Speaker 1: Hello, and welcome to the Psychology Podcast with doctor Scott
Speaker 1: Barry Kaufman, where we give you insights into the mind, brain, behavior,
Speaker 1: and creativity. Each episode will feature a new guest who
Speaker 1: will stimulate your mind and give you a greater understanding
Speaker 1: of yourself, others, and the world we live in. Hopefully
Speaker 1: we'll also provide a glimpse into human possibility. Thanks for
Speaker 1: listening and enjoy the podcast. I'm really excited to have
Speaker 1: Maya Solvitz on the show today. Maya is one of
Speaker 1: the premier American journalists covering addiction and drugs. Her work
Speaker 1: often appears in Time dot Com, The New York Times,
Speaker 1: Scientific American, Ella, Vice, and New York Magazine. She's a
Speaker 1: twenty fifteen twenty sixteen Soros Justice Fellow and has received
Speaker 1: major awards for a coverage of neuroscience and addiction from
Speaker 1: the American Psychological Association, the Drug Policy Alliance, and the
Speaker 1: American College of Neuropsychopharmacology. Her latest book is Unbroken Brain,
Speaker 1: A Revolutionary New Way of Understanding Addiction. Thanks for chatting
Speaker 1: with me today, Maya, Sure, thanks so much for having me.
Speaker 1: Wanting to chat with you for a long time about
Speaker 1: this topic. In this book. I appreciate it. Now, this
Speaker 1: book was very personal, the heavily scientifically researched. Is there
Speaker 1: a part of you that wishes you when you were
Speaker 1: in the thick of this had done that scientific research
Speaker 1: and had that knowledge, then well, I mean, yeah, it
Speaker 1: certainly would have been better if I had known early on,
Speaker 1: you know, what I was facing. But you also, to
Speaker 1: be frank, the knowledge has changed. The way we saw
Speaker 1: in the eighties is thankfully somewhat different to the way
Speaker 1: we see it today, although we're still struggling with the
Speaker 1: ideas left over from centuries of moralizing about this. So
Speaker 1: let me ask a very blunt question, and if I
Speaker 1: may sure, how did you go from being a gifted
Speaker 1: child and Ivy League scholarship student to injecting cocaine and
Speaker 1: heroin up to forty times a day. Well that is
Speaker 1: the story of the book. But briefly, I can say
Speaker 1: that I think I had undiagnosed Asperger syndrome as a child.
Speaker 1: What this meant is that the world was just too
Speaker 1: intense for me, and I was kind of overwhelmed by
Speaker 1: all kinds of normal sensory and emotional experiences, like you know,
Speaker 1: loud sounds, and itchy clothes and tastes and all of
Speaker 1: these kinds of things. This left me very socially isolated
Speaker 1: because I was always kind of just trying to deal
Speaker 1: with everything. And also the fact it was helpful in
Speaker 1: the sense that I was reading at three and it
Speaker 1: was clear that I was smart. But unfortunately I decided
Speaker 1: that my inability to connect with people and my sort
Speaker 1: of controlling nature because of trying to deal with my
Speaker 1: sensory stuff, meant that I was a bad person and
Speaker 1: was doomed forever to you know, not be able to connect. Yeah,
Speaker 1: and I think it's really interesting you said that you
Speaker 1: think you had aspers Were you ever diagnosed officially with Asper's.
Speaker 1: I have not actually been diagnosed officially, and I sort
Speaker 1: of thought about doing that for the book, but you know,
Speaker 1: I've had so many other diagnoses, and I kind of
Speaker 1: just feel like I know the flaws of the diagnostic
Speaker 1: system so much that it seems silly to get an
Speaker 1: official pronouncement from a system that is kind of screwy. Yeah,
Speaker 1: so I just figured, you know, whatever, I mean, I
Speaker 1: think that it is fair to say if you saw
Speaker 1: a three year old who was reading who had, you know,
Speaker 1: sensory overload issues, who had social problems, who was very
Speaker 1: took everything literally, was always getting bullied, and basically had
Speaker 1: pretty much all of the classic aspy symptoms that you
Speaker 1: know I probably would have been diagnosed. I also was
Speaker 1: diagnosed with ADHD at age three, which I did not
Speaker 1: discover until I was researching this book. I knew that
Speaker 1: I had briefly been on riddle in, and I knew
Speaker 1: that I had been diagnosed as hyper esthetic, which basically
Speaker 1: means oversensitive, but I didn't know until I talked with
Speaker 1: my mom that actually I had gotten an ADHD diagnosis.
Speaker 1: And about a third of people with aspers also have ADHD,
Speaker 1: so that's kind of another clue there. I think, just
Speaker 1: taking a very granular look at this, or a very
Speaker 1: broad look at taking a very broad look at this,
Speaker 1: I think it's just incredible. You're what you've overcome, what
Speaker 1: you've you know, the fact that you could have it
Speaker 1: at your height, been doing cocaine heroin up to four
Speaker 1: times a day, and then they scan your brain and
Speaker 1: they say it's normal. You know. I think this is
Speaker 1: a very I want to like kind of start with
Speaker 1: there before we get into all the details. Kind of
Speaker 1: like the big picture here, you know, there's I think
Speaker 1: can give a lot of hope to a lot of
Speaker 1: our listeners, and you know a lot of things you
Speaker 1: say are going to be surprising to people. You know,
Speaker 1: like that the older you get, the greater chances of
Speaker 1: recovering from addiction are and things like that. So I
Speaker 1: think that's just so interesting and not only quote normal,
Speaker 1: because who what is a normal brain? But they found
Speaker 1: that you have great cognitive control, so you kind of
Speaker 1: like emerged from this like stronger in a way, right,
Speaker 1: I mean, yeah, it's like it's hard to tell if
Speaker 1: that you know, sort of superior impulse control, which I
Speaker 1: don't always feel, but which I think part of the
Speaker 1: thing that was really funny about it was I'm clausterphobic
Speaker 1: and I'm lying in the scanner and is taking ninety
Speaker 1: percent of my impulse control to like not keep the
Speaker 1: ticket out of there. You know that I was actually
Speaker 1: okay on that task. I was kind of surprised about.
