Gabor Maté, Richard Schwartz & Marc Lewis - Rethinking Addiction

[Music] okay everybody welcome to this meeting of the minds discussion where we're going to be focusing on addiction i'm joined here with dr richard schwartz uh professor mark lewis and dr gabor mate um guys to get started maybe if you could just tell tell us a little bit about your background and maybe what sparked your initial interest in an addiction so maybe we could start with uh with mark on this if that's if that's possible sure um yeah well i had serious drug problems throughout my my late teens and 20s i was finally able to overcome them around the age of 30. and then i got into grad school and did well in psychology got to be a professor at the university of toronto and things looked quite a bit better and studied uh emotion emotion and cognition emotional development emotion regulation and then switched over to neuroscience for the latter half of my career and i i guess i brought these two strands together when i wrote my first book um memoirs of an addicted brain trying to bring the neuroscience element to to cast some light on my own my own memoir my set of nasty experiences in that dark world uh and then i got further involved and became kind of um [Music] i guess a flag waiver for the addiction is not a disease side of the debate so i spent a lot of time gave talks wrote a book called the biology of desire why addiction is not a disease and tried to work out a learning model of addiction that was congruent with the neuroscientific evidence but didn't require us to think of addiction as a pathology something wrong with the brain but rather as a learning process that got incredibly deeply entrenched and that's that's pretty much where i've ended up and i as i said i'm now seeing clients who have addictive problems uh in psychotherapy here in toronto and i'm using ifs methods i've used the the ifs approach really i've kind of i've dropped everything else pretty much because i find it the most effective way to to connect with these urges that people find so difficult to master and to and to understand brilliant thanks very much mark so who wants to go next there um gabor would you like to go well why don't we go to richard uh mark just spoke so well of the ifs approach so dick is the one who developed that so let's just go to him and then i'll follow okay i developed ifs working with what you could consider an addiction because i was working with eating disorders at the time and a lot of my we decided to do a study on bulimia and so that could be seen as an addiction to binging on food and i was a family therapist and uh decided to prove that family therapy could heal anything and you didn't need to explore these inner worlds of people because by just changing all these family relationships we could heal them and found that wasn't true and out of frustration began asking why my bulimic kids kept binging and purging and they started talking about these parts what they call parts and they would talk about them in ways that were scary at first for me because it sounded like they had a lot of autonomy and they had relationships with each other in inside of them and they could take over and make them do things they didn't want to do and i thought maybe these people are sicker than i thought until i noticed that i've got them too and some of mine are addicted in some ways to not to food in that case or drugs but to achievement to working and and so i became curious and you know for almost 40 years later there's this internal family systems model which which basically takes a position that it's the nature of the mind the nature of a healthy mind to have parts that they all have valuable qualities and resources for us in our life but they're forced out of their naturally valuable states by trauma and bad parenting by attachment injuries into roles that were maybe necessary when uh we were in the trauma but have become anachronistic for many of us and but still the parts because they're frozen in time back during the trauma i think they still have to keep doing it and so and they they've took taking on what i call burdens which are extreme beliefs and emotions that came into you from the trauma and then drive the way they operate like a virus so uh there are protective parts and then there are parts we call exiles that are locked away that carry a lot of the pain and shame and terror from bad experiences and they're frozen in time too and from my point of view and i know that we agree that it's those the pain of those exiles and the uh [Music] and some of the terror that drives a lot of addiction what's called addiction which you know is just a way to stay higher than the flames of emotion so [Music] anyway that's a very brief concise way of thinking about ifs thank you very much richard okay gabor whenever whenever you're ready sure sure i'm a physician now retired and um so in my family practice days um i saw some addicts mind you i probably saw more than i recognized at the time and then for 12 years i worked in vancouver's downtown east side in vancouver british columbia which is north america's notoriously most concentrated area of drug use so i worked with a highly addicted substance using population who were hooked on heroin cocaine crystal meth now on fentanyl of course nicotine caffeine marijuana so all manner of substances and um in my own life i recognized that there were some addictive patterns not to substances but what i've learned is that addiction is not restricted to substances and we do a great disservice when we limit it to substances addiction is a universal process that can manifest in people have said in bulimia in shopping and gambling in compulsive working like dick said it can manifest in sexual evolving it can manifest in eating it can manifest in internet gaming and so on so so first of all i i recognize that there's a universal addiction process of which drug use is one particular example number one number two i agree with both of my colleagues here that addiction is not a disease because when you ask people what does the addiction do for you they'll say it'll make me feel better it'll soothe my stress it'll soothe my pain it'll numb me when i'm in pain it'll give me social contact it gives you self-confidence gives you a sense of control what kind of disease does all these wonderful things for you in other words the fundamental problem is not the addiction the addiction itself is a solution to a problem which is the loss of control loss of self-esteem loss of social connection emotional pain and so on in fact these are all forms of emotional