INTRODUCTION

I used to feel insecure about working with addiction.  Too much had been written about it (2).  There were too many kinds.  I knew something (though not enough) of my own addictive patterns, and something (often too much) of those of my family, friends, colleagues and clients, yet little to link them had emerged.  I was in a tangle - exactly the sort of metaphor that my addictive clients came up with to describe themselves.  (Figure 1)

The last couple of years of research has helped me exorcise my addictive ghosts.  This 3-part paper is not about particular addictions, but about deconstructing the addictive process.  By 'deconstructing' I don't mean literary analysis of the meaning of words (though that will be touched on in Part II), but separating out mental confusion.  My Uncle Albert had a reputation for fixing things - steam irons, vacuum cleaners, that kind of thing.  He confided in me that it was no great skill.  He simply took things apart and remembered where the screws went.  This paper is more or less about that.
 
 

Part I

Let me come clean.  I'll be offering some opinion and speculation here and there, and it's only fair that you know where it comes from.  My personal therapy was psychodynamic (Jungian).  Early training was analytical and humanistic, followed by neuro-linguistic (NLP).  Influenced by my wife's transpersonal model.  I've specialised in metaphor therapy over the last 5 years or so, and David Grove's model of clean language symbolises my beliefs and values about psychotherapy and the politics of change (3).

1.  UNDERSTANDING ADDICTION

First I had to accept that addiction is not just about a substance or an activity, but about society.  We learn addiction.  Any one of our everyday addictions - to drugs, sex, gambling etc - is to me a metaphor for our primary addiction to the structures of authority and conformity in our lives which curb self-determination and foster dependency.

Keeping these patterns in place is what addiction counsellor Tina Stacey calls 'a network of supplementary dependencies'.  People-pleasing, for example.  Our need for approval.  It's easy to get approval: follow precedent.  I was brought up to be sexist, racist, homophobic and hierarchic, in a society which trained me as a technician to oil its wheels and help it run smoothly.  To fit in, I acquiesced (4)

'Addiction'/'therapy'/'client'

That is the political context of this paper.  When I use the word 'addiction', I shall be alluding not only to the usual suspects under the opening title, but also to our systemic dependency on external authority which keeps our authentic selves under lock and key.

And when I use the word 'therapy' I intend to discriminate between traditional psychotherapy, the effect of which has been to control the codependent relationship with the client through the use of interpretation, suggestion and the illusion of omnipotence (thereby reinforcing systemic dependency) (5), and postmodern psychotherapy, which aims to enable self-generated change and is an instrument for the transformation of society (6).

And when I use the word 'client' I mean me.  You.  Any of us who want to free ourselves and create another reality.

"I ought to have done so much more.  And what about those who didn't even do that?  Those who called out the name of the president with erotic passion, who slobbered over his photographs as if they were icons, who were obedient and tame victims, but also brutal hangmen?  Right now we need self-knowledge and Serbian denazification.  Otherwise we're doomed forever."  (Biljana Srbljanovic, Serb playwright, May 99)

Victim-Persecutor

The victim-persecutor codependency is a prime example of systemic addiction.  Each part needs the other for it to persist.  Milosevic plays persecutor to loyal Serbs who become victims, who in turn become persecutors to dissident Albanians who become victims ... (Figure 2)

Rescuer

And so on until a rescuers appears.  What happens now?  The codependency extends.  Nato plays rescuer to victim-Albanians, and in so doing becomes persecutor to persecutor-Serbs, who become victims in turn ...  Are we doomed forever?  (Figure 3)

"Addiction is the fibre of our society.  It produces the victim-persecutor-rescuer cycle in which victims are addicted to having persecutors to blame, and persecutors are addicted to blaming victims.  Victims seek willing rescuers, and each becomes addicted to the other.  Persecutors now have rescuers to blame, and rescuers become victims in turn.   Between us we produce a vicious circle of codependency that justifies nothing but itself."   (psychotherapist Laurena Chamlee-Cole)

Indeed, rescuers blame persecutors while telling victims they need help, which turns persecutors into victims and keeps victims as they are ... and so it goes on.  It's not only Serbs who need self-knowledge.  A Balkan dictator may have been a convenient reflector for our worst projections of ourselves, but we cannot displace our own responsibility for the democratic system which extends these tragic triangles of codependency (7).