Speaker 1: I also did another task completely backwards, so you know,
Speaker 1: clearly the stress was going on there, but they were
Speaker 1: able to analyze that because I did everything completely backward,
Speaker 1: so they could you know, run it as the positives
Speaker 1: were negative basically. But yeah, I mean, it has been
Speaker 1: an incredible journey, and it's very hard to know whether
Speaker 1: that sort of good impulse control came from recovery or
Speaker 1: allowed me to recover. And one of the things I've
Speaker 1: always thought was interesting was that I did get into
Speaker 1: recovery when I was twenty three, which is kind of
Speaker 1: around the time for most people that the cortex is
Speaker 1: kind of finishing itself up. And you might imagine that
Speaker 1: I was not able to stop before that because I
Speaker 1: just didn't have the ability to put on the brakes,
Speaker 1: and then finally I gained it because you know, something
Speaker 1: allowed that to grow. Yeah, I mean it's I don't
Speaker 1: know if you could say any brain is normal, and
Speaker 1: I'm certainly I don't think they would have described me
Speaker 1: as neurotypical, because I don't think there is such a thing,
Speaker 1: but it was certainly the case that, you know, there
Speaker 1: was no obvious damage, and I was very glad of that, obviously.
Speaker 1: But I mean, I think one one of the things
Speaker 1: that I've always thought about our conception of addiction that
Speaker 1: I find to be wrong is that I think, and
Speaker 1: I think there's a lot of data to support this.
Speaker 1: What goes wrong in addiction is that you fall in
Speaker 1: love with a drug or a compulsive behavior rather than
Speaker 1: a person, or rather than becoming focused appropriately on your
Speaker 1: new baby. And we have systems in the brain that
Speaker 1: are there to change our priorities when we fall in love,
Speaker 1: and to change our priorities when we have a kid,
Speaker 1: and to make us persist despite negative consequences in order
Speaker 1: to maintain that relationship or successfully raise that kid. You know,
Speaker 1: if we couldn't, nobody would ever, you know, everybody would
Speaker 1: kill their kids because it would be too impossible to
Speaker 1: deal with them. You know, they have that incredible puteness
Speaker 1: that makes you love them, and you know, unfortunately, when
Speaker 1: that kind of intense obsession gets directed towards a drug,
Speaker 1: you end up with people behaving very strangely, and it
Speaker 1: looks like people are choosing to do this perverse thing,
Speaker 1: that is, you know, destroying their life. And so I
Speaker 1: always felt that that's an example of kind of mislooking
Speaker 1: or pathological learning. But it's not really an example of
Speaker 1: brain damage. And that's not to say that if you
Speaker 1: you know, you can damage your brain, particularly with alcohol
Speaker 1: and certainly with the high doses of many different drugs.
Speaker 1: But that kind of damage that occurs is neither necessary
Speaker 1: nor sufficient to cause addiction. And we can tell this
Speaker 1: because gambling addiction exists with no chemicals whatsoever. Well, what
Speaker 1: do you think of sex addiction? Do you think that's
Speaker 1: a real form of addiction? Yes, I do think that.
Speaker 1: I mean, I also think that our culture kind of
Speaker 1: goes crazy with this, but I think that. You know,
Speaker 1: I've obsessed about the definition of addiction since before I
Speaker 1: actually got addicted, And the best definition that I really
Speaker 1: have found is this idea that addiction is compulsive use
Speaker 1: despite negative consequences, or compulsive behavior despite negative consequences. And
Speaker 1: this is basically how you can sum up the DSM definition.
Speaker 1: This is how the National Institute Drug Abuse defines addiction.
Speaker 1: I mean, it's a widely accepted definition at this point.
Speaker 1: And that's because if you just define addiction as like
Speaker 1: needing something to function, Prozac is addictive, you know. I mean,
Speaker 1: in the eighties, part of what allowed me to rationalize
Speaker 1: my cocaine addiction at least was I read, you know,
Speaker 1: in Scientific American that cocaine is no more addictives than
Speaker 1: potato chips. And now, of course we think potato chips
Speaker 1: are addictive, but The point really is that addiction has
Speaker 1: to involve compulsion and harm. It isn't just needing something,
Speaker 1: Because if it was just needing something or depending on something,
Speaker 1: we'd all be addicted to each other, we'd all be
Speaker 1: addicted to air, all being addicted to food. It just
Speaker 1: would become a kind of useless concept. I have a
Speaker 1: confession to make. I am kind of addicted to air. Yeah,
Speaker 1: I mean, you know, people will do some pretty intense things.
Speaker 1: So I've been thinking about like labeling, and I remember
Speaker 1: when we had met in New York a couple of
Speaker 1: years ago, we talked a little bit about labeling, and
Speaker 1: we're talking about the un Gifted, and I read in
Speaker 1: the book that you say that like label's not necessarily
Speaker 1: a bad thing. I think there's a footy quote in
Speaker 1: there by Elder Robinson maybe saying I would rather have
Speaker 1: a label than being called what I'm called on the streets. Yes, yes, yeah,
Speaker 1: I mean I thought yes, And I thought that was
Speaker 1: kind of profound. I think that what sometimes unfortunately happens
Speaker 1: with children and that can have a terrible effect on
Speaker 1: your long term development and mental health, is that if
Speaker 1: you are an outlier, if you don't fit in if
Speaker 1: you feel very different and you don't have any kind
Speaker 1: of label or any kind of way of understanding that
Speaker 1: you might give yourself or other people might give you
Speaker 1: all kinds of labels that are harmful, like selfish and bad,
Speaker 1: and you know, completely unable to socialize and instead of
Speaker 1: you know, when I learned about Asperger syndrome, I was like,
Speaker 1: oh my gosh, there's an explanation for all these weirdnesses
Speaker 1: about me, and they all fit together. Before that, I
Speaker 1: just had thought that, like, I'm socially awkward, I have
Speaker 1: these intense sensory and emotional dysregulation experiences. It just didn't
Speaker 1: fit together. I think that with children, you know, some
Speaker 1: children would take that ass be label and be like, Okay,
Speaker 1: you know, this brings some advantages and some disadvantages, but
Speaker 1: at least I'm not a Martian. At least I'm not
Speaker 1: you know, bad. At least this is a thing that
Speaker 1: is recognized that something can be done about. Now, other
Speaker 1: kids might react to it and be like, well, this
Speaker 1: means I'll never have friends and it's limiting and you know,
Speaker 1: I can't do anything. And obviously that is not the
Speaker 1: reaction want. But I think, you know, when we can
Speaker 1: understand these collections of symptoms that tend to hang together.
