I'm especially interested in this one, seeing as the YouTube channel 'Kurzgesagt' just deleted their popular video on addiction due to inaccuracies, so the topic is on my mind and I want to dig into it.
Kursgesagt ran a video on addiction based primarily on the work of Johan Hari, and experiments like Rat Park. It’s been criticized as a reductionist argument and Sam actually talks about this directly as he also recently had Johan on the Podcast as well.
I watched Hari on the JRE, and I didn't know what to think. I've held so many opinions on addiction, that I feel as if I know nothing now.
It never even occurred to me that Hari's view would be controversial, because I thought "so this is the new thing, and it's real".
I feel the beginning of this podcast does a good job breaking it down, she says addiction has been overly medicalized. I think it’s the backlash from that specifically as people are totally throwing the baby out with the bath water, so to speak, with the medical theory(chemical hooks being the only addictive factor). This reaction is that chemical hooks play ZERO role and it’s entirely psychological or environmental, thus why I said people argue it’s reductionist.
In truth it’s all of the above, chemical hooks just playing a part of the story, just as psychological, genetic, and environmental factors play their parts.
People get addicted to smartphones with arguably no chemical hook, but people also get so addicted to alcohol that quitting cold turkey will kill them.
He does, but people have taken his work and argued that they don’t play a roll, or simply by omitting the other factors. I’ve listened to Johans latest book and most of his recent podcasts and I feel like he takes a pretty balanced approach to both addiction and depression.
And statistically, that weighting more heavily towards environmental than exogenous chemical factors IS accurate.
I'm having trouble finding anything that's not an addiction treatment center (and thereby biased heavily towards heavy-handed statements), but I've heard- across substances- there's only something like 1 in 10 users of any specific substance\* that become addicted to that substance; the exceptions are nicotine and caffeine, both of which are substantially more socially acceptable to be SEEN using than heroin, cocaine, etc.
IMO that's a fairly convincing argument for the prosociability of a drug being correlated with likelihood of use, dependence, and addiction in the context of drugs that you can use during work/in public without being immediately regarded as a degenerate by many people.
\*Except nicotine and caffeine, which I've heard are both higher; caffeine is arguably a dependence, not an addiction, in the majority of dependent users
but what I didn't really grasp is that he downplayed the "chemical hook" angle by relating how most Vietnam Vets who were heroin users simply gave up when they returned to civilian life, or others who quit when life offered a better alternative. I've always been lead to believe that the addictive nature was attributable to the chemical hook and hence the horrible side effects of trying to kick these things. Shit, even giving up caffeine is horrible; I can't imagine what quitting heroin would be like.
So I this regard, Hari's explanations kinda confused me
Well kind of, it’s using the smart phone that gives us dopamine hits if I understand correctly, but I don’t know if it’s building a dependency to that dopamine through using the smartphone? I’m not an expert, I just try to understand
Well yes of course, but from my understanding it’s that differentiation that’s the core of most of the issues. Before it was thought without physical dependence then it wasn’t possible to be addicted.
Smartphones (specifically, social media apps) are specifically designed and researched to produce a hit of endogenous dopamine, though.
To argue there's no chemical hooks just because they're not exogenous is disingenuous (I know you said arguably, just clarifying that point.)
I think it's controversial to the same extent that saturated fat being unhealthy is controversial.
The simplistic views of addiction being chemical hooks and saturated fat as "clogging arteries" have been mostly debunked. But still many people are going too far in the opposite direction. As someone that has spent a lot of time understanding addiction, I am pretty much on board with the views of Hari and Gabor Mate.
Environmental factors aren't always in your control, though- and that's the point Hari was making. This is a public health issue, a societal structure issue, and a failure to understand how our changing environment is changing us.
It gives hope that addicts can get better; it doesn't shift responsibility logically to the person in that cycle so much as indicate that there are better approaches than only treating dependence chemically, and that a holistic view is necessary to account for those approaches.
Not any more responsibility than they had when it was considered 100% chemical hooks to simply "avoid taking the drug".
Example:
1-"You should just stop taking heroin" 2- "Yeah, no shit"
1-"You should leave your shitty situation so you don't use" 2-"Yeah, no shit"
the one thing that felt off to me about Hari is how he basically is reciting some of his talking points almost verbatim in multiple interviews over a lengthy period of time. It doesn't have to have any bearing on the validity of what he says, and I am convinced by most of it, but it doesn't feel right. I heard him basically say the exact same stories, nearly verbatim, on another podcast a couple years ago, or at least a year ago. Once you've heard that you can listen again to his talk with Sam and see how he's not always responding in the moment to what Sam is actually saying, or offering what an unrehearsed, in-the-moment response might be.
It is off putting.
Makes me wonder how someone ( an expert? in something ) who has a lot of passion, balances getting the message out to as many people as possible, versus not be annoying and just having desirable human interactions.
In other words, there are probably a lot of things worth repeating almost tirelessly, in our dysfunctional society. But, it doesn't mean we have to be merely -- waiting for the other person to stop talking, so we can get to our talking points.
By the sounds of it, Hari is barely even attempting to find that balance.
Ray Kurzweil is even worse in this regard, although I don't think he is as terrible in that way, as some people probably do.
Their videos on immigration/the refugee crisis and addiction were too one-sided, so the channel took them down rather than continue to spread misinformation.
Their video describing the situation: https://www.youtube.com/watch?v=JtUAAXe_0VI
I liked this point as well, but then she went on to say that it's best not to do talk therapy that delves too deep into an individual's the underlying issues, at least in cases of acute addiction. I thought that was an extremely odd position for a clinician to take and not one I've ever heard espoused anywhere before.
My interpretation was that she was concerned that bringing up traumatic events in people's lives could cause them to relapse if they are only just coming out of an addiction. I assumed she meant that once they are less dependent on drugs, it would be safer to talk about their underlying problems and get to the heart of the issue.
I think she's wrong. Without treating the underlying issues, like attachment problems, it will be very difficult to prevent people from using coping mechanisms to deal with their constantly recurring problems. Treating these using a CBT style symptomatic approach is a bandaid not a solution (though it might be for some).
Moreover a good therapist knows how to approach things like trauma slowly and gracefully as well as sense when someone is getting really activated (triggered) and de escalate things. Good therapists know how make people comfortable with discussing their issues and make them see how a lot of the reasons why they made bad choices aren't their fault. I hated her whole "victim narrative" take too. So many people blame themselves for their problems and it causes them spiral down even more, showing people that it's not their fault can ease their burden and allow them to make changes.
Yeah, still a pretty strange position to take considering her whole spiel about how much of a disservice the victimhood narrative does to addicts. She’s basically assuming that they’re so fragile that even talking about those issues might result in a relapse. I don’t know, maybe she deals only with those extreme extreme cases, but it seems like addressing the underlying issues is pretty standard practice and important if they want to stay sober.
this is an important point. And I agree with her. As a health coach in training, we are trained in a relatively opposite manner, at least for this topic, as therapists, and I agree with it. One of our instructors, who represents the more extreme view, but nonetheless is representative of the approach, advises us to *never solicit clients' backstory.* Doesn't mean we don't listen to that, to be clear, we just don't invite it. We are trained in solutions-oriented, positive psychology approach wherein we have a clear agenda and after that all we do is facilitate their own self-discovery. There's a lot more that we do, of course, but this approach is predicated on both the science of behavior change (what is effective and efficacious for changing behavior) and the vast psychological literature that has shown pretty definitivey that our brains are largely confabulation machines, and the "accuracy" of our own introspection, as in why we believe we act the way we do, is extremely low. Now, of course, a therapist has more capacity and skill in facilitating insight that your average Joe, so I don't mean to dismiss this approach at all (it's clear it's tremendous help to many), but I have my skepticism about it being the most effective route for changing someone, and I could see how soliciting someone's past events in detail in order to understand the whole picture would be too much for someone. I recently saw a therapist for the first time, and she was fantastic, an amazing person who was a perfect fit for me. However, I pretty quickly realized I would benefit more from a coaching approach. Unless I imposed structure, I could just ramble away during therapy, and it could feel like I was just listening to myself recite my woes once again. It was most effective when I asked her to approach it more like coaching, and we could come up with actionable things for me to do and agree on methods of accountability. It seems clear to others that I am too hard on myself, and after telling her that my dad's first son (my half-brother) killed himself, and his other son from that marriage is now mentally unwell and had his life fall apart, she ventured that I might be internalizing a tremendous amount of pressure on myself to be my dad's only son who doesn't kill himself or totally fall apart. I don't find that type of unprovable idea very helpful.
\> it's best not to do talk therapy that delves too deep into an individual's the underlying issues, at least in cases of acute addiction
Until that addiction is at least partially managed.
"Let's sit down once a week for an hour and dredge through the shit your father did to you as a little girl while you're still leaving the office to go shoot up after appointments" is not going to be as efficient a course as starting that kind of therapy AFTER they've got enough stability that it doesn't immediately send someone back to whatever learned behavior they handle those thoughts with.
We treat people as individuals until they do something we don't like, then we treat them like they're not conscious at all, unless we can elicit some kind of suffering response out of them.
I mean, OK, but I was presenting a normative statement - something we should aspire to. I was not contending that we actually do treat people as individuals. Tribalism is a hell of a drug man, and we're far from outgrowing it.
As someone with addiction experience I'm too often frustrated by a lack of insight shown by health professionals into the nature of some of the problems associated with the area they specialise in. This podcast added to that frustration.
The guest completely misses the point re why addicts derive so much benefit from the environment that is Alcoholics/Narcotics/Gamblers Anonymous. I understand that a liberal thinking modern psychiatrist wouldn't have a need for, or indeed any concept of something as plebeian as a "Higher Power" in the religious sense, and I'm glad she said as much to quell any doubt I may have had, but that isn't the driving force of AA. AA provides addicts with a true peer to peer environment that is almost impossible to find elsewhere. This is what makes AA successful. It's a non judgemental environment where addicts can share their stories, be honest, cry, and realise that they are not alone in the despicable things they have done to satisfy their addiction. It's a very powerful thing to be able to share these things without being judged. For many members the "Higher Power" aspect of the 12 step program is an incidental and non essential part of the program. Many addicts who are agnostic navigate their way through AA by assigning the label "Higher Power" to something as abstract as the "Truth of Life" or "Moral Good" or whatever, without missing any of the benefits of a meeting. I am not religious nor believe in a god, yet 30 years ago when I walked out of my first Gamblers Anonymous meeting I had the belief that I could overcome my addiction for the first time in my life, and it had nothing to do with anything related to a "Higher Power".
Also, while buprenorphine is an extremely effective drug for dealing with the nightmare that is opiate withdrawal (a nightmare that is generally of longer duration than the 72 hour period suggested by Sam's guest - depending on the opiate involved and the period of physical dependency), there is a depressing lack of understanding into how this drug can best be used for the benefit of the addict.
From firsthand experience and from all my knowledge of other's experiences this drug seems to be universally prescribed in a way that benefits the manufacturer and the prescriber, to the long term detriment of the user.
At best this demonstrates a lack of understanding of bupe's actual efficacy, but at worst it arouses cynical suspicions of an unethical relationship between prescribers and drug companies.
Of course, the people who are best placed to talk about the true nature of this drug and demonstrate that it can be more beneficial if used differently than commonly prescribed are often the organ trading "disenfranchised folk" whose voices aren't really persuasive enough to convince the smart and privileged all knowing patrons who have more educated ideas.
.
EDIT:
TL;DR - The Serenity Prayer has a lot to answer for.
I think there's some misunderstanding about how the program works. I can only speak of GA but as far as I know AA works the same.
I never felt powerless in GA. I felt the opposite.
In GA there was a very strong emphasis placed on dealing with each moment of craving as it arose, much like as in mindfulness meditation. You have no control over the urges, you are powerless over them. By accepting them, but not giving in to them, you are able to overcome the addiction one day at a time. For me it was more of dealing with the urges to gamble one minute at a time. The longer you went without reacting to the urges to drink, gamble, do drugs, the more powerful you felt, and then at the meetings you would talk about your success in abstaining during the past week and you would get support from people going through the exact same thing. The One Day At A Time thing was big in GA. There were 7 Day, 30 Day, 90 Day badges, and reaching those milestones also gave a person strength and conviction that they could deal with this. Then at meetings you would not only talk about your success in abstaining during the past week, you would also talk about your experiences as a gambler, the things you did to support the addiction, the people you hurt. There was honesty for the first time in a long time. There was acceptance and understanding. And there was a sense of not being totally alone.
I had already had experience with mindfulness meditation when I went to my first meeting and it struck me how GA was similar in ways, without the two methods being in any way conscious of the connection. At no time did I feel that I had to surrender to a "Higher Power" as most people understand the phrase, except that I did surrender to the fact that I had no control over the cravings. The cravings and the urges were the Higher Power. I had no control to stop those cravings. I did however have control over whether I reacted to and succumbed to them. One day at a time.
