Addiction and trust: Marc Lewis at TEDxRadboudU 2013



in my twenties I I spent five or six years being a drug addict I had an unholy attraction to opiate narcotics and I got me a lot of trouble of course at one point I was a psychology student by day and by night a thief I stole morphine from my lab rats it's a lot more than they needed and I also went out and stole things from pharmacies and medical centers and I got arrested I got convicted I got kicked out of graduate school my girlfriend left me despite all that crap I still couldn't stop for quite a while about two and a half four years I tried a lot of times as people do addicts try to stop a lot and it's hard anyway then I got back into school and I did finally quit and I got back into grad school and I got a PhD in psychology and went on to become a professor in psychology and neuroscience so what I've been doing the last 20-something years and for the last five of those years I've gone back to addiction this time as a as a scientist and kind of a commentator trying to blend subjective stories of addiction with the science the neuroscience especially of addiction what happens in the brain and I think that there's a lot of a lot of scope for that to help us understand how addiction works and why it's so hard to stop um so in that context a lot of people ask me how did you quit and how did you actually do it and the answer for a long time has been I don't know I'm not sure exactly how it worked but now especially a preparation for this conference I've been thinking a lot about trust and I think that the answer is is exactly self-trust I think that is the pivotal thing the thing that addicts need and finally so difficult to achieve is itself trust so I'm going to talk about two two psychological phenomena that I think help explain why well why self trust is so elusive so difficult for addicts to achieve and why it's so pivotal so important in order for them to to get better um the first of these is called ego depletion I was going to give up any minute um these are the parts of the prefrontal cortex that are in charge of impulse control and they get tired like a muscle they start to wear out so you can't keep impulse control going actively for a long period of time this the classic experiment is hungry people are brought into the lab and they are sat down in front of a bowl of chocolate chip cookies or a bowl of radishes and told they can't eat any and then 15 or so minutes later they are given a set of cognitive tasks and the ones who couldn't eat the cookies don't do as well they seem to be missing some special cognitive resource that's needed for control and so that's how it works and the problem for addicts is that it's it's more serious because they have to keep up self control not just for 15 minutes but for hour after hour after hour day after day after day and it's extremely taxing which is why what people think of addicts as being lazy or weak it's really just the opposite they work very hard to get through the day the other problem is that you're trying to keep up control when there are queues all around and queues to the thing that you're addicted to so the chocolate chip cookies are never far away and that makes it more difficult recent research shows that if you believe that you can control your impulses then you do a better job in a ego depletion context you can hold on for longer nobody knows exactly why but it could be because you don't have to stave off the feelings of self-doubt you can just focus on the single task of restraining that that one impulse so that's also a real problem for addicts because they don't believe they can do it they don't believe in their ability to control themselves why should they it never works they've tried it many many times and it never works and so they don't believe they can do it and so this lack of self Trust is a second you know a second bullet in their capacity to to withhold their their impulses okay the the next phenomenon is called this is a really resistant button if you fight trust that out of it right there okay it's called delay discounting and that is the tendency for for humans and other animals to value immediate rewards above long-term rewards or future rewards so if I were to offer you five euros today or 10 euros next week you would probably go for five euros today it would seem more valuable even though objectively it's not so that's the only discounting it's built in to all mammals and birds as well and for addicts what that amounts to is should I get high now today tonight or should I hold off so that I can have a happy marriage and next month or keep my job or get a better job or stay out of jail or have money in the bank these distant rewards pale in comparison with the immediate reward and that's a problem and it's especially a problem for addicts because that part of your brain right there the blue one it's called the striatum and that is the area that's responsible for well for achieving goals for seeking goals and that area is flooded with a neurochemical called dopamine when addicts are anticipating getting the thing that they're addicted to the function of dopamine dopamine spin around for hundreds of millions of years and it's evolutionary function is to get you to focus on what's going on right now right in front of you so in other words go for the low-hanging fruit or the low-hanging sexual partner that's terrific advantage for evolution but it's not a great advantage for addicts who are trying not to focus on the immediate present so you see that makes it more difficult as well okay so is there an antidote for delay discounting I think that and some other people have said that the antidote might be a dialogue that you have with yourself what you could call an inter temporal dialogue between your future self and your present self so your future self says just hold on the craving will go away after a while and you know you're gonna be okay and in a few weeks things are going to be a lot better the present self says okay I believe you and that's that's cool then I'll see you later and the the problem for addicts is that their future self is also an addict because if you've already been an addict for five years or ten years it's not very likely that you're not going to be an addict in a few weeks or a month from now so you see your future self isn't really someone you can trust and the dialogue that you have with that future self might be um well rather ineffective because it doesn't get you anywhere it doesn't get you past the moment it doesn't get you out of where you are so if you can't trust your present self and you can't trust your future self who can you trust for addicts the answer is very clear you trust the thing that you're addicted to and it's not just drugs it can be drugs it can be booze it can be cigarettes it can be sex it can be the internet it can be gambling you know there's that whole range of things they all function whole pretty much the same so you trust that thing and it makes you feel better for a little while and maybe if I sneak up on this bomb yeah makes you feel better for a while but not for that long and then you feel worse afterwards and so you feel betrayed again and you've betrayed yourself and so whatever a little bit of self trust you were able to muster is then used up um okay so the way I quit the hundred and eighty seventh time or so that I tried I wrote the word no on a piece of paper I put it on the wall where I had to go by it every day and I told myself I can do that I can say no to myself for an hour which means I can say no to myself for another hour and I started to believe it I worked it I pep-talk myself until I really believed I could do it I also told myself that I wasn't going to do drugs again ever not just for six months or a year but forever and that seemed much more credible so I formed that kind of trusting relationship in a future self and it were work for me and I learn by saying that the treatment programs for addiction nowadays seem to stress pretty much the opposite instead of trusting yourself they often emphasize giving you trust to a higher power whether that's God or the group or the doctor seeing yourself as having a disease so you're kind of helpless and I think that's the wrong way to go I think the kind of help that addicts need is help in forming it finding a part of themselves that they can trust and informing that intimate dialogue so that they can reach out for a future that they can live with thank you

