September 29, 2011: Guenther Pohlmann Society Meeting

     Recall that when a month has 5 Thursdays, on that 5th Thursday, our Spirit Mind Body Group holds a meeting of the Guenther Pohlmann Society in our friend, Guenther's honor. For those newcomers to our group and our blog, Guenther was a remarkable human being. He was a member of this group from the very beginning until his sudden demise several years ago. Guenther was born in Germany, and immigrated to the United States when he was a young man. His father had resisted the Nazi movement in Germany and suffered because of this resistance. Yet many 19th century German philosophers made their mark on Guenther. He read and frequently quoted: Hegel, Schopenhauer, Heidegger, and (though Danish) Kierkegaard. He also did a lot of writing about his own world view. He thought that our human brain was "hard wired" for the need for religious belief, perhaps because many of our religious groups and ideas were formed while our early human family lived in a place devoid of stimulation, the Middle Eastern desert. Yet he also believed that even Eastern religions have many similarities to our Judeo-Chrisitan background. I remember him questioning whether even Jesus could have traveled to the Far East, to become affected by some of these similar ancient belief systems. He often quoted Lao Tsu and the Zoroastrians. In addition, Guenther was highly well read in many other fields. He could speak on almost any topic. We always joked at this meeting, if our speaker was not present yet, or we had an opening in presentation, that Guenther would walk in the door, and we would say: "Guenther, can you present something to us today?" and lo and behold, he would! In his field of work, Guenther was known as the "physician's physician." He had a remarkable questioning mind for medicine at its finest. At our weekly Grand Rounds educational meeting at Columbia Hospital, no matter the topic, the speaker knew that eventually during the meeting, Guenther would raise his hand and pose a deep question about the medical topic and then he would often answer the question himself right then. He was a pulmonologist and nuclear medicine doctor who then became an intensivist. He always taught the internal medicine residents at Columbia and also the entire medical staff. He announced his retirement and we had the usual retirement party for him at Columbia, but he never really retired. He still taught the medical students and residents and still over saw various functions at the hospital that kept his figure seen in the corridors right up to his death. Guenther was also an excellent photographer and we have held sessions at this meeting to view some of his photos. He left a volume of writings and we have often used our meeting of the Guenther Pohlmann Society to read through some of these writings. On other occasions we read material that would have likely represented Guenther's view of things, in his memory. Such is the case for this week's meeting. Todd D. led the discussion.
Please read on for the article featured for this meeting: Why We Are All  Addicted by Andrew Weil.

WHY WE ARE ALL ADDICTED

by Andrew Weil


I recently ran across an article that appeared in "Science" back in 1961.
The senior author was a man named Heinz von 
Forster, who's an electrical engineer at MIT. The title of the article was 
"Doomsday, Friday the 13th, 2026." Von Forster, who was not a population biologist, and as a result of that the article
 outraged population biologists, did an analysis of the 
increase in world population and developed a new mathematical model to 
account for and predict the way the population
 was increasing. His conclusion was that the population curve was following 
what he called "super exponential growth," that 
the expansion of population was proportional to the square of the growth 
rate. He was concerned with the doubling time of 
the human population. In other words, the time it took for the human 
population to go from small numbers to one billion was
 a very, very long time. From one billion to two billion was a tiny fraction 
of that time, but still long. When I was growing up,
 the population of the world was two billion. From two billion to four
 billion has occurred within my lifetime; it took about 
thirty years. Von Forster's prediction is that from four billion to eight 
billion will be about fifteen years, from eight billion to 
sixteen billion around seven and a half years, and so forth. On the basis 
of this, he drew a curve that described this 
expansion and concluded that somewhere around the year 2026, plus or minus 
five years, the population of the world would 
reach infinity-that is all the mass of the earth would have been converted
 to people. Therefore, the end of the world would 
be by squeezing to death. Obviously, long before the population of the
 world got near infinity, there would be disasters of 
one sort or another -epidemics, wars, famines, or whatever.

When the article appeared in 1961 it was roundly denounced in subsequent 
issues of "Science" by mathematicians and
 population biologists. The theme of population biologists at that time was 
that the rate of increase of population was
 slowing, and therefore population biologists were putting out an optimistic 
message. However, a long letter appeared in
 "Science" in April of last year by a population biologist who urged readers 
to remember von Forster and the doomsday 
curve, and pointed out that the actual increase in world population since
1961 has not only conformed to von

The reasons for the global catastrophes that are coming have a lot to do
 with addictive behavior. The world population 
increase has a lot to do with addiction to sex, for example. The 
destruction of rainforests and the pollution of oceans and 
atmospheres has a lot to do with addiction to power and to money. The
 subject of addiction cannot be taken out of the context 
of the imminence of the end of life as we know it.

