We first encountered the neuroscientist and developmental psychology professor Marc Lewis when we read his captivating essay “The addiction habit” on Aeon. In this, he challenged the hugely influential disease model of addiction: instead of viewing addiction pathologically — as an illness — he argued in his essay (and in his most recent book, “The Biology of Desire”) that it’s something that’s learned, like a deeply ingrained habit.
In April, the now-retired prof chatted with us from his home in the Dutch city of Arnhem on Skype. The conversation has been edited for length and clarity.
Q > What patterns, routines, or rituals help to define or shape your life?
A > I guess [as a result of] being in academia for all those 35 or something years, argument and debate is a ritual that I value. The use of evidence, of logic, of moving from one perspective to another and trying to understand the relationships between perspectives — that kind of intellectual interaction is valuable to me and I try to keep it up. I guess the other thing is I really like connecting with people. I like intimacy and I like sharing. And I really like being honest — and I like it when people are honest with me.
Q > Now that you’re retired from the university, how do you fill your days — have you left the world of research behind?
A > I don’t have any funded research now… The research I do is online: it’s reading and writing and thinking and talking to people.
[Before retirement] I was very focused on research. I did clinical work on the side just a little bit, but mostly I was into academics and research. We saw clinical populations sometimes. We did EEG research, we looked at brain patterns of kids who had problems with anxiety and aggression and looked to see if that changed with therapy, for example.
I wasn’t doing the therapy but I was trying to understand how their brains might change before and after the treatment. So I’ve always been interested in clinical work [even though] I haven’t always done it.
I actually thought for many years that doing therapy again would be just incredibly frustrating and possibly even boring. And I’m not finding that at all. I’ve started doing it quite regularly, the last few years online; mostly with people in addiction. And I find it fascinating. I love it.
Right now I’m obsessed with this form of psychotherapy called Internal Family Systems Therapy. It’s a kind of psychotherapy that is a derivative of family systems theory, but the family’s all in here [Lewis points to his head]: it’s all about the kind of voices in our heads. And it looks at psychological conflict in terms of the conflict between different parts of oneself. It sounds so Byzantine and strange sometimes, but I just talked to a client for an hour [and] for him, the voices are absolutely real distinct and they fight and fight. They’re not in sync; they’re not on the same side.
Q > Is there any connection between those voices and disorders like bipolar or multiple personality disorder?
A > It’s not about multiple personality disorder or dissociative identity disorder, or any of that stuff. It’s about how the mind works.
I think that for people who have serious clinical problems — whether it’s addiction or other kinds of problems [such as] eating disorders, the dialogue can be more extreme; the differentiation of the parts from each other and from the self (whoever’s there in the middle) can be more extreme, but ever since I’ve started trying to examine this form of therapy, I’ve noticed my own parts better. And I spent 10 years in psychodynamic therapy years ago so I thought I knew all that stuff. But just noticing when they come online and what the hell does that mean? [Like when the] part of you from childhood comes online: what’s that mean? When you find yourself suddenly arguing with your spouse or whatever, it’s like… yes: you’re different — your younger self, your more anxious or more angry [self]… I think finding out about how to interact and connect with people and oneself is an endless process. Learning about how other people react — to oneself, to each other and to themselves — is an endless learning.
Q > Are there any fresh insights that have emerged from these therapy sessions?
A > The one I just shared with you is probably the one uppermost in my mind right now: that people have different parts of themselves that are not necessarily coherent or synchronised or integrated. You see that in addiction a lot when people say “I had such a strong craving; I couldn’t stop it; I just really wanted to get high.” And that was the end of that. People call that their addict self. And then we all know about the critical voice parent-self; most people that you talk to can identify with the part that scorns you and says, “You shouldn’t have said, or you shouldn’t have done that.”
So there’s a couple of voices. But in addiction, it can be obviously very destructive when people’s behaviour is strongly guided by a part of themselves that has a really hard time connecting with the rest of themselves. And there are good reasons for that. There’s something undetected and hidden, or they just don’t imagine or trust or anticipate that there’s anything else out there than the drug or whatever it is.
So that’s been a real eye opener for me. And using this kind of therapy with looking at internal voices has been very useful.
Q > Do you think it’s those internal conflicts that can trigger the addiction in the first place?
A > That was the case for me. When I look back on my own years of addiction, it was like at first I really didn’t care about the other parts of me that were being a good boy and doing well at school and all that stuff. I just wanted to get high and get out of myself. And a lot of people describe their experiences that way. But what happens when that part of you develops a kind of resistance to change? And I don’t want to say “takes over” — I mean, it’s not an automaton that lives inside of your brain but it’s loud and it can be kind of hived off so that it doesn’t have a chance to learn.
Q > And it blocks the other parts of you from learning?
A > Yes, and not only that, but it feeds the criticism and the shame — basically the agonies that you’re trying to escape from. So, there’s a horrible feedback loop right in the middle of it: what you’re doing to make yourself feel better is actually making you feel worse…
Q > Tell us something you can’t easily forget.
