Book Review-The Globalization of Addiction: A Study in Poverty of the Spirit

Why is addiction of all types on the rise in our society today? If the pharmacological theory of addiction is true – that demon drugs take over the minds of users after only one use – then why is it that there are other, non-drug addictions? How does that explain alcohol enslaving some people but not others? The answers, according to Bruce Alexander, are found in the fact that society is increasingly psychologically dislocated. In The Globalization of Addiction: A Study in Poverty of the Spirit, Alexander convincingly explains how we’re more disconnected from each other and our communities than we’ve ever been and how the chief actor in this play is the free market capitalism that most of the world has adopted.

Return to Rat Park

I called out, in Chasing the Scream, how a set of studies illuminated that rats would not overuse morphine added to a water dispenser if those rats had other rats and playthings to make their environment comfortable. That research, called “Rat Park,” was by Alexander and his team. They found that, even in rats, there was a big contrast between happy rats with the socialization and stimulation they needed and rats that didn’t.

This is a big part of the mystery. If morphine is inherently addictive, then how should the cage the rat is in matter? It shouldn’t, but it does. To answer the question of what the factors are that cause addiction, Alexander researched history, including the views of addiction.

Put Out the Fire

Addiction as Illness or Moral Defect

Throughout modern history, addiction in its various forms has been viewed from either the lens that it is an illness – a disease – that should be treated, or from the perspective that it’s a moral defect, and the person should develop a greater constitution. Sometimes addiction seemed to take both forms at once.

There are several reasons to view addiction as an illness. Twelve-step groups teach that it’s not a moral defect but an illness that can be managed but not solved. (See Why and How 12-Step Groups Work for more.) It doesn’t help that DSM-V (the manual for psychological dysfunction) lists various forms of substance addiction as official diagnoses. It seems as if established psychological care groups and addicts themselves have accepted the labeling of addiction as a disease.

At the same time, society has frequently shunned those with addiction for fear that they might somehow draw more people into their downward spiral. It’s as if the addict has the capacity to create a whirlpool that will bring down others.

However, before we get too deeply into Alexander’s research and how addiction has manifested itself across history, we’ve got to stop to define what we mean by addiction.

Alexander’s Four Definitions of Addiction

Robert Palmer sang the song “Addicted to Love,” and in doing so compared love to an addiction. The truth is that neuroimaging confirms infatuation-type love and addiction are virtually indistinguishable. But, in drawing this connection, he illuminated the problem we have with the word addiction. It doesn’t mean one thing; it means multiple. Alexander defines four types of addiction:

  • Addiction1 – Overwhelming involvement with drugs or alcohol that is harmful to the addicted person, to society, or both.
  • Addiction2 – Encompasses Addiction1
    and non-overwhelming involvements with drugs or alcohol that are problematic to the addicted person, society, or both.
  • Addiction3 – Overwhelming involvement with any pursuit whatsoever (including, but not limited to, drugs or alcohol) that is harmful to the addicted person, society, or both.
  • Addiction4 – Overwhelming involvement with any pursuit whatsoever that is not harmful to the addicted person or society.

The problem with these four definitions of addiction is that it becomes unclear what we mean when we’re speaking of addiction. While, sometimes, people are speaking of drug and alcohol use (Addiction1 and Addiction2), they could just as easily be speaking of dependence on a substance or activity (Addiction3 or Addiction4). While we socially make a difference between those addictions that are good for society (Addiction4) and those that are harmful (Addiction3), these distinctions are largely arbitrary.

Workaholic

Using the above definitions, it might be easy to categorize workaholics into category 4. After all, famous workaholics are great creators and people who have moved society forward. However, as you peer through the whitewashed veneer placed on their historical accounts, you often find places of inner turmoil and struggle that reveal a more complex existence. While, on the whole, workaholics may benefit society, the impact to their lives and the lives of those they love may be only slightly better than if they have a more recognized drug or alcohol problem.

An important underpinning of Alexander’s discussion is the need to recognize every addicted person as first a person. Trying to sort people and situations into differing kinds of addiction is necessary for discussion, but it runs the risk of failing to recognize the reality of the individual people who are suffering in ways that are both small and large.

Devoted

Another translation for the original Greek word from which we get addiction is “devoted.” In our modern use of the word, we fail to capture the attachment that exists between the person and the object of their devotion. While understanding addiction as devotion makes the neurological scans make sense, it does little in the way of helping us to sort through addiction and help those that are suffering.