Speaker 1: It can really help people understand themselves. And we have
Speaker 1: to be careful not to make a label into a
Speaker 1: sort of prophecy. It's just sort of a thing you
Speaker 1: can use to help yourself understand yourself and other people
Speaker 1: and understand, you know, the way you react to the world.
Speaker 1: I mean, you know, it was very interesting because I
Speaker 1: had actually written an earlier version of this book when
Speaker 1: I was in my twenties, no way, yeah, yeah, And
Speaker 1: do you have it saved? Yeah? I had it. I
Speaker 1: used it that. I mean, it's interesting because there were
Speaker 1: certain things that I now disagree with in terms of
Speaker 1: my view on addiction, but the you know, raw emotional
Speaker 1: and sensory experience was there. And when I did write that,
Speaker 1: I had never heard anything about autism or aspergers or
Speaker 1: anything like this. And I was really curious when I
Speaker 1: went back and read it to see, you know, what
Speaker 1: kind of emphasis I placed on the sensory stuff and
Speaker 1: on the dysregulation and this kind of stuff. And it
Speaker 1: was all great there. It was not like I had
Speaker 1: retrospectively imposed this framework on it. It was all really
Speaker 1: visible there. So it was that was. I was really
Speaker 1: glad that I had that to work with and that
Speaker 1: I hadn't had to later disagree with myself publicly. But
Speaker 1: it was really useful because it did give me, you know,
Speaker 1: the freshness and the rawness of the period of early
Speaker 1: recovery and the experience of, you know, undergoing such a
Speaker 1: dramatic change. That is so cool that you kept that,
Speaker 1: and what a valuable resource that was for you, you you know,
Speaker 1: thinking about this case. We talked in the book about
Speaker 1: how you want to place addictions in the same category
Speaker 1: as developmental disorders and talk about the importance of learning
Speaker 1: and addiction, and it was thinking about this you were
Speaker 1: talking about the patients who maybe or on morphine went
Speaker 1: for a couple of weeks to help them with pain,
Speaker 1: and then when they come home, they might feel like sick,
Speaker 1: like nauseous, shulder, but they don't know what to attribute
Speaker 1: it to, so they just sort of like, you know,
Speaker 1: kind of just wade through it, right, But they may
Speaker 1: think to that, But the thing is what they might
Speaker 1: actually be going through is addiction withdrawal symptoms. But because
Speaker 1: they don't know, ignorance is bliss when it comes to addiction.
Speaker 1: It sounds like you're saying. If I had to summarize
Speaker 1: it in a sense, I think it's very interesting because
Speaker 1: I was speaking with some doctors. You know, obviously we
Speaker 1: have a big opioid problem right now, and I was
Speaker 1: speaking with some doctors about, well, what if you just
Speaker 1: didn't even tell people they were being given opoints right,
Speaker 1: right experiments. But the thing that is interesting there is that,
Speaker 1: right you cannot be addicted unless you know what you're
Speaker 1: addicted to. Otherwise you can't go out and seek it
Speaker 1: despite negative consequences. And this is another thing about the
Speaker 1: importance of the distinction between addiction and physical dependence, because
Speaker 1: you know, like a baby can be physically dependent. A
Speaker 1: baby can unfortunately be born with opioids in their system,
Speaker 1: and since they were in the womb and that was
Speaker 1: the background for them, they have physical dependence on it.
Speaker 1: But that baby does not know that heroin is what
Speaker 1: it needs. All that baby knows is that it feels uncomfortable.
Speaker 1: But that might mean I need to be breastpread, I
Speaker 1: need to be hugged, I need to be changed, like
Speaker 1: it could mean anything that a baby, you know, experience
Speaker 1: is discomfort about. And also since the baby can't exactly
Speaker 1: you know, crawl out of the hospital and get itself
Speaker 1: to a drug dealer. It cannot continue to use despite
Speaker 1: negative consequences. And this sounds like it's silly distinction, but
Speaker 1: it really matters because when we labeled children as crack
Speaker 1: addicted during the eighties, that label was actually more harmful
Speaker 1: to some of those children than the drug itself. And
Speaker 1: that was because people interpreted their behavior as evil when
Speaker 1: it was actually sort of normal toddler behavior, and that
Speaker 1: set up sort of negative spirals for some of these kids.
Speaker 1: I mean, I wrote about case once where there were
Speaker 1: these four kids who were adopted and their parents were starving.
Speaker 1: The adoptive parents were starving them, and they were, you know,
Speaker 1: the twenty year old with something like so skinny that
Speaker 1: he looked like a four year old. I mean, it
Speaker 1: was horribly creepy. But the way, like the social workers
Speaker 1: had been in and out of these people's house and
Speaker 1: everybody thought they were wonderful. The other kids were fine.
Speaker 1: Everybody thought they were these wonderful parents because they were
Speaker 1: putting up with these horrible crack babies who had this
Speaker 1: horrible behavior and they were anarexic somehow from crack. Even
Speaker 1: though of course it was now twenty years since they'd
Speaker 1: been exposed to it. But it's the idea that crack
Speaker 1: turns you into a horrible monster who should be punished
Speaker 1: by withholding food that did way more damage than that
Speaker 1: exposure in the womb could have done to these kids. Look,
Speaker 1: I love the humanity that you put into this, into
Speaker 1: this topic, which is really rare in discussions of addiction.
Speaker 1: You say addiction is not a sin or a choice,
Speaker 1: it's not a chronic disease like Alzheimer's, and you do
Speaker 1: place it in the class of developmental disorder. I would
Speaker 1: like to really unpack this further, because you know, I'm
Speaker 1: not one hundred percent convinced. There are some things I'm
Speaker 1: trying to understand. Like you know, when you have a
Speaker 1: developmental disorder, you let's say you're on an autism spectrum
Speaker 1: and you show repetitive behaviors. Let's try in an analogy
Speaker 1: of some sort, and you show very narrow interests, but
Speaker 1: you're very obsessive to the point of maybe obsession about
Speaker 1: a particular repetitive structure or something, whether it's music or
Speaker 1: it could be creative things. I mean, we underestimate they
Speaker 1: send to which people on auto the spectrum that even
Speaker 1: being obsessed about something in particular can still lead to
Speaker 1: development of greatness, right, absolutely, yeah, So is it more
Speaker 1: of a like the similarity there is not in terms
Speaker 1: of the potential harmfulness of the object of obsession despite
Speaker 1: negative But the thing is with the development disorders, what
Speaker 1: is the negative aspect though in the way that you
Speaker 1: defined addiction, What is the persisting despite negative of results.