Institutionalising

Psychotherapy is not immune from the addictive disease.  Just as spirituality became systemised into religion, the practice of psychotherapy became systemised into institutions and procedures perpetuating what Anne Wilson Schaef (a 'recovering psychotherapist') calls 'the illusion of control and the myth of objectivity'.

The odd thing is that in this era of the search for a postmodern unity of science and healing, we are seeking to extend and legitimise these archaic structures of control.  I can only see this serving to codify the imbalance of power in the codependent relationship that exists between most therapists and their clients.  Institutionalising the human potential movement is an oxymoron - a contradiction in terms which (literally) points to its own foolishness.  In the context of our addictive society, however, I suppose it will be well-supported.

You may say that cycles of dependency like this are none of our fault, that we're only playing the hand with the cards we were dealt.  Well, one way into recovery is to stop playing the game, or at least change the rules.

Denominalizing

To get out from under my own addictions, I needed to denominalize the word (8).  'Addiction' is an academic subject.  Addictive behaviour is something we do. 

If addicting is a behaviour, then it involves choice.  Addiction is not something we catch unwittingly, like flu.  And as choice is centred in the individual, addicting has to be different for everyone.  Every human being is unique in what they do and feel, its prompts, effects and underlying patterns.  Addiction doesn't in itself define addictive individuals.

Abusing

It also helped me to correlate addiction with abuse.  Addictive behaviour is abusive behaviour.  Abuse may not be the aim, but therein lies addiction's 'double dysfunction'.  The act does not serve the intent.  The intent is to relieve pain, but the effect is to generate pain.  This corrupts not only the lives of the sufferers, but also the lives of those who suffer with them.  At its mildest it may only mean the addict is a bugger to live with on occasion.  At its worst addicting may gather despair and degradation around it and end in death.

Unexceptional

Finally in my attempts to deconstruct addiction I realised that those of my clients who were addictive had other problems too.  A compulsive gambler had a low anger threshold.  A chocolate addict suffered from dyslexia.  A lifetime smoker defined himself as a rebel against conformity.  If once I had perceived addictive clients as esoteric, I now saw them as unexceptional.

The fact of their addicting gave them something in common, but there was more that made each unique.  And just as I have learnt there is no one way of working with those other grand nominalizations 'schizophrenia` and 'depression`, I now know there is no one way of working with 'addiction'.  There is, I believe, an underlying structure to the addictive process, but approaches to treatment and recovery emerge naturally from considering the needs and patterns of individual clients.

The quest

Are we addicts seeking God?  Or are we all on a search for serenity?  Someone told me that addiction is an attempt to compensate for inadequate breast-feeding.  Someone else told me it aims to reinstate abundant breast-feeding (9).  Others believe that 'addictive personalities' are on a predestined path to a predetermined end, and nothing will stop them (10).

The primal wound

Most of the research I have come across agrees that whatever other factors may be involved, most addiction is associated with early trauma, so I subscribe to the transpersonal view which says that addiction is aimed at resolving or distracting unresolved need.

Crucial to my personal understanding of addiction was my experience of annihilation.  As a child I`d been left by my mother and felt the terror of 'non-existence' which transpersonal therapists identify as the state underlying all addiction.  Fear of non-being is not a fear of death.  Alcoholics and drug addicts prove time and again that pain or life-threatening illness is not enough to deter them.  What drives them is something darker than death - an intimation of the extinction of self while alive.  Overwhelming feelings, consciously recognised or unconsciously stored, of abandonment, powerlessness, hopelessness, worthlessness, insignificance.

In this scenario, addicting is a desperate response to the spectre of isolation and alienation that haunts the human condition.  It begins simply as a means of seeking compensatory positive experience.  The effects manifest in psychopathological patterns unique to every individual, but we can generalize: early abandonment may prompt a search for a better sense of belonging through relationship; powerlessness to the pursuit of power through alcohol or the control of others; worthlessness to a quest for self-acceptance through compulsive sex, and so on.

Addictive behaviour, like abusive behaviour, becomes a balm for the primal wound caused by the neglect or abuse, intentional or otherwise, of those with dominion over us.

