I've spent the first 25 years of my life around addicts of all sorts, you name it, they did it. A short list: smoking, coke, H, alcohol, cannabis, hash etc. Some didn't make it (mostly, the heroin and alcohol addicts, as well as a substantial number of the smokers), some lost their mental faculties (alcohol, cannabis, hash, coke), some kicked their habits (very, very few) and some managed to keep it going for years up to and including today.
I've seen more than I really care for in that sense, including what these substances do to people that once upon a time were nice and functioning adults, both friends and family. If there is anything I'm grateful for it is that they cured me once and for all from even trying any of this stuff. If they were as smart and capable as they seemed and all but a very rare exception ended up much, much worse than they started out (ostracized, poor, extremely ill or dead) then it seemed like a very simple decision not to partake.
And this is where it gets annoying: but the people who do all these things also excel in peer pressure, they'll try anything to get you to join them in their misery. In the end I just came to the conclusion it isn't worth it, and stopped interacting with people that don't have their habits under control. This is also a hard decision but I really don't have the energy.
As the article writes: heroin addicts often seem normal, but that's mostly compared to other people around them, rarely compared to the person that they were before they became addicts, the differences for those cases that I knew were stark and that's before we get into all of the side effects.
I was an “alcoholic” for many years. It ruined my life and alienated me from many people I love.
Then I met a wonderful woman who wouldn’t give up on me. We went to the doctor over and over again until I was diagnosed with dystonia, a disease which alcohol relieves the painful symptoms of. Once I knew that I wasn’t simply cured, but I had the hope and the knowledge to see though my pain.
Many other drugs are the same way. It’s easier to get these classes of drug illegally rather than legally. People who do these drugs know there’s something wrong with them, but they remain defiant and strong in the face of a society projecting its own decadence onto them.
If you do drugs or alcohol and you know it hurts you and want to stop, there is always hope for you as long as you can accept help. I know from experience.
And to all you who need drugs, but reject a diagnosis. As Big L said “If that’s what you need to maintain, go ahead and do your thang.”
Most people do drugs or alcohol for kicks or to put the pain away, as in general, but there are a lot of people who are self medicating symptoms they are well aware and they know this "medicine" works for them.
Breaking out of that habit is extremly hard.
At the beginning of covid I found myself in a really dark place and opted to seek help with psychotherapy.
I had a long story of health and legal issues and I often told my peers that second opinion is key, no one is omnipotent and with hard legal or medical case it's worth seeking out opinion of at least two professionals (and if their opinions are contradicting - keep seeking).
I met eleven certified experts.
At the beginning of my journey one of them, guy with stellar reviews, upon hearing that I haven't been properly diagnosed, but I suspect I might be on the spectrum looked at me and said "no... I'm looking at you look perfectly healthy". One after five sessions when I said I'm not getting any feedback, like anything, I was the only one talking during the sessions, told me it take years to get to the core.
Long story short - just before someone advertise as an expert doesn't mean they know anything, or they care. Even in highly regulated circuit.
So FWIW, that part is true. I started therapy in 2012. I got to the core in 2020, after going through 4 different therapists. Along the way I founded about 15 startups, missed out on roughly $2M in lost wages, almost divorced my wife and walked out on my kid, thought seriously about killing myself, and needed a global pandemic to finally get my life in order. But I did eventually get my life back. And I didn't even get involved with any drugs or chemical dependencies; video games were my worst addiction.
The reason it takes so long is because a therapist will never tell you the problem, they need you to experience it for yourself. That is part of the point. As one of the better therapists I saw (the last one, actually, the one that got me through the breakthrough) said: "One of the ways to make feelings go away is to, well, feel them." Until your brain has the capacity to distinguish your feelings from existence, separate them out, and then push through some often very unpleasant, potentially life-ending feelings and actually feel them, you'll usually tend to end up deflecting or coping with them.
Much of the process of therapy involves stripping away these coping mechanisms and seeing what the feelings are beneath them. And that takes years, and has to be done in parallel with your life, because living your life is the point of therapy. That's why my first therapist encouraged me to try getting involved in my first relationship, even though I suspected I would end up hurt by it. (I ended up marrying and having three kids with her - the youngest is currently sleeping with his foot draped over me. And yes, I gave up nearly all my dreams and everything I thought was my identity for her.) That's why my therapist encouraged me to quit my highly-paid but soul-sucking FANG job to follow my startup dreams. Until you're actually in those situations, where you are risking your ego and living with vulnerability, you're not in a position to process the feelings that arise from them.
Possibly the best advice I got - from a random stranger on Reddit, not a therapist - was to think of your therapist as a guide, not a fixer or even an expert. You do the work of figuring out yourself, and it takes years, perhaps a lifetime. The therapist is there to make sure you don't hurt yourself and to keep the focus on your real issues, because when it comes to unpleasant feelings, the natural inclination is to avoid them. It almost doesn't matter if they're any good, as long as they adhere to a basic code of ethics and professional conduct, because all of the heavy lifting and all the major discoveries are made by you yourself.
Took me four years to "graduate" therapy (showing up happy to every session and my therapist asking me "why are you still coming in?") and I agree with every word you wrote here.
With that said, those first few months were not just my therapist being "a guide" through the life I was living. There were parts of my history that I didn't realize I needed to cry about and forgive myself over, before I could even try to go through life without that chip on my shoulder.
> almost doesn't matter if they're any good
It's very difficult to rate therapists, because there's both an empirical (their training and experience) and subjective (do you feel comfortable with them?) component. A therapist can be incredibly smart and talented and will be the absolute wrong fit for a patient who doesn't feel comfortable with them. And someone else can be not-a-therapist-at-all (i.e. clergy), who the patient feels very comfortable talking to, but those conversations will go nowhere if the patient is never challenged and/or never willing to face the challenges. All anybody can do, really, is just keep trying.
This is not to try and devalue the nature of your specific experience at all, okay? But, with your and some other descriptions here of how therapy works and how much looking around and trying out a number of vaguely defined things it involves, i'm getting a distinct woo vibe from much of the industry, made, maybe, all the worse given how much more fashionable the idea of therapy has become in recent years and how few concrete standards some parts of the business (and it is a business in large part) really require.