pain and therefore rather than i never quite understood mark's learning model as much as i've studied it and as much as i love his writing i really do love his writing okay for me it's addiction it's not a learning issue it's a developmental issue when people are hurt hold on you know i'm sure we can sort this out um when people are hurt in childhood that affects how their brains develop the the brain circuitry of self-regulation of of stress circulation of opiates of dopamine incentive motivation they are interfered with by negative childhood experiences and then the question is not why the addiction but why the pain and so this is where dick's model works for me as well where the addiction is like a firefighter trying to douse the flames of severe emotional pain and distress so i think in large ways we're all on the same page we might have some detailed uh differences my own approach is one of uh what i could the approach that i teach is compassion and inquiry which really begins with just questioning now not what wrong with the addiction but what's right about it what does it do for you and and what qualities does it replace that are missing in your life and how did you lose those qualities that's my overall approach to addiction not why the addiction but why the pain is my primary question 100 um well i i think i'm just i'm really curious to ask you know are i think it's important to give some context here what would you say the scale of this problem actually is on a societal level you know could we give people a bit of an idea of that and why does it have such a powerful hold on people addiction why why is it does it have such an influence on human behavior well let me take that one first so let's define addiction first of all let's have a working definition i'm going to give you one if the others want to embroider on it or disagree with that that's fine but in my view addiction this is a complex process but it manifests in any behavior that a first person finds temporary relief or pleasure in and therefore craves but suffers negative consequences in the long term and doesn't give up despite negative consequences or when they do give up they suffer irritability withdrawal and so on that's when the addiction is now noticed i said nothing about drugs it could certainly and does certainly involve drug substances of all kinds could also be to all these other modalities so when you look at the addiction that way if you ask people according to that definition how many people will have an addiction in life out of a thousand people 999 will put their hands up and the one who doesn't is a liar you know so that's how widespread almost that's i'm exaggerating but addiction is really widespread in this society in fact consumer society lives off people's addictions by selling them and purveying goods that nobody needs what they think they need which is exactly what the addictive state is so it's a huge problem much beyond the very severe problem of substance addiction which in united states last year killed in 2020 killed 93 000 people just from overdoses not to mention all the diseases from alcoholism and cigarette smoking and obesity and and all manner of mental health issues so it's a problem that just is uh pervasive throughout our society that's how i would answer that question 100 um well mark i'd like to sort of bring you in here as well um how do you define addiction and have you get anything to add about what what uh gabor has said there i'm pretty good with his definition uh and yeah it's um i i do always try to differentiate between physiological and psychological addiction physiological addiction to me is not as interesting it occurs with respect to certain substances obviously opioids are the main perp here but um there are other things that are just as addictive psychologically like cocaine for example that are not physically addictive you don't have withdrawal symptoms you have mood problems after you stop but your body's not going crazy for a few weeks trying to recover its balance so i i focus on the psychological aspects and i see the physiological aspects as icing on the cake they make life even more miserable than it would otherwise be without this emotional support that you get from your substance because now you're physically miserable as well as emotionally miserable and that's a very nice combination so it just makes it harder harder to stop um and just to answer very briefly what gabor was talking about learning versus development i don't make a big distinction there a lot of development is learning i mean it's hard to imagine development without learning so i'm interested in uh behaviors and motives and see you know sequences that are recurrent and if they're recurrent then they tend to be self-reinforcing self-perpetuating they tend to build synaptic networks and reinforce synaptic networks more and more with each repetition and so there's a lot of causal elements that continue to uh reify that pattern of responding to stress and and fear and shame and all the the really uh really unpleasant painful emotions that that we uh come with i'd like to answer something that uh mark said but i really love to hear from richard first on the general social um dimensions of this problem and then there's something i do want to say in response to mark so i don't i don't want to preempt so i'll be brief uh i basically agree uh i think anybody who hasn't healed their what i call exile parts is gonna have to have some kind of uh what we call firefighter activity that you alluded to to to stay higher than or to stay distracted from or to to stay away from and keep contained these parts that without that activity would burst out and recreate all the the pain you would be go back into the past the traumas and feel all the emotions of it and so because our culture is a rugged individualist just move on kind of culture where if you have a trauma then you try to put away all the emotions and memories and sensations and so on not realizing that you're locking up all the parts of you that are still living there there since that's the cultural uh sort of meme then most people will have a lot of exiles that they need to deal with and some kind of addiction addictive firefighter activity will be necessary so uh i would say most everybody wow okay all right if i can go back to something mark said i think there's an important distinction mark that you're missing if i may say first of all all addictions are physiological okay because they all involve the brains dopamine apparatus as you well know the brain's endorphin apparatus the brain stress