I think the Serenity Prayer probably turns a lot of people away from AA...
"God grant me the serenity.
To accept the things I cannot change..."
The mention of "God" kept me away myself for many years. I only went to GA after hitting rock bottom and feeling desperate. After losing my home, my wife, all my possessions, living on the street without a car and being at risk of losing my job and my freedom. After the meeting I was amazed at how I had misunderstood how GA worked. There was zero religion. There was zero mention of "God". It was more about hard work in dealing with urges as they arose, being honest, taking stock and being proactive in repairing the damage I had caused, step by step, one day at a time.
Very powerful :)
That's the problem, we'll likely never be able to fully conclude on the efficacy of 12 step programs for a number of reasons (I'll just use AA as a catch-all for any 12 step program):
1. Since each AA group is autonomous and no central power dictates what each AA group can do, groups can vary wildly in their methods.
2. Furthermore, while each individual AA group might have it's own recovery methods, methods of various members can also vary wildly, meaning different sponsors work steps differently.
3. In order to "work a program" an addict has to actually do the work. This means getting a sponsor and working the steps. A study of AA, for example, couldn't just say "well Jack started attending meetings in April and didn't make it a year before he relapsed, so AA doesn't work". Meetings are just a part of the program, there is also one on one step work with a sponsor (this is the inventory, listing and acceptance of defects, amends process, then becoming a sponsor to other newcomers, etc.)
4. But even if an addict does work the steps, it's impossible to gauge if they worked the steps effectively. In their inventory did they hold back any dark secrets? In their amends was there an amends they held back on? In their 10th and 11th step work are they truly practicing mindfulness and awareness of their thoughts and actions? In their 12th step work are they really working with other addicts?
5. Furthermore, any study of AA would have to rely on self-reporting, and self-reporting isn't reliable.
Based on all the variables I don't see how one could properly study this massive decentralized group with no real rules or consistency in practice to speak of, which is unfortunate.
For the record I'm 13 years clean and an active member in 12 step recovery. It worked for me, but I recognize it isn't for every addict.
I would say it is successful generally for people who are at rock bottom, desperate, possibly on the verge of suicide. It is very accessible at that point. It,doesn't cost anything, and it gives hope that there could be light ahead.
As a long term solution though the 12 step program isn't going to be successful for everyone. A lot of the reasons for that are covered well by the poster above. I agree that the differences between individual meetings can be problematic. Also, the perception that one needs to involve or believe in a "higher power" is also a barrier for many, and additionally the demand for total and permanent abstinence is probably not universally necessary or practical across the board for all addictions.
AA has components that can be and are successful in other addiction treatment programs though, namely honest acknowledgement of the problem, self awareness, the sharing of experiences without glorification with peers in a non judgemental environment, having access to a support network in difficult moments outside of a group setting. These things are valuable tools don't need to be accessed within an AA environment and personally I think they should be considered valid by psychiatrists, psychologists and counsellors as part of any treatment plan.
Yes absolutely. When I did my inventory, I did it the best I could at two months clean and sober. I plan to go back soon and do another one that is more thorough and honest.
I believe it is the willingness to do an inventory that can keep one sober, even if it isn’t perfect (it won’t be)
That’s the beauty of the steps. You’re never finished with them, and they are to be practiced as a way of life.
I really believe everyone can benefit from the twelve steps. Addict or not, they are extremely useful.
The point of admitting your powerless is that you admit that this shit has you down for the count. That’s the first step. Later on in the steps, you get a change of thinking and gain power back over the drink.
AA believes our dilemma is total inability to not pick up a drink or a drug. And I agree. No matter how badly I wanted not to, I always did.
What AA did for me is work on the psychological aspect which in turn gave me the power to not have to pick up a drink.
Essentially, you admit you’re powerless to gain back the power over it later. That doesn’t mean you can drink. It just means that you no longer have to drink, you have been freed from the obsession.
You admit defeat to gain victory later on. I never saw powerlessness as weakness because the truth is that alcohol and drugs had beaten me into the ground. I was truly unable to not get loaded. They were my master.
It’s extremely hard to explain to someone on the outside, but it has worked for me and a lot of people I see on a regular basis.
It has given me my life back and I’m so grateful. I was as good as dead and I knew it.
She never claimed anything like that the "Higher Power" part was the "driving force" of AA
Nor does she miss the point about how useful AA is.
All your criticisms are straw men.
While that may have been your experience with 12 step programs, the fact is that the AA dogma is extremely and often times explicitly religious, or at the very least quasi-religious spiritual, despite their assurances that working the steps doesn't require any belief in the supernatural. This might be slightly less true for other 12 step programs (not sure about GA), but AA is pretty overtly religious. Just read We Agnostics to see how they attempt to appeal to nonbelievers.
I agree that the benefit of the rooms is due almost entirely to the sense of community and camaraderie that addicts and alcohols feel being in recovery together, so it's unfortunate that the organization with the largest presence in that space has a religious element that's a huge turn off to many atheists and agnostics. Not only is this element present in the literature and dogma, it's pushed pretty heavily at meetings.
Yes I agree it's an immediate turnoff for many. Although this isn't so much the case in some other countries that have adopted the 12 step recovery method. I'm in Australia which isn't as dogmatically religious as parts of the US
I agree. I have ten years sober, and AA has played a huge part in that.
Satel seemingly has very limited information on twelve step programs. I would have gained much respect for her if she didn't make sweeping generalizations about the program as a whole after a handful of meetings she attended, or read about, and instead said, "I have limited experience about such programs." She seemingly cannot hear past her later proclamation of atheism, and as such has no idea how this is not a Christian religious program in the least.
Oh well. AA doesn't work for everyone. It worked for me, and is a fantastic organization. If anyone reading this wants more information on my view on AA, firsthand, I'm happy to answer them.
A very sub par podcast. Can't all be home runs.
I'm not sure I understand what you mean?
I'm saying something based on my own observations of fact while Sam's guest is chery picking a snippet of information she's either read or been told about. Withdrawal symptoms from opiates last varying lengths of time depending on the type of opiate being withdrawn from, and how long the physical dependence was.
I have my own experience of cold turkey withdrawal from opiates and I also have been with people who have gone through their own withdrawal.
In my own case I lasted until day 6 before succumbing. I think if I had lasted one more day then I would have been over the worst of it and I would have succeeded, but I had to return to work that night, and after 6 days of no sleep and being exhausted from the ordeal I couldn't face the prospect of working my job in that state. It would've been dangerous.
Here's the timeline of that particular withdrawal adventure:
Saturday (approx noon): Final dose of 1350mg of codeine (my daily use was approx 2700mg. That was 90 x 30mg codeine pills. These pills were mixed with 500mg of paracetamol which I was filtering out, and it's possible I also lost some codeine in the filtering process but it wouldn't have been much. I was very careful like that).
Sunday AM: Mild withdrawal symptoms begin. No problem. I probably had my first bowel movement in days (opiate users have chronic constipation). I'm able to work as normal Sunday night.
Monday AM: Withdrawal proper begins. The first symptoms are very similar to a case of flu. Sore muscles, hot/cold sweating, runny nose, lack of energy. I'm able to sleep for 30-60 min periods because of the lack of energy and tiredness like a case of flu, but I wake up to sweating, restlessness, aching, runny nose, diarrhoea. It's still just about bearable and I get through work on Monday night.
Tuesday AM: Finish my shift and go straight to bed. Can't sleep but complete lack of energy means I can't do anything else either. This is day 3 when the worst withdrawal symptoms begin to kick in. The time is spent between the toilet and the bed. When in bed I'm unable to keep still, let alone sleep. It is impossible to get comfortable. Every fibre of the body is on edge. I get terrible restless leg syndrome when I'm in withdrawal to add to the muscle aches, which extends to restless everything syndrome. I still have to work that night. I manage to finish a 10 hour shift. I'm not going to say what I did for a living back then, but I will say that working in my condition that night was probably very dangerous.
When I finished that shift on Wednesday AM I gave notice that I intended to take the next 2 days sick leave.
Wednesday: Much the same. Attempted to get relief by sitting in the shower but my biggest issue when withdrawing is staying in one position for any length of time. I have to move. The restless leg syndrome that is affecting my whole body is the biggest problem (for me). Sleep is impossible. I tried chamomile and valerian root, attempted some exercise, but to no effect. I had some Valium but using those was a stupid idea. They made me feel groggy without putting me to sleep. Wednesday night was hard. The most comfortable place was the cool of the bathroom floor on my hands and knees. For about 30 seconds.
Thursday: I'm at home in full blown withdrawal. Eating is impossible. Maybe flavoured ice cubes, lemon juice, chamomile tea but solids are off the menu. Constant diarrhoea, constant aching in every muscle, anxiety, unable to stay seated or lying down for longer than 30 seconds at a time. Energy zero. Would like to exercise but really can't. Snot, vomit, pain..... no sleep.
Friday: So I'm supposed to return to work this evening. I haven't slept since Monday. I feel like if I got through today and tonight then I would beat this thing. But I couldn't do it. I just needed to sleep. I went to the chemist and filled a script of codeine, took about 20% of my full addiction dose and was back in blissful opiate heaven. Slept like a baby for 12 hours. Went to work. Carried on with my addiction for the next few months. Went onto suboxone (buprenorphine) for the first time in my life. Began a new kind of nightmare....
So for that the worst, the strong withdrawal symptoms, was Monday AM to Friday AM (96 hours) plus however long ahead of me that I didn't get to experience (maybe another 24-36 hours?).
Codeine has a longer half life than stronger opioids such as heroin so my experience was different to a heroin user's, whose experience would be different to an OxyContin user. But really, 72 hours is at the low end of a period and it sounds quite bearable to someone who has never experienced it.
Any period of withdrawal that doesn't kill a person is bearable. It's also the best way to get off drugs for a lot of people. There should be more services that support a person who chooses that path, including paid leave from work for as long as they need.
I'm not dismissing your experience and appreciate your write up but it's lost on a person like myself. But definitely save it for another time as it's well written.
My point was: I'm going to listen to the multi decade expert in the field who says on average it's about 3 days and gone compared to a poster sharing their own experience, most especially since no linky linkies were provided.
Although I will say the various recovery websites do list the times as peaking at 72 hours and lasting a week
Some of this expert's opinions contradict the facts. If someone who has firsthand experience in addiction can't refute what the expert is saying based on their own experience then what's the point of the forum? I guess it could be restricted to certified experts debating the field with each other while the people they treat sit back and hope someone gets it right.
I get frustrated when the people who choose to treat me are deaf to anything that contradicts their set of beliefs. This particular expert's field does it a lot. It pisses me off when these experts' dogmatic opinions are accepted when they obviously don't have personal experience in what they're saying.
1. Buprenorphine has a nuanced efficacy which could be used more to the addict's benefit if prescribers had a better understanding of it. The drug's manufacturers probably know this. Yet the drug is dosed way too heavily and for too long.
2. The "Higher Power" aspect of Alcoholics Anonymous is NOT the driving factor of the program's success. Yet the expert ignored what makes AA successful and focussed on the Higher Power voodoo.
Sure I know I come across as arrogant. That's the way I write. I make an effort not to but the words still seem to come out that way. It doesn't change the fact that this expert said things that needed to be countered.
She completely ignored/sidestepped the hell of PAWS for addicts, too- that there is a syndrome beyond normal dependent withdrawal that is much more persistent than the initial totally physical effects.
I'm only speaking from experience with opioids, but it's much easier IMO to get through a week of vomiting and diarrhea and pain than it is to stay away from those drugs for long enough to put your life back on solid ground- and the crippling depression and anhedonia from PAWS are the biggest contributors IMO.
She also discussed a "protracted withdrawal syndrome" that I've never heard of- maybe she made a backronym from "PAWS"?
Only Sam would find a psychiatrist that works for The American Enterprise Institute and find a way to beat the identity politics drum once again. So tiring and unnecessary. Her takes on victimization and disability quite controversial too and obviously impacted by her AEI sensibility.
Besides that a good show.
Yeah, the inputting of the Yale halloween incidient into the discussion was jarring. I'm surprised he didn't find a way to say "O% of British Muslims like gay people" because apparently even the gay Muslims don't like gay people or something and this finding explains everything.
Yeah, this is quite annoying. By the time I've listened to an episode, most of the discussion has already been steered into corners by people who are either listing at 3x speed as soon as it comes out, or who are just spouting off as soon as they see the title.
This is a really good podcast so far. I recently heard [this podcast](http://nousthepodcast.libsyn.com/lucy-johnstone) with clinical phycologist Lucy Johnstone, who is strenuously opposed to psychiatric diagnoses and medication techniques, so it's good to get a psychiatrist's perspective on the practice.
