Maia Szalavitz || Rethinking Addiction

the premier American journalists covering addiction and drugs. Her work often appears in Time dot Com, The New York Times, Scientific American, Ella, Vice, and New York Magazine. She's a twenty fifteen twenty sixteen Soros Justice Fellow and has received major awards for a coverage of neuroscience and addiction from the American Psychological Association, the Drug Policy Alliance, and the American College of Neuropsychopharmacology. Her latest book is Unbroken Brain,

A Revolutionary New Way of Understanding Addiction. Thanks for chatting with me today, Maya, Sure, thanks so much for having me. Wanting to chat with you for a long time about this topic. In this book. I appreciate it. Now, this

book was very personal, the heavily scientifically researched. Is there a part of you that wishes you when you were in the thick of this had done that scientific research and had that knowledge, then well, I mean, yeah, it certainly would have been better if I had known early on, you know, what I was facing. But you also, to be frank, the knowledge has changed. The way we saw in the eighties is thankfully somewhat different to the way we see it today, although we're still struggling with the

ideas left over from centuries of moralizing about this. So let me ask a very blunt question, and if I may sure, how did you go from being a gifted child and Ivy League scholarship student to injecting cocaine and heroin up to forty times a day. Well that is the story of the book. But briefly, I can say that I think I had undiagnosed Asperger syndrome as a child.

What this meant is that the world was just too intense for me, and I was kind of overwhelmed by all kinds of normal sensory and emotional experiences, like you know, loud sounds, and itchy clothes and tastes and all of these kinds of things. This left me very socially isolated because I was always kind of just trying to deal with everything. And also the fact it was helpful in the sense that I was reading at three and it

was clear that I was smart. But unfortunately I decided that my inability to connect with people and my sort of controlling nature because of trying to deal with my sensory stuff, meant that I was a bad person and was doomed forever to you know, not be able to connect. Yeah, and I think it's really interesting you said that you think you had aspers Were you ever diagnosed officially with Asper's.

I have not actually been diagnosed officially, and I sort of thought about doing that for the book, but you know, I've had so many other diagnoses, and I kind of just feel like I know the flaws of the diagnostic system so much that it seems silly to get an

official pronouncement from a system that is kind of screwy. Yeah, so I just figured, you know, whatever, I mean, I think that it is fair to say if you saw a three year old who was reading who had, you know, sensory overload issues, who had social problems, who was very took everything literally, was always getting bullied, and basically had pretty much all of the classic aspy symptoms that you

know I probably would have been diagnosed. I also was diagnosed with ADHD at age three, which I did not discover until I was researching this book. I knew that I had briefly been on riddle in, and I knew that I had been diagnosed as hyper esthetic, which basically means oversensitive, but I didn't know until I talked with my mom that actually I had gotten an ADHD diagnosis. And about a third of people with aspers also have ADHD,

so that's kind of another clue there. I think, just taking a very granular look at this, or a very broad look at taking a very broad look at this, I think it's just incredible. You're what you've overcome, what you've you know, the fact that you could have it at your height, been doing cocaine heroin up to four times a day, and then they scan your brain and they say it's normal. You know. I think this is a very I want to like kind of start with

there before we get into all the details. Kind of like the big picture here, you know, there's I think can give a lot of hope to a lot of our listeners, and you know a lot of things you say are going to be surprising to people. You know, like that the older you get, the greater chances of recovering from addiction are and things like that. So I think that's just so interesting and not only quote normal,

because who what is a normal brain? But they found that you have great cognitive control, so you kind of like emerged from this like stronger in a way, right, I mean, yeah, it's like it's hard to tell if that you know, sort of superior impulse control, which I don't always feel, but which I think part of the thing that was really funny about it was I'm clausterphobic and I'm lying in the scanner and is taking ninety percent of my impulse control to like not keep the

ticket out of there. You know that I was actually okay on that task. I was kind of surprised about. I also did another task completely backwards, so you know, clearly the stress was going on there, but they were able to analyze that because I did everything completely backward, so they could you know, run it as the positives were negative basically. But yeah, I mean, it has been an incredible journey, and it's very hard to know whether that sort of good impulse control came from recovery or

allowed me to recover. And one of the things I've always thought was interesting was that I did get into recovery when I was twenty three, which is kind of around the time for most people that the cortex is kind of finishing itself up. And you might imagine that I was not able to stop before that because I just didn't have the ability to put on the brakes, and then finally I gained it because you know, something

allowed that to grow. Yeah, I mean it's I don't know if you could say any brain is normal, and I'm certainly I don't think they would have described me as neurotypical, because I don't think there is such a thing, but it was certainly the case that, you know, there was no obvious damage, and I was very glad of that, obviously.

