March 29th, 2021
๐ย Addiction, Liturgy, Love, Recovery
What's the opposite of addiction? How do we cultivate centers of life?
โSalienceโ is the term that neuroscientists often use to describe the pull of substances on the addicted โ itโs more of a sense of wanting, even needing, than liking. The development of salience has been traced to the nerve pathways that mediate the experience as they emerge from the underside of the brain, in an area called the ventral tegmentum, and sweep out to regions such as the nucleus accumbens, hippocampus, and prefrontal cortex, which are associated with reward, motivation, memory, judgment, inhibition, and planning.
Lawford (), himself in recovery from drugs and alcohol, edited a 2009 collection of essays called Moments of Clarity in which the actor Alec Baldwin, singer Judy Collins, and others recount the events that spurred their recoveries. Some quit on their own; others got professional help. A theme in each of their stories is a jolt to self-image: โThis is not who I am, not who I want to beโ (). One recovered alcoholic describes the process: โYou tear yourself apart, examine each individual piece, toss out the useless, rehabilitate the useful, and put your moral self back together againโ (). These are not the sentiments of people in helpless thrall to their diseased brains. Nor are these sentiments the luxury of memoirists. Patients have described similar experiences to us: โMy God, I almost robbed someone!โ โWhat kind of mother am I?โ or โI swore I would never switch to the needle.โ
Recovery is a project of the heart and mind. The person, not his or her autonomous brain, is the agent of recovery.
I believe in the aesthetically impure as an accurate reflection of reality, just as I believe in the acceptance of compromise as a political ideal.
It was then I think I learned that if you stay very quiet and listen to the confusion of others and nod from time to time, people will think you understand. They will go away feeling better.
Myself, I am made uncomfortable by the notion that mankind is, at bottom, brutal. I would prefer to honor the ironies, pleasures and civilities of life. Yet I cannot get beyond certain brutal memories from childhood whose rumble I still hear going on in my head like an inner trembling. And maybe I hold on to them too much, also, out of pride.
I believe in the aesthetically impure as an accurate reflection of reality, just as I believe in the acceptance of compromise as a political ideal.
It was then I think I learned that if you stay very quiet and listen to the confusion of others and nod from time to time, people will think you understand. They will go away feeling better.
Myself, I am made uncomfortable by the notion that mankind is, at bottom, brutal. I would prefer to honor the ironies, pleasures and civilities of life. Yet I cannot get beyond certain brutal memories from childhood whose rumble I still hear going on in my head like an inner trembling. And maybe I hold on to them too much, also, out of pride.
Actually, one of the most basic causes of modern urban traffic problems lies in the opposite direction: in the fact that planning authorities are giving them not too little but too much thought. Indeed, such is their almost Freudian traffic fixation that they have ceased to care for anything but the swift movement of cars and its attendant problems, as if the sole purpose of the city were to serve as a race track for commuting drivers.
What has been completely overlooked in this obstacle-removing obsession of modern urban planners is that it is rapidly chewing up the greatest as well as the most precious obstacle to traffic of them all โ the city itself. If cities existed for traffic, their gradual removal would indeed represent a significant improvement.
Quantum theory is the deepest explanation known to science. It violates many of the assumptions of common sense, and of all previous science โ including some that no one suspected were being made at all until quantum theory came along and contradicted them. And yet this seemingly alien territory is the reality of which we and everything we experience are part.
The world is the whole of physical reality. In classical (pre-quantum) physics, the world was thought to consist of one universe โ something like a whole three-dimensional space for the whole of time, and all its contents. According to quantum physics, as I shall explain, the world is a much larger and more complicated object, a multiverse, which includes many such universes (among other things).
Dollars in bank accounts are what may be called โconfigurationalโ entities: they are states or configurations of objects, not what we usually think of as physical objects in their own right.
All fiction that does not violate the laws of physics is fact.
Some fiction in which the laws of physics appear to be violated is also fact, somewhere in the multiverse.