Add to the above the subtle notion of the onus on improvement lying with oneself as the patient, and it becomes all the easier for a therapist to fail because they don't know what they're doing, and then claim their patient failed because they didn't "try hard enough" or do the right things.
I've seen cases of therapy working, and know there's a lot of good exploration in related psychological fields, but it's definitely an area in which to tread carefully as someone seeking help.
I saw many therapists and I have pretty mixed feelings about it. I honestly it did a lot for me when a therapist simply said “Wow that’s a bad situation I feel really bad for you. It so unfair.”
But anytime I looked for instructions or objectives on how to improve my life they would basically say “I can’t tell you exactly what to do, you need to come to that conclusion for yourself.” The problem was I genuinely didn’t know what to do. They always tried to see things from my side, but never really believed that spending my night in a drunken stupor watching TV until I passed out was actually contributing to my happiness more than being in agony every night slowly building my contempt for humanity. Even though it’s against their training, they can’t help but judge you lifestyle and unusually that manifests as silence on important issues instead of disagreement.
> The problem was I genuinely didn’t know what to do.
That is the problem, yes.
I think a lot of the confusion from people just beginning their psychotherapeutic journey is that they think the point of therapy is to make them happier. No. The point of therapy is to make them happier, and sadder, and angrier, and more driven, and aware of their fear, and connected to their shame and guilt, and able to love. In short, it's to give you perspective on emotions, so that you can feel them on a minute-to-minute basis and decide what you want to do, and realize that "because you want to do it" is just as valid as any other reason, if not more.
> spending my night in a drunken stupor watching TV until I passed out was actually contributing to my happiness more than being in agony every night slowly building my contempt for humanity
A therapist would be naturally conflicted about this, because spending your night in a drunker stupor watching TV will make you happier, but being in agony every night slowly building your contempt for humanity is the work that needs to be done. The point of therapy is to help your understand a.) that you are in agony every night and b.) why are you building your contempt for humanity? It's to help you feel the emotions, and to feel them as emotions, and then to eventually integrate them into your life in a way that is constructive.
That’s the grift — healing sold as a subscription. The incentive for therapists to behave this way can’t be regulated away because the regulation itself acts as a cover for this behavior: credentials, ethics boards, continuing-ed checkboxes — all window dressing to sanctify creating a dependency in the patient. The system launders manipulation through professionalism and calls it care.
If you want to become fit, you need to exercise indefinitely or your muscles will atrophy. If you want to lose weight, you need to diet indefinitely or you'll regain it. The steps you take to lower your cholesterol? Indefinite. Blood pressure? Indefinite. Blood sugar? Indefinite.
It's no different with mental health. We are perpetual works in progress. Any changes take not only effort to accomplish, but effort to maintain. That's just how humans work.
I’m not so sure. I think there really are a lot of people who benefit from some kind of talk therapy and that that therapy might actually take a long time to produce results.
You have your whole life to ingrain thoughts, behaviors, and emotional responses into your being. If you anre unlucky, you might be surrounded by other people who reinforce maladaptive ways of thinking and being, such that they seem 100% normal. Expecting those deeply carved neural pathways to change quickly through any intervention is ridiculous.
Think about how cult deprogramming is a specialized skill with a high failure rate. Except this cult only has a single member, your inner monologue. It can take a lot of time for a therapist to figure out what the cult is even about, and it all comes from you talking (and talking and talking…)
> That’s the grift — healing sold as a subscription.
This therapist might've been, but often problems that require psychotherapy can't be done quickly, no matter how qualified they are and how expediently they're trying to help you. What they said wasn't wrong, but that description certainly makes it sound like they weren't trying to help at all which would've moved that healing timeline from "years" to "never".
Are you saying that psychological issues could be healed quickly if they just tried harder and didn't have the profit motive, or that they don't need to be healed at all?
And the problem is - after a few screw ups I've told myself - hey, maybe you don't know it all, maybe they have some secret formula you don't know about, just take it easy, lay back, don't be a smart ass, and let them take care of you. Be open minded.
I mean, I drove a Mustang in EU, shipped from US before Ford started selling them here. Local Ford didn't even had "mustang" in their system. I kept trolling them when they were offering free service for Ford drivers. My first 6 car mechanics were either a total scam or they were genuine but had absolutely no clue what they were doing.
What was I thinking? Maybe that the trade is regulated, and people with a title are more professional? Hell no.
It kind of proves it is a scam. You tried it, it did not work. But for some reason you lived experience is invalid, and you should keep trying again and again!
I know a few people, who import and run vintage american cars in EU. They do all servicing themselves, buy spare parts from american ebay. They totaly think modern car industry is a scam. They would never allow some "professional" mechanic into their beloved car.
You probably won't make any progress you if think of therapists like car mechanics, where you give them your broken car and they give you back a fixed one a few days later. Therapists can't just poke around in your brain to find the problems. They certainly can't fix them without your participation.
It's more like working with a physical trainer. You won't accomplish your fitness goals by just showing up. Rather, you need be engaged, learn how to actually use the tools they give you, strive to improve yourself and put in the effort to do so.
Five paid visits and I got no feedback at all.
Silent treatment is what you call it.
And when I finally confronted her about that she told me that I'm making a scene, because normally people are seeing a change only after couple of years.
To be devils advocate it was an intersection point between psychotherapy being socially acceptable here in my part of EU and the start of covid where a lot of people reached a breaking point. From a business perspective it's a hunting season and it's not so different from IT where a lot of people game their way in. I was only shocked because I thought it was highly regulated system and on average you should get at least some help.
I am happy it worked for you, but I find this a bit patronising and victim blaming. Not everyone has money, time and health to go to doctors "over and over again". Plus most doctors are just quacks, who throw hypothesis on the wall, to see what sticks.
> as long as you can accept help
What help? Society simple does not care about 49% of people, like at all! There are no shelters for abuse and violence victims, no support groups...
If you speak up or seek help, there is good chance society or abuser retaliates aganst you! You may endup in prison, homeless, or out of job. Or lose your kids!