But I mean, I think one one of the things that I've always thought about our conception of addiction that I find to be wrong is that I think, and I think there's a lot of data to support this. What goes wrong in addiction is that you fall in love with a drug or a compulsive behavior rather than a person, or rather than becoming focused appropriately on your

new baby. And we have systems in the brain that are there to change our priorities when we fall in love, and to change our priorities when we have a kid, and to make us persist despite negative consequences in order to maintain that relationship or successfully raise that kid. You know, if we couldn't, nobody would ever, you know, everybody would kill their kids because it would be too impossible to

deal with them. You know, they have that incredible puteness that makes you love them, and you know, unfortunately, when that kind of intense obsession gets directed towards a drug, you end up with people behaving very strangely, and it looks like people are choosing to do this perverse thing, that is, you know, destroying their life. And so I always felt that that's an example of kind of mislooking or pathological learning. But it's not really an example of

brain damage. And that's not to say that if you you know, you can damage your brain, particularly with alcohol and certainly with the high doses of many different drugs. But that kind of damage that occurs is neither necessary nor sufficient to cause addiction. And we can tell this because gambling addiction exists with no chemicals whatsoever. Well, what do you think of sex addiction? Do you think that's a real form of addiction? Yes, I do think that.

I mean, I also think that our culture kind of goes crazy with this, but I think that. You know, I've obsessed about the definition of addiction since before I actually got addicted, And the best definition that I really have found is this idea that addiction is compulsive use despite negative consequences, or compulsive behavior despite negative consequences. And this is basically how you can sum up the DSM definition. This is how the National Institute Drug Abuse defines addiction.

I mean, it's a widely accepted definition at this point. And that's because if you just define addiction as like needing something to function, Prozac is addictive, you know. I mean, in the eighties, part of what allowed me to rationalize my cocaine addiction at least was I read, you know, in Scientific American that cocaine is no more addictives than potato chips. And now, of course we think potato chips are addictive, but The point really is that addiction has

to involve compulsion and harm. It isn't just needing something, Because if it was just needing something or depending on something, we'd all be addicted to each other, we'd all be addicted to air, all being addicted to food. It just would become a kind of useless concept. I have a confession to make. I am kind of addicted to air. Yeah, I mean, you know, people will do some pretty intense things.

So I've been thinking about like labeling, and I remember when we had met in New York a couple of years ago, we talked a little bit about labeling, and we're talking about the un Gifted, and I read in the book that you say that like label's not necessarily a bad thing. I think there's a footy quote in there by Elder Robinson maybe saying I would rather have a label than being called what I'm called on the streets. Yes, yes, yeah, I mean I thought yes, And I thought that was

kind of profound. I think that what sometimes unfortunately happens with children and that can have a terrible effect on your long term development and mental health, is that if you are an outlier, if you don't fit in if you feel very different and you don't have any kind of label or any kind of way of understanding that you might give yourself or other people might give you all kinds of labels that are harmful, like selfish and bad, and you know, completely unable to socialize and instead of

you know, when I learned about Asperger syndrome, I was like, oh my gosh, there's an explanation for all these weirdnesses about me, and they all fit together. Before that, I just had thought that, like, I'm socially awkward, I have these intense sensory and emotional dysregulation experiences. It just didn't fit together. I think that with children, you know, some children would take that ass be label and be like, Okay, you know, this brings some advantages and some disadvantages, but

at least I'm not a Martian. At least I'm not you know, bad. At least this is a thing that is recognized that something can be done about. Now, other kids might react to it and be like, well, this means I'll never have friends and it's limiting and you know, I can't do anything. And obviously that is not the reaction want. But I think, you know, when we can understand these collections of symptoms that tend to hang together.

