Tuesday, December 30, 2014


“In the Realm of the Hungry Ghosts” makes it plain that addiction is a wretched fate with no “up side.”  But Maté also says that two things are worse than drug addiction itself and its capacity to destroy people.  One is that the official blunt-object reaction that demonizes pain-killers denies their legitimate relief for suffering people.  The other is that the exaggerated value and the power of covert distribution creates an underground economy of more power than any government.

Enough time has passed since the discovery of effective anesthesias that we’ve forgotten what a great contribution they were.  I wonder whether the media fascination with enacting childbirth agony as a source of drama isn’t a faint memory of a time when a woman going into labor never knew whether she and/or her child would survive.  In many parts of the world that’s still the case and in some parts of the world, it may even be hoped for. Life-saving surgeries like transplants would simply not be possible without deep anesthesia and even ordinary trauma like broken bones and abscessed teeth would be much harder to handle.

A hip replacement

My stepdaughter, a year older than me, died of cancer at age thirty.  There was very little chance of her being cured but she was in agony through the last months because the doctors didn’t want her to be addicted.  She was on a very strict schedule that nurses had to obey though it meant she begged and gripped her bed rails with white knuckles towards the end of the interval.  The doctor knew this, though he didn’t witness it much, and talked about severing her spine to relieve the pain, though it meant that if she did recover by some miracle, she would not be able to walk and would be incontinent.  Her priest said she was in hell on earth.  Today she would have a morphine pump and fentanyl patches.

We are only beginning to apply neuroresearch to pain though it is clear that pain is “in the brain,” that it doesn’t register as pain until it is recorded there in consciousness.  The rest of it forms in the other ninety-plus-percent of what the body does.  It is not necessarily related to tissue damage; even missing limbs can be a major source of pain.  It is a “symptom” that can be a disease in itself, limiting life.

The famous pounding donut

When volunteers were slid into fMRI machines, the experimenters were shocked to see that what lit up when their subjects were made to feel social “pain” (exclusion, rejection, disapproval, desertion) was the same brain network that lit up for “physical” pain.  We know that hypnotism, without any touching, can make people NOT feel pain, though no one has admitted using hypnotism to make people hurt.  

A notorious work of fiction appeared in Cosmopolitan magazine many years ago.  It used physical pain as a metaphor, proposing that young women were being given a drug that made all physical pain feel like pleasure, a bliss that they begged for, and their bodies were found on improvised operating tables where their spines had been opened to impose damage for the sake of the pain.  Of course, the author was talking about heroin, but also the kind of drama-trauma that some young women seem to crave as demonstrating true love: all that operatic jealousy, sacrifice, and renewed passion.  In certain circumstances, the outcome may be murder.

A mouse pup

Other experiments with animals show that the whimpering and calling that distressed baby mammals use to call their mothers can be suppressed with heroin, which means that the mothers never come and the pups never develop the parts of their brain that deal with interaction with others of their species, because brains learn by experience.  A rat pup that goes unlicked by its mother will be sociopathic.  Dysfunctional.  RAD.

We are deeply confused about pain and what it means and who “deserves” relief, as well as what to do about addiction.  We seem to be as stubbornly addicted to the neglect and abuse of children as we are to short-circuiting our brain systems.  According to Maté there are four main systems involved, each of them independent but interacting, far more unconscious than we admit.  1) opioid attachment-reward system, 2) dopamine-based incentive-motivation apparatus, 3) self-regulation areas of the prefrontal cortex and the 4) stress-response mechanism.

Maté flatly states that babies damaged by lack of care will be susceptible to drug addiction and conversely all addicts were neglected as infants.  This goes to the survival of the individual.  But there is also great threat to the survival of the society, because the legitimate government is soon accompanied by an underworld system of commerce based on huge profits capable of exceeding any income from taxes -- without paying any taxes and with private armies of enforcers.  So rich nations become a place where desperate people live under bridges, but even the bridges themselves are so unmaintained that they fall down.  Both are failures of infrastructure, neither supports survival of the human species nor any country.

So here comes my curve ball.  Religions are institutionalized belief systems that are meant to recommend behavior, create communities, and identify meaning for human lives that balances individuals and groups.  Forget about all the pre-existing religions because they evolved in a world that no longer exists.  By now they are so preoccupied with guaranteeing their own survival that they are willing to destroy any competition.  The main guides for their behavior are acquisition and status.

Let’s look at “zero-based” thought structures, based on what we know from research and personal experience will promote well-being.  First, I would want to separate sin (specific acts that are damaging and can be controlled in part, as well as identified with legislation) from evil (the human impulse to destroy and control, perhaps not even consciously).  If we look for the equivalents in terms of “good,” what might they be?  First, funding for the public welfare (the obverse of sin-based criminal systems).  Then against human “evil” we could endorse empathy, participation in the emotional lives of all others.  If evil is not caring about the suffering and destruction we impose on others, then good must be not just shared understanding but “feeling with” them -- not just their suffering but also their joy.

It’s a challenge, esp. when dealing with people whose joy appears to come from imposing suffering on others.  What do we do or think about general deprivation that obviously makes people evil in their effort to survive:  the people of Russia have lived for centuries in misery.  Can they ever be happy without being drunk?  It’s not that they have no natural resources, but that too many people don’t have a big enough share.  And the rest of the world seems to be imitating them.  

In the meantime the planet keeps throwing its own version of curveballs, or maybe more accurately boomerangs, in which our own excesses come back to us in melting icecaps and moving climate windows for crops and ecologies.  Poppies must now be grown north of the previous fields.  The topsoil that has supported the world’s wheat is washing out to sea, which comes a little more inland every year, creeping up over the curbs of the megacities where people have migrated by the millions in search of a livelihood.  What is the religious meaning of the Bangladeshis walking waist-deep in water across what used to be their land?  There isn’t any meaning.  No sin; no evil.  It just is.  The distinction is in the response by us.  That's where the felt meaning is -- in our own hands.

1 comment:

northern nick said...

. . . what an incredibly thoughtful, empathetic, hard-fought, and searching body of work you've accomplished this year. The longue duree, the arc of your writing, has brought us closer to what seems to unfold: an articulation of making meaning within the new structures and givens amidst this life we find ourselves, forging new understanding who we are. Thank you.