regulation apparatus the hypothalamic pituitary adrenal axis and other brain the orbital fungal cortex and its impulse regulation circuitry so to say that addictions are psychological if physiological makes no scientific sense to me whatsoever number one number two we have to make a distinction between dependence and addiction they're not the same dependencies when you go through withdrawal physiological withdrawal and as you suggest that's very severe with the opiates but you can also be dependent and not be addicted for example people who are given ssri medications and they try and stop them they go through severe withdrawal that's a dependence but it's not an addiction because they're not craving it and not using it to suit themselves to temporary pleasure so let's not fall into the mistake of confusing dependence and addiction and finally even what you call psychological addictions affect the brain so that you can look at the brains of uh of gaming addicts and they're different because of the gaming activity so to make a distinction between psychological and physiological to me it's just uh creating a gap that doesn't exist in real life and i'm sorry we seem to have lost mark i hope he comes back very soon yeah i think he'll be back shortly um in the meantime uh gabor can i just ask um you and mark have both spent a significant uh portion of your working lives uh basically debunking the disease model of addiction um why is it important that we let go of this narrative well so in society today there are two dominant views by far the dominant view is not the addict not the disease model but the choice model most people really think that people choose to be addicted and the law is based on that if the law didn't believe that people are choosing then what the heck are we doing punishing people that's right so that is the communist view not the disease model no within the treatment industry you're right the disease model dominates the disease model assumes that the problem originates in the brain and largely only to genetics which is you know genetically zero evidence for that i'm saying zero evidence uh there may be predispositions where people with certain genes might be predisposed to certain mental health conditions but in the right circumstances those people are no more likely to develop addiction than anybody else and same is true with animals so that genes don't determine addictions and the brain itself is the product of the environment so that to talk about addiction as a brain disease ignores the fact that the brain develops under the impact of the rearing environment beginning in the uterus so you can stress pregnant animals and their offspring will be more likely to use cocaine and alcohol as adults not because of any disease problem but because they develop stressed brains beginning already in utero so the disease model while it's stepped forward from the choice model in that you don't blame people for behaving a disease and you've offered them treatment and compassionate treatment it misses the point that they can i think are both very adamant about and i don't know that mark would disagree either that addiction is actually rooted not in the brain but in life experiences it is it affects the psyche and as it affects the brain and so therefore to deal with the addiction like richard's model brilliantly does and i hope i do as well is not to focus on the addiction itself but to focus on the dynamics that drive the addiction and the disease model totally ignores that 100 one of the things i i really i like that you said is that i think there's a vegan buddhism that says you know your your might your mind creates the world but you take that back and you say well yes it does but also the world creates your mind could you tell us about the significance of this this statement well you know what let me pass the rack at the richer than this one because he can address that well as i can and i actually be interested to hear from his words rather than mine because i've heard myself talk about it so often we're talking about how the how before the mind creates the world the world creates our minds that's what we're talking about okay well first i want to say i always love listening to you because not only do i agree with you but you're so much more articulate about all this than me and i i think you are having a huge impact as we're you know learning from all your success and so it just always warms my heart um just to add to what you were saying as you say it might be for some some families there might be a genetic component to it and that got way over generalized and they're you know they're i've worked with many families as of you where it is it does travel down the generations and uh that also we haven't in the ifs world what i call the concept what i call a legacy burden which is an extreme belief or emotion or activity that does travel down through your ancestors or through your ethnic group or is just around in the culture that we also absorb it doesn't really have anything to do with genetics but there are sometimes there are epigenetic studies of mice and rats for example but in the work i do we can find the parts of people that carry the legacy burden that they got from their father who got it from their father and so on and then we can actually unload that and send it on back up and uh and and the addictive parts really change when that happens so i'm with you gabor that it's not uh you know that both by unburdening things like that and healing these exiled parts that it's not a disease in that sense yeah and then this and yes and to show and to say that you know my grandfather was an alcoholic my father was an alcoholic i'm an alcoholic yeah things running families but what runs in families what was your family pain and trauma that's right exactly what what they call the legacy burden so it's not that i passed on a gene it's i passed on my pain that's right because as i did as a parent you know and and and because until i've you know if i had met dick not that he had the model then but if i had met dick when i was 20 years old and if i was working with him before i had kids then i might not have passed on my pain to the kids to my kids to the degree that i did but the fact is that i did and there's a tragic example of that here in canada where 30 of the people in our jails are first nations indigenous people largely often because of addiction related issues yeah these people had no addiction before colonization but they've been so severely traumatized over the centuries until even up till today by the culture that tried to