As a young boy, I remember venturing out on summer evenings to play hide-and-seek with the other neighborhood kids. We made up teams, sought out secret hiding places, and took full advantage of the local woods that surrounded our corner of the world. Our parents all knew each other, and while we were expending our energy running around in the dark playing games, they were talking around tables and sharing food and drink. There was no internet, cell phones, or other multimedia distractions competing for time. Life was simpler, slower.

Now, more than thirty-five years later, I find myself married with a young son and challenged to provide him the same care-free childhood that I experienced. Despite living in a pleasant, middle-class neighborhood, it is rare to see large groups of kids playing together outside. There are no local woods within walking distance, and even if there were, most parents (myself included) would be hesitant to allow their children to play unsupervised. Although everyone I encounter on my daily dog walks is friendly, there is a lack of deep intimacy among neighbors. Some have never even met despite living within blocks of each other for decades.

The stark contrast between life today and just a few decades ago is surreal. The year I was born the handheld calculator was invented, and today, handheld devices are minicomputers capable of video-conferencing around the world. But for all the benefits technology affords, there is a cost that gets lost in the frenzy of Facebook, YouTube, and Amazon.

In 1985, researchers set out to understand the degree to which people have family and friends they can rely upon to discuss matters that are personal in nature. A national survey was done, and in 2004, the same group decided to repeat the study to determine how core discussion networks had changed over two decades. The results are frightening.

• 25% of all Americans in 2004 reported they had no one in their life to discuss personal issues, compared to 10% in 1985
• The modal (most frequent) number of discussion partners in 1985 was three, but in 2004 that number plummeted to zero
• The average social network size has dropped from 3 confidants to 2
• The number of people who reported that their spouse was the only person they trust with personal issues increased by almost 50 percent since 1985

These outcomes paint a sobering picture of the price we may be paying for our technology-enhanced life. The lead researcher has said, “we know these close ties are what people depend on in bad times. We’re not saying people are completely isolated. They may have 600 friends on Facebook.com and email 25 people a day, but they are not discussing matters that are personally important.”

Source: Social Isolation in America: Changes in Core Discussion Networks over Two Decades, American Sociological Review, June 2006 71:353-375

“Addiction in the modern world can be best understood as a compulsive lifestyle that people adopt as a desperate substitute when they are dislocated from the myriad intimate ties between people and groups – from the family to the spiritual community – that are essential for every person in every type of society.”

Bruce K. Alexander, The Globalisation of Addiction: A Study in Poverty of the Spirit

In the previous post I discussed how adverse childhood experiences (ACEs) to a large extent play an important role in the development of addictions. Given that over 80 percent of those who develop addictions begin adaptive behaviors to cope with ACEs prior to the age of 15, we as a society need to place a greater emphasis on identifying at-risk kids and intervening as early as possible. But there is another insidious root to addiction that I believe goes beyond individual ACEs and plays an even greater role in the development of addiction – free market society.

Bruce K. Alexander spent decades as a distinguished addiction researcher in Canada before becoming so frustrated by a lack of progress in helping those who struggle, that he completly changed careers and decided to focus on teaching history instead. Despite doing everything he could to avoid topics around drugs and addiction, the more he studied history, the more he discovered insights that began to change his entire perspective on the nature of addiction.

In general, when we think about addiction, we think about it as an individual problem. Individuals are exposed to a host of risk factors, including ACEs, peer group influences, and the availability of objects of addiction in communities. The more risk factors an individual is exposed to, the more likely the chances are that he or she will develop an addiction. Conventional wisdom also suggests that the antidote to addiction is intervention and treatment. But when Dr. Alexander began studying history, he discovered cultures and societies where common objects of addiction were present (drugs, alcohol, sex, food), yet addictive behavior was minimal or nonexistent. ”Addiction can be rare in a society for many centuries, but can become nearly universal when circumstances change – for example, when a cohesive tribal culture is crushed or an advanced civilisation collapses (Alexander, 2008).” Throughout history, the primary factor responsible for the societal change leading to pervasive addiction is the introduction of free market society. Why?