Speaker 1: What is that in the autism or the ADHD that
Speaker 1: well do So if you think about like the way
Speaker 1: I think about addiction as a developmental disorder is as
Speaker 1: a very complex, heterogeneous one, just like everything else in psychiatry.
Speaker 1: So if you think about it, okay, developmental disorders have
Speaker 1: certain characteristics. One of them is that they tend to
Speaker 1: have an onset at a specific time in life, at
Speaker 1: a specific part of brain development. And this is really
Speaker 1: true of addiction, since ninety percent of it starts in
Speaker 1: the teams or early twenties, which is exactly the time
Speaker 1: before the cortex has fully developed and the time when
Speaker 1: you are really developing those systems that are involved in
Speaker 1: mating and reproduction. So this, you know, this is one
Speaker 1: clue to this. Another clue to it is that there
Speaker 1: are sort of many different pathways into it. So you know,
Speaker 1: if you have autism or ADHD, there may be many
Speaker 1: different genetics that lead you to that. And with addiction,
Speaker 1: you know, for example, let's say you have you know,
Speaker 1: ADHD increases the odds of addiction by like factor of
Speaker 1: four or five. It's something really large, you know, And
Speaker 1: I think that is because of the sort of sensory
Speaker 1: and the dysregulation that it imposes on your nervous system
Speaker 1: and how that makes it hard to fit in with
Speaker 1: other people and just be comfortable and just pay tention.
Speaker 1: But you know which gene creates that? Who knows, right,
Speaker 1: So I think you know, the other thing that's interesting
Speaker 1: about developmental disorders is that they sort of unfold based
Speaker 1: on these you know, sort of small influences at particular
Speaker 1: times and development. So let's say, like I think, well,
Speaker 1: psychiatric disorders are developmental. So let's take depression for example.
Speaker 1: You know, let's say a kid starts hating themselves because
Speaker 1: they feel alienated and they feel like they have no
Speaker 1: friends and nobody likes them, and then they start ruminating
Speaker 1: on that and that comes on top of like some
Speaker 1: kind of temperament that already predisposed them to feel a
Speaker 1: little out about the world, and then their parents also
Speaker 1: have a depressive style, let's say. So all of that
Speaker 1: coming at a time when the brain is forming itself
Speaker 1: can kind of build in these grooves that end up
Speaker 1: leading towards the direction of depression. And then that pain
Speaker 1: that comes from the experience of depression can lead you
Speaker 1: during adolescence to try to find ways to feel better,
Speaker 1: and drugs can often be a way of doing that.
Speaker 1: And then when you have exposed yourself to a substance
Speaker 1: that seems to work at least at first, that sets
Speaker 1: you up for the pattern of the compulsive use despite
Speaker 1: negative consequences, and it also sets you up to not
Speaker 1: learn the coping skills that could instead help you avoid
Speaker 1: getting so locked into that one behavior. So, yeah, that
Speaker 1: does make sense. So I'm trying to think of like
Speaker 1: everything in this world. Everything has like a point where
Speaker 1: it's adaptive, and then it gets too much and it's
Speaker 1: not adaptive anymore, you know, like everything. I'm just trying
Speaker 1: to take a very very broad view here. So love
Speaker 1: is not necessarily addictive, but love can become addictive having
Speaker 1: obsessive and actually I actually think to just interrupt for
Speaker 1: a secondary I actually think that a lot of role. Though.
Speaker 1: I think that love is the template for addiction. I
Speaker 1: think that like it's like the thing in the brain
Speaker 1: that predisposes us to addiction. Now it may also be
Speaker 1: the case that food seeking and behavior around food is
Speaker 1: another template prediction. But it's these fundamental survival systems that
Speaker 1: are good to set your priorities towards seeking this particular greame.
Speaker 1: That's exactly where I was going with this. You know,
Speaker 1: So at a very broad level, absolutely we have basic
Speaker 1: needs that from like a cybernetic perspective, like regulate itself
Speaker 1: to reach homeostace. It wants it to reach homeostasis. We
Speaker 1: can go beyond love. We can also talk about being
Speaker 1: addicted to esteam, which is what narcissism is. My view
Speaker 1: is that's how I view narcissism is addiction to esteem.
Speaker 1: So you can become addicted to any of our basic
Speaker 1: needs and in a way that makes it, like you said,
Speaker 1: absolutely shifts our priorities very I think very maslow about this.
Speaker 1: It becomes a very pre potent need. We kind of
Speaker 1: prioritize it over other goals in our life. It kind
Speaker 1: of like snaps it into that being the primary goal
Speaker 1: in our life, so our purpose all of a higher
Speaker 1: level goals kind of get you know, put aside. So
Speaker 1: I think that's true. So what I'm trying to think
Speaker 1: is like from within the same framework of development or
Speaker 1: as psychiatric source, maybe that's all part of the same thing.