extirpate their very being and that their parenting practices were completely destroyed and now they pass on the trauma from one generation to the next there's nothing genetic about it it's just that we pass on our pain and therefore addiction is not the only response to pain but it's only one of them but the addiction is passed on but not genetically 100 um so now you had maybe we've sort of we've covered it a little bit but i'd like to maybe sort of focus now on on root causes and i'm particularly interested to ask you richard about from from the ifs perspective and you know talking about uh the protector parts and everything maybe if we could give us an idea of how uh ifs would view how an addiction might develop or addictive behaviors might might occur in people yeah so as we've been talking it's very difficult to get through growing up in this culture and in particular families without a lot of what i call exiled parts and exiled parts before they got hurt are these inner children who are delightful and playful and loving and open and they're the ones that get hurt the most by what happens by the traumas in our our families and in our peer groups and just in living in this culture and like i said before once they get burdened with the the worthlessness or the terror or the sense of being abandonment being abandoned or the emotional pain then we want to lock them away inside and just move on and so so when you have a lot of exiles you feel much more delicate the world is much more dangerous so you have to have a bunch of what we call protectors who are other parts who ordinarily are just assisting us in our lives but are recruited or forced into roles to contain the exiles and to protect them from getting triggered and so most of us have are familiar with that inner critic for example so that part is often yelling at us to try and get us to behave better and look better and perform at a high level and and so it's just trying to control us so we don't get shame we don't get attacked by anybody or rejected and there are a bunch of other parts in similar kinds of preemptive roles trying to avoid anything that might trigger the exiles and they might try to keep us from getting too close to anybody so they can't hurt us or keep us you know focused on our appearance or keep us taking care of everybody else because and not take care of ourselves so these we call manager protectors because they're all trying to manage our lives so the exiles don't get triggered or burst out of exile world still has a way of triggering our exiles when that happens you've got to have a backup plan and then income what i call the firefighters who are fighting the flames of exile emotion and they do it in often in quite extreme ways because they think if they don't get you away from those feelings you're gonna die they really most of the time think your life is at stake so they'll and they don't care about the collateral damage they do to your body or to your relationships they just know that gotta get you higher than those flames or distract you until they burn themselves out now so the exile does its activity i mean the firefighter it gets you drunk or it gets you high or it makes you write an article or it makes whatever it does or a book or a book as we both know and and that activity uh activates people around us because they're hurt by it including the book actually and so those people get upset with us which triggers the critic who now calls us even worse names and that goes right to the heart of the exile that little young one who already carries a lot of shame and so now the exile burden is even greater and so there's more need for the firefighter and so you get into that vicious cycle where the actual attempt to help you by by getting you high uh creates more shame and more need for the activity for the the addictive activity and uh so a lot of the times when we try to work with that i'll actually start not with the addictive part but with the critic and if i can get yet to calm down and step out of the way then we'll go to the addictive part and in contrast to so many approaches except for gabors we honor the critic i mean not the critic the the addictive part it literally saved people's lives most of the time because the next firefighter on the hierarchy is often suicide that's right so we we honor it for its service and we offer an alternative way to deal with the pain so for me addiction is this is a if you pardon the expression a three-part problem there's the critic then there's the exile who who believes what the critic is saying about you and takes it in is shame and then there's the firefighter who's trying to get you away from the shame and will use whatever it takes to regardless of the consequences to make you not feel that but that that firefighter activity brings back the critic who comes back even harder you know in the case of the bulimics it was you know you're such a pig and then that goes right to the heart of the exile so you're in that vicious cycle in in addictions that's uh that's really interesting and i think maybe the point i don't know if it is or not but maybe the point to emphasize here is that in ifs these protective parts aren't seen as a as a negative thing they serve an adaptive purpose that kept us safe at a time when we were very vulnerable is that fair to say that's right you know they in a sense they're anachronistic and because they're frozen in these times when they were needed and they still think you know if i were to ask one of you how old does that addictive part think you are ask it how old it thinks you are usually you get a single digit they really literally think you're still seven years old and you need them to do this for you and and when if i if if i said mark tell it you're i don't know how else you are but uh tell it you're much older than seven often they don't believe it it's they are shocked totally shocked so some of the work is just updating them that i can handle that feeling now i don't need you to do this job for me yeah and but by the way i was just talking not to my parts but to my partner my wife who's helping me plug into various resources so i can stay with you guys but i i definitely understand what you're saying and i've been actually using that precisely that model precisely that model c sykes has been a consultant and i have a high-ranking ifs person who really understands addiction very well and she's taught me a lot about how to approach it and it's just as you say the firefighter is impulsive and wild and freedom seeking and is happy to get loaded happy to get stoned and doesn't