A different definition of addiction, and one that I am particularly fond of, is a coping skill that someone becomes enslaved to. Instead of the coping skill being useful to cope with life, it becomes necessary for survival. Instead of the position of helper, this new behavior or substance becomes the jail master. It’s that transition that isn’t captured well in addiction or devoted. However, it can be captured in another word: slavery.

Voluntary Slavery

Another way to think of addiction, one which probably comes the closest to capturing the mechanisms at work, is to think of addiction as voluntary slavery. This is paradoxical. Why would someone become a slave to someone or something else? The answer is that what the person gets seems more valuable than their freedom.

Consider for a moment the biblical story of the prodigal son. While the ending is well known to us now, it wasn’t for the son. He had disgraced his father by asking for his inheritance in advance and then blown it. He was scavenging for food and knew that his father took care of his hired hands well. His decision to come back wasn’t to come back into slavery but a difficult decision to walk back to the things he had done and suffer any consequences his father might dole out.

In short, he was willing to accept whatever the consequences were for the promise of regular food and shelter. This would be the same story if the father had taken the son as a slave. While slavery is an awful concept and demoralizes the slaves, it can provide some stability.

The Bargain

So, what’s the bargain that would lead someone to believe that slavery is the right answer? In the case of addiction, it’s the quelling of the pain. Though Alexander is very focused on psychosocial dislocation, in my experience, it’s broader than that. Psychosocial integration is the antidote to addiction, but the lack of it doesn’t cause addiction. Alexander himself acknowledges that the greatest limitation in his theory is the lack of ability to predict those who will become addicted and those who will not.

If you look at psychosocial integration as the way to smooth all the hurts and pains that we naturally get through life, a more complete story emerges. Psychosocial integration then functions like the antibodies that we produce. The lack of antibodies isn’t the direct cause of death. The lack of antibodies allows us to succumb to the bacteria that we encounter in going through life.

The addiction is a replacement for the psychosocial integration. It temporarily stands in for the connection that we all need. However, the object of the addiction is a poor stand-in for what we really need – connection to others.

The Pain

The pains that lead to addiction are many. It could be not being accepted by your family. (See How to Be an Adult in Relationships for more on the role of acceptance.) It could be feelings of fear. (See Find Your Courage is a good place to start to work on overcoming fear.) It could be a confusion between shame and guilt – and believing you are bad when you’ve only done something bad. (See I Thought It Was Just Me as a start on the journey for differentiating these two.) It can be the harmful things that were done to you. Whether you believe you should have “known better,” prevented them, or just realized that bad things happen, these hurts can become wedged in our minds and bring back repeated trauma.

Addiction makes the pain go away – at least for a while. Medications like ibuprofen (Advil), acetaminophen (Tylenol), and aspirin can help you relieve a hurt for a while, but, ultimately, the effects wear off, and you need more. Addictions quiet the pain for a time, but they ultimately don’t provide healing.

Healing

What Alexander is describing with psychosocial integration isn’t just covering up the pain but providing real healing for the hurting. While the temporary relief from the pain may be appropriate, without the work to protect the broken bone and realign it so it can heal over time, the pain will simply continue – and will probably get worse over time, requiring pain medication in greater doses. That’s addiction. It’s failing to recognize and resolve the root problem and instead focusing on pain symptom relief.

From the Scottish Highlands

It’s an interesting theory, but where’s the support for the idea that dislocation leads to addiction? Let’s start in the Highlands of Scotland. In the early 1700s, Scotland was relatively isolated from Great Britain and the benefits of modern English society. They lived together in relatively stable communities. However, transformation began in the latter half of the 18th century, as the Scottish could no longer ignore the growing influence of the English. Cattle and grain were replaced with hearty sheep that were more profitable to the landholders. They needed fewer people to tend the lands, and their communities ruptured. There was great displacement of people who no longer had roles in the community.

It was at this point that the Scottish discovered the alcohol that Christian monks brought with them three centuries prior. While alcoholism was relatively unheard of in their communities prior to the second half of the 1700s, it seemed to explode overnight.

To China’s Opium Dens

China had access to opium since the Ming Dynasty, and it managed to remain relatively productive until the losses in 1839 and 1858 to the British Empire. Suddenly, Chinese ports were open to the full commerce of the Empire, and the Chinese market was radically changed. As with the Scottish Highlands, the disruption in the market from a relatively stable communal relationship to a more free-market approach displaced members of communities whose services were no longer effective or necessary.