Speaker 1: So like as very adaptive to find repetitive, sort of stable,
Speaker 1: secure things. You know, security is a basic need as well, right,
Speaker 1: but you can find also we can become you know,
Speaker 1: like there are people and dispositions that when it interacts
Speaker 1: with certain environmental et cetera, et cetera, they become extraordinarily
Speaker 1: sensitive to disorder and to things that are chaotic. And
Speaker 1: people with autism really like certainty and like to know,
Speaker 1: you know, things that are repetitive. And you can go
Speaker 1: case by case and go like ADHD. You know, it
Speaker 1: was adaptive for exploration. The exploration need is what I
Speaker 1: would say driving that, and that's what I'm working on
Speaker 1: in this new theory. I'm working on that the exploration
Speaker 1: is a basic human need. But again you could become
Speaker 1: addicted to exploration. Great. So I think everything has its
Speaker 1: homey stage point and then in its addictive point when
Speaker 1: I say everything I'm saying all biological needs. Yeah, I mean,
Speaker 1: I think that's a really interesting point. And I think
Speaker 1: that you know what often, you know, basically, these are
Speaker 1: sort of cycles that elaborate themselves, and if you get
Speaker 1: stuck in the wrong groove, it becomes pathological. You can
Speaker 1: get stuck in a good groove and then you're like
Speaker 1: a brilliant composer, right, and you're obsession with understanding, you know,
Speaker 1: music theory is going to you know, pay off in
Speaker 1: all kinds of wonderful ways in a way that like
Speaker 1: your obsession with finning a wheel on a car toy
Speaker 1: car would probably not do. So. I think one one
Speaker 1: of the characteristics of being on the spectrum may be
Speaker 1: sort of learning too quickly, Like you lock into something
Speaker 1: before you get very quickly, Oh there's an association here,
Speaker 1: but you like sort of fixate on it instead of
Speaker 1: being flexible about it. And sometimes that's useful and sometimes
Speaker 1: that's harmful. But right, all of these things and all
Speaker 1: of these ways of connecting and understanding the world, you know,
Speaker 1: have good sides and bad sides. And I think, you know,
Speaker 1: this is why I really do like and I talk
Speaker 1: a little bit of in the book about the idea
Speaker 1: that you know, the things that you know can cause
Speaker 1: us the greatest harm may also be able to allow
Speaker 1: us the greatest joy if we can direct them appropriately.
Speaker 1: And I mean, I do think that the persistence through
Speaker 1: obstacles is really useful, you know, as long as you're
Speaker 1: not like seeking drugs, if you're seeking like success, if
Speaker 1: you're trying to, you know, make your relationship work, if
Speaker 1: you're trying to do things that are productive, like you know,
Speaker 1: nobody could ever succeed in the arts if they weren't
Speaker 1: able to persist us by rejection. I love that. I
Speaker 1: love that you put two things together that have typically
Speaker 1: not been put together, neurodiversity and that people who are
Speaker 1: what we call addicted in society or put that label on.
Speaker 1: I love how you put it under a bigger umbrella
Speaker 1: of appreciation and tolerance. So I love that. I love that.
Speaker 1: I have been very, very pleased by the fact that
Speaker 1: the autism world has not freaked out by me saying
Speaker 1: should embrace people with addiction as neu diverse. I was
Speaker 1: a little anxious because of the stigma around addiction, that
Speaker 1: a lot of people would feel like, you know, oh,
Speaker 1: like those are the bad people and you know, you
Speaker 1: shouldn't be comparing it. And I was really interested to
Speaker 1: see a study that came out. It was looking at
Speaker 1: like basically the entire Swedish population from certain years, and
Speaker 1: they found that people with autism diagnoses who had normal
Speaker 1: to high IQ actually had double the risk addiction compared
Speaker 1: to ejentulation. And you know, I sort of thought, oh, well,
Speaker 1: I'm just kind of really a weirdo in this too.
Speaker 1: But I started talking to other people on the spectrum
Speaker 1: who also have addictions and for this article that I
Speaker 1: wrote about that, and it was it was really quite fascinating.
Speaker 1: Oh yeah, I think that you know, you find in
Speaker 1: the autism community just great tolerance and just the neurodiversity
Speaker 1: community in general for anything. But where do we draw
Speaker 1: the line? I find this a very stimulating conversation, and
Speaker 1: so I have like really you know, unbaked questions for you,
Speaker 1: but that I am so excited to get a chance
Speaker 1: to explore with someone. And that's what I love to
Speaker 1: do in this podcast. Anyway. I'm just like, I'm addicted
Speaker 1: to curiosity. That's my probably downfall in life. You know,
Speaker 1: sometimes asking is essential, I mean, and any you know,
Speaker 1: I'm addicted to it. I don't know about that. Okay, Look,
Speaker 1: when I was reading your book, like I saw a
Speaker 1: new book idea in my head as a cheek because
Speaker 1: I'm cheeky, I'm a little bit cheeky. I'm like, Okay, well,
Speaker 1: serira killers, let's put them part of the NeuroD different Now.
Speaker 1: I'm not saying ur seria killers are the same, and
Speaker 1: that's not all I'm saying, but I'm saying we could
Speaker 1: take this what happens if we scale this up and
Speaker 1: we say, I think I could make a case that
Speaker 1: like rapist Serraco or is, like you know, they're like,
Speaker 1: it's some kind of like extreme alteration of what's a
Speaker 1: basic drive in all of us. Do you know what
Speaker 1: I'm saying? I do yet. I am actually quite interested
Speaker 1: in antisocial personality sort of men psychopathy, and I think
Speaker 1: that if you look at the neurology of psychopathy, you
Speaker 1: can make as good an argument for it being a
Speaker 1: brain disease as you can for addiction being a brain
Speaker 1: disease or for depression being a brain disease. And nobody
Speaker 1: wants to wrestle with that. Psychopathy was not put into
Speaker 1: the DSM so that it could not be used as
Speaker 1: an excuse for criminal behavior, and it is. You know,
Speaker 1: both ASPD and psychopathy, which is the extreme of ASPD,
Speaker 1: basically are kind of diagnoses of being a bad person.