It can really help people understand themselves. And we have to be careful not to make a label into a sort of prophecy. It's just sort of a thing you can use to help yourself understand yourself and other people and understand, you know, the way you react to the world. I mean, you know, it was very interesting because I had actually written an earlier version of this book when I was in my twenties, no way, yeah, yeah, And do you have it saved? Yeah? I had it. I

used it that. I mean, it's interesting because there were certain things that I now disagree with in terms of my view on addiction, but the you know, raw emotional and sensory experience was there. And when I did write that, I had never heard anything about autism or aspergers or anything like this. And I was really curious when I went back and read it to see, you know, what kind of emphasis I placed on the sensory stuff and on the dysregulation and this kind of stuff. And it

was all great there. It was not like I had retrospectively imposed this framework on it. It was all really visible there. So it was that was. I was really glad that I had that to work with and that I hadn't had to later disagree with myself publicly. But it was really useful because it did give me, you know, the freshness and the rawness of the period of early recovery and the experience of, you know, undergoing such a

dramatic change. That is so cool that you kept that, and what a valuable resource that was for you, you you know,

thinking about this case. We talked in the book about how you want to place addictions in the same category as developmental disorders and talk about the importance of learning and addiction, and it was thinking about this you were talking about the patients who maybe or on morphine went for a couple of weeks to help them with pain, and then when they come home, they might feel like sick, like nauseous, shulder, but they don't know what to attribute it to, so they just sort of like, you know,

kind of just wade through it, right, But they may think to that, But the thing is what they might actually be going through is addiction withdrawal symptoms. But because they don't know, ignorance is bliss when it comes to addiction. It sounds like you're saying. If I had to summarize it in a sense, I think it's very interesting because

I was speaking with some doctors. You know, obviously we have a big opioid problem right now, and I was speaking with some doctors about, well, what if you just didn't even tell people they were being given opoints right, right experiments. But the thing that is interesting there is that, right you cannot be addicted unless you know what you're addicted to. Otherwise you can't go out and seek it

despite negative consequences. And this is another thing about the importance of the distinction between addiction and physical dependence, because you know, like a baby can be physically dependent. A baby can unfortunately be born with opioids in their system, and since they were in the womb and that was the background for them, they have physical dependence on it. But that baby does not know that heroin is what it needs. All that baby knows is that it feels uncomfortable.

But that might mean I need to be breastpread, I need to be hugged, I need to be changed, like it could mean anything that a baby, you know, experience is discomfort about. And also since the baby can't exactly you know, crawl out of the hospital and get itself to a drug dealer. It cannot continue to use despite

negative consequences. And this sounds like it's silly distinction, but it really matters because when we labeled children as crack addicted during the eighties, that label was actually more harmful to some of those children than the drug itself. And that was because people interpreted their behavior as evil when it was actually sort of normal toddler behavior, and that set up sort of negative spirals for some of these kids.

I mean, I wrote about case once where there were these four kids who were adopted and their parents were starving. The adoptive parents were starving them, and they were, you know, the twenty year old with something like so skinny that he looked like a four year old. I mean, it was horribly creepy. But the way, like the social workers had been in and out of these people's house and everybody thought they were wonderful. The other kids were fine.

Everybody thought they were these wonderful parents because they were putting up with these horrible crack babies who had this horrible behavior and they were anarexic somehow from crack. Even though of course it was now twenty years since they'd been exposed to it. But it's the idea that crack turns you into a horrible monster who should be punished by withholding food that did way more damage than that

exposure in the womb could have done to these kids. Look, I love the humanity that you put into this, into this topic, which is really rare in discussions of addiction. You say addiction is not a sin or a choice, it's not a chronic disease like Alzheimer's, and you do place it in the class of developmental disorder. I would like to really unpack this further, because you know, I'm not one hundred percent convinced. There are some things I'm

trying to understand. Like you know, when you have a developmental disorder, you let's say you're on an autism spectrum and you show repetitive behaviors. Let's try in an analogy of some sort, and you show very narrow interests, but you're very obsessive to the point of maybe obsession about a particular repetitive structure or something, whether it's music or

it could be creative things. I mean, we underestimate they send to which people on auto the spectrum that even being obsessed about something in particular can still lead to development of greatness, right, absolutely, yeah, So is it more of a like the similarity there is not in terms of the potential harmfulness of the object of obsession despite negative But the thing is with the development disorders, what is the negative aspect though in the way that you

