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Phillip Seymour Hoffman Did Not Have Choice Or Free Will And Neither Do You

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I am posting a blog written by (oddly enough) another Debbie Bayer.  I did not write this but found it to be so profound and oddly coincidental, given the author’s name, that I had to share.

 

Phillip Seymour Hoffman 1967-2014

Phillip Seymour Hoffman 1967-2014

In the wake of the tragic loss of Phillip Seymour Hoffman, a great artist, partner, father, brother, and son, I offer the following facts about the neurological disease of addiction.

The overwhelming majority of adults in the western world have passed through experimental stages in their lives where they have dabbled with some kind of brain altering addictive substance, i.e., cigarettes, alcohol, prescriptionpain killers, ADHD medication, anti-anxiety medication, and yes, even marijuana (save the ‘it’s not addictive” arguments for later, please).  And the overwhelming majority of these adults will emerge from their experiments unscathed, believing that their free will and good choices are what saved them from becoming addicted.

The problem with this thinking is that it is factually incorrect.  In other words, they are all wrong.

What saved them (you) from becoming addicted is that their brains did not respond in the same way that an addict’s brain does. They were born with a resistance to addiction. Their free will and good choices had nothing to do with it.

It is time for all of us who got through unscathed to stop patting ourselves on the back for our genetic good luck, and it is time to stop judging those who were not born with the same good genes as defective.

About Phillip Seymour Hoffman, a relapsing drug addict, you may have had the thoughts, “He knew better.” or “Shame on him for throwing his life away.”

Let’s look at these ideas through the lens of how the brain actually works. Yes, he “knew better.” He ‘knew better’ in the frontal lobes of his brain, where we all execute our better judgment and can make calculations of our behaviors and circumstances based on risk and reward.

Here’s the problem, the activity of our frontal lobes can be shut down by the other parts of our brain when there is significant stress in our body. This comes from what is called the “fight, flight, freeze, or faint” mechanism.

This mechanism in the brain is hard-wired into each of us for survival purposes. It is the part of the brain that puts someone into shock when they have been injured and/or traumatized. It is also the part of the brain that can allow a person to lift a car by themselves if their loved one or someone they care about is in danger.

The brain does not analyze the type of stress it is experiencing, that is, this ‘fight or flight mechanism’ is binary. It functions on a “yes” or “no” basis.  ”Yes,” there is enough stress to activate the mechanism or “no,” there is not enough stress to activate the mechanism. Human beings have no control over when this mechanism is activated.

This is how PTSD works. Seemingly innocuous sights, sounds, smells or sensations trigger this brain mechanism even when there is no actual threat to the person. The stress in the body is not even consciously recognizable to the person with PTSD. The brain reacts to the trigger and the person is put into the experience of being threatened without choice or control because the frontal lobes cannot get their signals through. When this mechanism is activated free will and choice become impossible. This is true for each and every human being on the planet, whether we like it or not.

The brain of an addict, Phillip Seymour Hoffman in this case, experiences withdrawal symptoms as stress. And since it operates on a binary system, it does notsort out “good” stress (I’m so sick because I’m kicking heroin-good for me!) from “bad” stress (I’m so sick because I’m kicking heroin I’d better call a doctor). The brain only knows if the stress is present or not and how much stress is present.

When withdrawal symptoms, i.e., physical distress, anxiety caused by emotional stress, etc. reach a certain point in the brain, the brain automatically cuts off the access to the frontal lobes (in a manner of speaking) and begins to direct the body rebalance the stress, to find equilibrium, so that the brain can return to “normal” functioning.

“Normal” functioning to the brain of an addict is defined as having the addictive substance in the body. So while any relapsing addict “knows better,” the addict literally cannot access the part of his brain where his/her better judgment is stored. The addict loses his choice and free will and is at the mercy of his brain which is in extreme stress and working to regain it’s equilibrium, at any cost, i.e., get more of the addictive substance.

