The idea for this post came from a discussion on Collette’s blog, (Wine to Water) about Gabor Mate’s view that addiction is always rooted in childhood trauma (In the Realm of Hungry Ghosts: Close Encounters with Addiction). My friend did not see herself as having been traumatised as a child so this idea didn’t work for her. I’ve not yet read the book but I will. Whilst I happen to think a lot of mental health difficulties including addiction are rooted in childhood experiences I also think it can be reductionist and unhelpful to have linear cause and effect models for complex processes. The important thing about however you conceptualise a human problem is that it makes sense and is useful to the person with the problem. So this is an attempt to show the complexity of addiction using myself as a case study. These are my ingredients.
A cup of susceptible genes I come from a long line of alcoholism and problematic drinking on both sides of my family. My mum, my paternal uncles, cousins, paternal grandfather, maternal grandmother. That’s as far back as I know but I suspect it goes further. Animal modelling and heritability studies suggest large genetic contributions but epigenetics tells us that which genes get switched on depends on the environment so we can’t really solve the nature/nurture debate other than to say it’s both. There is also the question of how families ‘transmit’ things to each other – is it a genetic propensity to drink, a learnt behaviour or cultural? How our bodies deal with alcohol certainly has a genetic contribution. My ability to hold my drink and still function probably meant I could drink more for longer than some and didn’t have the physical reminders that it wasn’t good for me early enough to stop it becoming a problem.
2 cups of early trauma I did have quite a lot of trauma in my childhood. A prolonged separation in toddlerhood from my mother due to a sibling’s illness, then neglect from her drinking and intermittent unpredictable violence between my parents and sometimes my mum and older siblings. I think the separation probably led me to learn to shut down at times of threatened loss; whilst the violence meant I was physiologically primed to be alert to signals of threat and be ready to fight or run away. My nervous system was either over active or under active meaning I’ve never found it easy to relax. I’m restless, easily bored and easily wound up a lot of the time; and at others I’m flat, demotivated and miserable. Substances have been one of the ways I’ve regulated myself for years – controlling the ups and downs rather than being at their mercy. I have friends who manage themselves by running marathons, doing yoga, working too hard, cleaning excessively etc though so there are other ways to cope with early adversity than addiction.
A pinch of anxiety Its not obvious to many but I’m quite socially anxious and alcohol helped enormously. Once I’d had a few I’d be garrulous and slightly manic. I wasn’t really paying much attention by then to how I behaved or what people might have thought. It got me through that early discomfort. I also struggle being around drunk people – particularly women – clearly linked to my mum. I dealt with this by being the drunk woman myself. Strange but true! I am still triggered by this which makes socialising difficult at times though I’m realising most people my age don’t get drunk routinely. The pandemic has meant I’ve not had to confront this recently and I’ve enjoyed seeing friends on walks more than going to the pub.
A generous splash of stress I have had a stressful job since my early twenties. Life and death stuff and sharing others pain. For many of those years I was also raising my children and running a household. Like many women of my generation we seemingly had it all though it often felt like doing it all instead. I realised last week when I struggled to unwind on a Friday night and the wine witch came calling that my evening drink and smoke were how I switched off from all of it. Numb my brain and relax. Of course it makes it harder to actually deal with the issues but the short term gain seems worth it at the time and it quickly becomes a habit and learnt response.
Cook in a culture of acceptability As a society we have become much more tolerant of substance use and abuse. When I was a student we prided ourselves on drinking the lads under the table and the advertising industry have deliberately targeted women since that time. Alcohol is the accepted lubricant of society and it’s your fault if you develop a problem is the prevailing narrative. In my social circles other drug use is also acceptable and wide spread. I know plenty of people who have it seemingly under control but I’m aware I would have looked like that on the outside too. Increasingly I think it’s a way of keeping us all compliant with a society and system that doesn’t function to meet most people’s needs. We are cogs in the machine and if we get drunk and think we’re having fun at the weekend we’re less likely to complain about the unreasonable demands made on us. The reluctance to tax alcohol is about more than the power of the drinks industry I think. It’s a means of social control and what often starts as a rebellion – like the rave culture, becomes commercialised and sanitised for profit. The memes doing the rounds during the pandemic show this. The associated rise in alcohol related deaths is less publicised. Here’s one sent to one of my group chats recently about the easing of lockdown.
The more a drug is available and acceptable the more people will have problems with it. Anyone can become addicted to anything if they have enough of it for long enough.
So addiction is not just an individual problem; but is rooted in our family, work social and political context. Change starts with ourselves but there’s a lot that could be done in the wider spheres to help others not get to this point in the first place. What are your ingredients? I’d love to hear them.