defined addiction, What is the persisting despite negative of results. What is that in the autism or the ADHD that well do So if you think about like the way I think about addiction as a developmental disorder is as a very complex, heterogeneous one, just like everything else in psychiatry. So if you think about it, okay, developmental disorders have certain characteristics. One of them is that they tend to have an onset at a specific time in life, at

a specific part of brain development. And this is really true of addiction, since ninety percent of it starts in the teams or early twenties, which is exactly the time before the cortex has fully developed and the time when you are really developing those systems that are involved in mating and reproduction. So this, you know, this is one clue to this. Another clue to it is that there are sort of many different pathways into it. So you know, if you have autism or ADHD, there may be many

different genetics that lead you to that. And with addiction, you know, for example, let's say you have you know, ADHD increases the odds of addiction by like factor of four or five. It's something really large, you know, And I think that is because of the sort of sensory and the dysregulation that it imposes on your nervous system and how that makes it hard to fit in with other people and just be comfortable and just pay tention.

But you know which gene creates that? Who knows, right, So I think you know, the other thing that's interesting about developmental disorders is that they sort of unfold based on these you know, sort of small influences at particular times and development. So let's say, like I think, well, psychiatric disorders are developmental. So let's take depression for example.

You know, let's say a kid starts hating themselves because they feel alienated and they feel like they have no friends and nobody likes them, and then they start ruminating on that and that comes on top of like some kind of temperament that already predisposed them to feel a little out about the world, and then their parents also have a depressive style, let's say. So all of that coming at a time when the brain is forming itself can kind of build in these grooves that end up

leading towards the direction of depression. And then that pain that comes from the experience of depression can lead you during adolescence to try to find ways to feel better, and drugs can often be a way of doing that. And then when you have exposed yourself to a substance that seems to work at least at first, that sets you up for the pattern of the compulsive use despite negative consequences, and it also sets you up to not learn the coping skills that could instead help you avoid

getting so locked into that one behavior. So, yeah, that does make sense. So I'm trying to think of like everything in this world. Everything has like a point where it's adaptive, and then it gets too much and it's not adaptive anymore, you know, like everything. I'm just trying to take a very very broad view here. So love is not necessarily addictive, but love can become addictive having obsessive and actually I actually think to just interrupt for

a secondary I actually think that a lot of role. Though. I think that love is the template for addiction. I think that like it's like the thing in the brain that predisposes us to addiction. Now it may also be the case that food seeking and behavior around food is another template prediction. But it's these fundamental survival systems that are good to set your priorities towards seeking this particular greame.

That's exactly where I was going with this. You know, So at a very broad level, absolutely we have basic needs that from like a cybernetic perspective, like regulate itself to reach homeostace. It wants it to reach homeostasis. We can go beyond love. We can also talk about being addicted to esteam, which is what narcissism is. My view is that's how I view narcissism is addiction to esteem.

So you can become addicted to any of our basic needs and in a way that makes it, like you said, absolutely shifts our priorities very I think very maslow about this. It becomes a very pre potent need. We kind of prioritize it over other goals in our life. It kind of like snaps it into that being the primary goal in our life, so our purpose all of a higher level goals kind of get you know, put aside. So

I think that's true. So what I'm trying to think is like from within the same framework of development or as psychiatric source, maybe that's all part of the same thing. So like as very adaptive to find repetitive, sort of stable, secure things. You know, security is a basic need as well, right, but you can find also we can become you know, like there are people and dispositions that when it interacts with certain environmental et cetera, et cetera, they become extraordinarily

sensitive to disorder and to things that are chaotic. And people with autism really like certainty and like to know, you know, things that are repetitive. And you can go case by case and go like ADHD. You know, it was adaptive for exploration. The exploration need is what I would say driving that, and that's what I'm working on in this new theory. I'm working on that the exploration is a basic human need. But again you could become

addicted to exploration. Great. So I think everything has its homey stage point and then in its addictive point when I say everything I'm saying all biological needs. Yeah, I mean, I think that's a really interesting point. And I think that you know what often, you know, basically, these are sort of cycles that elaborate themselves, and if you get