Roger Walsh has said that he thinks that addiction is the fundamental
 problem. I could not agree with that more. It's
 fundamental in every sense of the word. It is a deep core problem. It is at 
the core of being human. It's also at the core of all
 of the specific problems that we have in the world today. I can think of no 
area in which it is more important to try to get 
help for ourselves and for everyone.

I also feel very strongly that addiction is a universal problem. All of us 
are taken up in addictive behavior. Hopefully, we 
are in a process of change now where we are beginning to see the 
universality of addiction. But still there is a tendency to 
focus on some kinds of addictions as the ones that are serious and to 
ignore others either because they are socially 
acceptable or because they don't fit our conceptual model of what addiction 
is.

I watched a movie the other night that was made in 1934 in black and white. 
All of the characters in the movie smoked. No
 wonder that generations of Americans were fascinated by smoking!

We are living at a time when that social consensus is changing. Smoking is 
becoming unfashionable. If you talk to any
 smoker you will hear how irritated they are about how unfashionable it is
 becoming. It's a very different situation from the
1930s. But that legacy of the 1930s and the years before conditioned our 
thinking about tobacco addiction.

In World War II soldiers were issued cigarettes in their rations. There was 
a tendency in the 1920s and 1930s to encourage
 people to smoke in the belief that smoking facilitated concentration. You 
only have to look back to the 1950s to Life 
magazine to find doctors selling cigarettes. You will find full page ads of
 doctors in white coats with mirrors on their heads,
 holding out packages of Old Golds saying, "I recommend these to all my
 patients because they're soothing to the throat. "
Imagine. That was forty years ago. It was only within the past ten years 
that the American Medical Association was forced to 
divest itself of tobacco stock by voices of protest from its constituents.

When I was a student in Harvard Medical School between 1964 and 1968, I was
 taught that tobacco was not addictive. I
 was taught that it was a health problem in that it led to emphysema and
 lung cancer, but there was not a word about it being
 addictive. It was a psychological habit and therefore unimportant. So it 
was not discussed. We didn't hear much about what 
they considered real addictions, either. Basically we heard a little bit
 about heroin addiction, which was the model or
 prototype of addiction. Tobacco did not fit that model so it wasn't taken
 seriously. Nobody paid any attention to it, and that 
consensus was so strong and it so affected American science that no one 
even did research to find out why that substance had 
such a powerful control over people's behavior.

For years I have urged people to look at smoking for what it is. Heroin
 addicts only have to get a fix once, twice, or three 
times a day. Tobacco addicts have to fix up every twenty minutes. Every 
twenty minutes the brain demands a discrete pulse
 of a high dose of nicotine coming through the arterial system. Why didn't
 anyone do research on that? Why didn't anyone look
 to see how nicotine caused such a profound influence on brain physiology?
 They didn't do it because it didn't fit the
 conceptual model and because it was a socially acceptable addiction. Well,
 there are many other socially acceptable 
addictions today that we don't take very seriously. It's awfully difficult
 in mainstream America to talk about sexual addiction 
as a concept. We live in a culture that tells us that it is desirable to 
have as many orgasms as possible all the time. When I
 ask people, as part of my medical history taking, if they have any sexual 
difficulties, the most common answer I get is that 
they aren't getting enough. In the cultural context in which we live, 
sexual addiction is invisible. Or take addiction to work or 
addiction to making money. These are both things that our culture tells us 
are good. So it is not seen in the same way that
 addiction to an unpopular drug is seen.

I think that many of our theories of addiction and our ways of looking at 
addiction are limited because they don't take into 
account the full spectrum of addictive behavior. As an example, let me read
 you a definition of addiction from this 
conference. After talking about how addiction extends far beyond the realm 
of chemical dependence, it then says, "In the
 broadest sense, addiction can be defined as an attitude that sees various
 aspects of the material world as exclusive sources 
of satisfaction. Addiction, understood in this way, represents a prominent 
feature of the entire Western civilization, which
 has lost the connection with its inner resources."