The idea of losing choice, of relinquishing free will, is unthinkable to most of us, especially those of us fortunate enough to live in the U.S. where we have so many choices in so many areas of our lives. Also, human consciousness defends heavily against the possibility of ‘no choice’ which is paradoxical considering we each carry a brain mechanism that removes choice, but I digress.

Suffice it to say that according to our brain physiology, choice and no choice are equally important to the survival of the species. The problem is that we humans are only conscious of the importance of choice (and the free will to make those choices).

Over the centuries, mankind has had tremendous difficulty acknowledging and treating brain disorders of all kinds.  And we haven’t made much progress in our supposed “enlightened” age of civil rights either.  Consider this, it was less than 50 years ago that 90+% of those born with Down’s syndrome were institutionalized for life.  Also, in spite of (or maybe because of?) a tremendous increase in the diagnoses of brain disorders in the last 40 years, all but a small percentage of treatment centers and publicly funded programs for treatment have been permanently shut down.

What we have on our hands in the U.S. is a mental health, i.e., brain health, crisis. This is abundantly clear to us every time someone with a serious brain disorder buys an assault rifle. Actually, those instances are but the tip of a gigantic iceberg. And even though we have had great breakthroughs in neuroscience, we are woefully lagging behind in treating people who suffer and offering support to their families.

How did this happen? There are more than a few ways to answer that question. One of the important answers is that we are naturally defensive against the idea that brain disorders which disconnect us from our free will exist. It’s too frightening an idea to consider, so we come up with stories.

A century or more ago our stories revolved around the idea that the person suffering was possessed by demons, and that these demons ran in the family. Perhaps the person’s mother was possessed? May she was a witch? Someone in that family must have sinned and now they are being punished, etc.

It was stories like these that ran so strongly through our cultures that families up until, well now, actually hid loved ones away in mental institutions and even disavowed knowledge or connection to them in order to avoid the stigma that would be placed on the healthy family members also.

We have made some progress, but as Mr. Hoffman’s death painfully points out, not nearly enough. We seem to have compassion and some amount of treatment and support available for those who have schizophrenia, psychosis, delusional disorder, autism, and Downs syndrome.  (It’s not nearly enough treatment and support and the families and loved ones of those with these disorders suffer an enormous amount financially, emotionally, and physically with the burden of lifetime care of those who live with these challenges.)

Outside of these few of the many neurological disorders that exist we lose all compassion and concern for people and their families who are suffering, and we tell a modern day version of the demon possession story about them.

We continue to isolate and reject people suffering from a physiological disorder of the brain and force their families and loved ones to bear the lifetime burden of their care in shame and silence, in 2014, in the wealthiest nation the planet has ever known.

Our stories about these people who look so normal, so successful, on the outside but whose lives come crumbling down upon them or are cut ridiculously short no longer revolve around possession by evil spirits but by a defect in their character (selfish, lazy, greedy, arrogant, gluttonous, apathetic, hedonistic, etc.), a defect in their temperament (evil, violent, narcissistic, vain, eccentric, etc.) or a defect in their judgement or intelligence (immature, moron, idiot, being an a**hole).

In the absence of knowledge about how the brain functions these stories created theories about the causes of these behaviors (moral corruption, low character) and consequences which mirrored our cultural value system (it’s their own fault, they got what they deserved).  Out of our stories came ideas on how to avoid these behaviors (work hard, believe in God, be kind to others), consequences of these behaviors (why goes around comes around, God helps those who help themselves) and systems of support to uphold the implementation of these ideas (church, 12 step, therapy). Sometimes the theories, ideas for correction and the support systems even work, but sadly, not most of the time.

All of the above stories/theories are normal individual and cultural adaptations to the unexplainable. This is how we humans learn and grow. Gratefully, these days few if any people think a person with a phobia has had a spell cast upon him by a witch and now needs an exorcism while the family and neighbors have to find and lynch the witch.

