Editor’s note: This commentary is by Gabriel Brunelle, who is a social worker working in the field of addiction in Chittenden County.
[I]n Gabor Maté’s book, “In the Realm of the Hungry Ghosts,” he outlines three necessary conditions for addiction to occur. One is the availability of a substance or activity with an addictive potential (i.e. marijuana, heroin, gaming, sex); another is a pre-existing vulnerability to addiction; and the last is the presence of significant stress.
I think the first and last criterion are widely accepted. Most anything has the potential to become addictive for someone of our human species, and our world abounds with stressors. What gives us pleasure or relieves stress can be as subjective and individual as the stressors themselves. Some are obviously more shared than others.
That a vulnerability to addiction must exist I think is less understood and is central to my view of addiction as a predominantly social phenomenon. What makes someone susceptible to addiction? What gives someone “an addictive personality,” a popular phrase which speaks obtusely to vulnerability yet isolates individuals from their social milieu with an all-encompassing fault?
I have long held that our mental health lives in our relationships — to ourselves, to each other, and to the world. At this point it is well researched that the quality of the relationships we have very early in life is critical to our development at those stages and can greatly influence how we develop later on. The vast majority of human brain development happens outside the womb, in the social environment, and is dependent on relationships. A young enough baby who is left unheld will die. Through their attunement and connection with early caregivers, babies grow the capacity to regulate their own stress and to deepen the rewards of their motivation and bonding.
The chemistry of healthy relationships is the chemistry of addiction. Opiates are involved with our bonding processes and other chemicals like dopamine and serotonin are involved with learning, ambition and happiness. Is it any wonder that if we don’t have the benefits of healthy early connections or some other trauma happens which leads us to be isolated or unable to feel connected with others, that many of us engage addictively with substances or behaviors that produce the same chemistry of motivation, bonding and emotional safety inside us? Because that is what we do as humans; we cope and adapt in the face of adversity. We triage as we need in order to protect ourselves and survive. Sometimes something essential and beautiful seems to be irrevocably lost in that process, perhaps because something essential and beautiful was missing in the first place. Involving personality, Maté has this to say about coping near the end of his book: “Indeed, what we call the personality is often a jumble of genuine traits and adopted coping styles that do not represent our true self at all but the loss of it.”
Maté also emphasizes that what seems forever lost can be regained; that the brain is elastic and can continue to change and grow with attunement and connections which we can achieve and foster at any time in our lives. I agree; and so I think a social model of addiction calls for social solutions.
I was deeply disappointed when the governor vetoed the paid family leave bill. To me, the cost to benefit analysis of that legislation was amazing. I think any policy that promotes healthy connections, family and community can pay huge dividends in terms of addressing myriad social problems like addiction, violence and poverty for generations after it is enacted. To draw such a line in the sand in front of even so small a tax was to me the placement of a rigid and binary framework over what is in reality a very rich, nuanced, and analog world.
I also think we need to expand access to other modes of trauma-informed healing as well. Trauma lives in the body. There is something fundamentally healing in safe physical contact; and yet many forms of trauma-informed touch therapy are not covered by our state insurance. I think many of our most vulnerable citizens are also the most physically lonely and could benefit from such options. My own mental health counselor told me that the state of Maine covers a lot of different physical therapies with its insurance. That such a conservative state has expanded its coverage suggests a savings on expensive acute care with that kind of holistic treatment, and there must be data available for legislative staff to assist our lawmakers in crafting expansions of our own coverage.