stuck in the wrong groove, it becomes pathological. You can get stuck in a good groove and then you're like a brilliant composer, right, and you're obsession with understanding, you know, music theory is going to you know, pay off in all kinds of wonderful ways in a way that like your obsession with finning a wheel on a car toy

car would probably not do. So. I think one one of the characteristics of being on the spectrum may be sort of learning too quickly, Like you lock into something before you get very quickly, Oh there's an association here, but you like sort of fixate on it instead of being flexible about it. And sometimes that's useful and sometimes that's harmful. But right, all of these things and all of these ways of connecting and understanding the world, you know,

have good sides and bad sides. And I think, you know, this is why I really do like and I talk a little bit of in the book about the idea that you know, the things that you know can cause us the greatest harm may also be able to allow us the greatest joy if we can direct them appropriately.

And I mean, I do think that the persistence through obstacles is really useful, you know, as long as you're not like seeking drugs, if you're seeking like success, if you're trying to, you know, make your relationship work, if you're trying to do things that are productive, like you know, nobody could ever succeed in the arts if they weren't

able to persist us by rejection. I love that. I love that you put two things together that have typically not been put together, neurodiversity and that people who are what we call addicted in society or put that label on. I love how you put it under a bigger umbrella of appreciation and tolerance. So I love that. I love that. I have been very, very pleased by the fact that the autism world has not freaked out by me saying

should embrace people with addiction as neu diverse. I was a little anxious because of the stigma around addiction, that a lot of people would feel like, you know, oh, like those are the bad people and you know, you shouldn't be comparing it. And I was really interested to

see a study that came out. It was looking at like basically the entire Swedish population from certain years, and they found that people with autism diagnoses who had normal to high IQ actually had double the risk addiction compared to ejentulation. And you know, I sort of thought, oh, well, I'm just kind of really a weirdo in this too.

But I started talking to other people on the spectrum who also have addictions and for this article that I wrote about that, and it was it was really quite fascinating. Oh yeah, I think that you know, you find in the autism community just great tolerance and just the neurodiversity community in general for anything. But where do we draw the line? I find this a very stimulating conversation, and so I have like really you know, unbaked questions for you, but that I am so excited to get a chance

to explore with someone. And that's what I love to do in this podcast. Anyway. I'm just like, I'm addicted to curiosity. That's my probably downfall in life. You know, sometimes asking is essential, I mean, and any you know, I'm addicted to it. I don't know about that. Okay, Look, when I was reading your book, like I saw a new book idea in my head as a cheek because I'm cheeky, I'm a little bit cheeky. I'm like, Okay, well, serira killers, let's put them part of the NeuroD different Now.

I'm not saying ur seria killers are the same, and that's not all I'm saying, but I'm saying we could take this what happens if we scale this up and we say, I think I could make a case that like rapist Serraco or is, like you know, they're like, it's some kind of like extreme alteration of what's a basic drive in all of us. Do you know what

I'm saying? I do yet. I am actually quite interested in antisocial personality sort of men psychopathy, and I think that if you look at the neurology of psychopathy, you can make as good an argument for it being a brain disease as you can for addiction being a brain disease or for depression being a brain disease. And nobody wants to wrestle with that. Psychopathy was not put into the DSM so that it could not be used as

an excuse for criminal behavior, and it is. You know, both ASPD and psychopathy, which is the extreme of ASPD, basically are kind of diagnoses of being a bad person. You cannot have those conditions without harming others, like you can have addiction without It's like not essential to hurt others to be addicted, you know, And it's not essential to hurt others to be depressed, even though in both of those instances others will often be hurt. But the

with you cannot be antisocial without harm. And so I keep thinking about writing this, and I've never really just got down and done it, but I do think we need to deal with that because what you know, it's not your fault that you are wired in a way such that you don't feel fear and you have difficulty to empathy. But it's not other people's fault that you, because of that wiring, you might kill them right right,

right right exactly. So if someone is coming at me because I try to practice, I just thought of another book title, how about radical acceptance of others, not of yourself, because there's so many books and radical acceptance of yourself, you know, But anyway you know, like self compassion, like, there's so many books on that, but what about like