So it is not quite true that, for instance, there are histories in which magic appears to work. There are only histories in which magic appears to have worked, but will never work again. There are histories in which I appear to have walked through a wall, because all the atoms of my body happened to resume their original courses after being deflected by atoms in the wall. But those histories began at the wall: the true explanation of what happened involves many other instances of me and it โ or we can roughly explain it in terms of random events of very low probability. It is a bit like winning a lottery: the winner cannot properly explain what has just happened without invoking the existence of many losers. In the multiverse, the losers are other instances of oneself.
Opiates relaxed you by abolishing the sensation of threat and letting your mind wander freely in the fanciful landscape left in its place.
So when Steve got a new batch of Oxys, which seemed to happen more and more often, Natalie felt a glow of anticipation, as if she were going home for the weekendโnot her real home, but a dream home of soft edges and benevolent beings. Thatโs when the synapses in her brain began a new wave of growth, forging a new set of connections. And when those synapses were activated, it felt to her like an approaching brightness, an arrow of hope.
Then there was nothing more to worry about, from the moment the needle pierced the vein, even before the drug transformed the chemistry of her nervous system. That wash of Peace started with the knowledge that this was a sure thing, no longer a maybe. This was what sheโd been looking for, perhaps for a very long time.
Tust slap anything on when you see a blank canvas staring at you like some imbecile. You donโt know how paralysing that is, that stare of a blank canvas, which says to the painter: you canโt do a thing. The canvas has an idiotic stare and mesmerises some painters so much that they turn into idiots themselves. Many painters are afraid in front of the blank canvas, but the blank canvas is afraid of the real, passionate painter who dares and who has broken the spell of you canโtโ once and for all. Life itself, too, is forever turning an infinitely vacant, disheartening, dispiriting blank side towards man on which nothing appears, any more than it does on a blank canvas. But no matter how vacant and vain, how dead life may appear to be, the man of faith, of energy, of warmth, who knows something, will not be put off so easily.
Here was the feedback loop that would bring him to his knees years later: anxiety, relief, then loss and longing, round and round, digging ruts in the fertile soil of his striatum, laying down pathways to his midbrain and back. Along those pathways, springs of dopamine pooledโreleased in a flash flood when it was time to drink again.
It took Johnny about four years to shift from normal drinking to serious drinking, as he calls it. During this period, the cues that pointed to the pub, after work or after a game, activated fields of synapsesโgrown heartier with each repetitionโthat stood for something different. Alcohol became a Symbol, the core of a network that included a promise of Peace, cessation of stress, relaxation. Neurally and psychologically, it invaded and overtook the companionship network, like crabgrass colonizing a lawn.
Of course, the pub was most attractive, not because of the company or the food alone, but because of the particular way these human needs interlaced with his need for alcohol. The sense of a home away from home and the liquid that muted his restlessness converged at the pub.
Orbitofrontal cortex (OFC): bottom surface of the prefrontal cortex; closely connected to the amygdala and accumbens; uses signals from these regions to create context-specific interpretations of highly motivating situations; generates expectancies and helps initiate an appropriate response.
Meth was like a sun that was always at the centre of his trajectory. It was never further away than the next thought. And living life in orbit changes the way you get from hour to hour and day to day. Wanting it was one thing. Even needing itโyes, he needed it; heโd admit that. But this constant tugging at his thoughts, at the atoms of his attention . . . this went beyond wanting and needing. This was a cognitive mutation.
The amygdala is a small structure embedded beneath the cortical layers on each side of the head. The amygdala is subcortical: in other words, itโs a more primitive system (around the same vintage as the striatum, hundreds of millions of years old), and itโs responsible for the emotional spray paint that stains every important experience, almost instantly, with emotional tone and colour: the fear you suddenly feel when you hear footsteps behind you on a dark street, or the jolt of shame you experience when you spill coffee all over your pants, or the sudden excitement and pleasure that Brian felt as soon as โcrystalโ came to mind.