> but reject a diagnosis
often that means months on strong medication, that makes things much worse. And if that does not work, oopsie, lets "try" another diagnosis. No compensation for the hell, from doctor who caused it, of course!
Most doctors truly are quacks. They are afraid and greedy.
Rehabilitation efforts would be more successful if not de-incentivized to expel participants for relapsing, i.e., compared to the rest of the world, US rehab programs are soft. Why?
This is an important topic, because people spend time and money pushing for social policies based on their belief that all opioid users are the homeless, dysfunctional people they see living on the street. Washington state has had republicans pushing for laws that would allow CPS to remove kids from a parent based entirely on the information that the parent uses illegal opioids [0]. If you think all of those parents are living in tents and motels and begging for food while spending the day high, this might sound reasonable. Putting kids in foster care is better than letting them die, is the argument.
But it isn’t reasonable, partly because there are so many opioid addicts that don’t show up in measures of homelessness etc. These laws would involve putting 10,000 kids into foster care so that maybe 10 deaths are prevented - and this would overwhelm the foster system entirely, tripling the size in an instant, so you’d almost certainly see ten children die because they were put into the system.
[0] As an example of the level of thought and knowledge going into these attempts, one legislator wrote a bill that said any opioid use meant CPS should remove your child. Don’t know if they didn’t know it could be a prescribed medication or what.
just stop all the programs, let the parents self-medicate, and let the kids do what they will. the problem will be solved in 12 months if the governments stays out of it. any solution has a cost in lost lives. some solutions don't keep killing people year after year.
This is anecdotal but I think heroin, or any drug, addicts often seem normal to those who have never taken drugs or been addicted. I remember my step brother mentioning that my cousin, now dead from an overdose, was high once when he seemed perfectly normal to me.
At a certain point one is "maintaining 0". High is "not on the floor writhing or worse."
That said, there can be signs. You may find them normalized from exposure. Or, perhaps: hidden, your cousin maintained appearances. With time and circumstance, everyone slips. Sometimes it's seen.
My (much older) brother managed his addiction, and appearances, well at work for decades. Now clean, thank goodness.
I have my own addictions, and to be honest, I expect everyone to notice and no one ever says anything. Sometimes I wonder if it’s that they don’t notice, or everyone is just too polite, or a mixture of both.
Article should be titled “Heroin Addicts Who Can Afford To Support Their Habit Often Seem Normal.”
His roommate’s klepto friend sure seemed abnormal.
Also, my understanding from folk who do use is that heroin doesn’t exist in meaningful quantity in today’s market. It’s all fent. Even the stuff that claims to be h is cut with fent, and maybe xylazine if you are especially unlucky.
This is actually why I think all recreational drugs should be legal. I know of approximately 0 people who have had the thought “I’d try heroin if it were legal”. All making it illegal does is make the supply deadly.
I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
I actually think more people would use if it were legal. Maybe not immediately but over time it would become more normalized. Regular joe character in tv shows would just use heroine. It would be available at college parties next to kegs. Etc…. And heroine companies (now that it’s legal) would find ways to market their drugs even if direct advertising isn’t legal.
I don’t think that’s true of heroin to a large extent, but I do think it would be true of cocaine, psychedelics, and other drugs. But regardless, I think the overall effect would be net harm mitigation given all the downsides of making it illegal. Funding violent crime at home and abroad, stigmatizing it and deterring treatment, overdoses from unsafe supply, etc. It’s entirely possible that more people would use it and it would still result in less harm to society.
I've been saying the same thing for years. Everything should be legal, prohibition just causes more problems. We learned this lesson with alcohol already.
Making it legal we could have things sold over the counter in pharmacies with proper age checks, we could even require further checks like before you can purchase heroin you need to go through a process where it is explained how it works, what a reasonable dose is, what side effects are, how addictive it is etc.
Same with other stuff. Most drugs are quite safe and harmless if done by people who know what they're doing. Of course self destructive people and morons would still harm themselves but honestly I'm not too worried about that. They will always find ways to harm themselves.
At least drug users wouldn't be funding cartels and warlords etc.
The US literally just tried that with gambling, and we discovered that making gambling legal increased the number of addicts by so much that it shows up in "total bankruptcies" statistics.
The key difference is people view heroin as something that will ruin your life, but think gambling is a harmless pass time until it is too late. There’s nobody who doesn’t know the perils of heroin, legal gambling existed in most places in some form and had for a long time. People view it much more like alcohol than heroin.
Also we didn’t just try that with gambling (48 states have had some legal form of it forever) we just tried it with online sports books, which turn out to be a particularly virulent form of gambling. And we haven’t really begun to sensibly regulate that, a lot of harm may be reduced in the near future as we do.
One data point, I live in East Asia, it’s very illegal, and vanishingly few people have drug problems (often they substitute for other problems that are less illegal, like gambling or sex).
Well, that’s really nice, and I don’t know how you pull that off, but it doesn’t translate to western societies. It’s very illegal most places, but how much of a problem it is seems to vary by region.
It's certainly true and in civilized countries (like the Swiss I think) the state offers the possibility to have your drugs screened and you can get clean syringes. Makes so much more sense than to criminialize addicted humans.
In Switzerland, at the appropriate facilities, the state provides heroin to addicts.
This has a dual effect - addicts get clean drugs and take them under medical supervision, reducing deaths, helping funnel some towards programs that will eventually get them clean etc. With this sort of support it turns out that people no longer steal to get their fix either, and can usually even hold down employment pretty well.
But also the young folk get to see these tired, worn out, older people queuing outside the clinic in the morning to get their fix and realise hey, maybe that isn't so cool and edgy after all...
Seems like a good plan to me, the problem is (as ever) puritans and their politicians, it's an easy thing to screech about. All it would take to kill it dead in a lot of countries would be someone standing up to shout "The opposition party want to spend YOUR tax money giving DRUGS to filthy JUNKIES!"
> I know of approximately 0 people who have had the thought “I’d try heroin if it were legal”.