30 comments

  1. Complete ego deflation and letting go of all need to control coupled with total surrender to “ A Higher Peer” becoming honest, with self and others. Making restitution and helping others. The 12 step process. Works. To stay surrendered daily. Trusting God. Is key. Self knowledge avails us nothing. In fact it’s an ego booster. Ego is the fasted rebuilding virus

  2. Addiction is the worst illness ever, in the fact that your very sick yet society is looking down on ya as most of them just think it's a case of self control when really your brain became hardwired to want drugs above all else. The fact that mother's lose or give up their kids demonstrates how powerful it's grip is. I'm doin ok now but still very jelous of folk who don't have any addiction issues, it just complicates life so much

  3. It seems to me that Mr. Lewis argues against the disease model of addiction yet offers physiological explanations for some aspects of the condition. Though I do not see it in the introductory passage here, I believe Marc Lewis wrote "The Biology of Desire" which I have not yet read and am considering buying at the moment though I fully endorse the disease model of addiction and reject the opposite pole of the argument.

    In most cases, so far as I know, people who have overcome addictions frequently have to fight that battle daily for the rest of their lives. Therefore I believe ignoring the disease model and supporting the disordered thinking model or however one wants to express that, is exceedingly cruel. An addict may be able to think him/herself away from whatever is craved but I believe the brain changes physiologically and drives the body from the point of addiction onward.

    The answer is heightened funding and research into the physical causes and cures for addiction.

  4. I'm working on my positive internal dialogue to achieve self trust and healthy self control. In my country dice Si se puede!

