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Just Sayin

April 10, 2017

          Although I have never met him, I am an unabashed fan of Johann Hari. Last year, while preparing to teach a graduate school class in Addiction at my university, I ran across the June 2015 TED Talk by Hari titled, “Everything You Know About Addiction is Wrong.” I was fascinated and after watching the 14 minute presentation, stunned, delighted, and frankly liberated. He uttered a phrase that sent me reeling: “The opposite of addiction is not sobriety; the opposite of addiction is connection.”

          Connection. It is clear that Hari is speaking here not just of intimate human bonds of attachment and affection, although these are central to his argument. People are also connected to one another, to their society, to families, neighborhoods, organizations, to their nation, to a sense of meaning and purpose, to a higher calling and sense of how they “fit” in the world. A sense of connectedness is relational, motivating, and deeply spiritual. It is inherent in the ways we are built as social beings. All these meanings flashed in front of me as I heard that pregnant phrase, and it sent me on my own journey of revisioning addiction for myself, my clients, and my students. This new frame of reference liberated me to explore.

          Let me take a step back and explain. I have been a professor of counseling and human services for over twenty-five years and throughout that time I have been privileged to know and work alongside some of the brightest lights in the field of Addiction Studies: Ernie Kurtz, William Miller, Stephanie Brown, William White, George Vaillant, Bruce Alexander, Tom McGovern, and many others. I have kept up-to-date with trends and changes in the literature and practice of counseling with addicts. I shared what I learned freely and continue to do so. But, this phrasing was so straightforward and apt that it left me breathless. In retrospect, it framed the insight that I had been waiting for.

          And so, when less than a year later Hari’s book, Chasing the scream: The first and last days of the war on drugs (Bloomsbury, 2015) made its appearance, I bought it quickly and gobbled it up. The book documents his journey into the depths of our American and global history with the war on drugs and tells, through the stories of seminal characters in that drama, a potent narrative of why the drug war has failed and how we might do better. It confirmed some of what I knew and taught me even more. Here was a journalist at the top of his craft reviewing and assessing the best information available. His interview subjects were well-chosen and the interviews themselves were revealing.

          Throughout the TEDTalk and the book, Hari conveys some real affection for the main characters that challenge our own thinking about addiction. His portrait of Bruce K. Alexander, the Canadian research scientist who first designed Rat Park, is full of insight and suggests the gentility and erudition of the man. The description of Dr. Gabor Maté, physician to the “hungry ghosts” of Vancouver’s addicted underworld, makes a powerful case for the influence of trauma and childhood adversity on the development of addiction. His brief discussion of Professor Ronald Siegel’s career-long studies of buzzing cows, tripping bees, and loco horses, and the ubiquity of intoxication in the animal world, is delightful and inspiring.

          I have spoken about these insights to any who would listen, including my students. I am currently writing a book, Tending Hungry Hearts: A Vital New Clue to Unlocking the Secrets of Addiction, which takes its inspiration from Hari and the many figures he describes. This has been a fruitful exploration for me and its benefits are not yet complete.

          So, imagine my consternation, reading Andrew Dobbs’ essay, published in that same year in The Fix, “Four things Johann Hari gets wrong about addiction – Updated with a response from Hari.” Dobbs resides in Austin, Texas and describes himself as an “environmental organizer and active Austin citizen,” but at least on his twitter account he seems to be more of a blogger and polemicist. His website is full of critical postings about a number of people he deems to be less than authentic or undeserving, over-inflated or pompous. He clearly misunderstands Hari’s work, it seems to me, and rather than inviting a dialog chooses the easier and softer path of glib criticism.

          His target in the essay I read in The Fix was Hari. As most know, The Fix is one of the “world's leading websites about addiction and recovery.” It contains investigative interviews, essays, lifestyle and cultural resources as well as blogs and letters on sober living. Dobbs’ critique appeared on July 29, 2015 and begins with the acerbic subtitle: “Outed as a lying plagiarist in the UK, the disgraced journalist Johann Hari has remade himself as an addiction expert. Or has he?” Clearly, the author views Hari differently from me. More about that later.

