A habit merits the term “addiction” when it costs you more than it’s worth; when you try to stop it, but find you can only put it “on pause” for a short while; and when you find your thinking (especially your judgment) is distorted by the high priority you place on repeating the habit. Another criterion is perhaps less important because it’s outside you, but it can be very important indeed: when multiple neutral or friendly people tell you they think you have a problem—especially if they haven’t spoken to each other about it beforehand. 

In an excellent book called In the Realm of Hungry Ghosts: Close Encounters with Addiction (2010), Gabor Mate argued that addictions have their roots in early trauma. He tells the story of the thousands of American soldiers who fought in the war in Vietnam, which at that time was part of the “golden triangle,” a geographical area that produced a large share of the world’s heroin supply. U.S. troops coped with horrific levels of combat trauma, including guilt/moral-injury; anxiety, uncertainty, and fear; bereavement and loss; the shock of seeing so much injury and death; and the various physical wounds, ruined health, lost limbs, and so on. Many became habitual heroin users. But when they came home, it turned out that for the most part, the soldiers who remained stuck in heroin addiction were those who had suffered childhood trauma, long before the war. The others were able to drop the habit, though heroin is perhaps the most addictive substance on Earth. 

Not every addict has a trauma background. But most do, and when you meet one who apparently does not, you can’t be certain they have (or have shared) a full knowledge of their own relevant personal history. While many different kinds of trauma can happen to a kid, the CDC lists a few of the big ones in its online material about Adverse Childhood Experiences (or “ACEs”):

Experiencing violence, abuse, or neglect.

Witnessing violence in the home or community.

Having a family member attempt or die by suicide.

Substance use problems.

Mental health problems.

Instability due to parental separation.

Instability due to household members being in jail or prison.

They add “not having enough food to eat, experiencing homelessness or unstable housing, or experiencing discrimination.”

This painful picture of deep human suffering should not be taken as a portrait of an “average addict,” since there’s no such entity. And what amounts to trauma is not actually the stuff that happens to somebody, but how it’s experienced. The mystery of resilience has to do with the kid’s temperament, circumstances, culture, and especially the interpersonal supports that did or did not keep the situation from being even worse. There are people who endured every ACE listed here, who have never been addicted to anything. And there are others who had only one or two of these to deal with, and in adolescence or adulthood became dependent on one or more substances or behavioral habits that cost them dearly. 

The difference is not a moral one, and there is no rational calculus about who had it worse, or who went on to put up the best fight against addiction or depression or anxiety. These pseudo-questions involve impossible apples-and-oranges comparisons and fictitious quantifications of how bad different childhoods were. The feelings are most important; the facts matter, too; but the measurements of them are largely illusory. The reality of trauma has to do with what happened inside the child: what the bad stuff meant to him or her. If parents are neglectful or abusive, a kid will infer that young person in the mirror is deeply flawed, and deserved the bad experiences. But if the same kid also has a benevolent art teacher, a well grounded mentor, a kind and wholesome uncle who is reliable and interested, sane and warm—the kid may be protected from drawing that toxic conclusion about the self, and grow up less susceptible to addiction, to cults, to swindles, to sadomasochistic attachments, and so on.

The trauma theory of addiction is the profound claim that we mammals, we primates, we human beings, have universal evolutionary needs for nurturance and protection, and when these go unmet, or are met with harm mixed in, addiction often results. The person seeks out whatever will soothe away the pain of neglect and/or abuse from long ago. Usually, it’s pain from very long ago: infancy is the first love relationship we ever have, the mother-baby dyad that sets the emotional foundation for the whole lifespan. Even if things don’t go relatively wrong until later in childhood, it’s the inner baby part-of-self within the older kid that’s most overwhelmed. Freud taught that each of us is all the ages he or she has ever been, so the baby who craves a substitute for the warm and milky breast is actually still active inside the active addict, running the show—which is why the addicted adult can be found making such poor decisions. A brilliant, short book by Abraham Twersky, Addictive Thinking (1997), spells out what that kind of cognitive distortion can sound, look, and feel like. 