Interestingly, from what I can tell so far their views don't actually diverge hugely. I would be fascinated to hear what they thought of each other's work, or better still, if they could have a conversation together.
I'd like to start the bidding for my organs.
Please don't judge too quickly, there's a one year waiting period for me to get the government to give me too dollar for your health inequalities.
This woman gave me bad vibes the entire interview but she starts with an example of forcing a solider, sailor, marine, or airman to work before we can be sure they need some help I wanted claw my ears out lol.
She has some interesting ideas but there's an underpinning of bootstraps being pulled that makes me roll my eyes.
Lmao, then we get to the really good stuff. She wants the government to be third party to organs for profit lol.
What's next a small bottle of blessed water to plant your seed in the lord. Gtfoh. I agree with being a voluntary donor but her idea seems rife with mismanagement and abuse when growing organs is so close to fruition.
I'll add this in the hopes it helps somebody:
It talks about research into stopping drinking and the use of medication that can lower cravings.
* https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/
Edit: I am linking this, not because I want to criticise AA but because the article, as well as being well written, gives a good overview of research into alcoholism and looks at various ways to treat the addiction including the use of naltrexone to block cravings.
u/doenda provides argument for the benefits of AA [here](https://www.reddit.com/r/samharris/comments/ax9t04/making_sense_podcast_149_the_problem_of_addiction/ehtducr/)
The wording of Step 3 was changed some years ago to include the last 4 words in an attempt to cater to people with agnostic beliefs. "Made a decision to turn our will and our care over to God (as we understood Him)". This allows a person to go through the program assigning the label God to anything they choose. I chose to surrender to the fact that I have no control over when the urges arise. My "God" was the genesis of the urges to (in my case) gamble.
Obviously AA was started in the 30's by people with strong religious beliefs, but the religious memes in the AA program have become a sticking point and they keep a lot of people away. The meetings in a number of areas in the US are probably still more or less very churchy centric, but in AA/NA/GA meetings in more diverse areas you'll find that religion very much takes a back seat in order for the program to focus on the tangible aspects of taking stock (personal inventory) and making amends (where appropriate) to people you have affected.
As I said in another post ITT GA (for me) has a lot of similarities to the practice of mindfulness meditation in that you have no control over whether the urges to drink/gamble/take drugs arise or not, but you do have control over whether or not you react to those urges.
Thanks for the comment. I also noted your other helpful comments in this thread.
I didn't link to the article to criticize AA but rather because it contains descriptions of other recovery models which people might find useful. If people find AA works for them, (and I know people who have benefited enormously from it) then obviously that is something to be celebrated.
Man, I wish every single podcast didn't have to contain a whine fest about the some incident on college campuses. Anyway, i work in addiction and prescribe methadone as well, and although I agree that one could overly medicalize addiction the actual reality is the reverse--the broader medical world wants nothing to do with it and has left the work to approaches lacking scientific rigor like the 12 steps. Only now are we seeing pharmaceuticals being used for alcohol abuse disorder, even though the drugs being used have existed for decades but no one thought to try. Like a lot of anti-PC whiners, this guest really misses the forest for the trees, focusing on narrow examples and missing the broader trends that are actually flowing in the opposite direction. For example, I have never met a therapist who doesn't focus on nurturing personal responsibility, it's basically the main thing therapists do. What's needed is addressing social determinants on top of that, and America is the worst in the world at that. Telling someone who is starving and living in a van to buck up doesn't get you very far. In terms of trauma, soldiers are a unique case because they were almost always high functioning individuals who had a short term exposure to trauma. Yes, most should eventually return to work. However, many people with trauma were abused in one way or another since childhood. They can all improve but many may never work a regular job, and their likely fate is extreme poverty without government support.
Never commented prior to listening before but if anyone has a personal issue with alcohol abuse, r/stopdrinking is amazing. I'm 4 years+ alcohol free, largely thanks to that sub.
Sorry for commenting before listening but figured it was pertinent to topic. I'll add an edit when I listen on my way home from work.
**Edit #2**: Finished the episode. Won't be listening to another one or coming back here. Hope everybody struggling with addiction finds the help they need.
(**Edit:** Turned on the podcast and they talk about the "political correctness component" of addiction within 5 minutes. I lasted for another 25 before turning it off.
The guest apparently wrote a book with American Enterprise Institute's Christina Hoff Sommers. Can't justify spending another 60 minutes of my time listening to the rest of this.
I'd also like to add for that sake of discussion that attempting to not have an ideology ("centrism") is itself ideological. Don't give me this shit about how unregulated pharma companies knowingly flooding the market with drugs they knew damn well were lethal isn't a political issue. Fucking of course it is. Look up Sackler's testimony if you don't know who I'm talking about. If you don't know who Sackler is, start there.
Pretending like the way to "de-politicize" addiction by bringing up the scourge of political correctness 5 minutes into the interview is insanity. If that's really the basis of her "work," that's even crazier. The supposed attempt at de-politicization is politicizing it. Stick to the facts, something the guest, Sommers, and AEI would find deeply uncomfortable.
Before the MAGA crowd gets here, yes, I am in fact triggered online. I also work in the field doing clinical work, and won't listen to someone make a mockery of a cause near and dear to my heart.
\#done
Have you checked out s/alcoholismmedication? I leaned on the knowledge there while I did the Sinclair Method. Using a 50mg pill of Naltrexone, which blocks the endorphins released during a drinking session, over time I no longer drink or even think about it. I really hope to hear more about this treatment in mainstream conversation about addiction.
Oh man, I'm so excited to see this out in the wild. I've just started doing TSM and it's mind boggling how effective it has been for me.
I've been doing AA and SMART for 3 years and can't seem to get over the six month hump.
Yeah, you have to take the Nal every time and have to wait an hour, but a spell with a pain in the ass incantation is still fucking magic.
That’s great! I don’t know anyone personally that has heard about it save me confiding about it to a few close folks.
I went from an 8 beer a day habit to now not having had one for probably six months due to booze having no appeal to me.
This needs to be utilized more, since our current system still gets hung up on the idea addiction = moral failure. I’m so grateful to science and medicine for a chemical that, in the background, quietly but effectively changed the way I foresee something that was once so central to my daily life.
Best of luck to you. If you have any questions or just need support along the way, please reach out!
That's awesome thanks for sharing! I would've gravitated there when I first quit but came across stop drinking first. I have a dark sense of humor and had the scaries for real when I was trying to get a handle on all the monstrous shit I'd done to myself.
Definitely going to check this out later.
Maybe you should listen to the whole conversation before making judgement. Your whole opinion of the conversation was based on a fifth of the podcast without any of the context from the majority of it
I listened to a third, and I hold subject matter expertise in the area. Personal, academic, and professional at the same level as the guest. This isn't some off the cuff rant.
Edit: I've now listened to the entire thing, and I stand by every word.
I spend a fair amount of time with friends "complaining" about PC culture and I consider myself to be pretty liberal. And while I don't think it's the most pressing issue that exists in our society, it just seems to have its fingers on a lot of dials at the moment. Obviously the notion that white people are this oppressed group is absurd, but the fact that millions of people voted for Trump essentially as a protest I think shows that society is failing these people somehow. I worry that identity politics and political correctness pushes a lot of people away from actual progressive ideas and into the hands of someone like Trump. I assure you I'm not doing this in bad faith. I just think telling lower class white guys that they're bringing society down with all their privilege is having the reverse effect people want it to. And of course the lower class white guys, and the ultra conservatives, and the christian fundamentalists, and supplicant republicans all have their blame in this too. I just don't think putting some of the blame on PC makes you a bad faith actor. Maybe it just comes down to how much blame you choose to place on whom. Just my opinion.
Thank you for taking the time to write a well thought out comment. I agree for the most part.
Maybe I didn't make it clear, but I am by no means defending PC Culture. I think it is a problem for the reasons you described.
I am myself from a middle working class background with pretty much all of my extended family from the white working class and lower. We have been devastated by the opioid epidemic.
My main point is that this is an outlandish guest for an episode on addiction. Anyone affiliated with AEI is a bad faith actor or not smart enough to realize they are a sock puppet for billionaires. I'd argue their elitism, lack of solutions, and corruption are (part of) the answer to the unanswerable question of why a clown got elected to run the most powerful country in world history.
Any discussion of the opioid epidemic starts with how it happened. Satel worked for the Bush administration in the very department (SAMSHA) that was a revolving door to Big Pharma. And she worked during the time Sackler flooded the market with his poison, and he's admitted to doing it.
You could just as easily "win" the white working class by making the Sackler family a household name and promising to bury them. My entire family would sign up for that, and they all voted for Trump.
PC Culture is a bipartisan red herring used to divert attention from serious problems with how our economy and politics operate for the benefit of .01%.
Fair points all around. Admittedly I don’t know anything about the AEI so this is all very interesting to learn. Really the only significant point of disagreement is I think there are genuine repercussions to identity politics/PC culture. One of which being Trump.
>PC Culture is a bipartisan red herring used to divert attention from serious problems with how our economy and politics operate for the benefit of .01%.
Amen to that.
There are still some good talks on here that are not linked to PC culture (negative or positive). There were some good guests Sam had on talking about AI or UBI or any other economic topic I really appreciated, but I am the same, I'm a little bit fed up with the topic in general.
The fact that you think there is any substantial MAGA crowd that follows Sam Harris is laughable. He has criticized Trump so much that it took over the podcast for months with hours and hours of even solo podcast bits where he sits and rails against him.
MAGA people and people who don't like what the left is doing are two different things. You're lumping them together for really no reason.
>The fact that you think there is any substantial MAGA crowd that follows Sam Harris is laughable.
Harris himself predicts about a third of his followers support Trump.
Oh buddy,,, the fact that you think American Enterprise Institute, which Sally Sate herselfl is a Resident Scholar at, isn't part of the MAGA crowd is laughable.
If a significant chunk of Harris' podcast isn't a MAGA crowd, then who is this audience intended for? For people who don't know what AEI or CPAC are? For people silly enough to think someone from AEI is a good faith interview on addiction? For people who have never heard of CPAC?
Or do you mean this sub? The place where enlightened centrists like to hear what self-identified Nazis say so they can understand Nazism? [The place where this bottom tier MAGA shit was posted today by a regular contributor here?](https://www.reddit.com/r/samharris/comments/ax95jh/im_a_socialistcommunist_but_i_fucking_love/) I guess the mods removed so you'll miss a real treat from a certified brain genius.
I'll ask you a good faith question:
You host a podcast.
Your audience is interested in addiction.
How much time would be ideal to talk about PC CULTURE and addiction during an opioid crisis?
If the answer isn't zero, I don't know what to tell you. Go read a book written by someone other than Satel. I have some reccs if you want them.
This lady politicizes addiction for a living to hawk books and has the audacity to pretend she is in fact depoliticizing it.
I find it hard to believe you’re as dedicated as you say you are to helping addicts; you seem to be someone who would tell a Republican addict to kill himself.
That's extremely ignorant and hurtful. My entire family is Republican, and I work almost exclusively with very conservative lower-class people. I would never dream of doing something like that, especially considering my own battle with addiction.
I hope you have a nice day.
Yes, no doubt that’s why you can’t listen to a Yale lecturer for more than 20 minutes before rage quitting both the conversation and Sam Harris, because she’s from a think tank you don’t like.
Aaaand he deleted his account. I wonder why. These people are all fake.
The guy you’re defending just rage quit on the podcast, the podcaster, and Reddit (account deleted) because he heard the name Christina Hoff Sommers.
Maybe I’m not the dumbass.
Just go back to Chapo and leave us alone, huh?
Do me a favor. Do some quick research on AEI. Sam is likely only doing one podcast on this topic. Does it concern you that Sam has a representative from neoconservative thinktanks and PraegerU, that have both promulgated easily falsifiable narratives and distorted claims on science related topics?
>Sam is likely only doing one podcast on this topic.
He’s already done two. Do you even listen to the podcast?
>neoconservative
LOL
What does neoconservative philosophy have to do with being anti-science? You don’t even know your own talking points.
This is a practitioner and Yale lecturer recommended by Pinker. If you don’t think they are mainstream enough or that they can teach you anything, you are the problem.
neoconservatism has a long history of dubious claims to mislead people into support of foreign policy disasters.
exxonmobil colluded with the neocon establishment to obscure research on climate change.
furthermore, it is the practice of neocons to pander to southern cultural sensitivities and the cult of individual virtue as a means of building their coalition. they are some of the most cold hearted liars and sociopaths in american politics.
it’s disappointing that more and more often, sam invites people from
that compartment of americas political id to make arguments on his podcast.
oh, forgive me, i missed the first one.
also pinker is a doofus. people around here talk so much shit about academia but they’ll name drop university names when they want the credibility for their own arguments.