          Dobbs has four complaints about Hari’s work, although reading his essay gives me the distinct impression that Dobbs is commenting more about his own willful mis-reading of Hari’s views. Dobbs seems to have pre-judged Hari — here’s where the “lying plagiarist” bias becomes important — and reads Hari’s work with a bee in his bonnet.

1. Dobbs accuses Hari of emphasizing “social isolation” as the cause of addiction to the detriment of any biological or physical impact from the drugs themselves. Dobbs makes his own point of view clear when he states that “the determining factor [in addiction] is almost certainly physical and/or genetic” and “not merely a yearning for lovingkindness that only a latte can fill.” Ouch! This is at the same time an over-statement and a somewhat disingenuous snark.

Dobbs offers no evidence for his biologistic model of addiction and seems to have little understanding of the long historical competition among models that offer up various culprits as the cause of addiction (genes, allergies, personality, choices, disease, vulnerabilities of various kinds, etc.). If one is so sure that biology plays the determinative role, then nothing else is good enough.

In this way Dobbs repackages the tired, decades-long battle among addiction models and takes the side of physicalist views. Fine. But, he also paints a straw man version of Hari that is both misleading and unfair, as Hari’s response later points out. Drawing distinctions is one thing. Painting (smearing?) with an overly broad brush is quite another.

Throughout his various presentations Hari is at pains to present a respectful and multi-causal view of addiction. However, when championing a subjugated minority view like the sociocultural one – social dislocation is a sociological concept – he has chosen to present a “strong case” version, selecting social dislocation, fragmentation of meaning, and connection as his main protagonists. Warm latte indeed!

The dominant majority view – addiction as disease – needs to be challenged; this is how science progresses with consideration given to new and alternative data. Biological realities are clearly involved, but other factors may be just as important. The reader will get none of this from Dobbs, however. Biology is his strong man here.

2. Dobbs’ essay takes issue with Hari’s criticisms of interventions from friends and family members, and in particular references the popular “reality television” show Intervention. Dobbs makes two points. First, addiction is a “disease,” he says, which also infects the addicts’ loved ones and persists through their “enabling” of the addict. Intervention, then, is a procedure intended to help those closest to the addict liberate themselves from the disease. If that requires threatening family members’ connections to the addict, so that she or he goes to treatment, so be it. Second, Dobbs derides Hari’s offer of deeper companionship to the addict, as opposed to threatening, and suggests that the offer sets people up for being manipulated by the unscrupulous and selfish addicts in their lives.

This criticism presents a very pejorative view of the addict as a manipulator with a disease who corrupts those around him or her. (No word about how a biological disease infects others and turns them into “enablers.”) This is also not a winning portrait of the addict’s loved ones who enable sick behavior and need protection from the addict’s machinations. This view comports with the old style approach of traditional treatment — the addict is “diseased” and family members are misguided “enablers” — and may help to explain the low success rates and revolving doors of old time treatment.

Even with all this, however, one could have fruitful debates with many of these points, but clarification is essential. The treatment literature is pretty clear that “confrontational” interventions, like the ones that make good television, enjoy very little real success. Family members are often unable or unwilling to follow through with the intervention or with the consequences; addicts go to treatment and then leave “against medical advice;” addicts are so resentful at the tactics used that they relapse soon after treatment finishes.

Invitational” interventions, like the evidence-based ARISE® program (A Relational Intervention Sequence for Engagement) of Dr. Judith Landau are better. Everyone benefits when (a) family members experience success with their efforts to help their loved one, and (b) the addict goes to treatment and receives a sufficient dose of medicine (recovery) to be confident of success. The success rate of ARISE is often around 80% as opposed to the 17% figure of more tradition confrontational interventions.