Perhaps it's because they weren't experiencing enough pain at the time. I think most people fall into drugs circumstantially, I'm not sure it often presents as a conscious lifestyle decision.
> I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
I believe that there would be less drug use overall if our economic system wasn't as rapacious as it currently is.
I was on oxycodone for about 6 weeks for a growth inside my knee. After it was removed, I had to wean off the drugs. Wasn't too bad, took less than a week.
Soon after I thought I'd try to kick the caffeine habit. Went from 4 cups, to 1 over a month, then just green tea, then just water. I only lasted about 6 weeks on water only.
My god. I couldn't believe how unmotivated, soulless, and empty I felt. Judging by the reddit sub for kicking caffeine, this can last for over a year. It's terrifying
These go back before the beginning of history. Quite a long time before.
There are also quite a few additives and preservatives in a Twinkie.† If you're making a point about ultraprocessed food, you're definitely correct. If you're trying to make a point about basic foodstuffs, you aren't.
... because sugar is extremely cheap. Even if it was legal, cocaine would be impossible to get that cheap, unless some DNA editing is done to make yeast shit it out maybe. If sugar cost $100/gram I could see crime happening to be able to taste some candy or non-sour bread.
The cheapness is due to the prevalence, and the prevalence of sugar caused sweetness receptors to be evolutionarily advantageous. There is no world in which sugar is extremely expensive, markets still function basically in the way they do now and humans experience the sensation of sweetness the way they typically do now. Cocaine and other types of "hard" drugs are qualitatively different in that regard.
Your example also doesn't really hold up because people typically don't process cocaine in the way they do with sugar and other carbohydrates. In your hypothetical scenario, we might see people consuming large amounts of pure sugar (or artificial sweeteners), but they wouldn't go to lengths of baking bread using it.
Luckily industrialisation and the processed food industry has your back providing cheap abundant simple carbs for your pleasure and (later... discomfort)
Sugar? For snobs anyway. Corn starch for the masses.
FWIW opiate addicts in particular (and probably others as well) often do seem normal. That’s the addiction. They need the drugs to not go into withdrawal. By the time they’re addicted they either aren’t feeling the high anymore or they’re inching closer to a deadly OD or both.
Maybe the problem is not really the drugs but mental illness and some people are just miserable. Those folks become the stereotype drug addict, not because of the drug but other things in life
I think anecdotes about addiction by individuals rather than organizations are an important source for growing trustful understanding of addiction. Whether we like it or not we’re in a world where every org is perceived to have a self-serving agenda.
This is just one facet of communities that stays opaque. I mean scientific literature, statistics, and demographics only go so far. Things done privately stay secret unless something severely breaks, or someone speaks up. Slice of life bits like this are good; if only we could have them come in large sample sizes, uniformly distributed.
In 19th century England, a lot of people were opium addicts, even a prime minister apparently; but it wasnt much of a problem as habituees could buy high quality opium at a reasonable price, get their fix, and otherwise live normal lives.
Normal is totally context dependent. It’s normal when you’re a young adult to have lots of transient friendships, sleep in, live with people you aren’t close to. Our behaviors are consequences of our environment more often than not.
This idea raises many questions about the reproducibility of certain cultures outside of specific locales, Silicon Valley being an obvious example.
Functional or not it is illegal. Both functional and non functional heroine users can be put into prison for life with no parole and it will fix both the problems of dysfunctional people roaming around and people dying from it. With real consequences people will actively avoid such substances. It will clean up society and disincentivize new people from trying as they will bot want to give up their life and family for something so petty. It needs to be overwhelmingly obvious that it will mess up your life for good if you try or distribite even a little bit.
What you said here is essentially "Because it is illegal and they knowingly broke the law we should ostracize these people from society" without ever broaching whether it should be illegal or not to start with or if drug use by itself deserves being ostracized.
I've spent the first 25 years of my life around addicts of all sorts, you name it, they did it. A short list: smoking, coke, H, alcohol, cannabis, hash etc. Some didn't make it (mostly, the heroin and alcohol addicts, as well as a substantial number of the smokers), some lost their mental faculties (alcohol, cannabis, hash, coke), some kicked their habits (very, very few) and some managed to keep it going for years up to and including today.
I've seen more than I really care for in that sense, including what these substances do to people that once upon a time were nice and functioning adults, both friends and family. If there is anything I'm grateful for it is that they cured me once and for all from even trying any of this stuff. If they were as smart and capable as they seemed and all but a very rare exception ended up much, much worse than they started out (ostracized, poor, extremely ill or dead) then it seemed like a very simple decision not to partake.
And this is where it gets annoying: but the people who do all these things also excel in peer pressure, they'll try anything to get you to join them in their misery. In the end I just came to the conclusion it isn't worth it, and stopped interacting with people that don't have their habits under control. This is also a hard decision but I really don't have the energy.
As the article writes: heroin addicts often seem normal, but that's mostly compared to other people around them, rarely compared to the person that they were before they became addicts, the differences for those cases that I knew were stark and that's before we get into all of the side effects.
I was an “alcoholic” for many years. It ruined my life and alienated me from many people I love.
Then I met a wonderful woman who wouldn’t give up on me. We went to the doctor over and over again until I was diagnosed with dystonia, a disease which alcohol relieves the painful symptoms of. Once I knew that I wasn’t simply cured, but I had the hope and the knowledge to see though my pain.
Many other drugs are the same way. It’s easier to get these classes of drug illegally rather than legally. People who do these drugs know there’s something wrong with them, but they remain defiant and strong in the face of a society projecting its own decadence onto them.
If you do drugs or alcohol and you know it hurts you and want to stop, there is always hope for you as long as you can accept help. I know from experience.
And to all you who need drugs, but reject a diagnosis. As Big L said “If that’s what you need to maintain, go ahead and do your thang.”
This.
Most people do drugs or alcohol for kicks or to put the pain away, as in general, but there are a lot of people who are self medicating symptoms they are well aware and they know this "medicine" works for them.
Breaking out of that habit is extremly hard.
At the beginning of covid I found myself in a really dark place and opted to seek help with psychotherapy.