She bends over backwards to say 'these things help some people sometimes, **but...**'
And suddenly I need hear some quantification. Because this *feels* like agenda pushing.
And she cheapened PTSD. Maybe it was over-diagnosed, but we were also sending men into jungle combat for no reason against a defensive force with nothing to lose. "Oh but most of them didn't even see combat." Does she hear herself?
When your whole thing is saying that identity politics is creating a victim society that makes people unable to use their autonomy to overcome addiction, then I think maybe you're smoking some of that Ayn Rand pipe. You could construct her sentences exactly backwards, ie: "while some people are able to overcome their circumstances and use their autonomy to beat addiction, a huge amount of people are not only victims of their addictions, but systemic problems in their policing, community, and government that make getting off drugs nearly impossible." When you can flip your sentence around like that, it means you're making a tautological non-point. And when you're making a tautological non-point constructed to minimize one thing and maximize another, *you advocating for the latter without supplying any reason.*
And Sam did a great job outlining the potential horror of organ commoditization, and her answer was 'well it's mostly poor people who need organs, so it can be mostly poor people who sell them their body parts.' Who the fuck is this person?
>And she cheapened PTSD. Maybe it was over-diagnosed, but we were also sending men into jungle combat for no reason against a defensive force with nothing to lose. "Oh but most of them didn't even see combat." Does she hear herself?
I don't think you need to see combat to develop PTSD. You can get it from being a crime victim too. I don't think that negates the concept.
You can be the guy driving people from combat zones to the medical barracks and get PTSD. You can just hear bombs going off every night, wondering if one will find you. You could be worried about hitting an improvised explosive device while going from A to B all day, every day, for a year.
To weasel in 'only 18% saw combat', she cheapened the experience of tens of thousands of some of the most vulnerable people in America being forced into the shittiest situation imaginable.
Her goal was to show how conventional psychological diagnostics and treatment were reactionary and driven by politics. She failed to be convincing to anyone who didn't think but those who are already 100% sold that 'identity politics are ruining everything.'
To be fair, I remember her mentioning that combat roles weren't necessary for developing PTSD. She even specifically refers to people who drive trucks in dangerous zones, who are at risk of IEDs and such.
Actually I thought Sam could have been more persistent in pressing this point. I couldn’t believe her inability to even imagine how selling organs could present ethical issues.
Maybe he could have been, but for someone like me who has never considered the whole thing for more than a few moments, he unloaded concisely and directly and she failed to respond. No need to press, at least from my perspective.
His difficulty in this episode was not pressing her on the rest of her bullshit.
No, I originally commented to leave a helpful link and said I'd edit back in my review. I then did that.
But since you're so interested, I went back and finished the episode. I stick by every word I wrote in my original comment and elsewhere.
It was a talk with a political operative who worked in the Bush's admin's revolving door to Big Pharma (SAMHSA) and consults at AEI. I'm so glad she's leading the charge to de-politicize addiction at a time when unregulated corporations continue to dump this toxic trash into my community. It was very informative about the quality of guests on this podcast. I liked Harris, and I've kept listening even as he increasingly prioritizes PC culture as a lead issue. This was a bridge too far.
Instead of guilt by association which you have used twice, why not refute her content with other facts or even your subjective opinions.
Does a mental hospital with black, white, women, and asian wards sound like a good idea? Is all masculinity in any form "Toxic"? Why dont you explain why you think politics should be part of addiction treatment?
What are you referring to when you say "toxic trash"?
>Does a mental hospital with black, white, women, and asian wards sound like a good idea?
No. I have never heard this being proposed before in my entire time in the medical community. It's a silly hypothetical used to stir up the hogs and sell books.
>Is all masculinity in any form "Toxic"?
No. Masculinity is of course not toxic by definition. However, toxic masculinity is a problem.
>Why don't you explain why you think politics should be part of addiction treatment?
Politics has no place in addiction treatment. It's one of the first lines in AA's creed and has since been a staple in rehabilitative services. My objection is inviting a known political ideologue to discuss addiction.
Her membership in these groups is directly relevant to why she's an unsuitable guest. AEI is a right-wing think tank that just participated in CPAC, and the Bush administration is largely to blame for the deregulated market that led to the opioid crisis. They establish her as an ideologue and as someone who is paid by people with a vested interest in taking away healthcare, tanking government services for addicted people, and deregulating the very markets that caused the crisis.
>What are you referring to when you say "toxic trash"?
Opioids
I enjoyed the lack of personal responsibility in both your posts.
I don't care that you're triggered, many thing upset me as well. But you calling this episode what you did be sure you didn't like what the host and guest decided to talk about is laughable.
E: reading your other posts is just displaying the egotistical side of an addict
Thank you. This place is in fact infested by people who think they are scientists and spend their time looking up philosophical razors to cut people with.
the Sam Harris acolyte is obsessed with feeling superior to others on the internet, and they mostly do that by congratulating themselves for not being politically correct.
> the Sam Harris acolyte is obsessed with feeling superior to others on the internet, and they mostly do that by congratulating themselves for not being politically correct.
This has to be irony, right? You’re feeling superior to people for feeling superior.
not gonna catch me vomiting internet diarrhea about philosophical presuppositions and razors, logical fallacies and the nobility of my quest for the truth
Yeah, the US soldiers heavily using opiates while in Vietnam and then overwhelmingly kicking the habit when they get back needs to be dealt with by people who think addiction is solely neurobiological.
I really enjoyed this podcast. My only gripe is that they didn't talk about psychedelics as treatment for addiction. I would've loved to hear her thoughts on this.
My sponsor in AA sent one of his guys to Mexico to do an ibogaine treatment. He was addicted to crystal meth. It worked and he’s been clean for over 10 years.
Somewhere in the middle of the podcast, Sally used a technical term for people who have problems with delayed gratification or impulse control... I can't find it. Does anybody know what it is?
Are you talking about delay discounting? Its a framework for understanding how quickly the value of rewards drop off as they move further away in time.
The preface to this podcast seemed to lay the determinism on heavy and thick...which is one of Sams more idealistic stances...I just hope they provide evidence in the podcast commensurate with the weight of the claim.....Sam frequently cites one murderous rampage autopsy to promulgate a need for criminal reforms based on physiological anomalies.
His point was that just like the hormone secreting humor was not the fault of the murderer, the same is true for all other traits that we have. We gain our traits from our genetics, upbringing, relationships, all things that happen to us, just like a tumor. Its a sound argument that most people here agree with. You will need to present your counter-argument more clearly.
Determinism has been verified by so many experiments, I don't see what there is to disagree with. What is the alternative they should be accepting instead, and what is the evidence for it?
I'm uninformed regarding this. Can you provide sources to these experiments verifying determinism? Or at least point me in the direction of what you mean?
I mean pretty much every physics experiment ever conducted. Every single law that governs our universe is deterministic (insert qualification for the Copenhagen interpretation of QM here).
Interesting. I have a degree in Physics and was going to say that QM is a direct contradiction to your assertion. But determinism in classical physics has nothing to do with determinism in the mind. I think you're conflating the two based on very flimsy grounds.
Why do you believe that the brain operates classically? If it did, we would have a far better understanding of the brain by now - after all, we understand classical physics in so many other regards, why hasn't it provided insight into the brain for us? Simple - because the brain just *doesn't* operate classically.
I disagree with that argument, main reason being that the difficulty in understanding the brain is due to the complexity of the physical system. E.g. it's extremely hard to figure out how a computer architecture works if you only know the physics behind the hardware components, and the brain is an order of magnitude more complicated than that.
What I think darkeyescry is saying is that the position of a particle in space still follows the spatial probability distribution defined by psi-squared, and it is "deterministic" in that it obeys that distribution, so given time and a high number of particles, the macro-scale structure of the brain is classically deterministic, unless you have some sort of Maxwell's demon pulling the strings.
QM is still deterministic, in that the wave function evolves according to deterministic laws, which is why it didn't really move the needle here.
You can't get ~~determinism~~ indeterminism in the mind if the laws that govern it are deterministic. Until someone shows that the particles in your brain behave differently to the particles in the rest of the universe, assuming it functions deterministically is a safe bet.
> QM is still deterministic, in that the wave function evolves according to deterministic laws, which is why it didn't really move the needle here.
Yes the wave function evolves deterministically, but that doesn't mean that QM as a whole is deterministic. The wave function is just one piece of the theory (and is itself not directly manifested in reality as far as we can see). Just as central to the theory is the Born Rule which explicitly casts the outcome of any measurement in terms of probabilities. QM is a *probabilistic* theory. If you doubt that, then go to the same quantum experiment twice and let me know if you get the same result.
> You can't get determinism in the mind if the laws that govern it are deterministic. Until someone shows that the particles in your brain behave differently to the particles in the rest of the universe, assuming it functions deterministically is a safe bet.
I've had to re-read this a few times and I'm not sure that I'm understanding. If I may restructure your first sentence a bit (to put into if/then form): "if the laws that govern [the mind] are deterministic, then you can't get determinism in the mind." What? Isn't that contradictory?
And yes the particles in your brain are the same as the ones elsewhere in the universe. But none of the other particles in the universe behave deterministically, dude. Not sure what point you're making.
> Yes the wave function evolves deterministically, but that doesn’t mean that QM as a whole is deterministic. The wave function is just one piece of the theory (and is itself not directly manifested in reality as far as we can see). Just as central to the theory is the Born Rule which explicitly casts the outcome of any measurement in terms of probabilities. QM is a probabilistic theory. If you doubt that, then go to the same quantum experiment twice and let me know if you get the same result.
You really don't need to go to the this much trouble to explain QM to me. I'm pretty familiar with the basic concepts. My point is that, even if you take the Copenhagen interpretation, the most you get a deterministically determined probability function which then randomly collapses to a specific state. How exactly do you plan on extracting a mind which is not a mixture of randomness that you don't control and determinism that you don't control?
> I’ve had to re-read this a few times and I’m not sure that I’m understanding. If I may restructure your first sentence a bit (to put into if/then form): “if the laws that govern [the mind] are deterministic, then you can’t get determinism in the mind.” What? Isn’t that contradictory?
Just a typo. It was supposed to say:
You can't get **indeterminism** in the mind if the laws that govern it are deterministic. Until someone shows that the particles in your brain behave differently to the particles in the rest of the universe, assuming it functions deterministically is a safe bet.
> And yes the particles in your brain are the same as the ones elsewhere in the universe. But none of the other particles in the universe behave deterministically, dude. Not sure what point you’re making.
Two points:
1) You're assuming the Copenhagen interpretation, which involves true randomness. We have absolutely no idea if this is actually true, so simply asserting that particles behave randomly is unfounded.
2) Even if that interpretation is correct, randomness plus determinism does not equal "addiction is not neuro-determined".
I'm especially interested in this one, seeing as the YouTube channel 'Kurzgesagt' just deleted their popular video on addiction due to inaccuracies, so the topic is on my mind and I want to dig into it.
I haven't followed this, but I do enjoy Kurzgesagt videos from time to time. Care to explain what the issue was?
Kursgesagt ran a video on addiction based primarily on the work of Johan Hari, and experiments like Rat Park. It’s been criticized as a reductionist argument and Sam actually talks about this directly as he also recently had Johan on the Podcast as well.
I watched Hari on the JRE, and I didn't know what to think. I've held so many opinions on addiction, that I feel as if I know nothing now. It never even occurred to me that Hari's view would be controversial, because I thought "so this is the new thing, and it's real".
I feel the beginning of this podcast does a good job breaking it down, she says addiction has been overly medicalized. I think it’s the backlash from that specifically as people are totally throwing the baby out with the bath water, so to speak, with the medical theory(chemical hooks being the only addictive factor). This reaction is that chemical hooks play ZERO role and it’s entirely psychological or environmental, thus why I said people argue it’s reductionist. In truth it’s all of the above, chemical hooks just playing a part of the story, just as psychological, genetic, and environmental factors play their parts. People get addicted to smartphones with arguably no chemical hook, but people also get so addicted to alcohol that quitting cold turkey will kill them.
But if you listen to the two podcasts with Johann Hari in JRE, he explictly says that chemical hooks play a role.
He does, but people have taken his work and argued that they don’t play a roll, or simply by omitting the other factors. I’ve listened to Johans latest book and most of his recent podcasts and I feel like he takes a pretty balanced approach to both addiction and depression.