Neither is a person with an addiction suffering from poor character, temperament, or judgment from which he can be cured with hard work, belief in God, attendance at church, 12 step and therapy. (Hang in there, recovered and recovering 12 steppers. I’m on your side. See ** below.)

What we fail to see is  a) how self-serving these old stories are, and b) how ineffective our current treatment modalities are (see #a). Our theories about addiction don’t really exist to explain the illogical behavior of someone who is suffering, but mostly to separate ourselves from that behavior with the assurance that what has happened to that “loser” won’t happen to us. And when the need to distance ourselves from that “loser” is satisfied we don’t bother to fact check our theories. Nor to we bother to notice if the treatment schemas we’ve created even work (they don’t).  Rather good proof that our theories are self-serving, don’t you think?

We also fail to notice the fear and sadness that comes up for us when we hear of the tragedies that befall those with high-functioning neurological disorders, especially now. It’s 2014 and tragedies like the death of Phillip Seymour Hoffman have been happening steadily for 40+ years, with no end and no answer in sight. In light of this kind of repetitive hopelessness we are left with little choice but to blame the victims in order to soothe ourselves. And it is difficult, if not impossible to create solutions in the presence of hopelessness.

The mental health/brain disorder crisis we are facing right now, this decades-long epidemic, is with the so-called high-functioning neurological disorders, i.e., depression, anxiety, bi-polar, ocd, anorexia, bulimia, and addiction (I have left out more than a few of the disorders, but these are the most familiar of the lot).

However, neuroscience is offering us the best reason to hope for good treatment outcomes in decades. The more we learn about how the brain works (like when the fight/flight mechanism is activated) and how it works when it is “broken” (fight/flight mechanism too easily triggered in addicts) the easier it will be for people who have these brain glitches to be identified and treated without shame and blame.

The first, most effective way to face our cultural crises of too many people with brain disorders being undiagnosed and untreated is to educate ourselves about these disorders and learn to spot the people who are suffering so that we can help them understand what is wrong with them and help them to agree to receive treatment.  We have to change our cultural view of addiction and the like before we can create more effective treatments for it and the other high-functioning neural disorders.

The change has to come from those of us who either do not have the disorders or have been successfully treated for the disorders because those with the disorders are not able to help themselves.

I like to say it this way, the last person to know that his brain is broken is the person with the broken brain.

This is just the way human consciousness works.  The only organ in the body that seems to make self-diagnosis impossible is the brain. I mean there is no mistaking a kidney stone trying to pass. When someone is in that kind of pain they don’t blame it on their lack of character. But the brain is expert at being able to reframe and explain away its own glitches.

Whatever isn’t working in a person’s brain is that person’s “normal.”  Over time people with high-functioning neurological disorders develop plausible explanations for their symptoms and adapt to them as best as they can.

And when life problems that are obviously (to those around them) connected to their neurological disorders become apparent on the outside of their lives (car accidents, drained bank accounts, lost jobs, broken marriages, etc.) they usually blame their own character defects or someone or something else. Therefore, the person with the problem is the least likely to be able to get themselves the help they need.

The way to begin to help people like Phillip Seymour Hoffman (deceased-drug addiction), actor Cory Monteith (deceased-drug addiction), singer Amy Winehouse (deceased-alcoholism), author David Foster Wallace (deceased-depression),actor Jon Hamm (depression), TV personality Nicole Richie (anorexia), actress Karla Alvarez (deceased-anorexia/bulimia), actress Amanda Byne (bi-polar disorder), actor Howie Mandel (ocd) , reality TV star Vinnie Guadagnino (anxiety disorder),  actress Brooke Shields (postpartum depression) is to become educated about the physiological causes of these disorders so that when you see the behaviors in friends and loved ones you can begin to educate and support them.

Here is where the education begins, when otherwise high functioning people think and act in ways that defy facts and logic and threaten their well-being and the well-being of their loved ones, then we need to understand that they have a brain disorder, not a moral or character disorder; and they need medical treatment, not shaming, blaming, therapy or a sentence to a 12 step program.