I had a long story of health and legal issues and I often told my peers that second opinion is key, no one is omnipotent and with hard legal or medical case it's worth seeking out opinion of at least two professionals (and if their opinions are contradicting - keep seeking).
I met eleven certified experts.
At the beginning of my journey one of them, guy with stellar reviews, upon hearing that I haven't been properly diagnosed, but I suspect I might be on the spectrum looked at me and said "no... I'm looking at you look perfectly healthy". One after five sessions when I said I'm not getting any feedback, like anything, I was the only one talking during the sessions, told me it take years to get to the core.
Long story short - just before someone advertise as an expert doesn't mean they know anything, or they care. Even in highly regulated circuit.
> told me it take years to get to the core.
So FWIW, that part is true. I started therapy in 2012. I got to the core in 2020, after going through 4 different therapists. Along the way I founded about 15 startups, missed out on roughly $2M in lost wages, almost divorced my wife and walked out on my kid, thought seriously about killing myself, and needed a global pandemic to finally get my life in order. But I did eventually get my life back. And I didn't even get involved with any drugs or chemical dependencies; video games were my worst addiction.
The reason it takes so long is because a therapist will never tell you the problem, they need you to experience it for yourself. That is part of the point. As one of the better therapists I saw (the last one, actually, the one that got me through the breakthrough) said: "One of the ways to make feelings go away is to, well, feel them." Until your brain has the capacity to distinguish your feelings from existence, separate them out, and then push through some often very unpleasant, potentially life-ending feelings and actually feel them, you'll usually tend to end up deflecting or coping with them.
Much of the process of therapy involves stripping away these coping mechanisms and seeing what the feelings are beneath them. And that takes years, and has to be done in parallel with your life, because living your life is the point of therapy. That's why my first therapist encouraged me to try getting involved in my first relationship, even though I suspected I would end up hurt by it. (I ended up marrying and having three kids with her - the youngest is currently sleeping with his foot draped over me. And yes, I gave up nearly all my dreams and everything I thought was my identity for her.) That's why my therapist encouraged me to quit my highly-paid but soul-sucking FANG job to follow my startup dreams. Until you're actually in those situations, where you are risking your ego and living with vulnerability, you're not in a position to process the feelings that arise from them.
Possibly the best advice I got - from a random stranger on Reddit, not a therapist - was to think of your therapist as a guide, not a fixer or even an expert. You do the work of figuring out yourself, and it takes years, perhaps a lifetime. The therapist is there to make sure you don't hurt yourself and to keep the focus on your real issues, because when it comes to unpleasant feelings, the natural inclination is to avoid them. It almost doesn't matter if they're any good, as long as they adhere to a basic code of ethics and professional conduct, because all of the heavy lifting and all the major discoveries are made by you yourself.
Took me four years to "graduate" therapy (showing up happy to every session and my therapist asking me "why are you still coming in?") and I agree with every word you wrote here.
With that said, those first few months were not just my therapist being "a guide" through the life I was living. There were parts of my history that I didn't realize I needed to cry about and forgive myself over, before I could even try to go through life without that chip on my shoulder.
> almost doesn't matter if they're any good
It's very difficult to rate therapists, because there's both an empirical (their training and experience) and subjective (do you feel comfortable with them?) component. A therapist can be incredibly smart and talented and will be the absolute wrong fit for a patient who doesn't feel comfortable with them. And someone else can be not-a-therapist-at-all (i.e. clergy), who the patient feels very comfortable talking to, but those conversations will go nowhere if the patient is never challenged and/or never willing to face the challenges. All anybody can do, really, is just keep trying.
You know why audiophile grade cables takes 900h of burn in? Because that's more than 30 days of return policy.
If you go a therapy and all you get is talking to a wall while you're therapist is skimming through a phone, that's not a progress, that's a scam.
Priceless comments in this thread, thank you.
This is not to try and devalue the nature of your specific experience at all, okay? But, with your and some other descriptions here of how therapy works and how much looking around and trying out a number of vaguely defined things it involves, i'm getting a distinct woo vibe from much of the industry, made, maybe, all the worse given how much more fashionable the idea of therapy has become in recent years and how few concrete standards some parts of the business (and it is a business in large part) really require.
Add to the above the subtle notion of the onus on improvement lying with oneself as the patient, and it becomes all the easier for a therapist to fail because they don't know what they're doing, and then claim their patient failed because they didn't "try hard enough" or do the right things.
I've seen cases of therapy working, and know there's a lot of good exploration in related psychological fields, but it's definitely an area in which to tread carefully as someone seeking help.
I saw many therapists and I have pretty mixed feelings about it. I honestly it did a lot for me when a therapist simply said “Wow that’s a bad situation I feel really bad for you. It so unfair.”
But anytime I looked for instructions or objectives on how to improve my life they would basically say “I can’t tell you exactly what to do, you need to come to that conclusion for yourself.” The problem was I genuinely didn’t know what to do. They always tried to see things from my side, but never really believed that spending my night in a drunken stupor watching TV until I passed out was actually contributing to my happiness more than being in agony every night slowly building my contempt for humanity. Even though it’s against their training, they can’t help but judge you lifestyle and unusually that manifests as silence on important issues instead of disagreement.
> The problem was I genuinely didn’t know what to do.
That is the problem, yes.
I think a lot of the confusion from people just beginning their psychotherapeutic journey is that they think the point of therapy is to make them happier. No. The point of therapy is to make them happier, and sadder, and angrier, and more driven, and aware of their fear, and connected to their shame and guilt, and able to love. In short, it's to give you perspective on emotions, so that you can feel them on a minute-to-minute basis and decide what you want to do, and realize that "because you want to do it" is just as valid as any other reason, if not more.
> spending my night in a drunken stupor watching TV until I passed out was actually contributing to my happiness more than being in agony every night slowly building my contempt for humanity
A therapist would be naturally conflicted about this, because spending your night in a drunker stupor watching TV will make you happier, but being in agony every night slowly building your contempt for humanity is the work that needs to be done. The point of therapy is to help your understand a.) that you are in agony every night and b.) why are you building your contempt for humanity? It's to help you feel the emotions, and to feel them as emotions, and then to eventually integrate them into your life in a way that is constructive.