Speaker 1: You cannot have those conditions without harming others, like you
Speaker 1: can have addiction without It's like not essential to hurt
Speaker 1: others to be addicted, you know, And it's not essential
Speaker 1: to hurt others to be depressed, even though in both
Speaker 1: of those instances others will often be hurt. But the
Speaker 1: with you cannot be antisocial without harm. And so I
Speaker 1: keep thinking about writing this, and I've never really just
Speaker 1: got down and done it, but I do think we
Speaker 1: need to deal with that because what you know, it's
Speaker 1: not your fault that you are wired in a way
Speaker 1: such that you don't feel fear and you have difficulty
Speaker 1: to empathy. But it's not other people's fault that you,
Speaker 1: because of that wiring, you might kill them right right,
Speaker 1: right right exactly. So if someone is coming at me
Speaker 1: because I try to practice, I just thought of another
Speaker 1: book title, how about radical acceptance of others, not of yourself,
Speaker 1: because there's so many books and radical acceptance of yourself,
Speaker 1: you know, But anyway you know, like self compassion, like,
Speaker 1: there's so many books on that, but what about like
Speaker 1: what would radical acceptance of others look like? It would
Speaker 1: go to the extreme in the sense that, now, if
Speaker 1: someone is coming at me with a machete, you know,
Speaker 1: an antisocial person, I'm not going to say, you know what,
Speaker 1: I really have tolerance and respect for the kind of
Speaker 1: brain wiring you have, and I want to you, I
Speaker 1: want to I want to give you a membership in
Speaker 1: the neurodiversity movement. Now, I wonder maybe if I did
Speaker 1: say that, maybe they put the machet down and give
Speaker 1: me a hug. Who knows, She's unlikely. Yeah, but there
Speaker 1: does seem to be a difference. So with addiction, though,
Speaker 1: it is a kind of harm like self harm in
Speaker 1: a way, right, Well, no, it certainly is. And I mean, like,
Speaker 1: you know, I've always like thought that the term drug
Speaker 1: abuse was really dumb, and I'm very glad that it
Speaker 1: got out of the DSM because you're not abusing the
Speaker 1: poor little drug. You might be abusing yourself. But that
Speaker 1: is a term that has been used for other things.
Speaker 1: You know, you cannot be addicted without harm to yourself
Speaker 1: because by definition, it's a definition involves harm, and I
Speaker 1: think it's important that it involves harm, because otherwise you
Speaker 1: can just be like, oh, I'm like addicted to playing
Speaker 1: the piano, and you know, and you could be addicted
Speaker 1: to playing the piano if like you are ignoring your
Speaker 1: wife and your kids and your job to do that.
Speaker 1: It would be a very rare thing, but you could
Speaker 1: see that that could potentially happen. But if there's no harm,
Speaker 1: there's no addiction because other wise is too expensive. But
Speaker 1: with antisocial personality disorder or psychopathy, the problem of harm
Speaker 1: to others is fundamental. And I don't think as a
Speaker 1: society we have wrestled with how do you deal with
Speaker 1: the fact that some of us probably are wired to
Speaker 1: have no empathy? And I think there is a person
Speaker 1: that we are dealing with as a nation right now
Speaker 1: that has that issue. And I actually feel that the
Speaker 1: psychiatric community has done a real disservice by avoiding looking
Speaker 1: at that. But that is probably a different conversation I
Speaker 1: think though, that we need to deal with. I mean
Speaker 1: it also like here we always get back. The Scandinavians
Speaker 1: tend to do everything right, but they punishment and oh,
Speaker 1: you know, they deal with it, but they what they
Speaker 1: do with, you know, antisocial people who simply cannot be rehabilitated.
Speaker 1: Is they incarcerate them, but in nice conditions, And like,
Speaker 1: I think that is a sensible strategy. I am astonished
Speaker 1: by the Norwegian's ability to put up with that evil guy,
Speaker 1: you know, who slaughtered so many kids, and then he's
Speaker 1: complaining about his cell conditions aren't nice, and they're like, oh,
Speaker 1: let's look at that. I had to bite my lip
Speaker 1: to have that kind of tolerance. Yeah. No, I mean,
Speaker 1: and I think that's like, really, you know, extraordinary and admirable,
Speaker 1: but it is. You know, I wish that as a
Speaker 1: diverse society we could achieve that kind of solidarity, but
Speaker 1: it's a lot easier to do it in a small,
Speaker 1: homogenious community. And I think the biggest question of how
Speaker 1: to govern ourselves involves how do we include diversity without
Speaker 1: splitting into pieces? Absolutely, And I do recognize that this
Speaker 1: conversation is probably gonna be controversial to a certain segment
Speaker 1: of our listeners, but I think it's worth having a
Speaker 1: discussion because at least I hope it's worth I hope
Speaker 1: it was a fair fair point because you know, I
Speaker 1: like to apply if you raise a logical argument to me,
Speaker 1: I want to think how it logically applies to everything,
Speaker 1: not you know, I mean that's the way my mind works.
Speaker 1: I don't circumscribe it just to the nice and pretty things, right, Like, So,
Speaker 1: taking a degree, I think that we would have to
Speaker 1: come to terms with this framework. And you know, if
Speaker 1: we view lots of things as adaptations that are alternative strategies,
Speaker 1: which is how I do like to view lots of
Speaker 1: these things as alternative evolved strategies to for survive on reproduction.
Speaker 1: I mean, there are lots of things that well, right,
Speaker 1: and I mean, like, you know, you can argue that
Speaker 1: part of the evolution of altruism involved having to evade
Speaker 1: the non altruisms, right correct, Yeah, so you know, and
Speaker 1: it's also the case that there are situations in which
Speaker 1: empathy is a handicap. When you are a surgeon and
Speaker 1: operating on somebody's brain, you don't want to be thinking
Speaker 1: about that person as human beings. The surgeon needs to
Speaker 1: be focused on the I am fixing this little piece,
Speaker 1: not like oh my god, I might slip and destroy
Speaker 1: a human Yeah. Yeah, so you know, I think that
Speaker 1: you know, there are situations where just absolutely shutting off
Speaker 1: empathy is productive, right, but I would say not shutting
Speaker 1: off compassion. Well, I know, I mean I just think
Speaker 1: that like what you need is really strong systemizing at
Speaker 1: that moment, and you know, like I just want them
Speaker 1: to be like doing the mechanics here and not thinking
Speaker 1: about like, oh I feel so nice for this person,
Speaker 1: but more like I am going to make sure I
Speaker 1: don't like make this thing that will destroy someone. So
Speaker 1: empathy is different than compassion. I'm just doing a thought
Speaker 1: experiment about the person, the doctor. Without compassion, I don't
Speaker 1: think it would motivate them to do a good job
Speaker 1: and be as meticulous because they wouldn't care as much
Speaker 1: about the outcome. You're just caring about how they're going
Speaker 1: to get paid, okay, okay, and they know that they're
Speaker 1: gonna get sued and lose money if they have a
Speaker 1: bad outcome. Maybe I'm too innocent. I mean, I'm just
Speaker 1: making this up, but I think that, you know, and
Speaker 1: I'm certainly not saying that doctors should be jerks, but
Speaker 1: I am saying that, like, it is understandable why they
Speaker 1: often are jerks, particularly surgeons, and it is the case
Speaker 1: that it is adaptive to turn off compassion in the
Speaker 1: hospital sometimes because otherwise you would just be too overwhelmed
Speaker 1: and you'd go in a corner and you couldn't help anybody. So,
Speaker 1: you know, it's complicated, and some of the traits that
Speaker 1: we think are completely useless, like impulsivity, can be useful
Speaker 1: in some setting. And you know, some of these antisocial
Speaker 1: things like where you're disregarding the reviews of others and
Speaker 1: this kind of thing. Again, there are certain circumstances in
Speaker 1: which that may be adaptive and productive. The problem is,
Speaker 1: as with all of this stuff, like when it causes
Speaker 1: harm and how you deal with how responsible that person
Speaker 1: may be for that behavior. Good. I really appreciate that nuance.