It’s here that it starts to become apparent that there is a cause of psychosocial dislocation. The free market system seems to destabilize communities and countries as it marches on towards efficiency, production, and, in some cases, greed. However, any kind of dislocation has the same impact.

To Native American Indian Displacement

A little closer to home in the United States (where I live) and Canada (where Alexander lives) is the displacement of Native American Indians as their lands were taken as property. Whether it was seized or negotiated for as a part of as a treaty makes little difference to the outcome. Natives, whose ancestors had always roamed the same land, were forced to move, and the disruption of their culture could not be more profound.

Children were trained only in English and were “encouraged” to forget their heritage. The resulting disintegration of culture left many adrift. Firewater, or alcohol, was an all-too-easy way to forget the suffering of having lost their way of life.

Warnings from Australia

Alexander didn’t mention the challenges of introducing change that Everett Rogers uses as a cautionary tone at the end of his work, Diffusion of Innovations. The real problem with change – any change – is that you cannot predict all the effects. In Rogers’ case, he referred to the impact of missionaries on aboriginal Australian people. In a culture where stone axe heads were a prized tool owned by the elders and lent through a ceremonial request, the missionaries introduced steel axe heads. The steel axe heads were, of course, more efficient than the traditional stone axe heads. However, more critically, the axe heads were given without the cultural underpinnings of respect. Missionaries offered them to women and young men who would never be able to own a stone axe head.

The intended result was, of course, to elevate the people and improve their standard of living. It seemed obvious that the introduction of the improved axe heads should increase the capacity of the tribe to create value for its members. However, the unraveling of society that came from the introduction couldn’t be predicted. Instead of greater productivity, the Aborigines slept more. The desire for the new power of the steel axe head caused at least some cases of husbands prostituting their wife to near total strangers in return for a steel axe head.

A simple introduction of one good – the steel axe head – seemed capable of collapsing an entire culture to near ruin. To be fair, the source article that Rogers refers to, “Steel Axes for Stone-Age Australians,” admits that, while the axe heads had primary influence, there were other influences coming in from Europeans. There was no way to say that the steel axe heads by themselves were causal for the breakdown. However, in the context here of explaining the introduction of free market and how it impacts the stabilization of a community, it makes little difference whether it was the axe head or some other disruptive, free market influence.

Poverty of the Spirit

The subtitle explains that Alexander’s work is a study in the poverty of the spirit. However, what does that mean? What does it mean to be poor in spirit? Reviewing the beatitudes from Mathew 5:3 in the New Testament of the Christian Bible doesn’t help. Alexander only says that he believes that dislocation is a poverty of spirit. He contrasts this with a material poverty.

It’s an important distinction. Is material poverty a mitigating factor for addiction directly, or is dislocation, or poverty of the spirit, the mitigating factor? Looking at celebrity addiction, it’s relatively easy to isolate material poverty as not being a mitigating factor. And so, it seems that, though those with addiction often find themselves in material poverty, this is more the outcome than the cause.

A deeper look into what it means to be poor of spirit is, however, warranted.

Poor in Spirit

There are context clues scattered throughout, which lead to an image of the emptiness and feeling of being lost or set adrift that are at the heart of the poverty of the spirit. To be full of spirit is to be full of life and zest. A compelling purpose sucks a person forward into the vastness of their potential impact. To be poor in spirit it to be without this light.

For some, it is possible that the light never shone. It’s possible that their very earliest memories had nothing lighthearted or fun. For most, however, there would be some light that burned or at least flickered before being snuffed out by life’s circumstances. Without the psychological integration that can nurture this flame and even relight it if necessary, those who are poor in spirit must remain this way.

Need for Purpose

Atul Gawande explains in Being Mortal that seniors in living facilities live longer if they have something to take care of – even if that something is simply a plant. It seems that we’re hardwired to need to take care of something. When we become disconnected from others, we have nothing to care for except ourselves. This is not a natural state for us as humans, and most find this to be a painful experience.

Stopping Addiction

While there may not be any sure-fire way of preventing the spread of addiction or helping those recover from addiction, it’s possible that we can learn more about the factors that increase the likelihood of addiction and try to understand what we might do to make things better. We can’t stop The Globalization of Addiction individually, but perhaps we can work together to make it better.