give a [ __ ] about the consequences at all and you try to come at that with a critic and it just blocks it it just knocks it out of the way it's not interested it doesn't need to listen to this critical voice uh and so you're and so people with addictions are um they're trapped between these two motive forces that have very opposite uh um very opposite intentions and goals and very different styles of reception and communicating and regulating one is you know top down you got to be good you got to prepare you got to be you got to do the right thing don't you do that again don't you dare do that again you better not and then the other voice is the hell with you man we're gonna get high right now we're gonna get high because it's gonna work so you can just buzz off that's it all right and you and also you don't know what's gonna happen if i don't get you high it's gonna be terrible yeah the anxiety is building and it can go to really bad places and that critic is steeped in what gabor was saying about the willpower model the critic really buys into that and says you you should be able to do this you're you're totally weak if you can't do this yeah yeah and you load that stuff on those criticisms and the result is that the exiles the the helpless younger younger parts who are inside and not fully conscious are getting all the more uh uh panicked there's like huge piles of shame coming down and oh no i can't stand be called those names again and you just you go more deeply into hiding so this this this wild dialogue going on at the surface of the mind as it were is obscuring these deeper sentiments needs feelings of despair uh anxiety and shame i mean criticizing yourself for the same thing day after day for months or years that's that's a heavy price tag to pay for anything a hundred percent um gabor um have you got anything to add here in terms of root causes and maybe this would be a good time to maybe bring in a bit about trauma and the role that plays in addiction well um look anything any of us say here is is a mental model of something and models are never the same as the actual thing but models can be very descriptive and they give us access to working with whatever the real experience is my model addiction it's very simple there's pain then there's a response to pain and there's different responses to pain in this model addiction is not the only response to to childhood suffering um but it's one of them it's a salient one uh my pers so what is trauma then so trauma then is a wound that we sustain so trauma is not what happens to us trauma is what happens to us inside of us as a result of what happens in fact trauma means wound that's what it means so where we're wounded we look for ways to solve that wound to to soothe it to you know and and there's many ways and those ways always are useful and even necessary in the beginning and then they become dysfunctional later on and and they can show up in addictions they cannot show up in physical illnesses like rheumatoid arthritis or or cancer or mental health conditions but originally they all begin a scoping mechanism so what i'm really saying is it's always essentially very simple we have pain we have pain either because bad things have happened to us that shouldn't have and those are covered beautifully under the adverse childhood experiences studies and we know that the more addressed shelter experiences abuse neglect violence and so on children sexual abuse children are subjected to exponentially degraded the risk of addiction not just of addiction of all kinds of other problems as well but we can also be wounded not by what was done to us that shouldn't have been but by what wasn't done for us that should have been that's right so if we weren't attuned with if we weren't seeing who we were if we were told our emotions are not acceptable then suppressing those emotions becomes a survival technique and like dick says experiencing those emotions becomes life-threatening why because in the beginning when our life depended on our attachment relationships and if those emotions threatened the attachment relationships the best we could do was to suppress them and that was brilliant on a part of our organism that's right i also honor all these coping mechanisms and what i'm saying is that fundamentally they're all coping mechanisms designed by nature to deal with trauma and then and even that critic you know um there's something terribly wrong with me it's a coping mechanism that's right you know um if if if as a child i'm not loved the way i need to be loved worse if i'm hurt there's two things that i can unconsciously assume one is that my parents are incapable of loving that they're against me or i can assume there's something wrong with me if i work hard enough maybe i can fix it which is the safer for the child to assume so to assume they're worth my worthlessness does there's something deeply wrong with me is itself a survival mechanism that's where we have to honor all these dynamics and all these scope mechanisms and the big calls and parts i call them coping mechanisms i have my own way of working with them but fundamentally it's all about recognizing the survival value and honoring the service that they did us and my god i know so many people that have told me that addiction which nearly took my life actually also saved my life because the next step for many people would have been the despair that drove them to suicide that's right um okay so maybe this would be a good point in the conversation to transition into effective approaches for working with addiction and potentially healing addiction and i'd like i'd be curious to ask you gabor about how compassion inquiry can be used in working with addiction well compassion is a model it means quite as a model that i developed over the years and i i never thought like dick i don't think developed big step down and said how can i develop a model you know um it just came out of our work and at some point and really it has to do with just asking questions which is the inquiry part but compassionately without judgment with acceptance and i really think that fundamentally um that's the most important part of what any of us do whether mark or richer than myself how we approach our clients it's not the method is important but it's not as important as the degree of compassion and and acceptance and and and valuation of the true worth of that individual that that comes into the picture and so the compassionate part is not to judge anything not to judge any uh coping mechanism any parts as you would say in ifs any aspect of ourselves but always