But acute or chronic trauma need not be the only reason for addiction, and often there is a very useful significance to the person’s particular “drug of no choice,” as it’s sometimes called in twelve step culture. For example, with or without the expectable ACEs, people who have uncontrolled habits of excessive sexuality may be trying to prove to themselves that they are indeed attractive sexual beings, capable of evoking erotic participation from others. Boys who were repeatedly rejected by the girls they hoped to kiss—and that’s most boys, who mature more slowly than girls tend to do—can grow up with a lot to prove. Many spend their late teens, twenties, and even their thirties struggling to establish that they are not icky “involuntary celibates” who will never find a mate (even if the guy himself is now the only person who sees him that way). If they can do this without deception, and without heaps of gender-based resentment, and without excessive risks to physical and mental health, they may manage to accumulate enough sexual experience to falsify their own worry about it. They can be fortunate enough to realize one day that they have indeed established what they were so desperate to establish. Now they are free to let go of the pattern that looked like, or really was, “sex addiction.”

Shopping addiction can be like that, too. I’ve said “people with uncontrolled habits of excessive sexuality may be trying to prove to themselves that they are indeed attractive sexual beings.” Well, people with uncontrolled habits of excessive consumerism may be trying to prove to themselves that they are indeed successful participants in the world of consumption, including the spells cast by advertising. Ads comprise a powerful technology of conscious and unconscious persuasion that links people’s self-esteem to their capacity to get hold of whatever product or service is being defined as beautiful, validating, and necessary. If I succumb to this, my identity will be bound up with my ownership of the bag, the boots, the car, the designer version of whatever I’ve been convinced I need.

Insofar as this is true of somebody in particular, that person’s sobriety will have a lot to do with identity: achieve an internal locus of value, and you can also build up an internal locus of control that defeats the addiction. When a person suddenly comes into a sum of money, a lot can be learned by watching how they spend it: the speed of the spending, but more importantly, the buying choices they make. If you are making large purchases of “designer stuff,” you might be an erudite connoisseur of fine handbags and their nuanced history since the year 1588. But it’s more likely you are buying an Hermes bag for $9,850 because that is what the surrounding culture told you was important, valuable, and above all, validating for the identity of the buyer. It is, ultimately… a bag.

A designer purse like that “says” plenty, but just what it says depends on the wisdom of the beholder. The message can range from “look, I am successful, you would be fortunate to share sex, love, friendship, or business with me” to “look, I cannot think for myself, and remain profoundly naive about the available better uses to which money can be put.” Those uses include appropriately limited altruism, where you get good feelings by helping others who need help; buying experiences (especially travel, but also course-taking, conference-going, skill-building, etc.) rather than things; connecting to the past and to the globe by acquiring works of art that speak to you; funding ambitious projects that you find fascinating and beneficial to the communities of which you count yourself a part; and so on.

I know brilliant, beautiful, accomplished people who collect high-end designer handbags. I see it as an expression of their aesthetic enjoyment of these exquisite objects. I also see it as a mechanism of compensation for early experiences of having to do without the goods that other kids had. If your peers in elementary school and middle school and high school all wore flashy stuff and drove expensive bikes, while you wore hand-me-downs and walked to school without wheels, you might well benefit from disproving the worry that they are blessed and deserving while you are deprived and unworthy. And the collectors I’m thinking of are at least as psychologically sophisticated as I am; they know all about their own formerly unconscious motivations for spending “real money” on glam and bling. But they do it anyway, and apparently it serves them well. Rather than judging anybody for buying or selling luxury goods, I am commenting on some of the common underlying dynamics that contribute to habitual choices which can come to feel quite unfree.

And that’s the issue with therapy for troublesome habits: is the habit a free and informed choice? Is it an addiction, or would we get better results framing it as a mere habit that needs tending? The more it costs you—in money, time, opportunity, relationships, access, etc.—to continue with the habit, the easier it is to decide that you must stop. The less it costs you, the more reluctant you or I will be to use the term “addiction,” or recommend 12-step programs, or insist that only abstinence will constitute recovery. Mild addictions to substances or behaviors can be addressed with a commitment to “harm reduction.” Someone who drinks a few times a week but does not lie about it, nor have blackouts, nor have a Jekyll-and-Hyde personality change when they’re intoxicated, is probably a person who can reduce drinking by, say, 65% without too much struggle. But if it turns out to be a big struggle, then the language of addiction might be very useful for getting hold of the habit and changing it.

