Dealing with past trauma may be the key to breaking addiction

Denying reality, however bad it may be, hurts in the end more since this sometimes subtly, sometimes not so subtly influences action to avoid the thing I denied out of being. Once everything is allowed there is not much necessity to deny the thing that is stopping you (me in this case). Imagine a central belief that can bring many useful actions to a halt just by being there.

Blame is from other people. You can deny all blame. You do not have to blame yourself. That's a thing which I haven't been taught before. Since I did rather the reverse, it needed the exact opposite to work out. Only consequences are physical. That's why only those matter.

What starts as normal use may evolve into unhealthy use and spiral out of control. Or it might just stay normal forever. Like everything, there’s a range. Sometimes the trauma is self-inflicted, in form of isolating and loneliness - and a self-destructive circle inwards. I have personal experience with this.

Workbooks aren't therapy, and therapy cannot be mass produced.

Ironically, most US readers of HN will never have seen such a clinic, as the only places actually staffed this way are things like county mental health departments in states where they can get funded.

So, anyway, psychiatry training REQUIRES that each of us provide many hours of supervised psychotherapy. Some training programs are better than others, but we all graduate with a working knowledge of psychotherapy. Many of us have less opportunity to use it than we would like.

Which brings me to my final point: it's not either / or. That's a false dichotomy. It's about the right tool (or combination of tools) for the job. There are plenty of problems that there is no pill for, and a few problems that no amount of talking about it is going to fix. Horses for courses, and all that.

edit: I'm sorry to see you are getting downvoted. I think many people arrive at the same conclusion you have, based on their experiences. I can totally understand how you arrived at that opinion.

Your comment really isn't with respect when you make this assumption about someone's profession based off no knowledge of that person's chosen career path.

I'm not sure what kind of a person knows many psychiatrists but doesn't understand that the boundary between psychiatry and psychology isn't some high garden wall whereby a psychologist tosses the ball over when they can't figure out the case.

Although there are certain parties interested in badmouthing psychiatry at every turn out of dogma and self interest - from the obvious of Scientology and their means of control to the fundamentalist and homophobe contingent angry over their role in destigmatization and having to look for new targets. They're pissed off that gay marriage is widely accepted - saying someone was for gay marriage in the 80's doesn't make them look wacko fringe like it did then but visionary from how utterly vindicated they were. They are angry that science "didn't stay in its lane". And psychiatry is science. Even in its bad old days of abuse of electroshock and lobotomies considered a valid treatment and despite qualitative aspects keeping it from hard equations and laws the fact that they let the evidence speak and draw the conclusions - 'no society is clearly wrong here - homosexuality is not a mental illness' is profoundly science in a 'and yet it moves' way.

So the next target for their otherphobic garbage of strawmen that I sadly am not making up is that psychiatrists and liberal parents want to reassign gender and provide hormone treatments and surgical treatments at will and everyone trans is a bathroom sexual predator.

Meanwhile back in the /bad old days/ of the past when gay-bashing was relatively accepted a trans Bond girl was treated as mere trivia with perhaps a few tasteless jokes that were still better than the horrific 80's AIDS 'jokes' instead of a 'franchise ruined forever' reaction.

This wasn't meant as snapping at you but at a clear frustrating trend that I have noticed.

Many parents, especially when looking at-risk demographics, look to psychiatry as an easy fix so that's what the doctors give them. The parents often can't afford to take time to drive their child to a psychiatrist twice a month let alone pay for the sessions. The end result is that psychiatry stuck in a terrible ethical spot, where their duty to treat not just symptoms but causes clashes with the realities where the parents are at the end of their rope. Are doctors stewards of health, responsible for the patient? Or are they professionals that have to meet their clients half way? I don't think there is an easy answer to that question.

Obviously there are many unethical and incompetent psychiatrists but my experience in California (as an adult) stands in stark contrast to all the horror stories I hear about child psychiatry from school administrators. As usual, there is a massive wealth gap and your mileage will vary.

You've got to get your numbers up.

It takes way more time to properly deal with psychological issues through therapy than it does to just prescribe a pill. They've got their pill, feel slightly better, so now you get to put them in the "done" pile. So your hospital gets to say it treats 1000 patients per quarter instead of just 100, so they are more attractive to pharmaceutical companies which pay them oodles of money.

The less cynical way to look at it is that the health care system is overloaded and underfunded, they don't have enough resources to properly treat people so they "have" to take the quick and easy route.

From the article:

"in his 40s and 50s, he began to unravel the root cause – and that took him all the way back to Budapest, where he was born in January 1944. Two months later, [snip] “Right now,” the doctor replied, “all the Jewish babies are crying.” This is because, explains Maté, what happens to the parent happens to the child: the mothers were terrified, the babies were suffering,

Later, Maté’s mother, fearing for his survival, left him for a month in the care of a stranger. All this, he explains, gave him a lifelong sense of abandonment and loss which had an impact on his psychological health. [snip] To compensate for his buried trauma, he had buried himself in work and neglected his family."

I get that is a truth for him, but it sounds contrived as only a psychologist can do (without more context)

It is definitely the case that trauma can cause addiction. However, I think it's over-reaching to describe it as the sole cause, especially when it comes to physically addictive drugs like opioids. Sometimes addiction just is what it looks like it is - the brain's neural nets finding a trivial solution to their prime directive.

Depending on how you define that, doesn't nearly everyone have some form of developmental trauma? Is there really such a thing as a perfect childhood with no trauma whatsoever? Isn't going to puberty itself already enough of a traumatic experience for a lot of people out there?

A kid can feel neglected and abandoned because they might have food and a roof over their head, but they're not getting nearly enough hugs and cuddles as they need. Or they grow older and they're not given any trust, the parents assume the worst intention the whole time and the kid becomes a scapegoat.

Or it's applied so inconsistently that you don't even know what's right and wrong, because you do one thing one day and it's praised and you do it the next day and you get your ass beaten for it.

It's not the sense of no future, it's the lack of nurture and care. And it festers because there's this whole belief that parents know best. The kid knows a damn lot too and needs to be heard.

MAOIs are good for getting people out of bed while their team figures out what other sorts of interventions they'd benefit from:

  [...] New research into MAOIs indicates 
  that much of the concern over their 
  supposed dangerous dietary side 
  effects stems from misconceptions 
  and misinformation, and that it is 
  still underutilized despite 
  demonstrated efficacy.[4] New 
  research also questions the 
  validity of the perceived severity 
  of dietary reactions, which has 
  been based on outdated research.

Later anti-depressants (Tri-cyclics, SSRIs, etc) tended to be less-effective than the MAOIs, but the MAOI's patents had expired.

B-vitamins can boost the metabolism. There's a prescription version of Methyl-Folate that's approved as an add-on for depression treatment (imho, this vitamin should really be a primary treatment).

There's lots of space for the medical perspective on a treatment team.