Your comment reminded me of this: https://m.youtube.com/watch?v=Bx2JA8KzV3s
> told me it take years to get to the
That’s the grift — healing sold as a subscription. The incentive for therapists to behave this way can’t be regulated away because the regulation itself acts as a cover for this behavior: credentials, ethics boards, continuing-ed checkboxes — all window dressing to sanctify creating a dependency in the patient. The system launders manipulation through professionalism and calls it care.
If you want to become fit, you need to exercise indefinitely or your muscles will atrophy. If you want to lose weight, you need to diet indefinitely or you'll regain it. The steps you take to lower your cholesterol? Indefinite. Blood pressure? Indefinite. Blood sugar? Indefinite.
It's no different with mental health. We are perpetual works in progress. Any changes take not only effort to accomplish, but effort to maintain. That's just how humans work.
>If you want to become fit, you need to exercise indefinitely or your muscles will atrophy.
You can feel and see the effects of exercise very soon after starting. It's cumulative and predictable. Therapy is nothing like that.
If therapy was like that, what would it look like?
That's the grift - fitness packaged as subscription. They want you to have to keep exercising to maintain fitness.
Sarcasm, right?
I’m not so sure. I think there really are a lot of people who benefit from some kind of talk therapy and that that therapy might actually take a long time to produce results.
You have your whole life to ingrain thoughts, behaviors, and emotional responses into your being. If you anre unlucky, you might be surrounded by other people who reinforce maladaptive ways of thinking and being, such that they seem 100% normal. Expecting those deeply carved neural pathways to change quickly through any intervention is ridiculous.
Think about how cult deprogramming is a specialized skill with a high failure rate. Except this cult only has a single member, your inner monologue. It can take a lot of time for a therapist to figure out what the cult is even about, and it all comes from you talking (and talking and talking…)
[delayed]
> That’s the grift — healing sold as a subscription.
This therapist might've been, but often problems that require psychotherapy can't be done quickly, no matter how qualified they are and how expediently they're trying to help you. What they said wasn't wrong, but that description certainly makes it sound like they weren't trying to help at all which would've moved that healing timeline from "years" to "never".
Are you saying that psychological issues could be healed quickly if they just tried harder and didn't have the profit motive, or that they don't need to be healed at all?
And the problem is - after a few screw ups I've told myself - hey, maybe you don't know it all, maybe they have some secret formula you don't know about, just take it easy, lay back, don't be a smart ass, and let them take care of you. Be open minded.
I mean, I drove a Mustang in EU, shipped from US before Ford started selling them here. Local Ford didn't even had "mustang" in their system. I kept trolling them when they were offering free service for Ford drivers. My first 6 car mechanics were either a total scam or they were genuine but had absolutely no clue what they were doing.
What was I thinking? Maybe that the trade is regulated, and people with a title are more professional? Hell no.
It kind of proves it is a scam. You tried it, it did not work. But for some reason you lived experience is invalid, and you should keep trying again and again!
I know a few people, who import and run vintage american cars in EU. They do all servicing themselves, buy spare parts from american ebay. They totaly think modern car industry is a scam. They would never allow some "professional" mechanic into their beloved car.
You probably won't make any progress you if think of therapists like car mechanics, where you give them your broken car and they give you back a fixed one a few days later. Therapists can't just poke around in your brain to find the problems. They certainly can't fix them without your participation.
It's more like working with a physical trainer. You won't accomplish your fitness goals by just showing up. Rather, you need be engaged, learn how to actually use the tools they give you, strive to improve yourself and put in the effort to do so.
Have you even read my post?
I met a gal who kept silent for five visits.
Five paid visits and I got no feedback at all. Silent treatment is what you call it.
And when I finally confronted her about that she told me that I'm making a scene, because normally people are seeing a change only after couple of years.
Yes the lack of a magic bullet is definitely the fault of science.
You can have bad experiences with therapy.
It will put patients off entirely from further therapy.
It sucks if this is you. It really does - because on the flip side, if therapy has worked for you, then you know how your life has improved.
To be devils advocate it was an intersection point between psychotherapy being socially acceptable here in my part of EU and the start of covid where a lot of people reached a breaking point. From a business perspective it's a hunting season and it's not so different from IT where a lot of people game their way in. I was only shocked because I thought it was highly regulated system and on average you should get at least some help.
I am happy it worked for you, but I find this a bit patronising and victim blaming. Not everyone has money, time and health to go to doctors "over and over again". Plus most doctors are just quacks, who throw hypothesis on the wall, to see what sticks.
> as long as you can accept help
What help? Society simple does not care about 49% of people, like at all! There are no shelters for abuse and violence victims, no support groups...
If you speak up or seek help, there is good chance society or abuser retaliates aganst you! You may endup in prison, homeless, or out of job. Or lose your kids!
> but reject a diagnosis
often that means months on strong medication, that makes things much worse. And if that does not work, oopsie, lets "try" another diagnosis. No compensation for the hell, from doctor who caused it, of course!
Most doctors truly are quacks. They are afraid and greedy.
Rehabilitation efforts would be more successful if not de-incentivized to expel participants for relapsing, i.e., compared to the rest of the world, US rehab programs are soft. Why?
This is an important topic, because people spend time and money pushing for social policies based on their belief that all opioid users are the homeless, dysfunctional people they see living on the street. Washington state has had republicans pushing for laws that would allow CPS to remove kids from a parent based entirely on the information that the parent uses illegal opioids [0]. If you think all of those parents are living in tents and motels and begging for food while spending the day high, this might sound reasonable. Putting kids in foster care is better than letting them die, is the argument.
But it isn’t reasonable, partly because there are so many opioid addicts that don’t show up in measures of homelessness etc. These laws would involve putting 10,000 kids into foster care so that maybe 10 deaths are prevented - and this would overwhelm the foster system entirely, tripling the size in an instant, so you’d almost certainly see ten children die because they were put into the system.