If you’re dealing with repeated behaviors that you suspect are costing you too much in money, time, peace of mind, or otherwise, consider booking a session with me. We can join forces to help you figure out your relationship to the habit in question, and find the best ways to change for the better—guided by your values and goals.

Email me through the contact form on this website, or call 917-873-0292.

Perhaps you were raised in a household with a chronically and deeply inculcated ethic of self-effacement. Perhaps people quoted to you that vexing line of scripture, Proverbs 16:18: “Pride goeth before destruction, and an haughty spirit before a fall.” Maybe that was a gendered experience, in which girls and women were raised to people-please, as if their maternal function were the only legitimate contribution they could make to the world. Or maybe it was a message for men and boys, that male people must be regarded as toxic opportunistic jerks, until and unless they establish their own goodness through people-pleasing.   

It’s true that people-pleasing and self-effacement are much better than the opposite extreme—where narcissists act as if the world owed them everything they could ever want, going through life exploiting others by deception, cheating, and entitlement. But there is a vast, wholesome, fertile middle-ground between these extremes.  

The culture of masochistic self-effacement—particularly common in the American Midwest, but not rare elsewhere—involves an extremely important error about human nature. When you withdraw into yourself like a turtle in its shell, giving up your claim to social space, resources, and dignity, other people in general do not actually benefit. Unprincipled characters may avail themselves of your services without reciprocating; such opportunists do not generally deserve what you’re giving them. Warmer folks might welcome your generosity and actually repay you in kind, but this is actual mutual goodness—not people-pleasing. Those who have the self-confidence to meet their own needs are going to do so with or without your self-sacrifice. And those who lack that confidence may be cowed by your example and feel shamed into emulating it (especially if you are their parent).  

Here are a few analogies, since the same principle applies in many other domains. Watching an anxious, apologetic musician perform is exhausting, whereas watching a confident and relaxed performer is energizing. When a singer is tense, tentative, inhibited, and nervous, the audience is drained by the performance and waits for it to end. When the singer is calm, expansive, centered, and open, the voice fills the whole space; the improvisation is playful and fluid; and the audience is captivated in delight.

Sociality tends to work the same way. The other people around you will benefit more from your loving self-acceptance than from your self-loathing. They are more likely to flourish if you flourish, than if you sulk, stagnate, or persecute yourself.  It is not anti-social to love yourself. It is pro-social to love yourself.  

As a brilliant Chinese political philosopher, Jiwei Ci,  once observed: “In a world of perfect altruists [who only promote their neighbors’ interests, not their own], no one has any interests for his neighbor to promote.”  

This same principle also applies to dating, where there are two major ways of being beautiful. One way is to absorb the standards of beauty that are tendered to you by the media and by your peers, and shape yourself to match those ideals as closely as possible. Some people will stop at nothing in pursuit of such external notions of aesthetic self-presentation, even at great personal expense, not all of it financial. Some will even inject their own faces with botulism toxin (“Botox”)—often at such youthful ages that there are not yet any wrinkles for the procedure to erase. The price is bigger than it seems, since the deactivation of facial muscles can make the human countenance less expressive, with serious possible consequences for emotional intimacy. Other forms of body modification have their risks, too. Fasting can have health benefits, or spiritual aspects, but starving oneself in pursuit of weight loss can constitute dangerous (even fatal) disordered eating. Working out in the gym can be a great enhancer of physical and emotional health, a rewarding and challenging part of self-care, and a venue for camaraderie. But it can also be the site of an “adonis complex,” where people toil for a missing self-respect that they associate with a highly muscular physique (this is a struggle often met with in some forms of Gay men’s culture).  

Most people benefit from some moderate degree of participation in shared ideals of attractiveness, maintaining their appearance as part of the pleasure of self-care—without overdoing it, or falling prey to excessive anxiety about how they look. At that point, the other approach to beauty takes over: sheer genuine confidence. So long as I have met this basic standard of self-care, my confidence that I am beautiful—even if my beauty is unconventional—has a benign influence on the way other people perceive me. Whatever my age, gender, sexual orientation, or social position might be, my comfort within my own skin, my genuine belief that, odd or not, I am cute as hell—is itself part of the way observers see me. The visual dimension of my self-image is part of my charisma; it is self-fulfilling.  