Speaker 1: We really kind of went on a bit of a
Speaker 1: tangent there and what was my fault? But this is
Speaker 1: what HAW is when you stick to people who have
Speaker 1: characteristics of what so one would call ADHD together in
Speaker 1: a conversation, Yeah, wandering does occur. Yeah, but this is great.
Speaker 1: I find this a really skintulating conversation. And then the
Speaker 1: other thing I was thinking is like with drug addiction,
Speaker 1: it's just it seems like I'm still not one hundred
Speaker 1: sec of I'm trying to think of as a developmental
Speaker 1: disorder because I do see the role of learning, but
Speaker 1: I also don't think it's and you would certainly not
Speaker 1: say it's one hundred percent all about learning. There are
Speaker 1: some things that are inherently more rewarding than others from
Speaker 1: a biological perspective, So that's true, Like these things like
Speaker 1: hijack or operate on our striatum and our lower order
Speaker 1: reward systems in such a way that it's irresistible to
Speaker 1: those systems that evolved. Do you know what I'm saying.
Speaker 1: What's interesting is that you know eighty to ninety percent
Speaker 1: of people who try heroin do not become addicted, and
Speaker 1: you know most people who gamble do not become a dang,
Speaker 1: Can I ask a foalup question about that? Because I
Speaker 1: kind of want to try heroin now? Or that you
Speaker 1: said that, like I see again, like I usually say
Speaker 1: right after that, that does not mean you should go
Speaker 1: try it. You would not fly on a plane that
Speaker 1: crashes ten percent of the time exactly. So yeah, that's
Speaker 1: my question is like it's still like heroin could still
Speaker 1: be dangerous for you physically, even though if it's not addictive,
Speaker 1: like you shouldn't. That doesn't mean that it's okay to
Speaker 1: try heroin. Well, I mean, the thing is that, like,
Speaker 1: you know, if you were to be given an injection
Speaker 1: of heroin in that was a safe and pure dose
Speaker 1: in a medical setting and somebody had narcan just in
Speaker 1: case you happen to have an overdose. I'm not recommending this,
Speaker 1: But the thing is that these are drugs that, in
Speaker 1: some settings, you know, if you are in extreme pain,
Speaker 1: are angels and miracle drugs, and in other settings are
Speaker 1: going to kill you and going to you know, destroy
Speaker 1: your life. So I think that it is certainly the
Speaker 1: case that the drug is not irrelevant. Well, okay, so
Speaker 1: this is so interesting because like I'm trying to think
Speaker 1: about other things who are equally as rewarding or almost
Speaker 1: seqly as rewarding from biological perspective, that we do every
Speaker 1: day of our lives. So for instance, when I eat pizza,
Speaker 1: every time I eat pizza, the grease he or the pizza,
Speaker 1: the more I bet it's really scitulating my stratum. My
Speaker 1: stratum loves that the pizza. You know, we think that
Speaker 1: like oh, something like heroin, like you know, it hijacks
Speaker 1: your brain or whatever, But the fact is that most
Speaker 1: people retain control over their use, and most people who
Speaker 1: are exposed to opioids do not become addicted. In fact,
Speaker 1: about a third of people exposed to opiates find them
Speaker 1: more unpleasant than pleasant. Another third kind of finds them well,
Speaker 1: some parts are pleasant, some parts are not. And then
Speaker 1: it's that final third they're like, oh, this is the
Speaker 1: best thing ever. But what's interesting about that is one
Speaker 1: third of people do not, you know, who try opias
Speaker 1: don't become addicted because within that group, a lot of
Speaker 1: people are like, Wow, this is the best thing ever.
Speaker 1: I Am not going to do it again because I
Speaker 1: don't want to lose my family, my job, et cetera,
Speaker 1: et cetera. This was a nice, blistful experian. But you know,
Speaker 1: if I ever have to be exposed to this, I want,
Speaker 1: you know, the doctor to be very careful of monitoring me.
Speaker 1: I think that's really important because I experienced lots of
Speaker 1: things in my life that I think to myself, Oh,
Speaker 1: I could so easily get addicted to this again. The pizza.
Speaker 1: But there are a lot of things in my life
Speaker 1: and people, you know, okay, listeners, use your imagination, you know, like,
Speaker 1: but like, yeah, yeah, there are lots of things in
Speaker 1: one's life that I think, you know, but I do
Speaker 1: have that sort of higher level conscious reflection mindfulness about
Speaker 1: it that I make the decision. But what is the
Speaker 1: difference between like what would put me over the right?
Speaker 1: So here's what often done, and I mean, these are
Speaker 1: the things that tend to set people up for addiction.