An exercise in understanding

You'll be relieved to know that you don`t need to experience annihilation directly to understand addiction.  We all possess the prerequisites for understanding: unwanted behaviours.  Which may turn into habits.  Which can in turn become addictive.

Schaef says, "A relationship addict can become just as insane as an alcoholic.  It's the same disease."  Arguably 'healthier', but Schaef is making a systemic point.  Dictators with an addiction to power can wipe out whole populations, and that isn't very healthy for anyone.

Think of a personal experience of attachment or compulsion. A time when you were in thrall to some attitude or activity that you found difficult to control, even if it was against your will or better judgement.

Recall your excessive dependency on Mars bars, Marlboro or the Lottery.  Your continuing deference to parents, teachers, bosses, gurus.  That habit of scratching yourself.  The cherished fantasy about your partner's best friend.  Your lifetime collection of licence plate numbers.  Or the lone little ritual in your everyday life that you've never liked owning up to - a need to count the spoons while watching the Nine O'Clock News, say.

Go on.  No-one will know you're doing this.  Confront yourself.

You may have some intuition about what this idiosyncrasy relates to in your early life.  Perhaps you grew up in a dysfunctional family, or went to a school where you were taught to distance yourself from others instead of relating authentically.  If you joined the so-called helping professions as a result of an early experience of coercion or isolation you'll probably know a great deal about the roots of your particular dependency.  But for now it's not important to know how it came about.

Just remember the negative feelings you experienced around your behaviour.  Intimations of shame, perhaps, or anxiety, guilt, vulnerability, even invisibility.

Sense how any of these feelings taken to extreme might have led you (perhaps they did) to the pit of despair.

And deeper yet could have led to your self-destruction.

A fun exercise, eh?  Well, hardly.  But now you may have a glimmer of understanding of the death of self and extinction of choice that characterise the later stages of addiction.

And here's a suggestion: having acknowledged your own addictions, read the first section of this paper again.  If you think you're free of addictions, haul yourself through this exercise in understanding again.  And if after all that you still believe you're clean, do human evolution a favour: offer yourself for cloning and let your genes multiply.

2.  A MODEL OF ADDICTION

Some addictions feel physical, but all addictions are mental.

My evidence for this model stems from the discoveries of neuroscience, particularly neural Darwinism, into the evolutionary structure of the brain.  Recent findings in neurobiology and evolutionary psychology seem to me to be entirely compatible with the experiential constructivist foundations of NLP.  Particular credit goes to neuroscientist Gerald Edelman for linking the realms of neurology and psychology in a way that Freud could only dream of (11).

As we go through this mental model, there are three things to bear in mind:

1.  We will probably never know everything about the way the mind works.  Although I believe that all our mental awarenesses (thoughts, feelings, memories etc) are the evolutionary outcome of physical (neurophysiological) processes in the brain, I don't believe they are open to deconstruction in the sense that 3 may be reduced to 1 + 1 + 1.  The brain is capable of more combinations of connection than there are particles in the universe (many millions more when I last counted (12)), and in this context 1 + 1 is easily transformed into the conceptual equivalent of 3, or 99, or 1,000, as the flavour of a stew is always more than the sum of its ingredients.  Thoughts, feelings, consciousness, sense of self etc are complex emergent properties of our extraordinary neural capacities.  Precisely how that happens we may never fully know.  However the fact that our minds already know so much about our minds is nothing short of miraculous, so who knows what we may yet come to know?

2.  The model is necessarily crude, and you should be wary of defining anything in terms of it.  There are obvious, subtle, delicate and complex differences between any model of human experience and the real thing.

3.  When I refer to the brain, I don't know (and nor does anyone else as far as I can ascertain) whether the brain knows it all, or whether the body knows things that the brain doesn't.  We can characterise the brain as diversity.  There are billions of ego-intellects in the world and each one is different.  The heart represents unity.  It allows us heartfelt connection with every other being.  The brain needs the heart and all the other organs of the body for full information.  We don't use our brains disembodied (yet).  So you could call this system the bodybrain or the mindheart, but here I call it the brain and credit it with somewhat more than mind-only awareness (13).

You may find this brain operation easy to follow, in which case stay with the text.  If you want to make your life easier still, just take in the drawings and skip to the Summary.