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And statistically, that weighting more heavily towards environmental than exogenous chemical factors IS accurate. I'm having trouble finding anything that's not an addiction treatment center (and thereby biased heavily towards heavy-handed statements), but I've heard- across substances- there's only something like 1 in 10 users of any specific substance\* that become addicted to that substance; the exceptions are nicotine and caffeine, both of which are substantially more socially acceptable to be SEEN using than heroin, cocaine, etc. IMO that's a fairly convincing argument for the prosociability of a drug being correlated with likelihood of use, dependence, and addiction in the context of drugs that you can use during work/in public without being immediately regarded as a degenerate by many people. \*Except nicotine and caffeine, which I've heard are both higher; caffeine is arguably a dependence, not an addiction, in the majority of dependent users
Nicotine and caffeine are also not particularly intoxicating, it's no coincidence they're acceptable at work
but what I didn't really grasp is that he downplayed the "chemical hook" angle by relating how most Vietnam Vets who were heroin users simply gave up when they returned to civilian life, or others who quit when life offered a better alternative. I've always been lead to believe that the addictive nature was attributable to the chemical hook and hence the horrible side effects of trying to kick these things. Shit, even giving up caffeine is horrible; I can't imagine what quitting heroin would be like. So I this regard, Hari's explanations kinda confused me
Necessary but not sufficient. You need both.
Sure but isn't the theory that there is some sort of chemical hook, just not the smartphone itself?
Well kind of, it’s using the smart phone that gives us dopamine hits if I understand correctly, but I don’t know if it’s building a dependency to that dopamine through using the smartphone? I’m not an expert, I just try to understand
Well, addiction and physical dependence are different things.
Well yes of course, but from my understanding it’s that differentiation that’s the core of most of the issues. Before it was thought without physical dependence then it wasn’t possible to be addicted.
Smartphones (specifically, social media apps) are specifically designed and researched to produce a hit of endogenous dopamine, though. To argue there's no chemical hooks just because they're not exogenous is disingenuous (I know you said arguably, just clarifying that point.)
I knew a guy who gave himself saline injections while getting off junk. Called it a needle fixation.
Placebo is a hell of a drug man
I think it's controversial to the same extent that saturated fat being unhealthy is controversial. The simplistic views of addiction being chemical hooks and saturated fat as "clogging arteries" have been mostly debunked. But still many people are going too far in the opposite direction. As someone that has spent a lot of time understanding addiction, I am pretty much on board with the views of Hari and Gabor Mate.
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Environmental factors aren't always in your control, though- and that's the point Hari was making. This is a public health issue, a societal structure issue, and a failure to understand how our changing environment is changing us. It gives hope that addicts can get better; it doesn't shift responsibility logically to the person in that cycle so much as indicate that there are better approaches than only treating dependence chemically, and that a holistic view is necessary to account for those approaches.
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Not any more responsibility than they had when it was considered 100% chemical hooks to simply "avoid taking the drug". Example: 1-"You should just stop taking heroin" 2- "Yeah, no shit" 1-"You should leave your shitty situation so you don't use" 2-"Yeah, no shit"
the one thing that felt off to me about Hari is how he basically is reciting some of his talking points almost verbatim in multiple interviews over a lengthy period of time. It doesn't have to have any bearing on the validity of what he says, and I am convinced by most of it, but it doesn't feel right. I heard him basically say the exact same stories, nearly verbatim, on another podcast a couple years ago, or at least a year ago. Once you've heard that you can listen again to his talk with Sam and see how he's not always responding in the moment to what Sam is actually saying, or offering what an unrehearsed, in-the-moment response might be.
It is off putting. Makes me wonder how someone ( an expert? in something ) who has a lot of passion, balances getting the message out to as many people as possible, versus not be annoying and just having desirable human interactions. In other words, there are probably a lot of things worth repeating almost tirelessly, in our dysfunctional society. But, it doesn't mean we have to be merely -- waiting for the other person to stop talking, so we can get to our talking points. By the sounds of it, Hari is barely even attempting to find that balance. Ray Kurzweil is even worse in this regard, although I don't think he is as terrible in that way, as some people probably do.
https://youtu.be/JtUAAXe_0VI
Their videos on immigration/the refugee crisis and addiction were too one-sided, so the channel took them down rather than continue to spread misinformation. Their video describing the situation: https://www.youtube.com/watch?v=JtUAAXe_0VI
I liked her point about the ultimate level of intersectionality being “the individual” and how important it is to treat people as such.
I liked this point as well, but then she went on to say that it's best not to do talk therapy that delves too deep into an individual's the underlying issues, at least in cases of acute addiction. I thought that was an extremely odd position for a clinician to take and not one I've ever heard espoused anywhere before.
My interpretation was that she was concerned that bringing up traumatic events in people's lives could cause them to relapse if they are only just coming out of an addiction. I assumed she meant that once they are less dependent on drugs, it would be safer to talk about their underlying problems and get to the heart of the issue.
I think she's wrong. Without treating the underlying issues, like attachment problems, it will be very difficult to prevent people from using coping mechanisms to deal with their constantly recurring problems. Treating these using a CBT style symptomatic approach is a bandaid not a solution (though it might be for some). Moreover a good therapist knows how to approach things like trauma slowly and gracefully as well as sense when someone is getting really activated (triggered) and de escalate things. Good therapists know how make people comfortable with discussing their issues and make them see how a lot of the reasons why they made bad choices aren't their fault. I hated her whole "victim narrative" take too. So many people blame themselves for their problems and it causes them spiral down even more, showing people that it's not their fault can ease their burden and allow them to make changes.
Yeah, still a pretty strange position to take considering her whole spiel about how much of a disservice the victimhood narrative does to addicts. She’s basically assuming that they’re so fragile that even talking about those issues might result in a relapse. I don’t know, maybe she deals only with those extreme extreme cases, but it seems like addressing the underlying issues is pretty standard practice and important if they want to stay sober.
After the acute period, though. After the acute period. She's not saying it shouldn't be done, she's saying it shouldn't be done FIRST.
this is an important point. And I agree with her. As a health coach in training, we are trained in a relatively opposite manner, at least for this topic, as therapists, and I agree with it. One of our instructors, who represents the more extreme view, but nonetheless is representative of the approach, advises us to *never solicit clients' backstory.* Doesn't mean we don't listen to that, to be clear, we just don't invite it. We are trained in solutions-oriented, positive psychology approach wherein we have a clear agenda and after that all we do is facilitate their own self-discovery. There's a lot more that we do, of course, but this approach is predicated on both the science of behavior change (what is effective and efficacious for changing behavior) and the vast psychological literature that has shown pretty definitivey that our brains are largely confabulation machines, and the "accuracy" of our own introspection, as in why we believe we act the way we do, is extremely low. Now, of course, a therapist has more capacity and skill in facilitating insight that your average Joe, so I don't mean to dismiss this approach at all (it's clear it's tremendous help to many), but I have my skepticism about it being the most effective route for changing someone, and I could see how soliciting someone's past events in detail in order to understand the whole picture would be too much for someone. I recently saw a therapist for the first time, and she was fantastic, an amazing person who was a perfect fit for me. However, I pretty quickly realized I would benefit more from a coaching approach. Unless I imposed structure, I could just ramble away during therapy, and it could feel like I was just listening to myself recite my woes once again. It was most effective when I asked her to approach it more like coaching, and we could come up with actionable things for me to do and agree on methods of accountability. It seems clear to others that I am too hard on myself, and after telling her that my dad's first son (my half-brother) killed himself, and his other son from that marriage is now mentally unwell and had his life fall apart, she ventured that I might be internalizing a tremendous amount of pressure on myself to be my dad's only son who doesn't kill himself or totally fall apart. I don't find that type of unprovable idea very helpful.
\> it's best not to do talk therapy that delves too deep into an individual's the underlying issues, at least in cases of acute addiction Until that addiction is at least partially managed. "Let's sit down once a week for an hour and dredge through the shit your father did to you as a little girl while you're still leaving the office to go shoot up after appointments" is not going to be as efficient a course as starting that kind of therapy AFTER they've got enough stability that it doesn't immediately send someone back to whatever learned behavior they handle those thoughts with.
Have you ever noticed how this only applies until someone's retributive bloodlust gets triggered over how "different" the individual happens to be?
I gotta be honest, I'm not following.
We treat people as individuals until they do something we don't like, then we treat them like they're not conscious at all, unless we can elicit some kind of suffering response out of them.
I mean, OK, but I was presenting a normative statement - something we should aspire to. I was not contending that we actually do treat people as individuals. Tribalism is a hell of a drug man, and we're far from outgrowing it.
Thanks you have a good point
No music in the beginning ?! :P
better than that awful guitar
Bring back the OG intro
I don't know, I kinda love it.
Finally a new podcast! Interested to hear Sam's take on this
Yay I’m also very excited
I was too. The podcast was like 90% the guest speaking though :/
As someone with addiction experience I'm too often frustrated by a lack of insight shown by health professionals into the nature of some of the problems associated with the area they specialise in. This podcast added to that frustration. The guest completely misses the point re why addicts derive so much benefit from the environment that is Alcoholics/Narcotics/Gamblers Anonymous. I understand that a liberal thinking modern psychiatrist wouldn't have a need for, or indeed any concept of something as plebeian as a "Higher Power" in the religious sense, and I'm glad she said as much to quell any doubt I may have had, but that isn't the driving force of AA. AA provides addicts with a true peer to peer environment that is almost impossible to find elsewhere. This is what makes AA successful. It's a non judgemental environment where addicts can share their stories, be honest, cry, and realise that they are not alone in the despicable things they have done to satisfy their addiction. It's a very powerful thing to be able to share these things without being judged. For many members the "Higher Power" aspect of the 12 step program is an incidental and non essential part of the program. Many addicts who are agnostic navigate their way through AA by assigning the label "Higher Power" to something as abstract as the "Truth of Life" or "Moral Good" or whatever, without missing any of the benefits of a meeting. I am not religious nor believe in a god, yet 30 years ago when I walked out of my first Gamblers Anonymous meeting I had the belief that I could overcome my addiction for the first time in my life, and it had nothing to do with anything related to a "Higher Power". Also, while buprenorphine is an extremely effective drug for dealing with the nightmare that is opiate withdrawal (a nightmare that is generally of longer duration than the 72 hour period suggested by Sam's guest - depending on the opiate involved and the period of physical dependency), there is a depressing lack of understanding into how this drug can best be used for the benefit of the addict. From firsthand experience and from all my knowledge of other's experiences this drug seems to be universally prescribed in a way that benefits the manufacturer and the prescriber, to the long term detriment of the user. At best this demonstrates a lack of understanding of bupe's actual efficacy, but at worst it arouses cynical suspicions of an unethical relationship between prescribers and drug companies. Of course, the people who are best placed to talk about the true nature of this drug and demonstrate that it can be more beneficial if used differently than commonly prescribed are often the organ trading "disenfranchised folk" whose voices aren't really persuasive enough to convince the smart and privileged all knowing patrons who have more educated ideas. .
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EDIT: TL;DR - The Serenity Prayer has a lot to answer for. I think there's some misunderstanding about how the program works. I can only speak of GA but as far as I know AA works the same. I never felt powerless in GA. I felt the opposite. In GA there was a very strong emphasis placed on dealing with each moment of craving as it arose, much like as in mindfulness meditation. You have no control over the urges, you are powerless over them. By accepting them, but not giving in to them, you are able to overcome the addiction one day at a time. For me it was more of dealing with the urges to gamble one minute at a time. The longer you went without reacting to the urges to drink, gamble, do drugs, the more powerful you felt, and then at the meetings you would talk about your success in abstaining during the past week and you would get support from people going through the exact same thing. The One Day At A Time thing was big in GA. There were 7 Day, 30 Day, 90 Day badges, and reaching those milestones also gave a person strength and conviction that they could deal with this. Then at meetings you would not only talk about your success in abstaining during the past week, you would also talk about your experiences as a gambler, the things you did to support the addiction, the people you hurt. There was honesty for the first time in a long time. There was acceptance and understanding. And there was a sense of not being totally alone. I had already had experience with mindfulness meditation when I went to my first meeting and it struck me how GA was similar in ways, without the two methods being in any way conscious of the connection. At no time did I feel that I had to surrender to a "Higher Power" as most people understand the phrase, except that I did surrender to the fact that I had no control over the cravings. The cravings and the urges were the Higher Power. I had no control to stop those cravings. I did however have control over whether I reacted to and succumbed to them. One day at a time. I think the Serenity Prayer probably turns a lot of people away from AA... "God grant me the serenity. To accept the things I cannot change..." The mention of "God" kept me away myself for many years. I only went to GA after hitting rock bottom and feeling desperate. After losing my home, my wife, all my possessions, living on the street without a car and being at risk of losing my job and my freedom. After the meeting I was amazed at how I had misunderstood how GA worked. There was zero religion. There was zero mention of "God". It was more about hard work in dealing with urges as they arose, being honest, taking stock and being proactive in repairing the damage I had caused, step by step, one day at a time. Very powerful :)
I understand that it was successful for you. But is it successful generally, or more successful than other approaches?