[0] As an example of the level of thought and knowledge going into these attempts, one legislator wrote a bill that said any opioid use meant CPS should remove your child. Don’t know if they didn’t know it could be a prescribed medication or what.
I would assume CPS in the context of drug addicts are not just worried about basic living conditions, but also about neglect by the parents.
I would be worried about the child of an alcohol addict, let alone an opioid addict.
But this is just an assumption; I don't actually know of any statistics correlating addiction with neglect.
just stop all the programs, let the parents self-medicate, and let the kids do what they will. the problem will be solved in 12 months if the governments stays out of it. any solution has a cost in lost lives. some solutions don't keep killing people year after year.
This is anecdotal but I think heroin, or any drug, addicts often seem normal to those who have never taken drugs or been addicted. I remember my step brother mentioning that my cousin, now dead from an overdose, was high once when he seemed perfectly normal to me.
It’s not necessarily that you’ve done it. It’s that you’ve spent time around addicts. Often these are overlapping life circumstances though..
At a certain point one is "maintaining 0". High is "not on the floor writhing or worse."
That said, there can be signs. You may find them normalized from exposure. Or, perhaps: hidden, your cousin maintained appearances. With time and circumstance, everyone slips. Sometimes it's seen.
My (much older) brother managed his addiction, and appearances, well at work for decades. Now clean, thank goodness.
I have my own addictions, and to be honest, I expect everyone to notice and no one ever says anything. Sometimes I wonder if it’s that they don’t notice, or everyone is just too polite, or a mixture of both.
Article should be titled “Heroin Addicts Who Can Afford To Support Their Habit Often Seem Normal.”
His roommate’s klepto friend sure seemed abnormal.
Also, my understanding from folk who do use is that heroin doesn’t exist in meaningful quantity in today’s market. It’s all fent. Even the stuff that claims to be h is cut with fent, and maybe xylazine if you are especially unlucky.
This is actually why I think all recreational drugs should be legal. I know of approximately 0 people who have had the thought “I’d try heroin if it were legal”. All making it illegal does is make the supply deadly.
I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
I actually think more people would use if it were legal. Maybe not immediately but over time it would become more normalized. Regular joe character in tv shows would just use heroine. It would be available at college parties next to kegs. Etc…. And heroine companies (now that it’s legal) would find ways to market their drugs even if direct advertising isn’t legal.
I don’t think that’s true of heroin to a large extent, but I do think it would be true of cocaine, psychedelics, and other drugs. But regardless, I think the overall effect would be net harm mitigation given all the downsides of making it illegal. Funding violent crime at home and abroad, stigmatizing it and deterring treatment, overdoses from unsafe supply, etc. It’s entirely possible that more people would use it and it would still result in less harm to society.
I've been saying the same thing for years. Everything should be legal, prohibition just causes more problems. We learned this lesson with alcohol already.
Making it legal we could have things sold over the counter in pharmacies with proper age checks, we could even require further checks like before you can purchase heroin you need to go through a process where it is explained how it works, what a reasonable dose is, what side effects are, how addictive it is etc.
Same with other stuff. Most drugs are quite safe and harmless if done by people who know what they're doing. Of course self destructive people and morons would still harm themselves but honestly I'm not too worried about that. They will always find ways to harm themselves.
At least drug users wouldn't be funding cartels and warlords etc.
The US literally just tried that with gambling, and we discovered that making gambling legal increased the number of addicts by so much that it shows up in "total bankruptcies" statistics.
The key difference is people view heroin as something that will ruin your life, but think gambling is a harmless pass time until it is too late. There’s nobody who doesn’t know the perils of heroin, legal gambling existed in most places in some form and had for a long time. People view it much more like alcohol than heroin.
Also we didn’t just try that with gambling (48 states have had some legal form of it forever) we just tried it with online sports books, which turn out to be a particularly virulent form of gambling. And we haven’t really begun to sensibly regulate that, a lot of harm may be reduced in the near future as we do.
One data point, I live in East Asia, it’s very illegal, and vanishingly few people have drug problems (often they substitute for other problems that are less illegal, like gambling or sex).
Well, that’s really nice, and I don’t know how you pull that off, but it doesn’t translate to western societies. It’s very illegal most places, but how much of a problem it is seems to vary by region.
It doesn't translate because you don't get the death penalty for having 1g of Cannabis
It's certainly true and in civilized countries (like the Swiss I think) the state offers the possibility to have your drugs screened and you can get clean syringes. Makes so much more sense than to criminialize addicted humans.
In Switzerland, at the appropriate facilities, the state provides heroin to addicts.
This has a dual effect - addicts get clean drugs and take them under medical supervision, reducing deaths, helping funnel some towards programs that will eventually get them clean etc. With this sort of support it turns out that people no longer steal to get their fix either, and can usually even hold down employment pretty well.
But also the young folk get to see these tired, worn out, older people queuing outside the clinic in the morning to get their fix and realise hey, maybe that isn't so cool and edgy after all...
Seems like a good plan to me, the problem is (as ever) puritans and their politicians, it's an easy thing to screech about. All it would take to kill it dead in a lot of countries would be someone standing up to shout "The opposition party want to spend YOUR tax money giving DRUGS to filthy JUNKIES!"
> I know of approximately 0 people who have had the thought “I’d try heroin if it were legal”.
Perhaps it's because they weren't experiencing enough pain at the time. I think most people fall into drugs circumstantially, I'm not sure it often presents as a conscious lifestyle decision.
> I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
I believe that there would be less drug use overall if our economic system wasn't as rapacious as it currently is.
The cruelty is the point.
if anything it being legal would make it less cool
IME most people dont want to be addicted, theyre just in a rut or life took them a certain way and just need support to get through the other side.
People who dont use drugs are way to hysterical about drug use though to ever see real improvement.
Yes.
Between all the coffee, nicotine, CBD, pain killers, psychiatric meds, hormones, nootropics, and micro dosing who’s even normal anymore?
Most of what you mention isn't actually normal for most people. But it is possible to tailor your info feed to make it seem like it's normal.
2/3 of Americans drink coffee. I’ll grant you the rest of the list though.
