Accepting the raw elements of living

Addiction cuts across geography, economy, ethnicity and gender with little variation. In Never Enough, Judith Grisel considers why some people are spared addiction while others are unable to escape its grasp.

It is enlightening to gain insight into Grisel's own experience with addiction and the various interlocking contributing factors. She writes about a persistent sense of needing to escape reality, issues surrounding self-acceptance and lacking a sense of purpose – all of which contributed to her substance use. An overwhelming feeling of not achieving anything substantial or quickly enough, parallel to a sense of confusion that 'unaddicted' individuals were happy to 'fritter away' their lives taking part in meaningless activities such as watching the news and planning parties, all played a role.

These insights led me to reflect on the potential importance of mindfulness to encourage focusing on the here and now, and strength-based therapy for addiction. Strength-based therapy supports an individual to perceive their strengths as resourceful and resilient when in adverse conditions. This approach is client led and focuses on an individual's goal and how their positive characteristics can support them to achieve this goal. In short, strength-based therapy may allow an individual to regain a sense of purpose, capability and achievement.

Feelings of guilt and shame and a yearning for approval, love and support are recurring themes in the book. Support networks are important. Support should be person-centred, not overbearing, and given in a way that is wanted. Drugs are often sought as an external fix to suffering. But drugs are an unsustainable solution to the pains of living we all feel at some point or another due to a variety of reasons. The balance of certainty and safety but also excitement and development is difficult to achieve.

Despite alcohol initially offering an escape, Grisel refers to the brain's infinite ability to learn and adapt. She explains the inevitable 'b process' which ensures the enticing effect of a substance, be it a high or a sense of relaxation, is always counteracted by the brain to produce the exact opposite effect. This process explains tolerance, dependence and withdrawal. The beginning of the end of addiction for Grisel was the realisation that there will never be enough drug… what she was trying to achieve was unattainable. She sought wellness, but became sick, sought fun but experienced a constant state of anxiety and sought freedom but became enslaved. Despite this, drug use remained more appealing than being exposed to the raw elements of living.

Grisel posits that four factors contribute to addiction: an inherited biological disposition, copious drug exposure, particularly during adolescence, and a catalysing environment. Recovery is a process of expansion, not restriction, and we, as psychologists, have the potential to play an important role. A biopsychosocial approach to support is imperative.

In our connected world, we are all more aware of tragedy and suffering worldwide. Many of us feel isolated, despite having an array of 'online' friends. Our brains are tuned to appreciate and learn from experiences with others and the world. Connections with others, communication, music and dance are all areas to focus attention on when hoping to halt the spiral of addiction. Human connections help us realise change – regaining choice and a sense of fulfilment through a meaningful life. With this in mind, Grisel says, we are closer to a cure than any pill can offer.

Reviewed by Charlotte Beames, Assistant Psychologist, The Disabilities Trust

Never Enough: The Neuroscience and Experience of Addiction by Judith Grisel is published by Anchor Publishing (2019). ISBN1003855428 (ISBN-13: 978-0385542845)