<div dir="ltr"><div>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman"">
</p><p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman"">I totally agree with Rafal here. The theory and models are
academic. The semantics are fun for us high IQ folks (meaning, I'd like to think, pretty much everyone on this
list). But there are serious public health
implications.</p>
</div><div><br></div><div>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman""><i>William Flynn Wallace said:
<span></span></i></p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman""><i>And if addiction is a
brain disease, how can talk therapy fix that? I strongly believe that the
psychological addiction is way more powerful than the physical one. All
behaviors of any kind come from the brain, I think, and if I acquire a liking
for daffodils, my brain is changed, so just measuring brain changes shows very little,
it seems to me. Maybe at best hypotheses to test </i><span> <br></span></p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman""><span> </span></p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman"">Talk therapy can help someone make new connections, develop
hope which is important, adapt to their environment, manage themselves better,
learn from their past, prepare for the future, live in the moment better. The brain
changes all the time. Learning is literal connections being made. Talk therapy
changes the brain.</p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman""><span> </span></p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman"">So how are we to think about addiction?</p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman""><span> </span></p>
<p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman"">The best resolution to the conflict of ‘addiction is a (brain)
disease’ vs., as bill w put it, “Let's call addictive behavior what it
is. Voluntary,” is from Dr. Kevin McCauley who has a documentary entitled
<em>Pleasure Unwoven. </em>He says addiction begins as a disorder of genes and
pleasure and ends as a “disorder of choice” because one's decisions are motivated
by abnormally intense cravings to seek out, obtain, and use substances in a
brain with an altered reward pathway. Here’s a less-than-5-minute clip on “hypofrontality
in addiction” from this documentary. <a href="https://youtu.be/jkOl7QIXxlQ" style="color:blue;text-decoration:underline">https://youtu.be/jkOl7QIXxlQ</a> I hope you all will watch it. I find his argument compelling and have yet to ask Carl Hart
what he thinks about the orbital frontal cortex and the anterior cingulate cortex
scans referenced. As always, this is an area where more research needs to be
done I’m sure. Practically speaking, this perspective I hope leads to
compassion for people struggling with addiction so we can help to reduce the
harm that comes to them and help provide treatment. <br></p><p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman""><br></p><p class="MsoNormal" style="margin:0in 0in 0.0001pt;font-size:12pt;font-family:"Times New Roman"">-Henry<br></p>
</div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Fri, Apr 8, 2022 at 4:39 PM Rafal Smigrodzki via extropy-chat <<a href="mailto:extropy-chat@lists.extropy.org">extropy-chat@lists.extropy.org</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div dir="ltr"><div dir="ltr"><br></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Fri, Apr 8, 2022 at 2:30 PM Will Steinberg via extropy-chat <<a href="mailto:extropy-chat@lists.extropy.org" target="_blank">extropy-chat@lists.extropy.org</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div dir="auto">What an overly simplified view of the brain, as if parts of the brain don't send signals to other parts.<div dir="auto"><br></div><div dir="auto">Why is it so hard to admit you are wrong? You are wrong. The science is the opposite of what you say. You are not a neuroscientist, are you? An addiction researcher? Is there any reason your intuition and personal single anecdote would possibly be something I would consider true over literal thousands of pieces of vetted scientific research?</div><div dir="auto"><br></div><div dir="auto">Blows my mind. Not sure how you are usually into science but not for this one thing.</div></div></blockquote><div><br></div><div>### I agree with you, Will.</div><div><br></div><div>I also think it is useful to look at the problem from a practical, problem-solving point of view. The most important characteristic of addiction is that it is a behavior that the addict continues despite knowing that it has significant deleterious effects on his life. One could quibble about what is "deleterious" but in practical terms addiction is the kind of behavior that just doesn't stop easily despite significant cost. If it stops after a stern talking-to, it's definitely not an addiction. If it continues after losing your job, money, spouse, after a jail time, being beaten up and going through rehab, yes, might be an addiction. Researchers will look at the neurological correlates of the behaviors but us practical people mostly ask "How do I fix the problem?"</div><div><br></div><div>People with a moralistic bent may talk about blame, guilt, shame, weakness, lack of willpower, etc. but again, what counts is the practical outcome - Is he still doing after whatever intervention you tried? Did he stop after the priest chewed him out? Did he get better with the help of suboxone or methadone? Did CBT help? </div><div><br></div><div>What counts is how many people avoided being homeless and overdosing in an alley or getting lung cancer, whether by pulling themselves up by their own moral bootstraps or by mere nicotine patch.</div><div><br></div><div>Rafal</div></div></div>
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