Is Addiction In The Head? : 13.7: Cosmos And Culture Reflections on a new memoir of addiction by cognitive psychologist Marc Lewis. The new neuroscience of addiction rests on unquestioned but very questionable assumptions.

Is Addiction In The Head?

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A Pakistani drug addict holds a syringe after injecting heroin on a street in "Kala Pull" (Black Bridge) district of Karachi on July 25, 2011.
Behrouz Mehri/AFP/Getty Images

Our attitudes to addiction conceal a whole philosophy.

And this goes for our neuroscientific theories as well.

It is commonplace for scientists theorizing about the brain to take for granted that, well, we are our brains. We seem to experience other people, surrounding environs, events, actions, things of value and importance. Yes, but, from a scientific point of view, this is all an illusion. Our brains have evolved to produce this robust confabulation!

After all, what is the world to us, really? At best: patterns of sensory rubbing. And what are our thoughts, feelings, our aspirations, our actions, our loves and our pleasures? What are our friends? What are wars? These are nothing but neuro-chemical fluctuations in the selves we really are.

According to the new experts, everything is a phenomenon — one might say disease — of the brain. Why does a baby love his mother? It's the opioides in the mother's milk, of course! And what is that love anyway but a neurotransmitter-induced alteration of activity in our neural circuits!

And so it should come as no surprise that the experts also think that addiction is a disease of the brain. What else could it be?

In fact, from the standpoint of the new philosopher-neuroscientists, there is almost something ideologically pristine or kosher about the addict's world view. Most of us non-addicts, we slog and toil, trying to make careers, support families, earn money, afford leisure — we work hard to make worlds for ourselves that can in turn provide us with satisfaction and meaning. We make choices.

But what a waste of time! How much smarter — in principle at least — to turn away from the "external world" and look to the inner worlds of our neurochemistry. Why bother going places and meeting new people when you can directly modulate your brain's neurochemistry by taking drugs? The world itself is nothing but a source of activation of the brain's chemical keyboard. So the addict — in a way — has the right idea: to hell with the world, I'll turn my gaze inward and use drugs or other behaviors to play the keyboard of my brain myself!

In a weird way, the expert's conception of what it is to be a human being — that each of us is a system of neurons and associated molecules — is the addict's apologia.

But we can — and I think we must — turn this on its head. The addict's distorted conception of him or herself — the addict's willful turning away from family, from commitment, from value, from choice, from freedom; the addict's screening off of the world that is our true home — this brings out precisely what is so false and wrongheaded in the conception of self that the new neuroscience just takes for granted.

The neuroscientist's theoretical mistake — and the idea that you are really identical to something inside you and that you are cut off from the world around you is a mistake — is the addict's practical or existential mistake. The addict shuns the world, stays in the dark, seeking private, interior strategies for effecting changes in his or her feeling states. For the addict, everything becomes a means to an end, and nothing can be an end in itself. Other people, situations, work, family — these become mere opportunities for self-regarding adventure.

The addict really lives the life the neuroscientist thinks we are by nature born to endure.

But not so. We are not all like the addict. We are at home in the world and open to it. We learn and grow, and love and connect, to people and to projects and values.

I was put in mind of all this after reading a remarkable and disturbing new book by the well-regarded University of Toronto cognitive scientist Marc LewisMemoirs of An Addicted Brain: A Neuroscientist Examines His Former Life on Drugs, due out next month from Random House. Much of the book is a blunt and unadorned, almost clinical, description of Lewis's life as a junkie, before becoming a professor. It is a tale of the young drug abuser's dogged efforts to manage his life by managing his neurochemistry.

The settings change (Toronto, Berkeley in the late sixties, a New England military academy) and people come and go (parents, lovers, friends, junkies, cops). But all this is described with unseeing indifference, unreality and cold disconnect. Lewis, the addict, does not live in the world, he does not know these others. They are shadows cast on the walls of his cave-consciousness and they figure at most instrumentally in his single-minded focus on manipulating himself by eating chemicals.

One thing I find disturbing about the book is the detachment the author exhibits to the characters that fill out his story. None of them ever take form in anything remotely like three-dimensions; no effort is made to flesh them out and exhibit them as real people. This treatment seems to perfectly match the addict's own self-involved indifference to the world around him. The author may no longer be an addict, but it is almost as if he adhere's to the addict's world view that his life is, well, a pageant for him alone unfolding in his head alone in a world that is, really, his own invention.

And indeed, he does. This comes out in the parts of the book that are devoted to explaining the neuroscience of drug experience. For Lewis, you are your brain, and learning and reward and love — he actually says that babies love their mothers because of the opioids in mother's milk — are conceived of as things that happen solo in our brains in our confabulated self-worlds.

The book contains lengthy and informative descriptions of the way drugs work on the nervous system. If you want to know why shooting heroin has different effects on you from eating LSD or smoking pot, read this book. But if you want to understand why a person lives the sort of life Lewis led, or if you want to understand what addiction is, you won't find much help here. Nevertheless, the book is a remarkable documentary record of the phenomenon of addiction, perhaps even despite its author's aims or understanding.

Is addiction a disease of the brain? Can we separate this claim from the very questionable but somehow never questioned assumptions of the new neuroscientist philosophers?

Stay tuned!

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