Heal

In “The End of Trauma: How the New Science of Resilience is Changing How We Think About PTSD” (2022), author and doctor George Bonanno highlights an inborn and often untapped resilience people can cultivate after exposure to traumatic events. A combination of being optimistic about the future, having confidence in the ability to cope, and a willingness to see trauma-inducing threats as a challenge; together can enable a flexible thriving in circumstances when one’s natural resilient abilities might otherwise be doubted. Moreover, Bonanno suggests that such skills may be honed and become easier to muster over time, perhaps even becoming partly automated with age (2022, p. 58, 123, 211).

Besides polishing skills at building resilience to address traumatic stress, author Haider Warraich in his book “The Song of Our Scars” (2022) states that to deal with various forms of pain and suffering more generally, several non-pharmaceutical approaches can be of value. For instance, exercise is a “potent stimulant of the body’s innate painkillers” (p. 232), while hypnosis, the original method of pioneering scientists including Sigmund Freud, today “offers tantalizing hints about an unexplored dimension within us all whose potential remains entirely untapped” (p. 237). Warraich similarly considers the potential of placebo medications to activate our own healing systems, even when administered with the awareness of the subject patient (p. 243). Many people also find benefit with yoga, meditation and, more recently, psychedelic therapy.

Despite the potential promise held by holistic mind-body approaches, are they not still reductionist in the sense of failing to account for the patient’s personal or social contexts? In the forward to Norman Cousins book titled, “The Healing Heart: Antidotes to Pain and Helplessness” (1983), Professor of Cardiology at the Harvard School of Public Health, Bernard Lown, observes that contemporary medicine has focused too sharply on the disembodied disease, rather than on the patient themselves: “This conventional biomedical model, through giving lip service to the patient as object of care, largely ignores the subjective dimension” (p. 11). Lown goes further by offering that an over-reliance on science and technology sidesteps the important aspect of human touch and connection in treating patients:

It is far easier to learn how to interpret scientific data than to acquire the art of obtaining a sound history or performing an adequate physical examination. A skewed cybernetic ensues, wherein inadequacy of bedside skills increases resort to technical solutions” (1983, p. 21).

Warraich adds a contemporary perspective to this view in stating that

an increasing loneliness and corresponding spiritual void set the stage for modern stressors as being borne increasingly by the individual rather than shared by the community, and rising anxiety wrought by a world that is increasingly digitally connected but interpersonally fractured” (2022, p. 177).

Addiction psychiatrist Anna Lembke, referenced in Beth Macy’s exploration of the opioid epidemic in her book Raising Lazarus (2022), expresses concern that some pharmacological approaches, including those used to wean people off opioids, can only ever be bandage solutions, as what is truly needed is

“a wholesale reinvestment in communities, starting with universal health care. If doctors keep simply medicating people who are anxious and depressed… society will be robbed of the energy that incites the political will to create change… we are broadly using these drugs to fix what are essentially social problems” (2022 , p. 216).

Even more broadly, Norman Cousins declares that ultimately “Holism means healing – not just of bodies but of relationships” (1979, p. 123).


Bonnano, G. A. (2021) The End of Trauma: How the New Science of Resilience is Changing How We Think About PTSD. New York, United States: Basic Books / the Hachette Book Group

Cousins, N. (1979) Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration. New York, United States: W. W. Norton & Company

Cousins, N. (1983) The Healing Heart: Antidotes to Pain and Helplessness. New York, United States: W. W. Norton & Company

Macy, B. (2022) Raising Lazarus: Hope, Justice and the Future of America’s Overdose Epidemic. New York, United States: Little, Brown and Company

Warraich, H. (2022) The Song of Our Scars: The Untold Story of Pain. New York, United States: Basic Books / the Hachette Book Group

Addiction

In his revealing book “The Urge: Our History of Addiction”, author and doctor Carl Erik Fisher states addiction is not a purely medical or scientific issue, but rather a culturally contingent function of unprocessed pain, “a brain disease, a spiritual malady, the romantic mark of artistic sensibility, a badge of revolution against a sick society, and all of these things at once” (2022, p. xiv).

Fisher traces addiction’s early roots with alcohol and drugs such as morphine through and including the nineteenth-century Temperance movement, twentieth-century Prohibition, Alcoholics Anonymous, and the War on Drugs, up to the current Opioid epidemic. The social stigma attached to addiction continues to be the biggest hurdle to a compassionate response in its treatment, where sufferers are seen as morally corrupt people often with a genetic predisposition to the addictive effects of various substances (2022, p. 124).

The early twentieth-century Harrison Act in the United States led to hard enforcement through regulation and a corresponding increased use of harder drugs, which themselves fell both into categories of “narcotics” associated with minorities and the poor, and into regulated “medicines” which often included prescribed versions of the same substances for consumption by the rest of society. The pejorative moniker “junkie” ascribed to destitute urban addicts who scoured junkyards for scrap metal in order to purchase street drugs, worked both on this literal level, and as a reference to how “respectable” society viewed them as human trash (2022, p. 145).

The pharmacologizing of psychiatry, which appeared to have “cracked the biological code of mental illness” with a growing panoply of medications, changed its scientific model from electrical neurotransmission, to efforts at altering chemical neurotransmission with pills that could ostensibly provide the solution to a wide range of mental health issues (2022, p. 234). In terms of drug tolerance, can the numbing effect of medicines quell physical and mental pain over the longer term, and how does this relate to addiction?

Only recently has the study of addiction been willing to consider whether behavioural adaptations, including to power, sex, eating, exercise, gambling, and the internet in general, qualify as falling within its sphere. Critics of this broad-brush view claim that over-pathologizing behavioural addictions can wind up adversely classifying them as mental disorders “merely because we like doing them a lot and miss them a lot when we stop” (2022, p. 117).

Certain approaches of addiction treatment favour abstinence, while newer research suggests “too rigid a focus on abstinence can cause an ‘abstinence violation effect’ wherein resuming substance use after a period of self-imposed abstinence, those who experience guilt, shame, and hopelessness are more likely to return to harmful use” (2022, p. 249).

In a report titled “A Hole In The Head: Can a Brain Implant Treat Drug Addiction?” (September 2022), author Zachary Siegel examines the implications of a surgical technique originally developed to treat chronic pain known as Deep Brain Stimulation (DBS) in addiction treatment. He observes that 6-inch long ‘metal chopsticks’ inserted through a nickel-sized skull hole and into a patient’s nucleus accumbens can deliver continuous electrical impulses which in theory give people with addictions more control over their impulses. After reporting on this research, Siegel concludes it is not a panacea, and that “Addiction might be more a symptom than a disease, a powerful compulsion generated by a matrix of pain and conflict within us” (September 2022, p. 32). Carl Erik Fisher echoes this sentiment in the closing words of his book:

Addiction is profoundly ordinary: a way of being with the pleasures and pains of life, and just one manifestation of the central human task of working with suffering. If addiction is part of humanity, then, it is not a problem to solve. We will not end addiction, but we must find ways of working with it: ways that are sometimes gentle, and sometimes vigorous, but never warlike, because it is futile to wage a war on our own nature” (2022, p. 300).


Fisher, C. E. (2022) “The Urge, Our History of Addiction”. Canada: Allen Lane – Penguin Random House Canada

Siegel, Z. (September 2022), “A Hole In The Head: Can A Brain Implant Treat Addiction?” in Harper’s Magazine, Volume 345, Number 2068 (pp. 25 – 32). New York, United States: John R. MacArthur / Harpers.org