9 Questions with Dr. Carl Fisher, author of The Urge, on the disease model, addiction supply industries, the difference between faith and hope, and the history and future of recovery
My biggest takes aways from this interview are 1) the concept of writing a proud history and 2) faith instead of hope. Writing a proud history is not a new idea - I have written letters to my future self before for example - but a "proud history" feels more profound. I am still going through the "worst year of my life" and I'm really struggling, writing a proud history of this time feels like it might be just the thing, or something, that I could do to lay some bricks on my path through this.
Pema Chödrön talks about hope as attachment. Dante wrote "abandon all hope ye who enter here" on the sign that stands at the entrance to the gates of hell in his Divine Comedy. It took me a while to accept this concept but I stuck with it and I get it now. Hope whiffs of desperation, pleading, hopelessness, attachment, victim. It is an awful, far more familiar place than I would like to admit. Tweaking the dial to faith feels held, supported and encouraged. Faith makes me feel like I can trust myself and the universe I live in. Faith feels like light in the dark whereas hope feels like darkness waiting for light to come and save it.
Holly, I really loved this interview with Dr Fisher and I knew I would because his book is both profound and concerning in so many ways. I will have to re-read this a few times and reflect further but this quote is really what stood out for me, “ I have faith that humans can change, that we can recover, and we can work for meaningful change in our communities.” The conversation about the notion/term of alcoholism as disease is one that I’m not sure where I land on. As someone new to recovery, I am thankful that my treatment is covered by insurance which is likely due to it being coined as a disease. On the other hand, the stigma that it creates as “other” is hard to swallow. I appreciate what Dr Fisher said regarding that anyone is susceptible to addiction and I need to ponder that a while longer. On the face, I agree, given access to substance/behavior, lack of other coping skills, stress; that feels fair. I think it’s a pretty radical notion though and one that most may disagree with. Thank you for the thought provoking interview!
So so so much good stuff in this interview. Let's just stop and appreciate for a moment a doctor, a psychiatrist speaking candidly about his own personal experience with addiction, as well as offering, from his own inside baseball perspective as a medical professional: "Even more importantly, treatment is only one part of the puzzle—medicine alone is insufficient to respond to the challenge of addiction." Medicine alone is insufficient to respond to the challenge of addiction. That feels like a huge statement. And also in writing the book: "The scope and enormity of the problem is soothing to me." Me too!!! And YES to, instead of framing addiction as a special kind of sickness, seeing it as an everyday human problem. What is so interesting to me: with all the completely limiting, unhelpful, and noxious ways humans have framed the phenomenon of addiction over thousands of years, this marrying of the American ideal of hyper-individualism with viewing addiction as a brain disease/lack of willpower seems to be the epitome of an extremely corrosive, shaming, and damaging framing of the whole issue, perpetuating so much suffering on top of suffering - thus the issue of needing to "undo" so much of our thinking around all of this. To include another reference to Buddhism - we've gotten ourselves into a kind of "Hell Realm" with the way we've come to think of it, and kudos to Dr. Fisher for lighting a lamp to highlight all the nuance and complexity surrounding addiction and offering faith that there is another way to come at all of this.
I really appreciated this take on addiction, and ending with exquisite compassion for one’s self to reduce harm one self and others is impactful and fills me with love. 💕
Highly thought provoking and I too will need to ponder and re-read. American hyper individualism is part of it , but capitalism itself is founded on ‘insourcing’ profits and ‘outsourcing’ the social, health and environmental costs of making those profits. This is the ‘free’ market in action and why we are facing catastrophe on several fronts - climate, well-being, peace.
I enjoyed reading the interview. I too have been confused about why the disease model feels bad. I like thinking about it as one aspect of the bigger picture. It always felt like an excuse to me and disregarded the fact that anyone can become addicted. The idea of connecting addiction to suffering and recognizes that (most) everyone experiences some level of suffering really speaks to me. Looking forward to listening to the podcast on Wednesday. Thank you Holly.
The last part of the interview reminded me of one of my favorite reflections on hope by Vaclav Havel - "hope is an orientation of the spirit". I learned of it at my first post-college job. I worked at an AIDS service org and my boss would often include an excerpt in her remarks at our events... I think she had seen it taped to the refrigerator of a friend who died of AIDS:
". . . [T]he kind of hope I often think about (especially in situations that are particularly hopeless, such as prison) I understand above all as a state of mind, not a state of the world. Either we have hope within us, or we don’t. . . . Hope is not prognostication. It is an orientation of the spirit, an orientation of the heart... Hope, in this deep and powerful sense, is not the same as joy that things are going well, or willingness to invest in enterprises that are obviously headed for early success, but rather an ability to work for something because it is good, not just because it stands a chance to succeed. The more unpromising the situation in which we demonstrate hope, the deeper that hope is. Hope is not the same thing as optimism. It is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out. In short, I think that the deepest and most important form of hope, the only one that can keep us above water and urge us to good works, and the only true source of the breathtaking dimension of the human spirit and its efforts, is something we get, as it were, from ‘elsewhere.’ It is also this hope, above all, that gives us the strength to live and continually to try new things, even in conditions that seem as hopeless as ours do, here and now.”
I so loved this interview. I have had his book since it came out, but thesis writing has taken over. I am going to have to etch some time out to start it this week because I love what he has to say so far. Thank you so much for sharing Holly!
I save all mail from you. Why isn’t is possible to highlight in newsletters?!? Or am I missing something?
A few of the gems:
… unless you are completely free from suffering, you have some addiction in you.
… to realize I’m not sick in some extraordinary way.
… They are not interested in the issue of addiction as a problem of sickness or disorder, but as an everyday human problem
I have faith that humans can change, that we can recover, and we can work for meaningful change in our communities.
