Addiction, Recovery, and the Power of Connection

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Dr. David Fawcett

In recent years, addiction has been described more and more often as an intimacy disorder. What this means is that addiction is not driven by a lack of willpower or an unreasonable quest for pleasure, as was believed for a very long time. Instead, addicts have an intimacy disorder that makes it easier (i.e., emotionally safer) to turn to an addictive substance or behavior to get their emotional needs met (or, more accurately, to temporarily avoid feeling the pain of their unmet emotional needs) than it is to become vulnerable with another human being, thereby risking rejection, feelings of shame, and other forms of emotional discomfort.

But this understanding of addiction is relatively recent in its development. Prior to that, scientists and those treating addiction typically viewed it as a moral failing coupled with an outsized appetite for pleasure. To be honest, this thinking was not unreasonable, given the fact that addictive substances and behaviors create a surge of dopamine, adrenaline, and other pleasure-related neurochemicals, thereby causing feelings of pleasure, excitement, intensity, etc. It seems only natural that after experiencing these sensations we might want to go back for more. Especially if we’re weak-willed and overly hungry for pleasure.

Even NIDA (the National Institute on Drug Abuse) once gave this theory – the rampant search for pleasure leads to addiction – its stamp of approval.[i] NIDA’s approval was partly based on the morality of the day and partly based on scientific research. For the most part, that research involved rats placed in cages with two water bottles – one with pure water, the other with opiate-infused water. These experiments uniformly found that rats almost always opted for (and eventually overdosed on) the opiate water. In other words, rats would rather drink “pleasure water” than regular water, even if it killed them.

From that, it was pretty easy to conclude that addiction is entirely linked to the search for pleasure. We now know, however, that this theory is incorrect. And when we think about it, this too makes perfect sense. Otherwise, any person who ever had a sip or two of alcohol would become alcoholic, anyone who ever ingested an opiate (even via prescription) would turn into a junkie, anyone who ever hit on a slot machine would become a chronic gambler, etc. But that’s just not what happens. In fact, the vast majority of people who experiment with addictive substances and behaviors do not become addicted. So even though the link between pleasure and addiction seems obvious and paramount, other factors must be in play.

The initial breakthrough into what else, beyond just pleasure, drives people to become addicted occurred in 1980, when addiction researcher Bruce Alexander started to question the earlier experiments with rats. Alexander recognized that rats are social creatures in very similar ways to humans, which is one of the reasons they’re so useful in psychological experiments. And to him, placing a rat into a tiny cage all by itself with nothing to do what decide between regular water and opiate water seemed like a poorly designed experiment. He thought, “Of course they choose to get high. What else are they supposed to do? They have no other choices.”

So Alexander created what we now refer to as “the rat park.” He got a great big cage and filled it with cedar shavings, toys, empty cans and boxes to play in, things to climb on, and not one but 20 rats of both genders. And then he watched to see if the rats preferred regular water or opiate water. Unsurprisingly, Alexander’s rats spent their time playing, mating, and fighting – i.e., socializing – and they almost uniformly ignored the opiate water.[ii] Even rats who’d previously been isolated and getting high chose healthy socialization and regular water when they were placed in the rat park.

Suddenly, it was clear that a lack of intimate emotional connection was a factor in the development and maintenance of addiction. Further research tells us that almost all addicts report some degree of familial dysfunction during their childhoods, which taught them that other people, even the people who are supposed to unconditionally love and care for them, cannot be trusted. That lesson takes root early in life and carries forward into adulthood, causing them, as adults, to feel ill-at-ease in the human version of the rat park. Thus, addiction.

In the years following Alexander’s initial rat part experiment, countless studies have linked early-life trauma to addiction and other emotional/behavioral issues. One well-known study found that survivors of chronic childhood trauma (four or more significant trauma experiences prior to age 18) are:

  • 1.8 times as likely to smoke cigarettes.
  • 1.9 times as likely to become obese.
  • 2.4 times as likely to experience ongoing anxiety.
  • 3.6 times as likely to be depressed.
  • 3.6 times as likely to qualify as promiscuous.
  • 7.2 times as likely to become alcoholic.
  • 11.1 times as likely to become an intravenous drug user.[iii]

Thus, we see an undeniable link between childhood trauma, feeling ill-at-ease in the human rat park, and numerous adult-life issues, including addiction. So addiction is not an out-of-control search for pleasure as many people once believed. Yes, pleasure opens the doorway to addiction, but it doesn’t push people through and slam the door behind them. It is a lack of (and fear of) intimate emotional connection that does that – by isolating individuals and essentially limiting them to a single choice of regular water or drugged water.

So what can be done about addicts’ lack of intimacy?

The good news here is that even the most isolated of addicts can learn to connect and develop intimacy. Generally, this process starts with individual therapy, where the addict slowly learns to trust a paid therapist with thoughts, feelings, fears, and secrets. In time, this expands to group therapy, 12-step groups, and other healing relationships. Slowly but steadily, as recovering addicts interact with safe, nonjudgmental, empathetic others – many of whom are deeply empathetic because they are recovering addicts themselves – trust is built. Eventually, the addict learns to become vulnerable with other people, opening up in ways that help the addict get his or her emotional needs met. With that, the need to escape the pain of unmet emotional needs through addictive substances and behaviors dissipates and long-term sobriety, recovery, and healing are possible.

The antidote for addiction is not willpower or 24/7 babysitters, it’s intimate emotional connection with empathetic others. The way to overcome addiction is to join (or rejoin) the human rat park.

That, of course, is an oversimplification. Though rats and humans are in many ways socially similar, humans are far more complex. We can’t just drop an addict back into mainstream society and expect that individual to immediately fit in, connect, and stay sober. With rats, that works. With humans, more effort is needed – therapy, social support, and ongoing effort through treatment, 12-step groups, and the like.

Consider the nation of Portugal. Portugal decriminalized drug use in 2001 and redirected resources from arrests, courtrooms, and prisons to treatment and social integration of problematic drug users.[iv] The government even subsidizes jobs and housing for recovering addicts. In other words, Portugal has focused on connecting addicts to other people and society at large, rather than further isolating them by placing them in prisons. And this approach is working. Drug deaths are down, incarceration rates are down, and countless former addicts are now former addicts.

Admittedly, Portugal is just one large-scale social experiment trying to pull addicts in rather than pushing them away. But taken in conjunction with the research of Alexander and others, it does seem clear that the addiction really is an intimacy disorder, and the long-term antidote absolutely must involve the development of emotionally intimate connections.

REFERENCES

[i] Bejerot, N. (1980). Addiction to pleasure: A biological and social-psychological theory of addiction. NIDA research monograph30, 246-255.

[ii] Alexander, B. K., Beyerstein, B. L., Hadaway, P. F., & Coambs, R. B. (1981). Effect of early and later colony housing on oral ingestion of morphine in rats. Pharmacology Biochemistry and Behavior15(4), 571-576.

[iii] Anda, R., Felitti, V., Bremner, J., Walker, J., Whitfield, C., Perry, B., … Giles, W. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256(3):174-186.

[iv] Hughes, C. E., & Stevens, A. (2010). What can we learn from the Portuguese decriminalization of illicit drugs?. The British Journal of Criminology50(6), 999-1022.