Reality and Addiction: Neuroscientific and psychological perspectives
Alan Gijsbers, June 2008.

Author

Dr Alan Gijsbers MBBS FRACP FAChAM DTM&H PGDip Epi is Specialist Physician in Addiction Medicine; Head, Department of Addiction Medicine Royal Melbourne Hospital; Director, Substance Withdrawal Program The Melbourne Clinic; Chairman Victorian Addiction Inter-hospital Liaison Association; State Chairman ISCAST(Victoria); Immediate Past Chairman, Christian Medical Fellowship of Australia.

Abstract

Mind-altering drugs are purported to enhance reality. However, drug-affected patients describe addiction as unreality, and recovery as a return to reality. Neuroscience helps to clarify the difference between perception and reality. Our perceptions are selective and colour particularly the way we view, recall and rework our own narrative. This is partly due to the defence mechanisms we all employ. Their use need not be a sign of ill-health, but a sign of healthy coping. However some of our damaged patients have such a poor sense of themselves that they see their whole narrative very negatively. Insight relates to understanding our perceptive filters and making them truer to reality. It is now recognised that the emotions shape our reasoning and our perceptions. These defensive processes are well-narrated in John’s Gospel, which deals with human responses to the Light of the World.
Part of addiction recovery is for patients to develop a truer understanding of the reality of their own history. This involves overcoming their own fear and denial and coming to terms with the painful emotions invariably attached to these memories. More deeply they need to reframe their distorted view of themselves and see themselves in a truer light. Recovery involves knowing the truth about themselves, for in the light of that truth there is freedom.

Key words

Reality, addiction, neuroscience, perception, narrative, defence mechanisms, entheogens, pleasure, biopsychosocial model, complexity.

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