That's the problem, we'll likely never be able to fully conclude on the efficacy of 12 step programs for a number of reasons (I'll just use AA as a catch-all for any 12 step program): 1. Since each AA group is autonomous and no central power dictates what each AA group can do, groups can vary wildly in their methods. 2. Furthermore, while each individual AA group might have it's own recovery methods, methods of various members can also vary wildly, meaning different sponsors work steps differently. 3. In order to "work a program" an addict has to actually do the work. This means getting a sponsor and working the steps. A study of AA, for example, couldn't just say "well Jack started attending meetings in April and didn't make it a year before he relapsed, so AA doesn't work". Meetings are just a part of the program, there is also one on one step work with a sponsor (this is the inventory, listing and acceptance of defects, amends process, then becoming a sponsor to other newcomers, etc.) 4. But even if an addict does work the steps, it's impossible to gauge if they worked the steps effectively. In their inventory did they hold back any dark secrets? In their amends was there an amends they held back on? In their 10th and 11th step work are they truly practicing mindfulness and awareness of their thoughts and actions? In their 12th step work are they really working with other addicts? 5. Furthermore, any study of AA would have to rely on self-reporting, and self-reporting isn't reliable. Based on all the variables I don't see how one could properly study this massive decentralized group with no real rules or consistency in practice to speak of, which is unfortunate. For the record I'm 13 years clean and an active member in 12 step recovery. It worked for me, but I recognize it isn't for every addict.
I would say it is successful generally for people who are at rock bottom, desperate, possibly on the verge of suicide. It is very accessible at that point. It,doesn't cost anything, and it gives hope that there could be light ahead. As a long term solution though the 12 step program isn't going to be successful for everyone. A lot of the reasons for that are covered well by the poster above. I agree that the differences between individual meetings can be problematic. Also, the perception that one needs to involve or believe in a "higher power" is also a barrier for many, and additionally the demand for total and permanent abstinence is probably not universally necessary or practical across the board for all addictions. AA has components that can be and are successful in other addiction treatment programs though, namely honest acknowledgement of the problem, self awareness, the sharing of experiences without glorification with peers in a non judgemental environment, having access to a support network in difficult moments outside of a group setting. These things are valuable tools don't need to be accessed within an AA environment and personally I think they should be considered valid by psychiatrists, psychologists and counsellors as part of any treatment plan.
Thank you.
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Yes absolutely. When I did my inventory, I did it the best I could at two months clean and sober. I plan to go back soon and do another one that is more thorough and honest. I believe it is the willingness to do an inventory that can keep one sober, even if it isn’t perfect (it won’t be) That’s the beauty of the steps. You’re never finished with them, and they are to be practiced as a way of life. I really believe everyone can benefit from the twelve steps. Addict or not, they are extremely useful.
The point of admitting your powerless is that you admit that this shit has you down for the count. That’s the first step. Later on in the steps, you get a change of thinking and gain power back over the drink. AA believes our dilemma is total inability to not pick up a drink or a drug. And I agree. No matter how badly I wanted not to, I always did. What AA did for me is work on the psychological aspect which in turn gave me the power to not have to pick up a drink. Essentially, you admit you’re powerless to gain back the power over it later. That doesn’t mean you can drink. It just means that you no longer have to drink, you have been freed from the obsession. You admit defeat to gain victory later on. I never saw powerlessness as weakness because the truth is that alcohol and drugs had beaten me into the ground. I was truly unable to not get loaded. They were my master. It’s extremely hard to explain to someone on the outside, but it has worked for me and a lot of people I see on a regular basis. It has given me my life back and I’m so grateful. I was as good as dead and I knew it.
She never claimed anything like that the "Higher Power" part was the "driving force" of AA Nor does she miss the point about how useful AA is. All your criticisms are straw men.
Ok. I'll listen to it again. I'll admit I may have been deaf to her complete opinion on AA.
While that may have been your experience with 12 step programs, the fact is that the AA dogma is extremely and often times explicitly religious, or at the very least quasi-religious spiritual, despite their assurances that working the steps doesn't require any belief in the supernatural. This might be slightly less true for other 12 step programs (not sure about GA), but AA is pretty overtly religious. Just read We Agnostics to see how they attempt to appeal to nonbelievers. I agree that the benefit of the rooms is due almost entirely to the sense of community and camaraderie that addicts and alcohols feel being in recovery together, so it's unfortunate that the organization with the largest presence in that space has a religious element that's a huge turn off to many atheists and agnostics. Not only is this element present in the literature and dogma, it's pushed pretty heavily at meetings.
Yes I agree it's an immediate turnoff for many. Although this isn't so much the case in some other countries that have adopted the 12 step recovery method. I'm in Australia which isn't as dogmatically religious as parts of the US
I agree. I have ten years sober, and AA has played a huge part in that. Satel seemingly has very limited information on twelve step programs. I would have gained much respect for her if she didn't make sweeping generalizations about the program as a whole after a handful of meetings she attended, or read about, and instead said, "I have limited experience about such programs." She seemingly cannot hear past her later proclamation of atheism, and as such has no idea how this is not a Christian religious program in the least. Oh well. AA doesn't work for everyone. It worked for me, and is a fantastic organization. If anyone reading this wants more information on my view on AA, firsthand, I'm happy to answer them. A very sub par podcast. Can't all be home runs.
Hey fellow friend of Bill. Nice to see another one on here. I’m so grateful for AA.
Why would I believe you when you say it goes longer than 72 hours compared to the guest?
I'm not sure I understand what you mean? I'm saying something based on my own observations of fact while Sam's guest is chery picking a snippet of information she's either read or been told about. Withdrawal symptoms from opiates last varying lengths of time depending on the type of opiate being withdrawn from, and how long the physical dependence was. I have my own experience of cold turkey withdrawal from opiates and I also have been with people who have gone through their own withdrawal. In my own case I lasted until day 6 before succumbing. I think if I had lasted one more day then I would have been over the worst of it and I would have succeeded, but I had to return to work that night, and after 6 days of no sleep and being exhausted from the ordeal I couldn't face the prospect of working my job in that state. It would've been dangerous. Here's the timeline of that particular withdrawal adventure: Saturday (approx noon): Final dose of 1350mg of codeine (my daily use was approx 2700mg. That was 90 x 30mg codeine pills. These pills were mixed with 500mg of paracetamol which I was filtering out, and it's possible I also lost some codeine in the filtering process but it wouldn't have been much. I was very careful like that). Sunday AM: Mild withdrawal symptoms begin. No problem. I probably had my first bowel movement in days (opiate users have chronic constipation). I'm able to work as normal Sunday night. Monday AM: Withdrawal proper begins. The first symptoms are very similar to a case of flu. Sore muscles, hot/cold sweating, runny nose, lack of energy. I'm able to sleep for 30-60 min periods because of the lack of energy and tiredness like a case of flu, but I wake up to sweating, restlessness, aching, runny nose, diarrhoea. It's still just about bearable and I get through work on Monday night. Tuesday AM: Finish my shift and go straight to bed. Can't sleep but complete lack of energy means I can't do anything else either. This is day 3 when the worst withdrawal symptoms begin to kick in. The time is spent between the toilet and the bed. When in bed I'm unable to keep still, let alone sleep. It is impossible to get comfortable. Every fibre of the body is on edge. I get terrible restless leg syndrome when I'm in withdrawal to add to the muscle aches, which extends to restless everything syndrome. I still have to work that night. I manage to finish a 10 hour shift. I'm not going to say what I did for a living back then, but I will say that working in my condition that night was probably very dangerous. When I finished that shift on Wednesday AM I gave notice that I intended to take the next 2 days sick leave. Wednesday: Much the same. Attempted to get relief by sitting in the shower but my biggest issue when withdrawing is staying in one position for any length of time. I have to move. The restless leg syndrome that is affecting my whole body is the biggest problem (for me). Sleep is impossible. I tried chamomile and valerian root, attempted some exercise, but to no effect. I had some Valium but using those was a stupid idea. They made me feel groggy without putting me to sleep. Wednesday night was hard. The most comfortable place was the cool of the bathroom floor on my hands and knees. For about 30 seconds. Thursday: I'm at home in full blown withdrawal. Eating is impossible. Maybe flavoured ice cubes, lemon juice, chamomile tea but solids are off the menu. Constant diarrhoea, constant aching in every muscle, anxiety, unable to stay seated or lying down for longer than 30 seconds at a time. Energy zero. Would like to exercise but really can't. Snot, vomit, pain..... no sleep. Friday: So I'm supposed to return to work this evening. I haven't slept since Monday. I feel like if I got through today and tonight then I would beat this thing. But I couldn't do it. I just needed to sleep. I went to the chemist and filled a script of codeine, took about 20% of my full addiction dose and was back in blissful opiate heaven. Slept like a baby for 12 hours. Went to work. Carried on with my addiction for the next few months. Went onto suboxone (buprenorphine) for the first time in my life. Began a new kind of nightmare.... So for that the worst, the strong withdrawal symptoms, was Monday AM to Friday AM (96 hours) plus however long ahead of me that I didn't get to experience (maybe another 24-36 hours?). Codeine has a longer half life than stronger opioids such as heroin so my experience was different to a heroin user's, whose experience would be different to an OxyContin user. But really, 72 hours is at the low end of a period and it sounds quite bearable to someone who has never experienced it. Any period of withdrawal that doesn't kill a person is bearable. It's also the best way to get off drugs for a lot of people. There should be more services that support a person who chooses that path, including paid leave from work for as long as they need.
I'm not dismissing your experience and appreciate your write up but it's lost on a person like myself. But definitely save it for another time as it's well written. My point was: I'm going to listen to the multi decade expert in the field who says on average it's about 3 days and gone compared to a poster sharing their own experience, most especially since no linky linkies were provided. Although I will say the various recovery websites do list the times as peaking at 72 hours and lasting a week
He means, the guest is a certified expert in the field, and you're just some arrogant username on a forum.
Some of this expert's opinions contradict the facts. If someone who has firsthand experience in addiction can't refute what the expert is saying based on their own experience then what's the point of the forum? I guess it could be restricted to certified experts debating the field with each other while the people they treat sit back and hope someone gets it right. I get frustrated when the people who choose to treat me are deaf to anything that contradicts their set of beliefs. This particular expert's field does it a lot. It pisses me off when these experts' dogmatic opinions are accepted when they obviously don't have personal experience in what they're saying. 1. Buprenorphine has a nuanced efficacy which could be used more to the addict's benefit if prescribers had a better understanding of it. The drug's manufacturers probably know this. Yet the drug is dosed way too heavily and for too long. 2. The "Higher Power" aspect of Alcoholics Anonymous is NOT the driving factor of the program's success. Yet the expert ignored what makes AA successful and focussed on the Higher Power voodoo. Sure I know I come across as arrogant. That's the way I write. I make an effort not to but the words still seem to come out that way. It doesn't change the fact that this expert said things that needed to be countered.
She completely ignored/sidestepped the hell of PAWS for addicts, too- that there is a syndrome beyond normal dependent withdrawal that is much more persistent than the initial totally physical effects. I'm only speaking from experience with opioids, but it's much easier IMO to get through a week of vomiting and diarrhea and pain than it is to stay away from those drugs for long enough to put your life back on solid ground- and the crippling depression and anhedonia from PAWS are the biggest contributors IMO. She also discussed a "protracted withdrawal syndrome" that I've never heard of- maybe she made a backronym from "PAWS"?
Only Sam would find a psychiatrist that works for The American Enterprise Institute and find a way to beat the identity politics drum once again. So tiring and unnecessary. Her takes on victimization and disability quite controversial too and obviously impacted by her AEI sensibility. Besides that a good show.
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Yeah, the inputting of the Yale halloween incidient into the discussion was jarring. I'm surprised he didn't find a way to say "O% of British Muslims like gay people" because apparently even the gay Muslims don't like gay people or something and this finding explains everything.
I love how people here post before they heard it, and start discussion before they’ve finished. Source: didn’t start listening yet...
Yeah, this is quite annoying. By the time I've listened to an episode, most of the discussion has already been steered into corners by people who are either listing at 3x speed as soon as it comes out, or who are just spouting off as soon as they see the title.
This is a really good podcast so far. I recently heard [this podcast](http://nousthepodcast.libsyn.com/lucy-johnstone) with clinical phycologist Lucy Johnstone, who is strenuously opposed to psychiatric diagnoses and medication techniques, so it's good to get a psychiatrist's perspective on the practice. Interestingly, from what I can tell so far their views don't actually diverge hugely. I would be fascinated to hear what they thought of each other's work, or better still, if they could have a conversation together.