This means that alcoholism, drug addiction, eating disorders, suicide attempts, phobias, adhd, anxiety and depression, et al are all disorders of the brain and as such need the treatment of a medical doctor first.

(Read that again. It’s a truth, not a theory. But since the truth is not widely known it will seem counter intuitive. You will want to say, “Yeah, but…..” Read it again. Alcoholism is a brain disorder. Drug addiction is a brain disorder. Let it sink in.)

Here’s why this is true–otherwise high functioning people could not be high functioning without good judgment, good enough character, and at least average intelligence.  If they can hold down a job, go about the activities of daily living, have friendships and loved ones, and display empathy towards others before and during their lapses, melt downs, relapses, et al.,  then their frontal lobes are fully functioning.

The only explanation, for their behaviors then, is that their frontal lobes (where their high-functioning skills are located) have been hijacked by a different part of their brain.  When someone’s brain is highjacking their frontal lobes, they need medical treatment.

Blessedly, neuroscience is catching up with us and giving us facts about how our brains actually work.  So it is time NOW to drop those stories we have made up and begin to apply the facts of neuroscience as we understand them to the untimely deaths of addicts of all kinds and to the public meltdowns of otherwise functioning adults.

And it is way past time that we spread the word about what is really going on with these people who struggle mightily and their families who bear the burden of loving them and having to care for them.

Remember, these people don’t know that their brains are broken.  They are high-functioning and so they blame themselves. And they come to hate themselves for their problems more than you can imagine.  They live in a dark and self-loathing world where they come to believe that they don’t deserve any help which is why they don’t surrender themselves for treatment. They need the help of their friends and families and the world around them in order to get around the obstacles of their broken brains to get help.

When our entire culture understands as common sense that addiction is an individual neurological disorder that requires immediate medical attention then a person like Phillip Seymour Hoffman has a chance to understand that he has “one of those brains” that will shut down his frontal lobes and take away his ability to exercise good judgement and control of his behaviors.  And until he knows this fact about his brain in same the way that he knows a bone sticking out of his leg means he needs to go to the ER, then him and those like him will not be able to ask for help.

And a guy like Phillip Seymour Hoffman isn’t going to know these things until we all know them.  And that time is NOW.

Phillip Seymour Hoffman died from having a combination of sensitivities in his neural wiring that caused his brain to override his better judgement, take away his free will and caused him to take the actions that ultimately killed him. It appears that these sensitivities were unknowingly activated by a prescription of pain killers that were necessary at the time to treat a different medical condition.  Because of his previous 23 years of being clean and sober he was presumed  safe to take the pain medication. And it looks like what he and maybe even his doctors didn’t know about how his brain worked kept him from staying in treatment long enough to allow his brain to rewire itself around those sensitivities and render him clean and sober again. For this, like all addicts in this situation, he deserves our kindness and compassion.

If this post has helped you to understand addiction please do share it.  My passion is to help educate us all so that more people with neurological disorders will get the treatment they need.

Debbie Bayer, MA, MFTI

**A note to my 12-step friends:  There are two caveats to the success of 12-step work 1) It works when you work it. and 2) You have to be honest, and some people are constitutionally incapable of being honest with themselves.  There is no doubt that over the last 70+ years the 12-step community has the highest success rate among alcoholics of any other treatment modality. This community is also incredibly successful in the support of sobriety among drug addicts of all kinds.
The problem lies in the millions of people who cannot meet the two criteria for success in a 12-step program due to other types of brain disorders.  Their suffering demands that health professionals continue to seek out effective treatment strategies for them.  I am certain that you have compassion for their plight and support these more unfortunate folks in their recovery.
DB

Tips for Staying Clean and Sober During the Holiday Season

Holidays can be especially difficult for people in recovery.  
Here are some tips to help stay clean and sober this season.  
 