Stage 1  Once upon a time

There was an external event.  It didn't have to be sudden or obviously traumatic, like losing a parent or near-drowning.  It may have been a pattern of sub-traumatic disturbance extending over years - low-level violence, constant carping, the exercise of arbitrary power, etc.  The brain itself didn't 'see', 'hear' or 'feel' this event.  It experienced an onslaught of stimuli from the senses and constructed a symbolic representation of the event in the physical space of the brain.  And because every brain is different, with a uniquely evolved configuration of neuronal groupings and their synaptic and chemical connections, this particular brain made a subjective interpretation of the stimuli, prompting:

A bad feeling.  An idiosyncratic series of neural connections resulting in an uncomfortable or unpleasant internal sensation experienced in the gut, heart, head etc.  It may have been interpreted as anything from mild anxiety to utter hopelessness.  An emotion.  Arguably the most complex of all mental states, commingled as it is with every other mental process (attention, memory, consciousness, etc), and having historical, cultural and biographical connections.

It's possible to deconstruct this 'bad feeling' (or negative-impact emotion) further:
 

 * an idiosyncratic neural interaction arising from the individual's emotional history which gives a weighting or 'value' to the event.

The feeling is likely to be worse if the judgement includes a belief that the event was unjust, or that there was negative intentionality behind it.

The combination:

was experienced by the individual as a single event, and left:

A wound.  Not a faithful reflection of the event, but a subjectively constructed memory circuit, affirmed or repressed at the time by other parts of the brain.  Nerve cell signals may be excitatory or inhibitory, and it is their complex interactivity - there can be up to 100,000 individual synaptic connections per cell - which determines what kind of signal is ultimately received by other cells.  So delicate may this balance be that it sometimes seems almost arbitrary about whether the wound remains raw or is partly-healed, whether it is obvious or not at any given time, whether it may flare easily or be deeply protected.

Stage 2  Another time

There is a new event in the brain.  A new thought or feeling, a remembered thought or feeling, or a response to another event.  Some research suggests that this event is more likely to occur in adolescence, when there is radical disturbance generally.  The event produces a new neural sequence, which triggers:

A bad feeling.  Similar to the original one.  Reminding the brain consciously or not of the original, and evoking:

A memory of the wound.  A re-construction of the original memory, identified consciously or not.  So far, so normal.  But around this time another significant event occurs:

Doing X - smoking, drinking, sex etc - which has associations with positive benefit: assertion-of-self-against-authority, socialising-with-peers, reward-for-bad-experience, novel-pleasure, and so on.  Many alcoholics remember their first drinking experience from this time in great detail.  Many addictive gamblers experience a significant win at an early stage of their lives.

For example, nicotine, heroin or cocaine entering the bloodstream trigger the release of dopamine, a neuro-transmitter associated with feelings of pleasure.  Chocolate gives fast-injection energy from sugar and caffeine; and mood enhancement from phenyl-ethylamine and theo-bromine - a similarly satisfying mindbody effect.  Caffeine stimulates the heart by suppressing the effects of adenosine, one of the brain's naturally inhibitory chemicals, and this produces a perking effect.

The effect of doing X is to:

Feel better.  Establishing another neural circuit, which has synaptic connections to the concurrent 'doing X' circuit (a circuit active at the same time), which itself has synaptic connections to the contemporaneous 'bad feeling' circuit (active in the same period of time), which in turn has synaptic connections to the primary 'bad feeling' circuit (the original).

Thus a neural pattern of association is formed.

Addiction is not necessarily a one-time learning, but a learning over time.

Stage 3  The next time

There is a similar event in the brain, which triggers a similar:

Bad feeling.  Now something new happens.  The ready-formed neural pattern of association, consisting of the old bad feeling circuit, the doing X circuit and the feel-better circuit, is triggered at the same time.  And so strong is this association that the brain finds it very difficult to separate out the constituent parts of the activity in order to know what's really happening.  The result is an exceptionally intense, self-generated, hallucinatory experience interpreted by the brain as a 'craving', or:

Desire for X, in order to feel better.  Followed by:

Doing X.  Which results in a:

Good feeling.  Which evolves into a higher-order feeling of apparent:

Satisfaction.  The feeling that comes from having done something to solve a problem.  In this case the problem was wanting to lose the bad feeling.  The satisfaction, however, is actually self-deception.  It's based on the perception that X actually solved the underlying problem, whereas the reality is that X was merely associated with relieving an immediate problem.  This self-deception will have to be unpicked before recovery can start.  At this stage it gives the illusion of:

Fulfilment.