looking the inquiry is yeah why did you come along and and what's what's uh purpose are you serving and furthermore what does it cover up that that true essential self that we all cannot lose as long as we're alive is covered over by all these coping mechanisms and false beliefs and so asking the right questions will get you not only to be compassionate towards your coping mechanisms that you've hated it also gets you it also removes the barriers to experiencing yourself as you really are which is the ultimate goal of any psychotherapy and what i tell my students is that your job number one is um to help the individual be in a compassionate relationship with themselves in the present moment not coming from the past but in the present moment and number two your second job is to get yourself fired as fast as you can and fire not because you're doing a terrible job but because you've done such a good job 100 so it's really it's asking the right questions but doing it from a place of compassion and curiosity and yeah that's is that fair to say that's exactly what it is okay um and then uh i i think we could maybe talk about how ifs can be used in trading addiction and uh mark maybe we can go to you here because you've spent your whole life you know researching the neuroscience of addiction and coming at it from the point of a developmental psychologist as well and out of all the different approaches you've tried you've found that ifs to be one of the most effective if not the most effective ways of dealing with it so i'm just curious about how you arrived at that and um how you're finding uh working with it and with your clients at the minute yeah well um at first it's really interesting to hear how uh in sync gabor's way of talking about this is with the ifs metapsychology very much in sync and the centrality of compassion compassion curiosity being there for these parts that are you know that are in one way or another misfiring um malfunctioning helpless and scared so like for me my original training was in psychodynamic psychotherapy and i was a developmentalist as a researcher um and then when i started to do more and more therapy i used emotion focused therapy and some stuff from act acceptance and commitment therapy you know try different things but mostly i was interested in dealing with people with addiction problems addicts you know i don't like to use that word because it's often a derogatory um but but this to me the genius of ifs is nailing that the firefighter nailing it and recognizing this is a part that has a very distinct style it's impulsive it's it it's looking at the anxiety and how to overcome it right now it's not looking at the present at the future at all it's not looking at the past it's not trying to keep thing keep the boat steady it's just trying to uh feel better that's all it's trying to do and it's it's a part for me as someone who used to have drug these are serious drug problems that firefighter part of me when i was four or five years old i used to run to the ravine i used to run out of my house and go down to the ravine and you know jump on the ice and try to get off just in the nick of time before it would break you know i mean it's and it's the same part it's the same part that just wants to be free and crazy and feel uh released so um so what what do you do with it so the critic is not working that part isn't being listened to it's just being uh shoved aside where do you send this compassion from how do you connect it to the suffering and in ifs what you do and is um you you use the sent this the self this capital s self which is the what they call a part that's not a part and what people who meditate recognize as a kind of internal central stable peaceful uh place that feels like it belongs here and from there you extend compassion to all all three parts the firefighter i get what you're doing i understand you know yes you just want to get wild and crazy but you know what you know we've done this like a lot of times and it really does kind of screw things up so maybe we can just pull it back a little bit so you can connect with uh tune to and also help to modify with the critic yes i get why you're so upset and angry of course you are because this keeps leading to disastrous consequences like you're kind of panicked i i understand why so you you send compassion but the i guess the third and most important recipient is the the exile who is just pure shame and anxiety and cringing down there inside and you try to connect with that part from this inner self and say i'm here i'm here for you you're not completely isolated it sounds bizarre when i try to explain this to clients i'll say you know this sounds like alchemy i know it sounds like byzantine but and i know jacob said this too it sounds it's it sounds crazy to talk to yourself in that way but you could really do it and you can provide an attachment relationship to these helpless desperate parts from in here that doesn't require anybody else in the room doesn't require anybody else to connect with you can give that love acceptance and compassion and then these these highly emotional parts calm down they just start to feel safer and when they start to feel safer the firefighter doesn't have to go to such extremes anymore the critic doesn't have to be so upset and angry the whole system starts to settle down and i think that that really is why ifs why i have found it to work so much better than really any any other form of therapy that's really interesting and it seems that it's so important um if you're going to be using this to work with addiction or you know um calming exiles or firefighters or whatever um that you need to develop this sort of relationship with the self with a capital s like that seems to be super important and um richard i'm just curious to get your thoughts on this you know if maybe some have you ever had the experience of someone has tried ifs and they've had difficulty with um connecting to that uh self with a capital s and have you got any thoughts about how to maybe strengthen that relationship if someone is struggles to get there certainly and i'll i'll speak to that in a second but i just want to mention what a treat it is for me to hear mark describe his uh experience with the model and also uh whenever gabor and i talk i'm i was amazed at how basically independently pretty entirely independently we came up to such similar ways of understanding all this and working with it and uh so that's always a treat for me as well um and i forgot your question oh have i run into people where you can't access cell yes uh not that you