When a society introduces free markets, exchange of goods and services optimally are not encumbered by family ties, cultural traditions, religious values, or anything else that may impede free play of the laws of supply and demand. In other words, free markets create an “every man (or woman) for yourself” dynamic that puts me in competition with everyone else for jobs, insurance, a house, goods, services and Lady Ga Ga tickets. One consequence of this system is that people become dislocated, or disconnected from one another because of the time and energy necessary to keep up with the Jones. Free markets are incredibly profficient at knowing how to keep people focused on stuff over experiences. Flashy ads, mass media, and the latest gizmo from Steve Jobs keeps us always wanting more. In the pursuit of the American dream, what many get instead is isolation, fear, and dislocation, which ultimately leads to compulsive lifestyles where people develop addictive relationships to stuff and get further and further disconnected from nurturing human relationships.

Dr. Alexander’s Dislocation Theory of Addiction is well documented in a paper titled The Roots of Addiction in Free Market Society (highly recommended reading) and a more extensive read: The Globalisation of Addiction: A Study in Poverty of the Spirit. His work is extremely important in helping us all understand many of our current societal ills beyond addiction, including: divorce, single parenthood, children in poverty, obesity, unemployment, and excessive time in front of the TV. Until we as a society place relationships and experiences over materialism, consumption and stuff, Thoreau’s observation that ”the mass of men lead lives of quiet desperation” will ring ever more true.

What is the solution to mass dislocation? I believe part of the answer lies in making some tough societal changes including ending the senseless war on drugs (a big topic for another time). But for the individual struggling right now with addiction, the answer is much more about restructuring life in a way that emphasizes relationships over stuff. To do this, one must have the developmental  capacities necessary to know how to initiate, develop, and maintain healthy human relationships.

Dr. Sandra Bloom is a psychiatrist largely responsible for the creation of the Sanctuary Model, which is both a framework for treating trauma, as well as an organizational change model that integrates evidence-based trauma interventions with the benefits of therapuetic communities. The brillance of this model is that it optimizes the safety and healing of all parties involved in social systems of care: patients and clinicians, prisoners and judges, victims and advocates, addicts and counselors. It is a model, in my opinion, that is applicable across all organizations no matter what their purpose, because it provides a roadmap for how humans should treat one another, no matter what position they may find themselves in.

Why do we need it? Because most social/healthcare service organizations are in crisis. U.S. healthcare problems were detailed in a number of publications by the Institute of Medicine, with outcomes indicating that the U.S. has the most expensive healthcare system in the world, yet ranks far down the list in terms of overall quality. But it is not just our healthcare system that is in dire need of overhauling. Our education, criminal justice, mental health, child welfare, and…yes, our addiction treatment system are all struggling to meet the needs of the populations they serve. The Santuary Model suggests that the problems are rooted in unhealthy systems, not individual people. If we understand the system, we then stand a chance of making changes within the system that ultimately translate into better outcomes for all involved.

Across the different social systems, the problems are similar: reduced funding, decreased training and education, more paperwork, more surveillance and  micromanagement, greater staff turnover, and lots of stress across all levels of organizations. These factors then translate into organizations that are chronically stressed, attempting to do more with less, always operating in a reactive/crisis mode, ultimately leading to folks being chronically hyperaroused. In this state, it is like Brian Farraher, CEO of Andrus Children’s Center has said, “Managing like your hair is on fire.”  Stress leads to a loss of basic safety and trust, a breakdown of emotional intelligence, behaviors that result in more conflict, and staff who feel disempowered. As relationships become strained, more autocratic approaches to leadership (counseling/healthcare/justice) emerge, and then folks just stop talking. In essence, organizations stop learning. The outcomes are costly for all involved.

The Santuary Model is the antidote. It acknowledges that stress, trauma…life problems, exist not only in the clients who show up for help (or are mandated for help), but also in the helpers. The served and the servers are mirrors of each other, and both require focus and attention on seven commitments:

Implementing the Sanctuary Model in organizations, and incorporating the commitments into all of our lives, means embracing our responsibility to the common good of all people, to our future, to our planet. The details of the commitments, and how best to implement them are documented on the Sanctuary Website and in Creating Sanctuary: Toward the Evolution of Sane Species.