  5. This is the most shady Ted ever…how can u give the most important subject on the planet killing more now than homicide n traffic accidents 10 mins really…wow…so so sad

  6. Absolutely! Very insighful that the "future self" can't be trusted because it is also an addict. Totally agree that the disease model is not the most accurate model but if it works for someone, then hey, go ahead and use whatever works!

  7. No human power can relieve an addict from the bondage of self.
    He might not agree, but say that to the world of AA, NA, SA, Faith based recovery and so oooooooon.

  8. Naltrexone is a very useful tool in helping addiction reduction and used in many applications including depression, weight loss and quitting smoking. Of course, your local doctor will not even suggest naltrexone why because it is a cheap effective pill that is given away for free in many countries. It has a very good success rate and some minor side-effects but nothing compared to most drugs the doc will get you on!

  9. Can anyone explain to me what he is on about?
    Is it just me or is he not really making any much sense?
    He first states that an addict needs to have self trust in order to stop. After which points out that it's extremely illusive among addicts to have or find self trust??

  10. recovery is an individual journey with many individual factors involved. does it matter if it is 12 steps or any other form? science can teach us all so much and help individuals make informed choices on thier recovery journey.
    brilliant info!keep up the good work.

  11. We know that there are many highly accomplished people who carry on significant careers despite being addicts, and Prof. Lewis gives a very plausible theory of why (as well as an argument against a legal-medical system that forces addicts into 12-step programs as a one size fits all solution.)

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  13. I am an alcoholic in recovery. I will always be an alcoholic whether I pick up a drink now, or 20 years from now. I strongly disagree with Marc Lewis' statement that he does not think the treatment programs are teaching recovery correctly. I am grateful that I did not see this video while I was new and struggling with early sobriety. Statistic after statistic is evident. For most alcoholic/addicts no human power could relieve us of our difficulty. You stress self-reliance; look where it led so many of us with the gene of addiction.

  14. Interesting ideas, but "Self Trust' is not what finally freed me from Long term Heroin Addiction. Self Control does come however, but in trusting Self. My obsession and Cravings for Dope have been removed. Basically I will stick with Trusting in the Power of God, not Self.. Self Control over impulses came through that not through Self Reliance or Trust, but reliance upon the Power,

  15. He seems like a good man, but it amzes me that such undeveloped arguments are enough to form a TED talk.
    "I wrote 'NO' on a pice of paper and believed in my future self". I believe he's telling the truth, but that's notbscience, that's not a TED talk.
    "Dopamine makes you go for the low fruit". That's not accurate. Dopamine has several functions and none of it is connected with 'going for the low fruit'. Marc has taken half understandings and presented them as a complete picture. Trust is the key, but its not as he's describing it at all.

  16. Im struggling with issues myself i don't know if its under abuse self meditating or addicted..either way it sucks. But yet the will to stop again..seeing how i was clean for over two years. Is little to none..its just become a pointless goal to me..i got sober life was good for my family i guess i still didnt enjoy it how people claim they do..then i went back relapsed to the point of having my cloths cut of me from an overdose being in icu and waking up marchmenacted into a detox unit that i signed myself out of the moment the march was up and went and got high..i dont regret it. But youd think its the knock in the head i needed obviously not..i think some of us are just meant to use sadly.

  17. So, he opines that we need to develop a sense of self trust or trust between our current self and future self, but the way in which our brains have evolved makes this almost impossible. Then he states that he got clean by saying NO to himself and saying he was just never going to use drugs again. What a freaking useless talk.

  18. http://www.amazon.com/Enemy-You-Ilka-Palmer-ebook/dp/B014LRVDYO/ref=sr_1_6?ie=UTF8&qid=1441136965&sr=8-6&keywords=Enemy%3Ayou

  19. Drug addiction is a serious thing, but difficulties in discerning between drug addiction and severe drug abuse prevent obtaining meaningful data from retrospective/convenience sample analyses regarding long-term outcomes.

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