can't but where it takes a long time and their protector parts are very entrenched and they're afraid they're like in family therapy we used to call them parentified children parentified inner children you know they they carry so much responsibility they lost trust in self because self didn't protect during the traumas and they think they've got to run the ship and they've got to deal with the world and the idea of them giving any power over to self is terrifying and so often uh i have to talk to those parts directly and we call direct access and from myself and listen to them and and you know at some point form enough of a trusting relationship with me that they're willing to just give it a try and and separate and when they separate it's the same damn self that pops out with all the hc's and then we have to form a repair between that self and this this protector and also a lot of appreciation and you know that can take a year in some cases before you even get an inkling of so and those people are usually real severe complex trauma survivors who it wasn't just one trauma it was daily it was over and over and they just came to these protectors just came to think i've got to run things because if i don't here comes the the other shoe is going to drop any second and anyway yeah 100 and you've got a book an audio book i think it's called greater than the sum of your parts and maybe that could be helpful in helping people sort of develop this relationship as well as well thank you yeah the that book that you just held up is um an elaboration on the audiobook you mentioned now brilliant brilliant um so we've only got a few minutes left guys um one of the things we've talked about in this conversation is about you know the this this um society's problem with addiction is at a societal level and i'm just curious about what your thoughts are on what can be done to change the narrative we we have around addiction and what we can do to improve things going forward and maybe uh gabor have you have you any insights here that you'd like to share on that first of all what's happening is that there's been much more trauma awareness in the world right now um our mutual offend uh bestsell vanderkorg's book on trauma the body keeps the score has been a new york times bestsellers for over a year now uh bruce perry's book with oprah what happened to you is a bestseller so there's in society is increasing trauma awareness so one of the things we have to do is keep elevating the level of trauma awareness in a society in all institutions in medical schools in education uh certainly in the law certainly in the realm of social policy um i i dare say that my book which i'll also take the liberty of holding up in the rumble from your ghosts an addiction has gratifyingly made a an impact in in the addiction world in in in helping people see the connection between trauma and addiction and its social sources so that if you look at right now the overdose crisis is not about individuals it's also about the fact that hot whole sections of the economy have been hollowed out and you've got these deaths of despair that case and deacon write about didn't write about uh owing to changes in the economy and and the social alienation so we're dealing with a huge social problem here um and we have to look at and and we have to begin with that recognition that this is not just individual trauma it's not just individual psychopathology if you want to call it that it's not just individual coping mechanisms it's also a huge social problem in a society that number one fails to meet human needs and number two traumatizes people and number three profits off all that so that's my next book which i won't mention the title yet because it won't come out for another year but we have to look at the large social question that's what i would say and um i just want to put in a plug for my own work here so that it's great i mean nick and i are doing a program together actually beginning this week for sounds true on comparing contrasting and working with passion inquiry and ifs and those that are interested in compassion inquiry can certainly check out the websites for that we've had about 2 000 people in over 80 countries studying it in the last two or three years and so i just want to mention that as a modality and it's not in competition with ifs in fact we've had dick coming and teaching to us to our great benefit so it's a wonderful collaboration and mark i you know for all our ostensible disagreement your book is one i often talk about and and quote and i i carry passage of it passages of it um copy it out on my laptop as i travel because i'm often citing you so uh yeah thank you awesome um mark would you like to add anything here about addressing this at a at a societal level yeah i mean it's complex uh but obviously as gabor has um talked about it's i think one really clear vector here is that people are often uh they reject isolate humiliate people who have addictions for a very good reason it's because people find addiction to be so aversive so challenging so scary so why do they find it to be so scary because the idea of losing control of this firefighter this impulsive warrior who tries to help you at the expense of everything is an incredibly volatile and dangerous situation and i think we all recognize that at some level that uh i don't want to go there and as as my colleagues have said this is something which touches many many lives not just the identified addicts i don't want to go there i want to stay in control i want to keep the the manager the business manager in charge here and so people are repelled by it and that's why addicts are treated so badly i think 100 and uh richard just did anything to conclude here yeah basically i'm agreeing with both those guys uh i'd like to thank not only of individuals through this map with the managers firefighters and exiles but you can apply it to countries or even bigger and if you look at the united states right now we've never had so many exiles that the income disparity is in our history almost never been this great there have never been so many people having to work three jobs and just barely making it with three jobs and so there's lots and lots and lots and there's lots of pain for other reasons too including the legacy burdens of racism and patriarchy and so on so there's huge massive amounts of exiled pain and when any system at any level has that much pain they have to have both firefighter activities and also very polarized manager parts which we have in our government and uh and also that whole willpower paradigm contributes