I’ve discussed musical performance and physical attractiveness as examples of the broader issue I raised at the beginning: my belief in myself is better for me—and for others—than my self-doubt. Put another way, other people will benefit more from my achievement of loving self-acceptance than they will from my continued self-denial and people-pleasing.

This applies to many more arenas than the few I’ve discussed here. For example, one of the best books I’ve read on sex is Male Sexuality: Why Women Don’t Understand It and Men Don’t Either, by psychoanalyst Michael Bader. He spells out the way that sex between men and women can go poorly if both people are entirely focused on the other person’s pleasure. Of course, it can also go poorly if they’re exclusively concerned with their own pleasure, but that problem is much more obvious, and much easier to discuss. Some generous attention to the other person is, of course, important, since sexual giving is both gratifying in its own right, and ethically salient—but so is some degree of embodied raw desire for stimulating experience of one’s own, without distraction, judgment, guilt, or ambivalence. When you share what’s yours, you’re sharing what’s yours.

As is said on every airline flight, and metaphorically repeated in myriad therapy sessions: put on your own oxygen mask first, because that’s the necessary preparation that makes it possible to help anyone else. If you do not start off by loving yourself (and it’s never too late for that), but instead regard yourself as a despicable sinner who must find ways to prove his or her own decency, then how do I know whether your kindness to me is a genuine gift, or just another impersonal effort to demonstrate that you’re a worthy human being? We generally prefer to receive kindness from people whose motive is not to escape hell (in this world or the next), nor to win entry into post-mortem paradise. We prefer to receive kindness as an authentic expression of somebody’s good nature, or, if we know each other well, as a communication about their feelings for us—not as a mere byproduct of their own secret wrestling match with a tyrannical conscience. Love yourself, and your love for others will mean more to them, not less.

Two thousand years ago, the great Rabbi Hillel said this unforgotten thing: “If I am not for myself, who will be for me? If I am only for myself, what am I? And if not now, when?”

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

Patients sometimes say things like this: “If psychotherapy is largely a process of cultivating self-love, where is it supposed to come from? I don’t feel like I love myself. I can hardly stand myself. Where do I begin?”

Well, anyone who is alive to ask this question has survived, because at some point in the critical period of their infancy they, too, were loved. And babies love their caregivers, because love works as a circuit, a between-ness, like the glue between two surfaces. The love feels good because it works: my caregiver is loving me and I’m receiving it, and when I love her back, I experience my own goodness in the delight she takes in my smiles, my sounds, my touch, my presence.

My goodness is twofold, without any distinction being drawn: I am worthy of the Mother’s love, and my love for her is good. Therefore: I am good. I love myself. Trauma interferes with the benefits of that good foundational experience—but not completely, since you are still here, even though you’re also in pain. The task at hand is to reawaken those early, primitive good feelings and make them sustainable.

First, who do you love? It need not be a human person, but it must be a person in your eyes: a dog, a cat—a bear or an elephant if you know anyone who is an actual member of those species—or your nephew, grandmother, partner, friend—anybody you love. It could be a figure from religion or the arts, so long as admiration is not the main thing, but love. And if there is nobody in your life, bring to mind your feelings on seeing a baby or an elderly person, your spontaneous compassion for children in distress, even kids you don’t know.

If you can think of someone for whom you feel love, think of your feelings for this person. Feel the feelings. Notice that they arise naturally, without structure or measurement or transaction. Notice that they are not based on achievements, or talents, or cost/benefit calculations. As the philosopher Kant taught in the 18th Century, persons are ends in themselves, not means to an end. Adults love the baby because-the-baby.

An infant is too young to have accomplished anything cultural, and it’s too early to tell whether there are any significant talents present or not—thank goodness. That way, these extrinsic grounds for esteem can’t interfere with the fundamentally non-rational flow of love between caregivers and babies that is absolutely necessary for the survival of individuals, and of the species. As we therapists never tire of mentioning, babies tend to die if they aren’t loved-over-time by at least one individual caretaker, whatever other love, food, and shelter they do receive. If you’re still here, somebody loved you. That means you have some experience of the thing you’re looking for.

