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Thanks for the reference. Do you know if Lembke has had much success in treating addiction? That is how I usually filter authors like this, there is too much co

Thanks for the reference. Do you know if Lembke has had much success in treating addiction? That is how I usually filter authors like this, there is too much content and almost none of it actually helps addicts. In my experience the mainstream view of addiction is harmful, so I feel the need to push back to help others who have fell into the trap of “it’s a disease so I don’t have a choice”. Of course I am simplifying, this is a comment thread and not a dissertation.

haswell 3y ago
> Do you know if Lembke has had much success in treating addiction? She is Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University, and her writing is based on her clinical experience. I became aware of her via her book Dopamine Nation, which is especially relevant here due to the book’s wider view of addictive behaviors and the role of social media. The book also helped me get through some of my own issues. > Of course I am simplifying, this is a comment thread and not a dissertation. The guidelines of this site strongly encourage curiosity and substance over generalizations and simplifications. “I don't have a choice” is one extreme, but there’s a wide spectrum of space to explore between that and “it’s their fault”. I’d be cautious about just pushing back if you’re directing people towards a mindset that they should be able to just choose something else. This can be just as harmful. The person who doesn’t have the tools to work through their issues is driven to despair wondering what is so broken about them that they can’t overcome the problem. Getting help is often necessary.
- brutusborn 3y ago
  She has a fancy title and clinical experience… but is there any evidence that her ideas produce more effective treatments than others? I know it’s a hard thing to study but there are tomes written about addiction, and I am yet to find an academic that has any unique insight in actually solving the problem. I agree it is a complex issue, but in my experience the truth is closer to “you have a choice to change things” than “you are helpless.” I wouldn’t phrase it as “it’s your fault”, e.g. some people start drugs because their parents share with them in adolescence and that isn’t their fault. But ending it is their choice. Maybe I am being too harsh in how I frame it. Frequent relapse can definitely lead to despair, but I honestly think the idea that “I don’t have a choice” causes more despair than the opposite.
  - amanaplanacanal 3y ago
    I suspect that a lot (maybe even most?) people that start using drugs in adolescence or young adulthood are doing so because they have mental health issues that they don’t understand, and the drugs help them feel better.
  - haswell 3y ago
    I agree that there are plenty of unhelpful ideas about addiction. I'm not aware of any available sources where I can prove to you "here's her success rate", but again, I found her work directly applicable to my own addiction issues and reformulating some of my preconceived ideas and self-hatred that had been hammered into me from an early age and were actually part of my problem. "I don't have a choice" is a straw man. "There are a myriad of factors I didn't choose that led to the circumstances of my addiction" is not a realization of helplessness, but an understanding of the systemic factors involved. Understanding this is critical to making the internal mental shifts necessary to actually break the cycle. Factors beyond one's control doesn't imply no choice is available. It just contextualizes the problem, and the resulting understanding can be an escape hatch. I can't change the circumstances of my birth. I can't undo the childhood filled with complex trauma that left me seeking any kind of relief I could find. But understanding those factors means I can learn how to cope with them in better ways.
    - brutusborn 3y ago
      Thanks for the reply, I was grumpy yesterday and pushed back a bit hard, I think I understand your nuance of choice of continuing addiction vs choice of developing addiction now. Out of interest, what addiction did she help you overcome?
      - haswell 3y ago
        It's all good. It's one of the harder facts of life to swallow: I didn't choose the factors that lead to this, but I still have to deal with them, and I'm the only person who can. True of many things in life. I'd prefer not to add more unique data points to my HN profile for privacy reasons, but to speak in generalities, I've struggled with a variety of substances and behavioral loops since I was in my late teens stemming from that abusive background. I spent a lot of time pissed off at my parents, and later at myself for not "having the strength" to overcome these things on my own, while not understanding why I was drawn to them in the first place. If the car is eating oil, something probably needs to be tuned up, so to speak.

haswell 3y ago

> Do you know if Lembke has had much success in treating addiction? She is Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University, and her writing is based on her clinical experience. I became aware of her via her book Dopamine Nation, which is especially relevant here due to the book’s wider view of addictive behaviors and the role of social media. The book also helped me get through some of my own issues. > Of course I am simplifying, this is a comment thread and not a dissertation. The guidelines of this site strongly encourage curiosity and substance over generalizations and simplifications. “I don't have a choice” is one extreme, but there’s a wide spectrum of space to explore between that and “it’s their fault”. I’d be cautious about just pushing back if you’re directing people towards a mindset that they should be able to just choose something else. This can be just as harmful. The person who doesn’t have the tools to work through their issues is driven to despair wondering what is so broken about them that they can’t overcome the problem. Getting help is often necessary.

brutusborn 3y ago
She has a fancy title and clinical experience… but is there any evidence that her ideas produce more effective treatments than others? I know it’s a hard thing to study but there are tomes written about addiction, and I am yet to find an academic that has any unique insight in actually solving the problem. I agree it is a complex issue, but in my experience the truth is closer to “you have a choice to change things” than “you are helpless.” I wouldn’t phrase it as “it’s your fault”, e.g. some people start drugs because their parents share with them in adolescence and that isn’t their fault. But ending it is their choice. Maybe I am being too harsh in how I frame it. Frequent relapse can definitely lead to despair, but I honestly think the idea that “I don’t have a choice” causes more despair than the opposite.
- amanaplanacanal 3y ago
  I suspect that a lot (maybe even most?) people that start using drugs in adolescence or young adulthood are doing so because they have mental health issues that they don’t understand, and the drugs help them feel better.
- haswell 3y ago
  I agree that there are plenty of unhelpful ideas about addiction. I'm not aware of any available sources where I can prove to you "here's her success rate", but again, I found her work directly applicable to my own addiction issues and reformulating some of my preconceived ideas and self-hatred that had been hammered into me from an early age and were actually part of my problem. "I don't have a choice" is a straw man. "There are a myriad of factors I didn't choose that led to the circumstances of my addiction" is not a realization of helplessness, but an understanding of the systemic factors involved. Understanding this is critical to making the internal mental shifts necessary to actually break the cycle. Factors beyond one's control doesn't imply no choice is available. It just contextualizes the problem, and the resulting understanding can be an escape hatch. I can't change the circumstances of my birth. I can't undo the childhood filled with complex trauma that left me seeking any kind of relief I could find. But understanding those factors means I can learn how to cope with them in better ways.
  - brutusborn 3y ago
    Thanks for the reply, I was grumpy yesterday and pushed back a bit hard, I think I understand your nuance of choice of continuing addiction vs choice of developing addiction now. Out of interest, what addiction did she help you overcome?
    - haswell 3y ago
      It's all good. It's one of the harder facts of life to swallow: I didn't choose the factors that lead to this, but I still have to deal with them, and I'm the only person who can. True of many things in life. I'd prefer not to add more unique data points to my HN profile for privacy reasons, but to speak in generalities, I've struggled with a variety of substances and behavioral loops since I was in my late teens stemming from that abusive background. I spent a lot of time pissed off at my parents, and later at myself for not "having the strength" to overcome these things on my own, while not understanding why I was drawn to them in the first place. If the car is eating oil, something probably needs to be tuned up, so to speak.