The desire or craving of Stage 3 is a change in chemistry experienced by the brain (given that the brain has already registered Stages 1 and 2) as a need.  To the addict it may seem like a simple physical equation.
 

In fact what has happened is that the brain has coded the seeming 'satisfaction' of the apparent 'craving' and set up a complex pattern of association which has become a virtual 'memory' of:

Stage 2: 'I remember doing X and feeling better' and
Stage 3: 'I remember feeling the desire, doing X, feeling better and getting satisfaction'.

This virtual memory is experienced by the brain as if it were real, and is signalled to the body as a physical craving.  Philosopher of consciousness John Searle calls such events 'the remembered present'.  An immediacy which may be triggered by any number of external physical events or internal mental events.

Stage 4  Subsequently

A brain event triggers:

Bad feeling, which fires:

'Need more X'.  Doing X then becomes an activity with virtually automatic connections to the feeling of 'need'.  The addict does X, not because it 'works' as it did in Stage 2, or because it became a habit, as it did in Stage 3, but because of a belief, given the virtual memory control loop, that it ought to work as it did in Stages 2 and 3, when it was a successful strategy.  At this time the client may be building their life around X and nurturing it with other activities.  There might even be no recognisable reward from X as there was in Stages 2 and 3.  Choice is absent, and:

X is taking over.

In each case the pattern of mindbody activity has been encoded in the brain in a way that each similar subsequent experience only serves to reinforce, and a memory trace which once related solely to the desire for present positive experience as a reward for past negative experience has developed into an apparent 'craving' for X.  Each revival of the memory (actually a reconstruction, never the exact original) will be triggered by cues in the present, which may be anything associated with X in the past.

Thus real sensations turn into virtual obsessions.

The desire for X is a mental cue triggering --> a physical response which has --> a mental effect.
 

This loop generates an unconscious habit essentially no different to that of a concert pianist playing a complex arpeggio or an artillery gunner performing an intricate firing drill prompted by the word of command.

When the clock strikes four I feel the need for a cup of tea and a custard cream.  Seeing someone take out a cigarette may prompt another smoker to do the same.  Entering a cinema may trigger a sequence of events in the brain which may be experienced as a desire for popcorn.  The body experiences the sequence as a craving.  And what may have once been a feeling of isolation or sensory deprivation becomes re-interpreted as a need to smoke or drink, have sex, eat chocolate.

Internal or environmental triggers don't have to be obvious.  They're certainly not always simple.  A withdrawal symptom from addiction can itself become the bad feeling of Stages 2, 3 or 4, triggering a craving and setting off a complex recursive sequence that will be difficult to unpick.

Stage 5  Eventually

The circuits interconnect almost simultaneously:

Brain event --> Bad feeling --> 'Can't do without X'.  Now:

X is in possession. 

It may be very difficult indeed to separate out this structural sequence.  The client's experience, after all, is of one event.  And it will be very tempting for the client to assume that somehow X is controlling them, rather than that the simultaneity of events is being experienced by them as a lack of control.  "It is at this stage", says addiction specialist Alistair Rhind, "that the spirit begins to diminish."

Thereafter illusion itself runs the loop.

Stage 6  Finally

There may be no respite from:

Emotional overload, leading to mental, spiritual and eventually physical:

Breakdown.  The mind gives up trying to make sense.  Rage and paranoia may overwhelm the personality, and suicide or overdose may result.  It is a desperate irony that the addictive process which enabled the personality to survive its early experience of 'non-being' ends in the parting of body and soul which the addiction was originally designed to prevent.

Applying the model

As a therapist you could use this structural continuum in various ways.

1.  To affirm for yourself and the client that addictive states of mind don't just come from nowhere, but are something we construct from our subjective experience.