Speaker 1: Obviously we've talked about how oftentimes it's exposure during these
Speaker 1: developmentally sensitive periods. Right. Also if you have severe childhood trauma,
Speaker 1: like about two thirds of people with addiction have been
Speaker 1: exposed to at least one traumatic experience. The more and
Speaker 1: the different types and the more extended the traumatic experience,
Speaker 1: the greater the risk. About fifty percent of people have
Speaker 1: also with addiction also have a other mental illness, and
Speaker 1: so that sets you up for it. And then the
Speaker 1: third kind of biggie is like existential and economic despair
Speaker 1: and a sense of hopelessness because really it's yeah, I mean,
Speaker 1: you know, and this is where you know, certainly in
Speaker 1: poor communities, you know, people has made an argument in
Speaker 1: the past that addiction is a rational choice when your
Speaker 1: alternative is like McDonald or death if people are mortality
Speaker 1: high mortality rates. Yeah, yeah, I mean, so you know,
Speaker 1: at some point, like certainly using drugs in that circumstance
Speaker 1: can be seen as a rational choice. I don't think
Speaker 1: addiction is actually the rational choice, but certainly using drugs
Speaker 1: to escape and create an identity and a purpose for
Speaker 1: yourself in a world that seems meaningless and purposeless, that
Speaker 1: is a part of addiction for many people. And this
Speaker 1: is also why for me, people like God or spirituality
Speaker 1: can be an answer to that, because that can be
Speaker 1: in the answer to existential questions for some people. So
Speaker 1: this is not to say that there aren't medical and
Speaker 1: learning and all kinds of other aspects to it, but
Speaker 1: if you you know, it is like depression in the
Speaker 1: sense that there is an existential piece of it. Good.
Speaker 1: I'm really glad you add the news because I want
Speaker 1: to make clear you're not make the argument learning is
Speaker 1: the only piece. You're saying, it's a crucial piece that's
Speaker 1: been missed out. A lot of people kind of equate
Speaker 1: it like you're spelling the myth of the instant addiction exactly.
Speaker 1: I think, look, and I think that's really important. Absolutely,
Speaker 1: So I'm glad you added these other layers onto it
Speaker 1: as well, because I think all the it's like a system.
Speaker 1: All the pieces are important, and you're saying learning is
Speaker 1: one important part of that system as well, that gets
Speaker 1: often that gets neglected, no exactly, And what I'm trying
Speaker 1: to say is that the so we've sort of as
Speaker 1: a society had this sort of chronic brain disease model
Speaker 1: of addiction, and that model often and ignore social factors.
Speaker 1: Often has been seen to ignore learning and can often
Speaker 1: be stigmatizing. And in America is like deeply entwined with
Speaker 1: the twelve Step and the moral and the spiritual approach
Speaker 1: to addiction. So what I'm trying to say is just that, Okay,
Speaker 1: we're all going to agree addictions of medical problem. What
Speaker 1: kind of a medical problem is it. It's a developmental
Speaker 1: problem that occurs in the context of all of these things.
Speaker 1: And you know, learning brings in culture because like you
Speaker 1: don't learn in a vacuum, and learning brings in all
Speaker 1: of these other things because it is where the environment
Speaker 1: and the genes meet. So that is why I have
Speaker 1: really tried to emphasize that, because if you just see
Speaker 1: it as a chronic progressive disease at like Alzheimer's, that
Speaker 1: can be a pretty hopeless view. And if you see
Speaker 1: your brain as like irreparably damaged, and you're always going
Speaker 1: to have to be fighting it. That is a serious problem.
Speaker 1: Now this is not to say that I think it's
Speaker 1: safe for me to go shoot heroin, but it is
Speaker 1: certainly to say that, like, I do not spend any
Speaker 1: time thinking about, oh gosh, it'd be really nice to
Speaker 1: do opiate, And I did spend a lot of time
Speaker 1: thinking about that in my early recovery, you know, and
Speaker 1: I have gotten better. You know. It's like when you
Speaker 1: break up with somebody, like you know, at first, it's
Speaker 1: like really really you know, like now it's like, okay,
Speaker 1: they're my ex I don't care, you know. So that's
Speaker 1: a good point. I want to end here with the
Speaker 1: one line you wrote the book, which you probably didn't
Speaker 1: mean it to be as deep as I read it
Speaker 1: to be, but I found it like when I read
Speaker 1: this line, I was like, that is one of the
Speaker 1: most profound things I've ever read in my life. Okay,
Speaker 1: so it's a very seemingly simple line you wrote, we
Speaker 1: all learn to become who we are, Holly cow. I mean,
Speaker 1: if you really think through, like if you really sit
Speaker 1: down and reflect on the meaning of that for all
Speaker 1: areas of our lives. That's pretty profound, right well, and
Speaker 1: I mean I did mean that in this okay expanded sense,
Speaker 1: because you know, that is how we become who we are,
Speaker 1: right like, by learning, and we are learning in all
Speaker 1: different contexts, in the context of our neurology, in the
Speaker 1: context of our sociology, and the context of our psychology,
Speaker 1: our parents. I am trying to bring you sort of
Speaker 1: multifactorial nature of this together, and learning is at the
Speaker 1: center of that because it is how we become who
Speaker 1: we are. And so when you become addicted, that is
Speaker 1: one of the elements that becomes a part of that.
Speaker 1: And I think one of the interesting things about the
Speaker 1: whole norrodiversity thing is, you know, a lot of autistic
Speaker 1: people are very like I'm autistic, like proud of that
Speaker 1: and very much like you know, see, that is central
Speaker 1: to their identity, and so much so that they don't
Speaker 1: like people with autism. They want to be called autistic people, right.
Speaker 1: And then there's this other view, well, oh, my addiction
Speaker 1: is separate from me. I'm a person with addiction, not
Speaker 1: an attic, you know. So there's I mean, I think
Speaker 1: there's very interesting layers of what parts of yourself you
Speaker 1: embrace and what parts of yourself you say, well, that's
Speaker 1: not me, right, And I am trying to, you know,
Speaker 1: have an inclusive sense of self that can deal with
Speaker 1: the things that are problematic, but also can acknowledge that
Speaker 1: these things can also you know, bring you know, good things.
Speaker 1: I think, you know, there are certainly instances where disabling
Speaker 1: conditions are just disabling and they're not bringing any benefits.
Speaker 1: But I also think that if we are faced with
Speaker 1: whatever we have and whatever we are, we may as
Speaker 1: well look for the upside and where we are at
Speaker 1: well well, I want to thank you for such a
Speaker 1: refreshing take on this topic and for chatting with me today.
Speaker 1: Thank you, Maya, Oh, thanks so much. This is fun.
Speaker 1: Thank you so much for listening to the Psychology Podcast
Speaker 1: with doctor Scott Barry Kaufman. I hope you found this
Speaker 1: episode just as thought provoking as I did. If something
Speaker 1: you heard today stimulated you in some way, I encourage
Speaker 1: you to join in the discussion at the Psychology podcast
Speaker 1: dot com. That's the Psychology Podcast dot com.