I was on oxycodone for about 6 weeks for a growth inside my knee. After it was removed, I had to wean off the drugs. Wasn't too bad, took less than a week.
Soon after I thought I'd try to kick the caffeine habit. Went from 4 cups, to 1 over a month, then just green tea, then just water. I only lasted about 6 weeks on water only.
My god. I couldn't believe how unmotivated, soulless, and empty I felt. Judging by the reddit sub for kicking caffeine, this can last for over a year. It's terrifying
We've also been drinking coffee for a long, long time.
To be pedantic, we've also been prescribing opioids since Ancient Sumer, 8,000 years ago.
Plus it isn't true that we've been drinking coffee for a long, long time.
Wikipedia:
> There is no confirmed evidence, either historical or archaeological, of coffee as a [missing word?] being consumed before the 15th century.
That's more than 600 years. That counts as a long time in my book.
It's basically infinitesimal in comparison to almost everything else we eat or drink.
(Also, an unknown point in the 15th century could be less than 600 years ago.)
How long have we been eating Twinkies
Going by the ingredients list:
sugar, wheat, barley, egg, soybean oil, starch, whey, salt, tallow
These go back before the beginning of history. Quite a long time before.
There are also quite a few additives and preservatives in a Twinkie.† If you're making a point about ultraprocessed food, you're definitely correct. If you're trying to make a point about basic foodstuffs, you aren't.
† https://www.youtube.com/watch?v=KcS3kQg5blw
Can't forget the amphetamines
Don't forgot sugar, which is stronger than cocaine
I never sold possessions to buy more sugar...
... because sugar is extremely cheap. Even if it was legal, cocaine would be impossible to get that cheap, unless some DNA editing is done to make yeast shit it out maybe. If sugar cost $100/gram I could see crime happening to be able to taste some candy or non-sour bread.
The cheapness is due to the prevalence, and the prevalence of sugar caused sweetness receptors to be evolutionarily advantageous. There is no world in which sugar is extremely expensive, markets still function basically in the way they do now and humans experience the sensation of sweetness the way they typically do now. Cocaine and other types of "hard" drugs are qualitatively different in that regard.
Your example also doesn't really hold up because people typically don't process cocaine in the way they do with sugar and other carbohydrates. In your hypothetical scenario, we might see people consuming large amounts of pure sugar (or artificial sweeteners), but they wouldn't go to lengths of baking bread using it.
Luckily industrialisation and the processed food industry has your back providing cheap abundant simple carbs for your pleasure and (later... discomfort)
Sugar? For snobs anyway. Corn starch for the masses.
If heroin was $1/kg I doubt anyone would sell possessions for that, either.
A ton of people died over spices lol
FWIW opiate addicts in particular (and probably others as well) often do seem normal. That’s the addiction. They need the drugs to not go into withdrawal. By the time they’re addicted they either aren’t feeling the high anymore or they’re inching closer to a deadly OD or both.
Maybe the problem is not really the drugs but mental illness and some people are just miserable. Those folks become the stereotype drug addict, not because of the drug but other things in life
I think anecdotes about addiction by individuals rather than organizations are an important source for growing trustful understanding of addiction. Whether we like it or not we’re in a world where every org is perceived to have a self-serving agenda.
This is just one facet of communities that stays opaque. I mean scientific literature, statistics, and demographics only go so far. Things done privately stay secret unless something severely breaks, or someone speaks up. Slice of life bits like this are good; if only we could have them come in large sample sizes, uniformly distributed.
In 19th century England, a lot of people were opium addicts, even a prime minister apparently; but it wasnt much of a problem as habituees could buy high quality opium at a reasonable price, get their fix, and otherwise live normal lives.
Interesting book on the topic https://www.goodreads.com/book/show/158925.The_Pursuit_of_Ob...
A girl I knew in high school died of a heroin OD. She was the sweetest kindest girl as I knew her, and was a teacher at the time of her death.
This feels so sad. What happened to her?
I don't know what it was exactly, but I think it was some combination of chronic pain and the stress of her profession.
She died of a heroin overdose?
This seems a little disingenuous. I read it as more "what led to her addiction, given the other outwardly positive parts of her life?"
Heroin is a name brand drug designed for pain by Bayer.
Later it became the illegal substance it is today.
I imagine patients seemed perfectly normal at the time it was released, otherwise it would never have been released for widespread medical use.
But, like fentanyl, a subset of the population exhibits the extreme behaviors that become stereotypical.
It is the same for fentanyl. I was administered many of these drugs in the ICU and never felt like taking any more after I healed months later.
Some fraction of the population has chronic pain and uses this to manage and some other fraction uses it for the euphoric feeling.
If they seem normal then what's the problem? (other than the stigma and associated difficulties)
The massive monetary outflows necessary to maintain a baseline level of enjoyment that non-addicts get for fre?
That would be one of those stigma-associated difficulties to which I referred.
Persecution from the state
... half of them die very young?
Normal is totally context dependent. It’s normal when you’re a young adult to have lots of transient friendships, sleep in, live with people you aren’t close to. Our behaviors are consequences of our environment more often than not.
This idea raises many questions about the reproducibility of certain cultures outside of specific locales, Silicon Valley being an obvious example.
Functional or not it is illegal. Both functional and non functional heroine users can be put into prison for life with no parole and it will fix both the problems of dysfunctional people roaming around and people dying from it. With real consequences people will actively avoid such substances. It will clean up society and disincentivize new people from trying as they will bot want to give up their life and family for something so petty. It needs to be overwhelmingly obvious that it will mess up your life for good if you try or distribite even a little bit.
What you said here is essentially "Because it is illegal and they knowingly broke the law we should ostracize these people from society" without ever broaching whether it should be illegal or not to start with or if drug use by itself deserves being ostracized.
Yes, that is what I did.
You’re right, we should also shoot the left handed and start persecuting religions we don’t like by sending them to death camps.
In the US is not illegal to be left handed, nor does being left handed ruin anyone's life. It is in no way comparable.
Why help people when you can just get rid of them instead /s
The goal is to improve life for law abiding citizens. Removing these from society is helping all the people in society. 2 birds with 1 stone.