A > After I had been kicked out of grad school because of a criminal conviction when I was taking a lot of drugs and I finally got back into grad school, I was very insecure about it and I thought, “Oh, I don’t know if I can make it; I don’t know if they’re going to accept me; I don’t know if this is for me.” The first term paper I wrote I worked very hard on. And the professor came trundling down the hall with the paper in his hands and he said, “This is the best paper I’ve ever read! I wish I could give more than an A plus!”
And I was like, “Oh wow, really?!”
Q > You were faculty at the University of Toronto for over two decades before moving to Arnhem in The Netherlands in 2010. How do the two cities stack up?
A > I love the quiet here. Arnhem is a city of about 150,000 — it’s not tiny — but we’re kind-of on the outskirts. And we just got lucky. We found a nice house that we could never have afforded in Toronto, probably. Life has a rhythm to it and it’s quiet… When I want to go downtown, I get on my bike — that’s all; everybody bikes. What a great way to get around, right? In Toronto it’s asking for suicide. I like it [here]. I can work here pretty well and I’m working quite consistently.
We’re moving back to Toronto this summer — that’s the plan, Covid permitting. Toronto is a really big city and it’s become more commercial, competitive, noisy, crowded, et cetera. like it’s trying to be kind of a Canadian New York or something [which] doesn’t appeal to me. Here it’s peaceful and there’s a lot of greenery. I can see cows across the river, when I look out my window. I mean, that’s amazing.
But our boys are very excited. They want to be in the big city and Toronto is the big city.
Q > Which areas of the study of addiction do you think are breaking new ground?
A > The introduction of MDMA (ecstasy), psilocybin and ketamine into psychiatry is a huge change. I imagine 20 or, 30 years from now, people are gonna have a lot more control over what kind of substances they decide to use and then education and knowledge and context and setting is going to be considered much more important than whether or not you’re using a certain drug.
I think more and more in the West, people are beginning to recognise there is very little connection between taking psychedelics for self-enhancement and exploration and alcohol for social lubrication and heroin or opiates for soothing.
Q > Do you think that there will be greater scepticism about the disease model?
A > There’s a number of people who are progressive like I am, who argue against the disease model — such as Bruce Alexander. But even Nora Volkow, the famous neuroscientist and head of the National Institute on Drug Abuse who’s been the queen of the disease model for ages has also come down off of the kind of high church “addiction is a brain disease” model platform and has recognised the social, economic and developmental factors that strongly affect how and whether, and when people become addicted, differences in people’s addictions and the possibility of recovery — which she never used to talk about.
Those of us who are more progressive — the first thing we say is that most addicts recover. And that’s becoming part of the accepted dialogue. As a progressive evolutionary journey, addiction is just one stage or one phase or one facet. So if you call addiction a brain disease, it completely cuts across that sort of thinking.
Q > Do you think this will lead to a more enlightened approach to addiction overall?
A > People become addicted to drugs and other things when they can’t find something, a source of value and meaning available in their lives that can be far more flexible, open, fun and interesting and exciting. I don’t think there’s a lot of recognition that people become addicted to drugs when they’re lonely and helpless. And if that recognition isn’t there, addiction is not going to go away, or get better. Societies have to change — social support has to be available for people who are in trouble.
With the political upheavals happening around the world, you get great advances in one place and then other places start swinging to the far right. And it’s hard to be completely optimistic. On the other hand, with cannabis legal in Canada and increasingly so in the US — and with more acceptance of psychedelics and ecstasy and so forth… That’s a step in the right direction.
Q > Are there any drugs that you use now — at the age of 69?
A > I don’t drink to excess, but I do drink Scotch and red wine. And, I take kratom sometimes, which is a herb — a mild stimulant, relaxant and mood enhancer. That’s pretty much it, these days, occasionally I take recreational drugs, but it’s more and more occasional the older I get. Oh, I should mention, I have taken psychedelics recently. I kind of forgot. A few Ayahuasca trips in the last five or six years and, a few months ago, DMT. I’ve only taken it once, but I found the experience just tremendously uplifting. It’s not the kind of thing you do very often; it’s a kind of exploration when you do that.
Q > When it comes to drugs, what’s your approach as a parent?
A > My kids are 14. I want them to stay away from drugs completely for the next three to four years, ideally; it probably won’t last that long. And then, when they do start to experiment, I want them to be wise and careful and knowledgeable. I can maybe help them with that.
Marc Lewis is a neuroscientist and recently retired full professor of developmental psychology, at the University of Toronto from 1989 to 2010, and at Radboud University in the Netherlands from 2010 to 2016. He is the author or co-author of over 50 journal publications in psychology, cognitive science, and neuroscience, editor of an academic book on developmental psychology, and co-author of a book for parents. His two two books on the science and experience of addiction are Memoirs of an Addicted Brain (2011) and The Biology of Desire: Why Addiction is Not a Disease (2015).