what would radical acceptance of others look like? It would go to the extreme in the sense that, now, if someone is coming at me with a machete, you know, an antisocial person, I'm not going to say, you know what, I really have tolerance and respect for the kind of brain wiring you have, and I want to you, I want to I want to give you a membership in the neurodiversity movement. Now, I wonder maybe if I did say that, maybe they put the machet down and give

me a hug. Who knows, She's unlikely. Yeah, but there does seem to be a difference. So with addiction, though, it is a kind of harm like self harm in a way, right, Well, no, it certainly is. And I mean, like, you know, I've always like thought that the term drug abuse was really dumb, and I'm very glad that it got out of the DSM because you're not abusing the poor little drug. You might be abusing yourself. But that is a term that has been used for other things.

You know, you cannot be addicted without harm to yourself because by definition, it's a definition involves harm, and I think it's important that it involves harm, because otherwise you can just be like, oh, I'm like addicted to playing the piano, and you know, and you could be addicted to playing the piano if like you are ignoring your wife and your kids and your job to do that. It would be a very rare thing, but you could see that that could potentially happen. But if there's no harm,

there's no addiction because other wise is too expensive. But with antisocial personality disorder or psychopathy, the problem of harm to others is fundamental. And I don't think as a society we have wrestled with how do you deal with the fact that some of us probably are wired to have no empathy? And I think there is a person that we are dealing with as a nation right now that has that issue. And I actually feel that the psychiatric community has done a real disservice by avoiding looking

at that. But that is probably a different conversation I think though, that we need to deal with. I mean it also like here we always get back. The Scandinavians tend to do everything right, but they punishment and oh, you know, they deal with it, but they what they do with, you know, antisocial people who simply cannot be rehabilitated. Is they incarcerate them, but in nice conditions, And like,

I think that is a sensible strategy. I am astonished by the Norwegian's ability to put up with that evil guy, you know, who slaughtered so many kids, and then he's complaining about his cell conditions aren't nice, and they're like, oh, let's look at that. I had to bite my lip to have that kind of tolerance. Yeah. No, I mean, and I think that's like, really, you know, extraordinary and admirable,

but it is. You know, I wish that as a diverse society we could achieve that kind of solidarity, but it's a lot easier to do it in a small, homogenious community. And I think the biggest question of how to govern ourselves involves how do we include diversity without

splitting into pieces? Absolutely, And I do recognize that this conversation is probably gonna be controversial to a certain segment of our listeners, but I think it's worth having a discussion because at least I hope it's worth I hope it was a fair fair point because you know, I like to apply if you raise a logical argument to me, I want to think how it logically applies to everything, not you know, I mean that's the way my mind works.

I don't circumscribe it just to the nice and pretty things, right, Like, So, taking a degree, I think that we would have to come to terms with this framework. And you know, if we view lots of things as adaptations that are alternative strategies, which is how I do like to view lots of these things as alternative evolved strategies to for survive on reproduction.

I mean, there are lots of things that well, right, and I mean, like, you know, you can argue that part of the evolution of altruism involved having to evade the non altruisms, right correct, Yeah, so you know, and it's also the case that there are situations in which empathy is a handicap. When you are a surgeon and operating on somebody's brain, you don't want to be thinking

about that person as human beings. The surgeon needs to be focused on the I am fixing this little piece, not like oh my god, I might slip and destroy a human Yeah. Yeah, so you know, I think that you know, there are situations where just absolutely shutting off empathy is productive, right, but I would say not shutting

off compassion. Well, I know, I mean I just think that like what you need is really strong systemizing at that moment, and you know, like I just want them to be like doing the mechanics here and not thinking about like, oh I feel so nice for this person, but more like I am going to make sure I don't like make this thing that will destroy someone. So empathy is different than compassion. I'm just doing a thought

experiment about the person, the doctor. Without compassion, I don't think it would motivate them to do a good job and be as meticulous because they wouldn't care as much about the outcome. You're just caring about how they're going to get paid, okay, okay, and they know that they're gonna get sued and lose money if they have a

bad outcome. Maybe I'm too innocent. I mean, I'm just making this up, but I think that, you know, and I'm certainly not saying that doctors should be jerks, but I am saying that, like, it is understandable why they often are jerks, particularly surgeons, and it is the case that it is adaptive to turn off compassion in the hospital sometimes because otherwise you would just be too overwhelmed