If we ignore the warning signs so clearly right in front of us, “Human history becomes more and more a race between education and catastrophe.” HG Wells, Outline of History, 1920

This past week I had a few minutes to spare in Washington DC, so I dropped by the National Geographic Society headquarters and discovered a project that has significant relevance to successfully solving the problem of addiction. Writer and photographer Dan Buettner embarked on a journey around the globe in search of communities that optimized lifestyle for longevity and happiness, places he calls blue zones.  He boiled down his research for the book Blue Zones into principles for living a long and prosperous life. Here is a great summary of the book he did for TED:

For those who struggle with addiction, the keys outlined in the book (and the speech above) provide a road map for translating the MRC solution into reality. Let’s look at how they line up:

Manage
Successfully dealing with addiction requires identifying those things in your life that are chronic issues, and then developing strategies that appropriately keep these things in-check. When we expect to permanently solve a chronic problem we set ourselves up for failure because there is no cure or end to these issues, they require ongoing attention. Addiction, diet, chronic medical issues, time and exercise are all things we must learn to successfully manage. In Blue Zones, the keys that line up with manage include:

• Learn to move naturally. Those who live to be 100 rarely engage in rigorous exercise. Instead, they incorporate  walking, gardening, yoga and other less body-stressful movements into their daily routine. Developing a healthy lifestyle free from addiction necessitates learning to move in the world in a new way, in a natural, physically and emotionally pain-free way.
• Slow down. Our culture perpetuates addictive behavior by encouraging lifestyles where multi-tasking, reliance on technology, and instant gratification become packaged in a speedaholic existence. Not so for those who live in blue zones. An important aspect of successful long-term management of addiction is learning to slow down, become conscious of how you spend your time, and align it with what is most important in your life.
• Eat and drink wisely. Food and drink are common objects of addiction, and although abstinence from alcohol is possible, we cannot stop our relationship with food. The same goes for those who struggle with sexual addiction. It is not possible to remain abstinent from sex, we are sexual beings by nature and healing requires finding healthy ways to express our sexuality. The key is moderation, balance, and of course, eating more fruits and vegetables. Red wine has also been shown to increase longevity, but if it creates more problems than benefits (e.g., abuse, relapse) it should not be on your list.

Resolve
There are some life problems that we should not manage, but solve, permanently. Homelessness, debt, acute pain, many developmental constrictions/deficits, legal problems, and suicide ideation. None of these things are healthy to manage over a long period of time, and our work should focus on resolution. Two significant problems most addicts need to resolve are lonliness and isolation. The key that lines-up with resolve is:

• Be Connected to Others. Those who live the longest put family and loved ones first. They belong to communities that nurture and protect each other. Many share their spiritual faith in community, and hang out with people that have healthy habits, both physical and emotional. I have written a lot about how the essence of solving the problem of addiction is disconnecting from object-relationships and learning to engage in healthy, intimate connections with people. But to do this very often requires resolving barriers to human relationships. These barriers include unresolved trauma that lead to isolation, developmental stuck points, and debilitating shame and grief. This work is not easy, but necessary for relationships to blossom.

Create
Many who struggle with addiction spend all their time on the pathological side of the equation. Treatments, interventions, fixes, cures, treatments….all intended to reduce or stop addictive behavior. This stuff is important, but at the same time it needs to be integrated with actions that optimize life.  Sometimes taking a break from intervening on addictive behavior and directing energy to what we want out of life can actually produce the outcomes we seek. Those who live in blue zones:

• Have a clear purpose. They call it “ikigai” – the reason for which you wake-up in the morning. If your ikigai is that you don’t want to drink, smoke,  or act-out today, well…this is not a very compelling reason to get out of bed, it just gets you to focus on what you don’t want! The key is redirecting your life energy towards creating what you do want.

For additional information on blue zones, checkout the author’s website: bluezones and the book.