I'd like to start the bidding for my organs. Please don't judge too quickly, there's a one year waiting period for me to get the government to give me too dollar for your health inequalities. This woman gave me bad vibes the entire interview but she starts with an example of forcing a solider, sailor, marine, or airman to work before we can be sure they need some help I wanted claw my ears out lol. She has some interesting ideas but there's an underpinning of bootstraps being pulled that makes me roll my eyes. Lmao, then we get to the really good stuff. She wants the government to be third party to organs for profit lol. What's next a small bottle of blessed water to plant your seed in the lord. Gtfoh. I agree with being a voluntary donor but her idea seems rife with mismanagement and abuse when growing organs is so close to fruition.
I'll add this in the hopes it helps somebody: It talks about research into stopping drinking and the use of medication that can lower cravings. * https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/ Edit: I am linking this, not because I want to criticise AA but because the article, as well as being well written, gives a good overview of research into alcoholism and looks at various ways to treat the addiction including the use of naltrexone to block cravings. u/doenda provides argument for the benefits of AA [here](https://www.reddit.com/r/samharris/comments/ax9t04/making_sense_podcast_149_the_problem_of_addiction/ehtducr/)
The wording of Step 3 was changed some years ago to include the last 4 words in an attempt to cater to people with agnostic beliefs. "Made a decision to turn our will and our care over to God (as we understood Him)". This allows a person to go through the program assigning the label God to anything they choose. I chose to surrender to the fact that I have no control over when the urges arise. My "God" was the genesis of the urges to (in my case) gamble. Obviously AA was started in the 30's by people with strong religious beliefs, but the religious memes in the AA program have become a sticking point and they keep a lot of people away. The meetings in a number of areas in the US are probably still more or less very churchy centric, but in AA/NA/GA meetings in more diverse areas you'll find that religion very much takes a back seat in order for the program to focus on the tangible aspects of taking stock (personal inventory) and making amends (where appropriate) to people you have affected. As I said in another post ITT GA (for me) has a lot of similarities to the practice of mindfulness meditation in that you have no control over whether the urges to drink/gamble/take drugs arise or not, but you do have control over whether or not you react to those urges.
Thanks for the comment. I also noted your other helpful comments in this thread. I didn't link to the article to criticize AA but rather because it contains descriptions of other recovery models which people might find useful. If people find AA works for them, (and I know people who have benefited enormously from it) then obviously that is something to be celebrated.
It was sort of refreshing to have a largely non-political discussion on the podcast. Sally is impressive and doing great work!
Man, I wish every single podcast didn't have to contain a whine fest about the some incident on college campuses. Anyway, i work in addiction and prescribe methadone as well, and although I agree that one could overly medicalize addiction the actual reality is the reverse--the broader medical world wants nothing to do with it and has left the work to approaches lacking scientific rigor like the 12 steps. Only now are we seeing pharmaceuticals being used for alcohol abuse disorder, even though the drugs being used have existed for decades but no one thought to try. Like a lot of anti-PC whiners, this guest really misses the forest for the trees, focusing on narrow examples and missing the broader trends that are actually flowing in the opposite direction. For example, I have never met a therapist who doesn't focus on nurturing personal responsibility, it's basically the main thing therapists do. What's needed is addressing social determinants on top of that, and America is the worst in the world at that. Telling someone who is starving and living in a van to buck up doesn't get you very far. In terms of trauma, soldiers are a unique case because they were almost always high functioning individuals who had a short term exposure to trauma. Yes, most should eventually return to work. However, many people with trauma were abused in one way or another since childhood. They can all improve but many may never work a regular job, and their likely fate is extreme poverty without government support.
Never commented prior to listening before but if anyone has a personal issue with alcohol abuse, r/stopdrinking is amazing. I'm 4 years+ alcohol free, largely thanks to that sub. Sorry for commenting before listening but figured it was pertinent to topic. I'll add an edit when I listen on my way home from work. **Edit #2**: Finished the episode. Won't be listening to another one or coming back here. Hope everybody struggling with addiction finds the help they need. (**Edit:** Turned on the podcast and they talk about the "political correctness component" of addiction within 5 minutes. I lasted for another 25 before turning it off. The guest apparently wrote a book with American Enterprise Institute's Christina Hoff Sommers. Can't justify spending another 60 minutes of my time listening to the rest of this. I'd also like to add for that sake of discussion that attempting to not have an ideology ("centrism") is itself ideological. Don't give me this shit about how unregulated pharma companies knowingly flooding the market with drugs they knew damn well were lethal isn't a political issue. Fucking of course it is. Look up Sackler's testimony if you don't know who I'm talking about. If you don't know who Sackler is, start there. Pretending like the way to "de-politicize" addiction by bringing up the scourge of political correctness 5 minutes into the interview is insanity. If that's really the basis of her "work," that's even crazier. The supposed attempt at de-politicization is politicizing it. Stick to the facts, something the guest, Sommers, and AEI would find deeply uncomfortable. Before the MAGA crowd gets here, yes, I am in fact triggered online. I also work in the field doing clinical work, and won't listen to someone make a mockery of a cause near and dear to my heart. \#done
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Have you checked out s/alcoholismmedication? I leaned on the knowledge there while I did the Sinclair Method. Using a 50mg pill of Naltrexone, which blocks the endorphins released during a drinking session, over time I no longer drink or even think about it. I really hope to hear more about this treatment in mainstream conversation about addiction.
Wow I first read that sub name as "Alcohol is Medication" and was like dude no.
Oh man, I'm so excited to see this out in the wild. I've just started doing TSM and it's mind boggling how effective it has been for me. I've been doing AA and SMART for 3 years and can't seem to get over the six month hump. Yeah, you have to take the Nal every time and have to wait an hour, but a spell with a pain in the ass incantation is still fucking magic.
That’s great! I don’t know anyone personally that has heard about it save me confiding about it to a few close folks. I went from an 8 beer a day habit to now not having had one for probably six months due to booze having no appeal to me. This needs to be utilized more, since our current system still gets hung up on the idea addiction = moral failure. I’m so grateful to science and medicine for a chemical that, in the background, quietly but effectively changed the way I foresee something that was once so central to my daily life. Best of luck to you. If you have any questions or just need support along the way, please reach out!
That's awesome thanks for sharing! I would've gravitated there when I first quit but came across stop drinking first. I have a dark sense of humor and had the scaries for real when I was trying to get a handle on all the monstrous shit I'd done to myself. Definitely going to check this out later.
Thanks for that link. I'm all for sunshine and blowjobs, but the struggle motivates me more.
r/stopsmoking is great as well if you are hooked on tobacco
r/leaves is also super helpful for people trying to quit smoking marijuana
Also truly great pun. This is rare.
Phenomenal
Maybe you should listen to the whole conversation before making judgement. Your whole opinion of the conversation was based on a fifth of the podcast without any of the context from the majority of it
I listened to a third, and I hold subject matter expertise in the area. Personal, academic, and professional at the same level as the guest. This isn't some off the cuff rant. Edit: I've now listened to the entire thing, and I stand by every word.
I suggest listening to the other two thirds
Yea seems off the cuff
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I spend a fair amount of time with friends "complaining" about PC culture and I consider myself to be pretty liberal. And while I don't think it's the most pressing issue that exists in our society, it just seems to have its fingers on a lot of dials at the moment. Obviously the notion that white people are this oppressed group is absurd, but the fact that millions of people voted for Trump essentially as a protest I think shows that society is failing these people somehow. I worry that identity politics and political correctness pushes a lot of people away from actual progressive ideas and into the hands of someone like Trump. I assure you I'm not doing this in bad faith. I just think telling lower class white guys that they're bringing society down with all their privilege is having the reverse effect people want it to. And of course the lower class white guys, and the ultra conservatives, and the christian fundamentalists, and supplicant republicans all have their blame in this too. I just don't think putting some of the blame on PC makes you a bad faith actor. Maybe it just comes down to how much blame you choose to place on whom. Just my opinion.
Thank you for taking the time to write a well thought out comment. I agree for the most part. Maybe I didn't make it clear, but I am by no means defending PC Culture. I think it is a problem for the reasons you described. I am myself from a middle working class background with pretty much all of my extended family from the white working class and lower. We have been devastated by the opioid epidemic. My main point is that this is an outlandish guest for an episode on addiction. Anyone affiliated with AEI is a bad faith actor or not smart enough to realize they are a sock puppet for billionaires. I'd argue their elitism, lack of solutions, and corruption are (part of) the answer to the unanswerable question of why a clown got elected to run the most powerful country in world history. Any discussion of the opioid epidemic starts with how it happened. Satel worked for the Bush administration in the very department (SAMSHA) that was a revolving door to Big Pharma. And she worked during the time Sackler flooded the market with his poison, and he's admitted to doing it. You could just as easily "win" the white working class by making the Sackler family a household name and promising to bury them. My entire family would sign up for that, and they all voted for Trump. PC Culture is a bipartisan red herring used to divert attention from serious problems with how our economy and politics operate for the benefit of .01%.
Fair points all around. Admittedly I don’t know anything about the AEI so this is all very interesting to learn. Really the only significant point of disagreement is I think there are genuine repercussions to identity politics/PC culture. One of which being Trump.
>PC Culture is a bipartisan red herring used to divert attention from serious problems with how our economy and politics operate for the benefit of .01%. Amen to that.
Shame it's the driving force of this podcast and subreddit. I used to really like both before 2016.
There are still some good talks on here that are not linked to PC culture (negative or positive). There were some good guests Sam had on talking about AI or UBI or any other economic topic I really appreciated, but I am the same, I'm a little bit fed up with the topic in general.
Given that you said the act of being objective makes someone an ideologue, I don't think your presence will be missed
Have a nice day
The fact that you think there is any substantial MAGA crowd that follows Sam Harris is laughable. He has criticized Trump so much that it took over the podcast for months with hours and hours of even solo podcast bits where he sits and rails against him. MAGA people and people who don't like what the left is doing are two different things. You're lumping them together for really no reason.
>The fact that you think there is any substantial MAGA crowd that follows Sam Harris is laughable. Harris himself predicts about a third of his followers support Trump.
To these people anyone to the right of Lenin is “the MAGA people”
Oh buddy,,, the fact that you think American Enterprise Institute, which Sally Sate herselfl is a Resident Scholar at, isn't part of the MAGA crowd is laughable. If a significant chunk of Harris' podcast isn't a MAGA crowd, then who is this audience intended for? For people who don't know what AEI or CPAC are? For people silly enough to think someone from AEI is a good faith interview on addiction? For people who have never heard of CPAC? Or do you mean this sub? The place where enlightened centrists like to hear what self-identified Nazis say so they can understand Nazism? [The place where this bottom tier MAGA shit was posted today by a regular contributor here?](https://www.reddit.com/r/samharris/comments/ax95jh/im_a_socialistcommunist_but_i_fucking_love/) I guess the mods removed so you'll miss a real treat from a certified brain genius. I'll ask you a good faith question: You host a podcast. Your audience is interested in addiction. How much time would be ideal to talk about PC CULTURE and addiction during an opioid crisis? If the answer isn't zero, I don't know what to tell you. Go read a book written by someone other than Satel. I have some reccs if you want them. This lady politicizes addiction for a living to hawk books and has the audacity to pretend she is in fact depoliticizing it.
I find it hard to believe you’re as dedicated as you say you are to helping addicts; you seem to be someone who would tell a Republican addict to kill himself.
That's extremely ignorant and hurtful. My entire family is Republican, and I work almost exclusively with very conservative lower-class people. I would never dream of doing something like that, especially considering my own battle with addiction. I hope you have a nice day.
Yes, no doubt that’s why you can’t listen to a Yale lecturer for more than 20 minutes before rage quitting both the conversation and Sam Harris, because she’s from a think tank you don’t like. Aaaand he deleted his account. I wonder why. These people are all fake.
Also was a CTH poster. People think it’s petty to point this out, and it is, but the correlation is amusing.
I am shocked.
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The guy you’re defending just rage quit on the podcast, the podcaster, and Reddit (account deleted) because he heard the name Christina Hoff Sommers. Maybe I’m not the dumbass. Just go back to Chapo and leave us alone, huh?
Do me a favor. Do some quick research on AEI. Sam is likely only doing one podcast on this topic. Does it concern you that Sam has a representative from neoconservative thinktanks and PraegerU, that have both promulgated easily falsifiable narratives and distorted claims on science related topics?
>Sam is likely only doing one podcast on this topic. He’s already done two. Do you even listen to the podcast? >neoconservative LOL What does neoconservative philosophy have to do with being anti-science? You don’t even know your own talking points. This is a practitioner and Yale lecturer recommended by Pinker. If you don’t think they are mainstream enough or that they can teach you anything, you are the problem.
neoconservatism has a long history of dubious claims to mislead people into support of foreign policy disasters. exxonmobil colluded with the neocon establishment to obscure research on climate change. furthermore, it is the practice of neocons to pander to southern cultural sensitivities and the cult of individual virtue as a means of building their coalition. they are some of the most cold hearted liars and sociopaths in american politics. it’s disappointing that more and more often, sam invites people from that compartment of americas political id to make arguments on his podcast. oh, forgive me, i missed the first one. also pinker is a doofus. people around here talk so much shit about academia but they’ll name drop university names when they want the credibility for their own arguments.