and you'd go in a corner and you couldn't help anybody. So, you know, it's complicated, and some of the traits that we think are completely useless, like impulsivity, can be useful in some setting. And you know, some of these antisocial things like where you're disregarding the reviews of others and this kind of thing. Again, there are certain circumstances in

which that may be adaptive and productive. The problem is, as with all of this stuff, like when it causes harm and how you deal with how responsible that person may be for that behavior. Good. I really appreciate that nuance. We really kind of went on a bit of a tangent there and what was my fault? But this is what HAW is when you stick to people who have characteristics of what so one would call ADHD together in a conversation, Yeah, wandering does occur. Yeah, but this is great.

I find this a really skintulating conversation. And then the other thing I was thinking is like with drug addiction, it's just it seems like I'm still not one hundred sec of I'm trying to think of as a developmental disorder because I do see the role of learning, but I also don't think it's and you would certainly not

say it's one hundred percent all about learning. There are some things that are inherently more rewarding than others from a biological perspective, So that's true, Like these things like hijack or operate on our striatum and our lower order reward systems in such a way that it's irresistible to those systems that evolved. Do you know what I'm saying.

What's interesting is that you know eighty to ninety percent of people who try heroin do not become addicted, and you know most people who gamble do not become a dang, Can I ask a foalup question about that? Because I kind of want to try heroin now? Or that you said that, like I see again, like I usually say right after that, that does not mean you should go try it. You would not fly on a plane that

crashes ten percent of the time exactly. So yeah, that's my question is like it's still like heroin could still be dangerous for you physically, even though if it's not addictive, like you shouldn't. That doesn't mean that it's okay to try heroin. Well, I mean, the thing is that, like, you know, if you were to be given an injection of heroin in that was a safe and pure dose in a medical setting and somebody had narcan just in

case you happen to have an overdose. I'm not recommending this, But the thing is that these are drugs that, in some settings, you know, if you are in extreme pain, are angels and miracle drugs, and in other settings are going to kill you and going to you know, destroy your life. So I think that it is certainly the

case that the drug is not irrelevant. Well, okay, so this is so interesting because like I'm trying to think about other things who are equally as rewarding or almost seqly as rewarding from biological perspective, that we do every day of our lives. So for instance, when I eat pizza, every time I eat pizza, the grease he or the pizza, the more I bet it's really scitulating my stratum. My

stratum loves that the pizza. You know, we think that like oh, something like heroin, like you know, it hijacks your brain or whatever, But the fact is that most people retain control over their use, and most people who are exposed to opioids do not become addicted. In fact, about a third of people exposed to opiates find them more unpleasant than pleasant. Another third kind of finds them well,

some parts are pleasant, some parts are not. And then it's that final third they're like, oh, this is the best thing ever. But what's interesting about that is one third of people do not, you know, who try opias don't become addicted because within that group, a lot of people are like, Wow, this is the best thing ever. I Am not going to do it again because I don't want to lose my family, my job, et cetera,

et cetera. This was a nice, blistful experian. But you know, if I ever have to be exposed to this, I want, you know, the doctor to be very careful of monitoring me. I think that's really important because I experienced lots of things in my life that I think to myself, Oh, I could so easily get addicted to this again. The pizza.

But there are a lot of things in my life and people, you know, okay, listeners, use your imagination, you know, like, but like, yeah, yeah, there are lots of things in one's life that I think, you know, but I do have that sort of higher level conscious reflection mindfulness about it that I make the decision. But what is the difference between like what would put me over the right? So here's what often done, and I mean, these are the things that tend to set people up for addiction.