2.  To track where your client is in their present relationship to X.

3.  To track back with them to likely points for intervention.  There are specific examples of symbolic-constructivist (Grovian) interventions in Part II of this paper under Client Outcomes (Eleanor and Simon).  And an experiential-constructivist (NLP) intervention in Part III under Pattern (Jane), where the client's goal was to deconstruct an unwanted neural sequence and construct a more useful one.

4.  Therapists working in metaphor process might like to map across from the client's symbolic model on occasion.  Sometimes while facilitating a client's metaphoric journey I feel as if I'm tracking a spaceship from a parallel universe, and it's nice to get a sense now and again of where everything is in relation to earth.

5.  You could also use the model as a frame of reference for your outcome and the client's.  We'll talk more about outcomes in Part II.

Summary

Physical, or neurophysiological, phenomena (the collection, connection and interaction of neurons, synapses, receptors and neurotransmitters in the brain) give rise to mental phenomena (thoughts, feelings, beliefs, consciousness, sense of identity, spirituality and the like).  Mental phenomena are simply higher-level emergent features of the brain in the same way that heat is an emergent property of the motion of air molecules experienced by the senses and informed by subjective experience.

Conclusion

We can conclude that although some addictions have a physiological component and may be perceived as physical, all addictions are in fact mental.  Therefore the process of taking control of addiction is primarily a mental one.

Although each stage of this continuum of addiction is at a higher level of mental complexity than the one before, and may be perceived by therapist and client as further removed from reality, each stage can be accessed neuro-linguistically.  Ways you might do that are many and varied.  There are hints about starting in Parts II and III.

Post-script: thinking

I don't mean to dismiss the notion of 'physical' addiction, only to widen its definition and question an addictive belief system which states that addiction is a physical process which can only be treated by physical, ie medical, means (14).

 "I am a thinking being, therefore I am a physical being."  (John Searle, revising RenÈ Descartes)

Descartes, of course, said, "Cogito, ergo sum."  I think, therefore I am.  Given two hundred years of research into human consciousness since Descartes, I'd like to suggest a small variation: 'Sum, ergo cogito'.  I am, therefore I think.  I am a physical being, therefore I am a thinking being.  It is the physical fact of the evolution of the human brain which has produced our higher-order consciousness and our ability to think.  And our ability to process a thought such as 'physical addiction is actually a mental construction' may help evolve our addictive thinking beyond what were once assumed to be physical limits.

Re-thinking

Before starting treatment I can think of no more important thing to think about in addiction than deconstructing addictive thinking.

Deconstructing supposes the possibility of reconstructing.

The brain is a living, changing, continually adapting entity.  Brain cells make and remake their connections constantly, we are told (I have only to think about that to be convinced).  They can alter the strength of their connections over the short term and the long term, and they can retain and continue new connections.  Given that billions of neurons are doing this continously, and doing it on many levels, it is not fanciful to suggest that the landscape of the mind may be accessed and reconfigured in almost any way we will.  We can adapt and change through thought.

Thought, according to Searle, is dependent on an individual's symbolic abilities, language, logic and inner dialogue.  Any psychotherapy I can think of makes use of these capacities of the human mind.  Obviously not all psychotherapies work through thought alone.  And clearly not always through conscious thought.

The client in metaphor therapy utilizes symbol, language, logic and inner dialogue at many levels.  The exquisite and particular logic of the Grovian therapist's clean language prompts an inner dialogue with the client's unconscious mental processes.  This allows the client access to self-generated symbolic representations of neural patterns of association at the interface between the conscious and unconscious mind.

In Grovian process information 'pops up' into consciousness.  The client is often surprised, but rarely rejects the information, because at some level it is recognised.  Literally, through re-cognition, or knowing again.  David Grove calls this new-old information 'tacit knowledge', or 'knowledge you don't know you know until you know it'.

As re-cognition feeds back into the client's system and re-associates, a process of multi-level re-thinking takes place when new neural patterns of association are formed.  It is in these neural patterns of association where the neurochemical change necessary for therapeutic change takes place.

You'll find more about change in relation to addiction in Part II.

P.S. You should particularly read Part II if you're a therapist and want to help people.  That's potentially addictive behaviour.

© 1999 Philip Harland

References - See Part 3

Notes
(1) Adapted from a client quotation in an article by Gillian Riley, The Therapist Autumn 1997.