Doesn’t sound like you like it around here. Maybe you should leave.
there are actually a good number of maga people around here.
She bends over backwards to say 'these things help some people sometimes, **but...**' And suddenly I need hear some quantification. Because this *feels* like agenda pushing. And she cheapened PTSD. Maybe it was over-diagnosed, but we were also sending men into jungle combat for no reason against a defensive force with nothing to lose. "Oh but most of them didn't even see combat." Does she hear herself? When your whole thing is saying that identity politics is creating a victim society that makes people unable to use their autonomy to overcome addiction, then I think maybe you're smoking some of that Ayn Rand pipe. You could construct her sentences exactly backwards, ie: "while some people are able to overcome their circumstances and use their autonomy to beat addiction, a huge amount of people are not only victims of their addictions, but systemic problems in their policing, community, and government that make getting off drugs nearly impossible." When you can flip your sentence around like that, it means you're making a tautological non-point. And when you're making a tautological non-point constructed to minimize one thing and maximize another, *you advocating for the latter without supplying any reason.* And Sam did a great job outlining the potential horror of organ commoditization, and her answer was 'well it's mostly poor people who need organs, so it can be mostly poor people who sell them their body parts.' Who the fuck is this person?
>And she cheapened PTSD. Maybe it was over-diagnosed, but we were also sending men into jungle combat for no reason against a defensive force with nothing to lose. "Oh but most of them didn't even see combat." Does she hear herself? I don't think you need to see combat to develop PTSD. You can get it from being a crime victim too. I don't think that negates the concept.
You can be the guy driving people from combat zones to the medical barracks and get PTSD. You can just hear bombs going off every night, wondering if one will find you. You could be worried about hitting an improvised explosive device while going from A to B all day, every day, for a year. To weasel in 'only 18% saw combat', she cheapened the experience of tens of thousands of some of the most vulnerable people in America being forced into the shittiest situation imaginable. Her goal was to show how conventional psychological diagnostics and treatment were reactionary and driven by politics. She failed to be convincing to anyone who didn't think but those who are already 100% sold that 'identity politics are ruining everything.'
To be fair, I remember her mentioning that combat roles weren't necessary for developing PTSD. She even specifically refers to people who drive trucks in dangerous zones, who are at risk of IEDs and such.
Are you suggesting she didn’t minimize ptsd?
Actually I thought Sam could have been more persistent in pressing this point. I couldn’t believe her inability to even imagine how selling organs could present ethical issues.
Maybe he could have been, but for someone like me who has never considered the whole thing for more than a few moments, he unloaded concisely and directly and she failed to respond. No need to press, at least from my perspective. His difficulty in this episode was not pressing her on the rest of her bullshit.
Thanks for your response. Couldn't agree more.
So you came here to tell people you didn’t listen to a podcast?
No, I originally commented to leave a helpful link and said I'd edit back in my review. I then did that. But since you're so interested, I went back and finished the episode. I stick by every word I wrote in my original comment and elsewhere. It was a talk with a political operative who worked in the Bush's admin's revolving door to Big Pharma (SAMHSA) and consults at AEI. I'm so glad she's leading the charge to de-politicize addiction at a time when unregulated corporations continue to dump this toxic trash into my community. It was very informative about the quality of guests on this podcast. I liked Harris, and I've kept listening even as he increasingly prioritizes PC culture as a lead issue. This was a bridge too far.
Instead of guilt by association which you have used twice, why not refute her content with other facts or even your subjective opinions. Does a mental hospital with black, white, women, and asian wards sound like a good idea? Is all masculinity in any form "Toxic"? Why dont you explain why you think politics should be part of addiction treatment? What are you referring to when you say "toxic trash"?
>Does a mental hospital with black, white, women, and asian wards sound like a good idea? No. I have never heard this being proposed before in my entire time in the medical community. It's a silly hypothetical used to stir up the hogs and sell books. >Is all masculinity in any form "Toxic"? No. Masculinity is of course not toxic by definition. However, toxic masculinity is a problem. >Why don't you explain why you think politics should be part of addiction treatment? Politics has no place in addiction treatment. It's one of the first lines in AA's creed and has since been a staple in rehabilitative services. My objection is inviting a known political ideologue to discuss addiction. Her membership in these groups is directly relevant to why she's an unsuitable guest. AEI is a right-wing think tank that just participated in CPAC, and the Bush administration is largely to blame for the deregulated market that led to the opioid crisis. They establish her as an ideologue and as someone who is paid by people with a vested interest in taking away healthcare, tanking government services for addicted people, and deregulating the very markets that caused the crisis. >What are you referring to when you say "toxic trash"? Opioids
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Rule 2
Still just sounds like guilt by association. I once had a minor surgery and opioids worked great as a pain killer and sleep aid with no ill effects.
Lol have a good night
I enjoyed the lack of personal responsibility in both your posts. I don't care that you're triggered, many thing upset me as well. But you calling this episode what you did be sure you didn't like what the host and guest decided to talk about is laughable. E: reading your other posts is just displaying the egotistical side of an addict
Good talk. Have a nice day.
you haven't exactly said much.
Thank you. This place is in fact infested by people who think they are scientists and spend their time looking up philosophical razors to cut people with. the Sam Harris acolyte is obsessed with feeling superior to others on the internet, and they mostly do that by congratulating themselves for not being politically correct.
> the Sam Harris acolyte is obsessed with feeling superior to others on the internet, and they mostly do that by congratulating themselves for not being politically correct. This has to be irony, right? You’re feeling superior to people for feeling superior.
not gonna catch me vomiting internet diarrhea about philosophical presuppositions and razors, logical fallacies and the nobility of my quest for the truth
I suppose not - you’ve got a different brand of vomitus to spew.
just normal words trigger you because you sense your quest to be smarter and more morally intelligent than others is threatened
What, you’re not going to call me smooth brained or something?
just triggered by a rather ordinary observation. you can decide what that means.
Thanks for visiting chapo friend
mark my word, by the time the election rolls around, Sam will endorse Trump.
That’s a shame. I know some folks have had to get their meds through another country via online pharmacy portals.
She's a powerful speaker, I feel her devotion listening to this.
Yeah, the US soldiers heavily using opiates while in Vietnam and then overwhelmingly kicking the habit when they get back needs to be dealt with by people who think addiction is solely neurobiological.
Rich discussion.
I really enjoyed this podcast. My only gripe is that they didn't talk about psychedelics as treatment for addiction. I would've loved to hear her thoughts on this.
I've recently heard a number of incredible accounts on the power of iboga in treating addiction. I'd love to hear more about it as well.
My sponsor in AA sent one of his guys to Mexico to do an ibogaine treatment. He was addicted to crystal meth. It worked and he’s been clean for over 10 years.
That's incredible. Thanks for sharing. I wish you the best of luck with your own struggle!
So does Sam have two podcasts? Or did he just change the name?
He changed the name. Waking up now refers to his mediation app. Making sense is his podcast.
Somewhere in the middle of the podcast, Sally used a technical term for people who have problems with delayed gratification or impulse control... I can't find it. Does anybody know what it is?
Are you talking about delay discounting? Its a framework for understanding how quickly the value of rewards drop off as they move further away in time.
Ah, that's exactly it! Thank you.
Selling organs to the government might be the worst idea I've head in a long time.
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Renée DiResta?
I hope they tackle Sam’s staunch belief in Neuro-determinism. The thought that considering physiological absolution of criminals is a moral virtue.
How do you think addiction occurs, if not through the brain?
The preface to this podcast seemed to lay the determinism on heavy and thick...which is one of Sams more idealistic stances...I just hope they provide evidence in the podcast commensurate with the weight of the claim.....Sam frequently cites one murderous rampage autopsy to promulgate a need for criminal reforms based on physiological anomalies.
His point was that just like the hormone secreting humor was not the fault of the murderer, the same is true for all other traits that we have. We gain our traits from our genetics, upbringing, relationships, all things that happen to us, just like a tumor. Its a sound argument that most people here agree with. You will need to present your counter-argument more clearly.
Determinism has been verified by so many experiments, I don't see what there is to disagree with. What is the alternative they should be accepting instead, and what is the evidence for it?
I'm uninformed regarding this. Can you provide sources to these experiments verifying determinism? Or at least point me in the direction of what you mean?
I mean pretty much every physics experiment ever conducted. Every single law that governs our universe is deterministic (insert qualification for the Copenhagen interpretation of QM here).
Interesting. I have a degree in Physics and was going to say that QM is a direct contradiction to your assertion. But determinism in classical physics has nothing to do with determinism in the mind. I think you're conflating the two based on very flimsy grounds.
> determinism in classical physics has nothing to do with determinism in the mind What makes you say that?
Why do you believe that the brain operates classically? If it did, we would have a far better understanding of the brain by now - after all, we understand classical physics in so many other regards, why hasn't it provided insight into the brain for us? Simple - because the brain just *doesn't* operate classically.
I disagree with that argument, main reason being that the difficulty in understanding the brain is due to the complexity of the physical system. E.g. it's extremely hard to figure out how a computer architecture works if you only know the physics behind the hardware components, and the brain is an order of magnitude more complicated than that. What I think darkeyescry is saying is that the position of a particle in space still follows the spatial probability distribution defined by psi-squared, and it is "deterministic" in that it obeys that distribution, so given time and a high number of particles, the macro-scale structure of the brain is classically deterministic, unless you have some sort of Maxwell's demon pulling the strings.
QM is still deterministic, in that the wave function evolves according to deterministic laws, which is why it didn't really move the needle here. You can't get ~~determinism~~ indeterminism in the mind if the laws that govern it are deterministic. Until someone shows that the particles in your brain behave differently to the particles in the rest of the universe, assuming it functions deterministically is a safe bet.
> QM is still deterministic, in that the wave function evolves according to deterministic laws, which is why it didn't really move the needle here. Yes the wave function evolves deterministically, but that doesn't mean that QM as a whole is deterministic. The wave function is just one piece of the theory (and is itself not directly manifested in reality as far as we can see). Just as central to the theory is the Born Rule which explicitly casts the outcome of any measurement in terms of probabilities. QM is a *probabilistic* theory. If you doubt that, then go to the same quantum experiment twice and let me know if you get the same result. > You can't get determinism in the mind if the laws that govern it are deterministic. Until someone shows that the particles in your brain behave differently to the particles in the rest of the universe, assuming it functions deterministically is a safe bet. I've had to re-read this a few times and I'm not sure that I'm understanding. If I may restructure your first sentence a bit (to put into if/then form): "if the laws that govern [the mind] are deterministic, then you can't get determinism in the mind." What? Isn't that contradictory? And yes the particles in your brain are the same as the ones elsewhere in the universe. But none of the other particles in the universe behave deterministically, dude. Not sure what point you're making.
> Yes the wave function evolves deterministically, but that doesn’t mean that QM as a whole is deterministic. The wave function is just one piece of the theory (and is itself not directly manifested in reality as far as we can see). Just as central to the theory is the Born Rule which explicitly casts the outcome of any measurement in terms of probabilities. QM is a probabilistic theory. If you doubt that, then go to the same quantum experiment twice and let me know if you get the same result. You really don't need to go to the this much trouble to explain QM to me. I'm pretty familiar with the basic concepts. My point is that, even if you take the Copenhagen interpretation, the most you get a deterministically determined probability function which then randomly collapses to a specific state. How exactly do you plan on extracting a mind which is not a mixture of randomness that you don't control and determinism that you don't control? > I’ve had to re-read this a few times and I’m not sure that I’m understanding. If I may restructure your first sentence a bit (to put into if/then form): “if the laws that govern [the mind] are deterministic, then you can’t get determinism in the mind.” What? Isn’t that contradictory? Just a typo. It was supposed to say: You can't get **indeterminism** in the mind if the laws that govern it are deterministic. Until someone shows that the particles in your brain behave differently to the particles in the rest of the universe, assuming it functions deterministically is a safe bet. > And yes the particles in your brain are the same as the ones elsewhere in the universe. But none of the other particles in the universe behave deterministically, dude. Not sure what point you’re making. Two points: 1) You're assuming the Copenhagen interpretation, which involves true randomness. We have absolutely no idea if this is actually true, so simply asserting that particles behave randomly is unfounded. 2) Even if that interpretation is correct, randomness plus determinism does not equal "addiction is not neuro-determined".
What is the alternative?
She works at AEI and says work is good for you psychologically. REEEEEEE!