Obviously we've talked about how oftentimes it's exposure during these developmentally sensitive periods. Right. Also if you have severe childhood trauma, like about two thirds of people with addiction have been exposed to at least one traumatic experience. The more and the different types and the more extended the traumatic experience, the greater the risk. About fifty percent of people have also with addiction also have a other mental illness, and

so that sets you up for it. And then the third kind of biggie is like existential and economic despair and a sense of hopelessness because really it's yeah, I mean, you know, and this is where you know, certainly in poor communities, you know, people has made an argument in the past that addiction is a rational choice when your alternative is like McDonald or death if people are mortality

high mortality rates. Yeah, yeah, I mean, so you know, at some point, like certainly using drugs in that circumstance can be seen as a rational choice. I don't think addiction is actually the rational choice, but certainly using drugs to escape and create an identity and a purpose for yourself in a world that seems meaningless and purposeless, that is a part of addiction for many people. And this is also why for me, people like God or spirituality can be an answer to that, because that can be

in the answer to existential questions for some people. So this is not to say that there aren't medical and learning and all kinds of other aspects to it, but if you you know, it is like depression in the sense that there is an existential piece of it. Good. I'm really glad you add the news because I want to make clear you're not make the argument learning is the only piece. You're saying, it's a crucial piece that's

been missed out. A lot of people kind of equate it like you're spelling the myth of the instant addiction exactly. I think, look, and I think that's really important. Absolutely, So I'm glad you added these other layers onto it as well, because I think all the it's like a system.

All the pieces are important, and you're saying learning is one important part of that system as well, that gets often that gets neglected, no exactly, And what I'm trying to say is that the so we've sort of as a society had this sort of chronic brain disease model of addiction, and that model often and ignore social factors. Often has been seen to ignore learning and can often be stigmatizing. And in America is like deeply entwined with the twelve Step and the moral and the spiritual approach

to addiction. So what I'm trying to say is just that, Okay, we're all going to agree addictions of medical problem. What kind of a medical problem is it. It's a developmental problem that occurs in the context of all of these things. And you know, learning brings in culture because like you don't learn in a vacuum, and learning brings in all of these other things because it is where the environment

and the genes meet. So that is why I have really tried to emphasize that, because if you just see it as a chronic progressive disease at like Alzheimer's, that can be a pretty hopeless view. And if you see your brain as like irreparably damaged, and you're always going to have to be fighting it. That is a serious problem.

Now this is not to say that I think it's safe for me to go shoot heroin, but it is certainly to say that, like, I do not spend any time thinking about, oh gosh, it'd be really nice to do opiate, And I did spend a lot of time thinking about that in my early recovery, you know, and I have gotten better. You know. It's like when you break up with somebody, like you know, at first, it's like really really you know, like now it's like, okay, they're my ex I don't care, you know. So that's

a good point. I want to end here with the one line you wrote the book, which you probably didn't mean it to be as deep as I read it to be, but I found it like when I read this line, I was like, that is one of the most profound things I've ever read in my life. Okay, so it's a very seemingly simple line you wrote, we all learn to become who we are, Holly cow. I mean, if you really think through, like if you really sit down and reflect on the meaning of that for all

areas of our lives. That's pretty profound, right well, and I mean I did mean that in this okay expanded sense, because you know, that is how we become who we are, right like, by learning, and we are learning in all different contexts, in the context of our neurology, in the context of our sociology, and the context of our psychology, our parents. I am trying to bring you sort of multifactorial nature of this together, and learning is at the center of that because it is how we become who

we are. And so when you become addicted, that is one of the elements that becomes a part of that. And I think one of the interesting things about the whole norrodiversity thing is, you know, a lot of autistic people are very like I'm autistic, like proud of that and very much like you know, see, that is central to their identity, and so much so that they don't like people with autism. They want to be called autistic people, right. And then there's this other view, well, oh, my addiction

is separate from me. I'm a person with addiction, not an attic, you know. So there's I mean, I think there's very interesting layers of what parts of yourself you embrace and what parts of yourself you say, well, that's not me, right, And I am trying to, you know, have an inclusive sense of self that can deal with the things that are problematic, but also can acknowledge that these things can also you know, bring you know, good things.

I think, you know, there are certainly instances where disabling conditions are just disabling and they're not bringing any benefits. But I also think that if we are faced with whatever we have and whatever we are, we may as well look for the upside and where we are at well well, I want to thank you for such a refreshing take on this topic and for chatting with me today. Thank you, Maya, Oh, thanks so much. This is fun. Thank you so much for listening to the Psychology Podcast

with doctor Scott Barry Kaufman. I hope you found this episode just as thought provoking as I did. If something you heard today stimulated you in some way, I encourage you to join in the discussion at the Psychology podcast dot com. That's the Psychology Podcast dot com.