The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture

It is doubtless tempting, like “most addiction specialists and treatment programs” (214), to view addiction as a disease. As Maté highlights, addiction shares many similarities with conventional disease. It involves “a dysfunctional organ, tissue damage […] physical symptoms, impairment of certain brain circuits, cycles of remission and relapse, even death” (216). The disease paradigm takes away much of the stigma surrounding the condition; if addiction is “largely genetically programmed” (215), the result of chemical imbalances in the brain, it makes no sense to blame the sufferer. The disease paradigm also provides hope for recovery. If addiction is ultimately a biochemical disorder, it is plausible that a medication would be able to treat it. As imagined in Yaa Gyasi’s novel Transcendent Kingdom (2020), a pill might yet be found that can cure addiction for good.

Despite its appeal though, such a straightforward view of addiction produces many problems. For one thing, statistics show that someone’s background greatly influences their susceptibility to addiction. A Canadian study in 1997 looking at over 100,000 students found that “adolescents who had experienced either physical or sexual abuse were two to four times as likely to be using drugs as those who reported no such molestation” (223). Similar results were found in a California study. These showed that children who had suffered high levels of adversity also “had a risk of intravenous drug use forty-six-fold greater” (230) in adulthood than children with no adversity. Such strong correlations would not be apparent if addiction were a disease caused by genetic abnormality. Further, these statistics are corroborated by the personal narratives of many addicts. Given voice in interviews with Maté, various people addicted to a variety of drugs, describe how they found in their addiction social connection, inner “warmth” (217), peace, normalcy, and “a kind of love and acceptance” (218).

At root, as Maté says, these individuals were seeking “coping mechanisms” (216) for an absence that had its origins in earlier trauma and abandonment. This personalized view of addiction, as a response to lack, is not at odds with recent neuroscience. On the contrary, the notion that addiction stems from a lack of love complements research showing addiction’s link to a natural lack of endorphins, the brain chemical associated with emotional closeness. It is just that this more complex view of addiction may be harder for many to accept. As happens in the rest of The Myth of Normal, this view moves addiction from being an individual dysfunction into being the reflection of a broader societal malaise. The text suggests that the roots of addiction run far deeper into our “normal” world than many would want to accept. It also implies that the way to address addiction must be far more radical than proponents of the “disease” model ever considered.