to all of that because we're in the same vicious cycle in the in our country that we are in our heads when it comes to addiction so anyway that's just a sample of what the way i think about it okay can i make a quick comment um only when you said about the three jobs there's a youtube segment you can watch with george bush junior at a town hall meeting and some poor woman is asking uh will there be old age security because when i retire because um i'm working so hard right now and um and bush sister well you you're working on you she says yeah i got three jobs and bush says appreciatively oh three jobs how uniquely american and everybody applauds that's the attitude yeah that's right that's the that's the managers that's right maybe maybe it'd be best if we could get some of these politicians some ifs therapy and some comparison inquiry maybe that would help as well um listen hold on if i may say i in my new book i talk about this and what's what's very characteristic of politicians is they don't do self-inquiry like trump said i don't look at myself i don't want to find out what what is there hillary clinton said the same thing sarah palin said the same thing margaret thatcher was the same so you're never going to get these people ourselves you know and and there's very few amongst the politicians we elect people who are not self-reflective that's why they can do all these terrible things wow so i'm afraid that'd be a nice idea but i don't think they're going to knock in on our doors anytime soon we can try anyway um i just want to say a huge thank you to all three of you today i've really enjoyed this conversation i find it really really limiting so um before we go is there anywhere you'd like to send people online any resources you'd like people to check out um book books anything you want to mention yeah well i'll just say dick in case you don't want to blow your own horn too much there's so much on the ifs website and these days it's i think the popularity of this approach is exploding you can't get into workshops and trainings anymore that they have double waiting lists and they say don't even try to get on the waiting list because they're also occupied so what are you going to do to learn more about it well there's 20 or 30 books on the website that explore different aspects of ifs some for practitioners some for the regular people and lots in between so i think that's a that can be a very rich valuable resource thank you mark and and uh i'll mention the website which is ifs hyphen institute dot com uh we do run a i mentioned two things we run a online program called the online circle for people that can't get into the training or interested in an introduction and that's opening october 20th so people can look into that and then second um we have our annual conference starting in about a week online also if people are interested in that and uh yeah godboard did the service holding up my book and i i want to say also that uh he and i are going to be talking shortly on his amazingly popular show um and uh what wisdom of trauma wisdom of trauma uh i'm nervous because it's the biggest audience i'll have ever spoken to and uh and his his work also has become amazingly popular so you know i'm really thrilled that we can join forces this way because i think together we can have much bigger impact than separately and as we've been talking our work is so compatible so seems to be thank you very much richard and gabor just just to finish off well so i mentioned compassion inquiry um it's a course that has been taken as i said by 2000 people in over 80 countries by now uh just today we have a first session of 440 people from i don't know how many dozens of countries it's an online program for therapists and it's very intensive it's very demanding it's time-consuming it's not for the faint-hearted and the first three months the first three modules are not about what you do with clients but how you get to your own self before you start working with clients that we do that three times a year and you can just look up at the compassionate inquiry website there's also my own website dr gabriel mate we're all amazing and there's this film that richard alluded to it's called the wisdom of trauma when you when it aired in june within a week he was seen by over four million people now we're showing it for the second time along with a whole lot of great interviews i spoke to bessel yesterday i think later on today i'm talking with dick and a lot of others on several others on addiction so um yesterday we did an interview with with ashley judd and and and jamie curtis and the rapper ramona hider on women and trauma and addiction and so on so that's available online www.thewisdomeoftrauma.com [Music] and a year from now of a new book out which i'll i'll start to vlog closer to the time thank you for this conversation and i really appreciated being with my two um really respected colleagues maybe i could just mention i can't compete with those numbers but i do have an online blog and i do get a couple hundred thousand people coming in and coming and going and i've been working on this for 10 years maybe some of it's more theoretical more conceptual more back you know the uh the the background but also the experience the understanding the uh the neuroscience and how it melts with the psychology so it's uh i think you can find it by googling understanding addiction and my name mark lewis and you know there's stuff there that can be interesting to people who want to explore this this domain i'm sorry mark and i also just contributed to a new textbook haven't we sorry which what do you mean didn't i both you and i contributed to a new textbook on addiction yeah the one by uh nick heather's the first editor what's the title of it it's it's about evaluating the disease model of addiction right yes and clearly many of us are not happy with this model and want to want to move quite a bit further than that so there's a lot of people in that book who have lots of interesting perspectives to share brian and mark's actually got a series of blog posts on ifs and addiction which is probably a good follow-up we'll link to that in the show notes as well after this conversation but you guys thank you so much for your time today i really appreciate it it's been great great to speak to you all thank you

Channel: The Weekend University

Views: 59,671

Keywords: the weekend university, psychology lectures, psychology talks, psychology lecture, Gabor Maté, Richard Schwartz, Addiction, Marc Lewis

Id: U5meU_-EnVk

Length: 62min 29sec (3749 seconds)

Published: Fri Oct 15 2021