That, to my mind, is far from being a broad conception of addiction. And it 
surely does not involve just the Western world. 
That's a very limited view. First of all, if it's the attitude that various
 aspects of the material world make us feel all right,
 what about sexual addiction? Is that a material addiction? I mean it may 
involve physical organs and other people, but what 
we're really talking about is an addiction to an inner experience. What
 about addiction to thought?  That's something hardly 
ever discussed in the Western world. It is discussed in Buddhism. In
 Buddhist psychology, addiction to thought is seen as a 
serious impediment to enlightenment. That's one of the reasons you meditate
 to try and get some freedom from thought. So
 you could look at universities as monuments to thought addiction where you 
are rewarded for the beauty or complexity or novelty of the thoughts that you produce. Given that social context, with
 those social rewards, why would you ever even 
think that thought could be addictive. And if your conception is that 
addiction involves something material and external, then 
that doesn't fit, so you don't pay attention to it.

I maintain that the essence of addiction is craving for an experience or 
object to make your-self feel all right. It's the craving 
for something other than the self, even if that's within the realm of the
 mind. I also feel that addiction is something that's 
fundamentally human; it affects everybody.

It's very easy to feel special about our addictions. That's an attitude 
that I run into a lot. One of the things that in the past has 
put me off about some of the twelve step programs is that they tend to 
regard certain addictions as more important than 
others, that alcohol addiction is somehow fundamentally worse, more
 difficult, than coffee addiction. I love to talk about 
coffee addiction. My new book has an entire section on coffee addiction. To
 me, that's the most interesting drug at the 
moment, because it's a hidden addiction in our culture. So I don't agree 
that alcoholism is somehow more important than
 coffee addiction. On the level that I'm talking about, on the level that we 
have to look at addiction, it is the same thing. It's the
 same process. It's the same craving for something apart from yourself to
 make you feel okay. What I'm most interested in is 
that process. What is the origin of craving? And what is the solution to
 the craving?

I had a patient come to me about four or five years ago who was shooting
 five to six grams of cocaine a day intravenously. I 
had never encountered cocaine use on that scale. She had been doing that 
for six months and had gotten into it after several
 years of snorting vast amounts of cocaine. When she moved in with a man who 
was dealing cocaine, he introduced her to
 using it intravenously and her usage quickly escalated. Remarkably, given
 the nature of that drug and the nature of her usage,
 she was in good health. She actually held a job. She was a single mother,
 and at the moment she was doing a fantastic 
juggling act of keeping her life together despite her drug usage. I didn't 
know how much longer she would be able to do that.

I learned a number of things just in listening to her talk about her 
addiction. First of all, in describing the experience that she
 had from using cocaine in this way, she said that the first few minutes
 after the first injection of the day, she felt an
 overwhelming pleasure and rush. But that was it for pleasure. The rest of
 the time - five or six hours - was filled with 
paranoia, violent shaking, insomnia, and palpitations. I find this 
interesting because many people think that people get 
involved with addictions because they're sources of pleasure, but when you 
look at people caught up in extreme forms of 
addiction, especially with substances and food, the percentage of pleasure
 relative to the percentage of distress is minimal. 
There's not that much pleasure there, so the pleasure is certainly not the 
thing that keeps the addiction going. So after going 
on very articulately about how awful her life had become being a slave to
 this compulsion, she looked off and said
 something that was just a beautiful expression of the plight of the addict.
 She said, "I want not to want it."

If you want not to want things, how do you achieve that? What is this
 problem of craving? Where does it come from? What is 
the origin?

It seems to me that the Eastern spiritual philosophies, especially
 Buddhism, have the most to say on the subject. The first 
noble truth of Buddha is that life is somehow incomplete and unfulfilled, 
so that in anything you do there is something 
missing. There's a sense that there should be more and it's not supplied by 
the things of this world and the things of life.  It's
 often translated as life is suffering - and I suppose there is certainly a
 suffering that comes out of that - but suffering is very 
easily misunderstood by speakers of English. That's not the sense of it; 
it's that life is incomplete; it's unfulfilled. The second 
noble truth is that the cause of this incompleteness is craving and
 attachment. But the Buddha has nothing to say about where
 craving comes from. That's the question that has always interested me. Why 
do we crave? Why does everyone crave? Why
 aren't we content to just be as we are? If, in fact, our core essence of 
being is pure self-luminous consciousness, why do we 
have to go outside of that? That's not an easy question to answer.