We can do tremendous good just by working on stopping harm to ourselves and to others—it’s a beautiful and noble thing, and it should be celebrated.
Shunryu Suzuki Roshi: “to shine one corner of the world–that is enough. Not the whole world. Just make it clear where you are.”
My biggest takes aways from this interview are 1) the concept of writing a proud history and 2) faith instead of hope. Writing a proud history is not a new idea - I have written letters to my future self before for example - but a "proud history" feels more profound. I am still going through the "worst year of my life" and I'm really struggling, writing a proud history of this time feels like it might be just the thing, or something, that I could do to lay some bricks on my path through this.
Pema Chödrön talks about hope as attachment. Dante wrote "abandon all hope ye who enter here" on the sign that stands at the entrance to the gates of hell in his Divine Comedy. It took me a while to accept this concept but I stuck with it and I get it now. Hope whiffs of desperation, pleading, hopelessness, attachment, victim. It is an awful, far more familiar place than I would like to admit. Tweaking the dial to faith feels held, supported and encouraged. Faith makes me feel like I can trust myself and the universe I live in. Faith feels like light in the dark whereas hope feels like darkness waiting for light to come and save it.
Holly, I really loved this interview with Dr Fisher and I knew I would because his book is both profound and concerning in so many ways. I will have to re-read this a few times and reflect further but this quote is really what stood out for me, “ I have faith that humans can change, that we can recover, and we can work for meaningful change in our communities.” The conversation about the notion/term of alcoholism as disease is one that I’m not sure where I land on. As someone new to recovery, I am thankful that my treatment is covered by insurance which is likely due to it being coined as a disease. On the other hand, the stigma that it creates as “other” is hard to swallow. I appreciate what Dr Fisher said regarding that anyone is susceptible to addiction and I need to ponder that a while longer. On the face, I agree, given access to substance/behavior, lack of other coping skills, stress; that feels fair. I think it’s a pretty radical notion though and one that most may disagree with. Thank you for the thought provoking interview!
So so so much good stuff in this interview. Let's just stop and appreciate for a moment a doctor, a psychiatrist speaking candidly about his own personal experience with addiction, as well as offering, from his own inside baseball perspective as a medical professional: "Even more importantly, treatment is only one part of the puzzle—medicine alone is insufficient to respond to the challenge of addiction." Medicine alone is insufficient to respond to the challenge of addiction. That feels like a huge statement. And also in writing the book: "The scope and enormity of the problem is soothing to me." Me too!!! And YES to, instead of framing addiction as a special kind of sickness, seeing it as an everyday human problem. What is so interesting to me: with all the completely limiting, unhelpful, and noxious ways humans have framed the phenomenon of addiction over thousands of years, this marrying of the American ideal of hyper-individualism with viewing addiction as a brain disease/lack of willpower seems to be the epitome of an extremely corrosive, shaming, and damaging framing of the whole issue, perpetuating so much suffering on top of suffering - thus the issue of needing to "undo" so much of our thinking around all of this. To include another reference to Buddhism - we've gotten ourselves into a kind of "Hell Realm" with the way we've come to think of it, and kudos to Dr. Fisher for lighting a lamp to highlight all the nuance and complexity surrounding addiction and offering faith that there is another way to come at all of this.
I really appreciated this take on addiction, and ending with exquisite compassion for one’s self to reduce harm one self and others is impactful and fills me with love. 💕
Highly thought provoking and I too will need to ponder and re-read. American hyper individualism is part of it , but capitalism itself is founded on ‘insourcing’ profits and ‘outsourcing’ the social, health and environmental costs of making those profits. This is the ‘free’ market in action and why we are facing catastrophe on several fronts - climate, well-being, peace.
I enjoyed reading the interview. I too have been confused about why the disease model feels bad. I like thinking about it as one aspect of the bigger picture. It always felt like an excuse to me and disregarded the fact that anyone can become addicted. The idea of connecting addiction to suffering and recognizes that (most) everyone experiences some level of suffering really speaks to me. Looking forward to listening to the podcast on Wednesday. Thank you Holly.
Ordering today! Thanks Holly!
This is EXCELLENT! I'm getting this book! The last paragraph especially moved me. Thank you so much. ❤️
The last part of the interview reminded me of one of my favorite reflections on hope by Vaclav Havel - "hope is an orientation of the spirit". I learned of it at my first post-college job. I worked at an AIDS service org and my boss would often include an excerpt in her remarks at our events... I think she had seen it taped to the refrigerator of a friend who died of AIDS:
". . . [T]he kind of hope I often think about (especially in situations that are particularly hopeless, such as prison) I understand above all as a state of mind, not a state of the world. Either we have hope within us, or we don’t. . . . Hope is not prognostication. It is an orientation of the spirit, an orientation of the heart... Hope, in this deep and powerful sense, is not the same as joy that things are going well, or willingness to invest in enterprises that are obviously headed for early success, but rather an ability to work for something because it is good, not just because it stands a chance to succeed. The more unpromising the situation in which we demonstrate hope, the deeper that hope is. Hope is not the same thing as optimism. It is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out. In short, I think that the deepest and most important form of hope, the only one that can keep us above water and urge us to good works, and the only true source of the breathtaking dimension of the human spirit and its efforts, is something we get, as it were, from ‘elsewhere.’ It is also this hope, above all, that gives us the strength to live and continually to try new things, even in conditions that seem as hopeless as ours do, here and now.”
Disturbing the Peace, pp. 181-182
I so loved this interview. I have had his book since it came out, but thesis writing has taken over. I am going to have to etch some time out to start it this week because I love what he has to say so far. Thank you so much for sharing Holly!