3. Dobbs objects to the Hari rhetorical device that I found so compelling, namely that “the opposite of addiction is connection.” Dobbs rightly observes that the recovering community utilizes the power of connection to facilitate recovery and inoculate against addiction. I agree, and I would add that recovery groups welcome and nurture addicts as a way to connect with them and pave the way for healing, while the treatment industry often tells families NOT to employ the very same strategy. The industry often conveys that it can do a better job with addicts than friends or family members. This is not only wrong-headed (who best to provide an experience of connection?), it is ineffective. It’s a bit counterintuitive.

Dobbs’ objection to Hari’s phrasing is that Hari places addiction and connection on opposite poles. To me, it seems that Hari views a lack of connection as predisposing to addiction and the restoration of connection as the way to recovery. If you are a bit baffled here, you are not alone. I do not understand Dobbs’ quibbling here.

4. Dobbs saves his major criticism for last, and it is a doozy. He rehearses Hari’s ethical shortcomings as a journalist, pointing out the incidences of plagiarism in his past and his use of pseudonyms to discredit others in his profession. Dobbs then goes on to assert that Hari has been insufficiently contrite for these failings and has not utilized the rigorous honesty that is needed for recovery. Hari is, then, in Dobbs’ estimation someone whose work on addiction cannot be trusted; Dobbs has taken his inventory. In addition, Dobbs believes that Hari is still trying to “plagiarize” the insights of others, namely recovering people, by claiming that isolation is the root of addiction and connection is the way home. Even worse, Dobbs believes that Hari is “seeking a return to journalism on the backs of people too marginalized to protect themselves,” and reminds us that recovering people, like Dobbs himself, value honesty above all else.

          While all this is a bit self-serving and grandiose — does he really believe that all 23-plus million of us in recovery are “too marginalized to protect” ourselves? — it also flies in the face of the facts. Months before Andrew Dobbs published his essay in The Fix, Hari had given an extraordinary interview to Decca Aitkenhead that was published in The Guardian (Jan 2, 2015) and is widely available online.

          I do not wish to rehearse here the egregious nature of Hari’s failings or speculate about the “defects of character” that might have led to them. Hari himself did so in the interview. I do wish to point out, however, the honesty and authenticity that permeate his remarks. First, Hari is at pains to separate his failings from his own drug use (Provigil). He does not take the convenient out of blaming his own struggle with addiction for his shortcomings. He claims his failures straightforwardly and takes responsibility. A quote might suffice:

          Look... I can talk to you about why what happened in my life happened. But I just think that’s a way of trying to invite sympathy, and that would be weaselly. If you tell a detailed personal story about yourself, you’re inherently asking people to sympathize with you, and actually I don’t think people should be sympathetic to me. I’m ashamed of what I did. I did some things that were really nasty and cruel.”

          Toward the end of this long interview, Hari is asked about the consequences he faced (loss of job, loss of profession) and the disgrace he continues to endure. Hari makes it clear that he believes the punishment fits the crime and that he does not want to talk about the repercussions as a kind of “redemptive fable.” Fair enough. But I see it differently.

          Frankly, I’m a sucker for redemption stories. Hell, my own recovery story certainly fits into that genre as I suspect do the stories of countless others. What else is recovery but a story of redemption, writ large. I can’t get enough of them. And Dobbs is correct: radical honesty is an absolute requirement. Reading the Guardian interview, I believe Hari has met that test. And besides, what he is saying about addiction and recovery is so right that it’s hard to disagree with.

          Of course, there will be quibbles about this and that. But they don’t add up to a serious indictment of Hari’s work. I believe his insights, and what he has learned during his journey into the heart of the drug war, will stand the test of time.

I urge anyone who is interested to follow that journey. Review Andrew Dobbs’ essay and Hari’s response at…

as well as the Hari interview with Decca Aitkenhead at …

Then, if you remain interested, you might wish to view the TEDTalk, Everything You Think You Know About Addiction is Wrong, at…

and finally read Chasing the Scream: The first and last days of the war on drugs (Bloomsbury, 2015).