1. Have A Plan!
Make sure you have a way out.
Bring your own beverages and/or sober support person.
Know what to say when asked why you are not drinking 
Drive yourself or have cab fare
 
2. Stay Away From Slippery Places
There is absolutely no reason to check out your former favorite establishments or drinking and using friends.  Instead you can meet for coffee or breakfast but stay out of old haunts.
 
3. Create New Traditions…
To replace your old using patterns.  If you’re in recovery, chances are your holiday season hasn’t gone so well in the past.  Here is your opportunity to really show up for your family and friends with true holiday spirit!
You can drive around to look at Christmas lights, make cookies, go to a play, or watch holiday movies.
 
4. Go To Meetings!
People at meetings understand what you’re going through.  You can also pick up some more tips on how to cope through the holiday season.  If you’re feeling particularly shaky then ‘double up’.  Maui AA has an alcathon at Cameron Center every year.  Check out www.aamaui.org for more information.
 
5. H.A.L.T. – Hungry, Angry, Lonely, Tired
This is a lethal combination for people in recovery.
If you’re hungry – get something to eat
If you’re angry – talk to someone about it
If you’re lonely – go to a meeting, call a friend, or your sponsor
If you’re tired – rest
 
6. Ask for Support from Family and Friends
Those who are truly supportive of your recovery will be happy to help you throughout the holidays.
 
7. Don’t Overindulge
Too much sugar and caffine can make cravings worse and cause mood swings that you don’t need during the holidays.  Remember moderation.  Eating healthy is important for recovery. 
 
8. Volunteer Your Services
There are many people in your community less fortunate than you.  You will be helping not only the needy but also yourself.  Maui AA central office can always use volunteers.  You can reach them at 244-9673.
 
9. Make a List and Check it Twice
Have a list of 10 people you can call.  Carry the list and your cell phone at all times.  Start getting used to calling these people now.  It won’t be as uncomfortable as calling during a slippery situation.
 
10. Stay In The Moment
Live one day at a time and enjoy your recovery.  Enjoy today, live today.  Write out a gratitude list daily.  Celebrate your recovery!

happy-holidays

Jamie Lee Curtis talks Drug Addiction, Alcoholism, and Sobriety

I appreciate it when famous people talk about recovery. The stigma still exists in today’s society. As much work as we have done to prove that addiction is a brain disease, people are still ashamed to admit they have the disease. Evidence supports what Ms. Curtis said about changing the prevalence of addiction in her family. When one person gets into recovery it has an impact on others in the family. Thank you Ms. Curtis for “coming out.”

67286-jamie-lee-curtis

Read the full article here.

Subtle (and not-so-subtle) Signs that You May Need Alcohol or Drug Rehab Treatment

“Admitting that you have a problem and may need alcohol or drug rehab treatment is very difficult for most people. It’s hard enough to admit it to yourself – and even harder to let others know you need help. But, unless you take that courageous first step, you’ll continue down a path of self-destruction that may have dire consequences for yourself – as well as for those you love.” –Elements Behavioral Health

Chances are if you are asking yourself the question you may have a problem. It is important to have an accurate assessment of your alcohol and drug use in order to determine if some sort of substance abuse treatment is indicated.  The first step in addiction recovery is the hardest to take. If you think you or a loved one is abusing alcohol or drugs please give as a call we can help you determine what kind of help would be best. -Debbie Bayer, BHH

Read the full article here.

Your Brain on Drugs

Substance Abuse affects our Brain's Neurotransmitters

http://www.drugrehab.us/news/how-substance-abuse-changes-the-brains-basic-thought-processes/
It is important to understand that addiction is a problem with brain functioning. Addict/Alcoholic’s do terrible things but the are almost never terrible people. Once the person gets off the drugs and in recovery you start to see the real person emerge. It takes several months for the brain to heal. The addicted individual needs to be actively involved in some sort of treatment, sober support, or 12-step program.