(2) Key in the word 'addiction'to Whitakers Book Bank CD-ROM and it comes up with 1,800 titles.

(3) Grovian metaphor therapy, originated by David Grove and further developed by Penny Tompkins and James Lawley. The therapist works at a symbolic level with clean language questioning to help the client (a) define (b) develop and (c) transform their problem state without interpretation or suggestion from the therapist. For articles about how it works see back numbers of Rapport or The Developing Company's website at https://www.cleanlanguage.co.uk/. See also Tompkins and Lawley's forthcoming book on Symbolic Modelling, which will surely become required reading for every therapist.

(4) For more about the addictive society read Anne Wilson Schaef (References above).

(5) Interpretive therapy: who are we to say that clients need more 'self-esteem', or 'balance', or 'unblocking', or have unresolved issues with their parents and pets? Therapists with an unresolved need to feel wise or wanted, that's who.

(6) My definition of postmodern : an open paradigm untrammelled by current established (antiquated) scientific, psychological and socio-economic beliefs and methods.

(7) Victim-Rescuer: even to believe there is some kind of intentionality to life - a force holding and directing us as evolution unfolds - seems to me to keep us in victim mode, albeit at a higher level where there are spirits, gods and mystic philosophers like Ken Wilber to rescue us.

(8) More on denominalizing in Richard Bandler and John Grinder, The Structure of Magic Volume I. Unrelieved use of conceptual nouns or nominalizations ('addiction', 'fear', 'depression') may indicate a stuck state in client or therapist. Opening up such a noun into a verb or activity can help mobilise stuckness. How do you do 'addiction', 'psychotherapy' etc?

(9) Breast feeding: the theory goes that if as babies we learn the world is bountiful, as adults we can wait for gratification.  The alternative theory, of course, is that we can't wait.

(10) 'Addictive personality'. Some geneticists believe there is a gene which may predispose some people to addiction. As our 70,000 + genes all interact, it can't be said that any one gene causes anything. If there is a predisposition gene it wouldn't affect an addict's need to work with present effects. A few people may be genetically predisposed to nicotine addiction through carrying a gene (CYP2A6) which allows them to clear nicotine quickly from the system. A chainsmoker with this gene might be left craving the next fix earlier than other smokers.

(11) If you want to go further into mind as the product of neural evolution and explore how this affects the nature of memory, consciousness and language read Edelman and others (References above).

(12) Each individual brain has about 100 billion neurons. Each neuron has up to 100,000 synaptic connections to other neurons. One neuron may send up to 300 signals a second. The number of possible combinations of connection (10 followed by millions of zeros) is astronomically more than the sum of all the fundamental particles - electrons, protons and neutrons - in the whole of the known universe (10 followed by only about 80 zeros). Is it any wonder that the hyperinteractivity of this near-infinite number of permutations in the brain gives rise to all our mental experience, including a sense of self and belief in spirit?

(13) Bodybrain: mechanistically it used to be thought that the body performed functions of which the brain remained ignorant, and vice versa. Now we're discovering that everything is interconnected. Even proteins used by the gut have receptors in the brain. If every system in the body has two-way communication with the brain at molecular level, it becomes a systemic circuit where every element interacts with its totality.

(14) Drug therapy: as crude a science in its way (trial and error) as is psychotherapy (largely guesswork). Many psychiatrists do good work, and would be delighted not to give out drugs if they had evidence that psychotherapy 'worked' for addiction. It's the usual systemic dilemma. The philosophy and belief systems of existing medical research models are unlikely to produce 'objective' evidence about subjective experience, and the tenets and limits of one-to-one therapy don't lend themselves convincingly to large-scale randomised trials. We're all addicted to our own convictions. However there has been more receptivity between medical and psychotherapeutic practice in recent years, and therapists supporting substance withdrawal do well to work closely with G.P.s, psychiatrists, staff at specialist clinics and specialist support groups. Alcohol, heroin and minor tranquiliser addicts receiving drug treatment for withdrawal may still experience craving and relapse if the psychological component of the addiction hasn't been dealt with. And although I've heard the average withdrawal from substance addiction described as 'about as bad as a bout of flu', drug therapy may well be indicated if a person is very damaged or has severe symptoms.