink.

Not how to not drink.

It's a crucial distinction.

It's a revolution in thinking.

Because today we are trying to teach the alcoholic how to not drink.

It will not work and it makes the alcoholic feel even worse about himself.

And of course he needs to drink even more.

We are setting up the addict for failure with this kind of approach.

Similarly we should teach the narcissist how to extract narcissistic supply.

Because the narcissist is addicted to narcissistic supply.

We should teach the narcissist how to extract narcissistic supply, how to get attention without harming other people.

We should not come to the narcissist and say you should not get supply.

You should not get attention.

You should be ignored.

You should be abandoned.

You should be rejected.

You should be at home.

We don't say this to the narcissist.

We should say to the narcissist you deserve attention.

You need attention.

Okay.

Let's teach you how to obtain attention without harming other people.

And without harming yourself in the process.

We should use the addiction's attraction.

The attraction of the addiction.

The allure of the addiction.

The momentum of the addiction against the addiction.

And this is what we do in Aikido, the martial arts where we have the Tenkan movement.

We use the momentum of the adversary.

Momentum of the enemy against the enemy.

So we should use the momentum of the addiction against the addiction.

The addict should not experience shame, should not experience guilt, should not experience dissonance and should not experience the bad object.

And today when we treat addicts, we use all these, we magnify them.

We make the addict ashamed of himself.

We make the addict feel guilty.

We make the addict reject himself and his addiction.

We make the addict, you know, addiction is the addict.

The fantasy defense of the addict is the addict.

When you reject the addiction, you are rejecting the addict.

There's not two ways about this.

Not two ways about this.

What kind of treatment is this?

Imagine that you go to a hospital with tuberculosis and the doctor tells you tuberculosis, it's a disgusting disease and you're a disgusting person because you have tuberculosis.

Can you imagine something like this?

Or HIV, AIDS, which is exactly how AIDS started. Doctors were shaming the homosexuals with HIV. It's not done. Should not be done.

The big ally of the therapist working with the addict, the big advantage is the addict's conflicted relationship with the addiction.

As I explained, the addict is divided in two.

Yes, he uses the addiction to self-destruct and then he wants to escape from the self-destruction into a fantasy created by the addiction.

So there's a conflict there.

That is the advantage of the therapist.

The therapist should help the addict develop regulatory management, responsibility and internal locus of control, the belief that the addict controls his life, not the addiction, not other people, not the world, not Donald Trump, not anyone.

The addict controls his life.

So internal locus of control and a balance of defenses.

Sometimes the addict should blame himself, sometimes he should blame others, auto-plastic, alloplastic defenses and so on.

This is healing.

Healing from addiction is not about giving up, changing dramatically.

That's not healing.

Healing from addiction is when I used to drink three bottles of vodka a day and now I drink only one or two shots a day.

That for me is good enough. That's healing and that should be our target.

In other words, the treatment of addiction nowadays is grandiose, is narcissistic.

Those who treat addicts are grandiose narcissists because they claim that the treatment goal is to destroy the addiction. They feel godlike. They will make the addict give up on the alcohol and the drugs. They are like magicians, wizards, nonsense. This is charlatanism bordering on con-artistry.

Our goal should be realistic and we should be humble and modest in the face of addiction because it fulfills many needs of the addict and we should accept and understand this.

Thank you very much.

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