Is it “Just Pot”

I am on the mailing list for a treatment center in Canada called Edgewood. I have had the pleasure of visiting the facility and have referral several people who were happy to have been treated there. Here is some of the article: Our experience at Edgewood suggests the general public, those families who struggle with addiction, and most certainly those advocating for medicinal
use of marijuana could benefit from more information. What we are
concerned with is the lack of knowledge of the potential addictive qualities of the drug and other associated health
risks. As with alcohol consumption, many people use marijuana without suffering any apparent negative consequences. Like the occasional drinker, the occasional ‘toker’ may not recognize
or give credence to the potential for harm from the
substance. It is well documented that while consumption
of alcohol is benign for some, it can lead to addiction issues, physical and neurological damage, family crisis, or medical and
police emergencies for others. While statistics for the consequences of marijuana use are limited, it is
reasonable to suggest a percentage of those using marijuana run the risk of experiencing the same types of harms associated with alcohol. (Most people choose not to use illegal or controlled
substances, so it remains to be seen if legalizing marijuana would change its consumption and/or harm patterns.)For those genetically predisposed to addiction, marijuana is both highly
addictive and destructive. For others, prolonged use can negatively affect brain function, trigger psychotic
episodes and lead to lung disease from the constant exposure to toxins in the inhaled smoke. When despite all of this, the person using marijuana cannot stop, that’s addiction. Choice at that
point has nothing to do with it. For those who support medicinal
use of marijuana the implications of the method of delivery of the active ingredient is worth considering. Our experience with marijuana addicts in treatment is that they are admittedly
less interested in a controlled dosage in pill or tablet form. They are more interested in smoking as much as they themselves deem to be “okay”. And, while anecdotal evidence abounds, there
still is no clear scientific evidence that proves marijuana an equal, or superior, medicine to conventional medicines already available.
Society continues to debate the merits and perils of marijuana use and its legalization, but if we are going to engage in debate let us at least be as informed as we can be on this complex
subject and consider all aspects of its use. For some, marijuana remains a benign social stimulant; for others it can be the beginning of a path to ruin.

Talking to teens about pot now that it’s ‘cool’ in Washington

When I talk to my adolescent clients and their parents I am told that “everyone on Maui smokes weed.” I happen to know that statement is not true because I live on Maui and I do not smoke pot.  Frank Couch talks about why it is important to know your policy. It is not “just marijuana.”  You are putting a powerful substance on a brain that is still developing. Be informed.

Here’s a great piece from MyNorthwest.com.

Talking to Teens about Pot

Recover to Live – An Interview with Author Christopher Kennedy Lawford

Christopher Lawford (nephew of John F. Kennedy) is a Maui resident and willing to help our community raise awareness about the stigma attached to addiction, and to educate this community about what works and what does not work when dealing with addiction. In his book he talks about families educating themselves about enabling behaviors and how to break the cycle in the family. To quote ” You can throw them a rope but don’t go in the water,” is a great way to tell families they can help their loved ones only if they help themselves. Debbie Bayer is a licensed family therapist and addictions specialist, she has over 30 years of personal recovery from addiction. She lost her Mother to alcoholism in 1988. Debbie understands the disease of addiction both from the perspective of the addict/alcoholic but also from that of the family members.

Read his full interview about his latest book, Recover to Live: Kick Any Habit, Manage Any Addiction here.

Christopher Lawford

TED Talk – Brené Brown: Listening to shame

Shame is an unspoken epidemic, the secret behind many forms of broken behavior. Brené Brown, whose earlier talk on vulnerability became a viral hit, explores what can happen when people confront their shame head-on. Her own humor, humanity and vulnerability shine through every word.

TED Talk

What Does Marijuana Do to Your Brain?

Medical marijuana and the legalization of marijuana has brought up controversy in the recovery community.  Most intensive outpatient facilities will not treat people on medical marijuana because it is too difficult to monitor how the person is using the substance, amongst various other reasons. Marijuana addiction can be as equally devastating to the life of its victims. It just doesn’t do it in such an obvious way as other drugs or alcohol. Please read the article posted by Promises Recovery Center in Malibu California here for more information.