The prevailing view in psychiatry and medicine and science today is that 
consciousness is an epiphenomenon that happens to
 arise out of the chance circuitry of the brain or biochemical interactions
 in the brain. In other words, consciousness is
 incidental. It's a product of matter arranged in certain ways. There is, 
however, a minority opinion - call it the mystical view
- that consciousness precedes matter. In other words, consciousness is
 what's primary, and consciousness initiated the
 evolution of energy and matter into more and more complex forms, seemingly 
with the purpose of knowing itself better. At 
the moment, human consciousness is the form where that process has reached
 its highest expression. But why does
 consciousness need to know itself in this roundabout way? Why can't it just
 sit in its own being's awareness of bliss and
 self-knowledge? The whole paradox of existence is tied up with that question.

The most frustrating and interesting aspect of quantum physics and the 
quantum view of reality is the paradoxes that are 
revealed by it. If you push knowledge inquiry in any direction, you run 
into the limit of paradox. And the essence of paradox 
is self reference. The reason you get into paradox is because you're trying 
somehow to refer to the thing that you're part of. 
So the old view that we are passive observers of a mechanistic universe
 doesn't work anymore. We're connected; we're part 
of the universe that is trying to understand itself. So you get into that 
endless loop of paradox like a dog chasing its tail. And 
all of that was initiated by consciousness attempting to know itself and in
 the process initiating a cycle of manifested
 existence. So the big bang was not the initiating event. The big bang was
 an effect of what I'd call the little itch.

What is that little itch? What is it that disturbed consciousness that led
 to all this? It was the primal craving. To me, if you try 
to trace the root of craving, you literally get tied up with the origins of
 the universe and the evolution of human 
consciousness. It's that fundamental. It's that much a part of our 
humanness. Not only is addiction universal not only are all of 
us in it but it's the essence of our being as humans. It's not something to 
be disowned. You can't do that, because addiction is 
part of our core being. It's part of who we are. Given that, what can we do 
about addictive behavior? I can think of only two
 things to do about it. The first is to try to move it, to try and shift it
 so that the forms of its expression are less harmful rather
 than more harmful. lt is better to be addicted to a twelve-step program
 than to be addicted to alcohol. It is better to be 
addicted to exercise than it is to be addicted to smoking. You can make
 those value judgments about addictive behavior. 
And that approach to addiction should not be discounted because, in fact, 
maybe that's the only thing that most of us can do.

The only other strategy is to try and get at the root of craving. The 
Oriental religions would have us believe that this is 
possible through intense introspection and meditation and practice. I'm not 
so sure of that. I think maybe you can go a long 
way - you can get way down there - but if the origin of craving is indeed
 tied up with the origin of the universe, then I'm not
 so sure that it can be uprooted. I think all you can do is do the best you
 can. I mean, go after it; try and contain it and 
understand it. The biggest mistake we can make is trying to disown it.

I don't think addiction is curable until the expansion of the universe
 reverses and we begin going back to a single point. But
 that should not be a source of despair. That's part of who we are. What we 
need to do is to accept that aspect of our 
humanness and work with it so that it's not destructive to ourselves or to
 other people. We also need to celebrate it for what 
it is. Because it connects us with all other people, it's a source of great 
compassion and great empathy. It's a motivation to 
work with others to try to halt the kinds of destructive behavior that are
 happening today. I can think of nothing more 
important than that.

So don't let your perspective about addiction be limited by one group's
 definition of it. It is the broadest and most important 
problem we face. It's something that all of us share, and it's what
 connects us to everybody and to the higher power. That's
 how it is."


     Some statetments from the group on this article: Make of them what you wish.
" You always lose something when you get something (even when what you get is something great)."


" We are always wondering about our beginning and the beginning of the universe. Likewise we are always questioning about the meaning of our life. The truth is that these are things that we can't understand. We are not capable of understanding. It is liberation to release this questioning and just accept that we can't know these things, because we are just human."


"God is in our protoplasm but it goes beyond that. God is in mind as well. Protoplasm is too material a statement."


 " Consciousness initiated time and matter in order to know itself."


"Everything in life is unsatisfactory. This creates an itch in us that needs to be satisfied. The Big Bang was the beginning itch, the primal craving. In order to satisfy this itch in all of us, addiction is the essence of our humaness. Any of these little itches can turn you into an unfunctional person if you pursue it. But you need to know you can always choose another plane -- a plane of peace, of meditation. You can always return to peace and you get better at it with practice.