Thinking of a person you love brings up feelings of care, protectiveness, belonging, warmth, similarity, compassion, and esteem. You need to get yourself onto the list of beings who deserve this good stuff from you. Then you need to get yourself up to the top of that list. The fundamental reason to love yourself is because it is your right and role, your dharma, your vocation as a living organism on this planet. But if that currently feels too foreign and far-off, be motivated by altruism. Some depressed people only hate themselves, while others hate everybody; right now, I’m addressing the first group. Love yourself because the oxygen mask on your own face will keep you capable of giving oxygen to somebody else, instead of collapsing for lack of it.

After some time spent trying to love yourself so you can help other people, your motives may ripen and expand to include genuine, intrinsic self-love. Meantime, Nietzsche wrote, “The self-despiser nevertheless esteems himself—as a self-despiser.” In other words, if the only thing you can approve of about yourself is that you have sufficiently high standards by which to condemn yourself, well, those high standards are an esteemable form of investment in the Good, so start from there, and build out. Are you using the high standards as guides to improvement, or as a blunt instrument for self-punishment? If switching from punishment to guidance is hard, there is some internal cruelty in the mix, and you may currently be addicted to that cruelty.

Well, how would you feel and act if the person you love was being treated the way you treat yourself? You would intervene protectively; you would make emotional contact, to make sure the person was ok; and you would help your beloved to defend against attacks. Do that for yourself, as a matter of ordinary responsibility, like washing your hands after you use the bathroom, or like offering a glass of water to somebody who obviously needs it. Decency. If you can’t be kind to yourself, start with being polite to yourself, and work your way up to lovingkindness.

Elsewhere on this blog I’ve written about the inner exercise you can do to get better and stronger at self-love. It is an imaginal exercise, something you do with your imagination. What’s “imaginary” is a mental representation of something physical, compared to which the representation is relatively unreal—it is “merely imaginary.” But working to heal your inner child is itself a mental (both emotional and intellectual, both affective and cognitive) job. The problem, the solution, and the work of applying it are all psychic, not material. They all share the same form of realness, namely psychic reality. Inner actions are actions indeed, just as much as taking out the garbage, changing a tire, or dressing a flesh-wound is taking an action. A better analogy would be practicing with a musical instrument, because each session of practice—with all its frustrations and small glimmers of triumph—improves the prospects for progress the next time. Like therapy.

 If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

We often want to help people with their regrets, by telling them: “If you could have done any better, you would have. The reason you didn’t, is that you were constrained by your trauma background, your history.”

They reply that this is a slippery slope; that if they allow themselves the solace of explaining their bad choices by invoking their past history, they might recklessly let themselves off the hook for all kinds of error—laziness, impulsivity, greed—in the present and the future.

But it is not a slippery slope, so long as we locate the determinism in the past, where it belongs, and the freedom in the present, where we need it. Both the past and the present are constrained by the effects of the remote past I call my childhood. But the past of my young adulthood is already fixed, whereas the present is still relatively fluid, with room for choice and decision.

What is the precise extent of today’s freedom? How far can I hope to excel my previous performances? How free am I this morning, to do better than before? The only way to find out is to do the best I can now do, and learn about the flaws in today’s efforts only in hindsight, later on. Only tomorrow’s perspective will reveal the hidden limits of today’s freedom. I can best reach those limits—I can make optimal use of today’s undefined opportunities—by living as if I were entirely free of the constraints my origins impose on me. I am now 55. For my twenties, therefore, this process is now complete, so I’m now free to conclude that at 25 I indeed did the very best I could do—even though some of my choices that year were relatively disastrous. Had I been more free, I would have done better.

This is not a moral framework; the goal is to understand, not to excuse. Understanding will give me the breathing room to choose how to handle the moral dimension of my past conduct, prioritizing compassion over punishment, wisdom over bitterness, edification over regret.

Every child experiences some particular mixture of three things: getting the good stuff (love), not getting the good stuff (neglect), and getting the bad stuff (misuse, or worse: abuse). The particular mixture supplied by a particular childhood has consequences—exerts constraints on our freedom of thought and action—for the whole lifetime. But those constraints can loosen and fade with experience, especially with enough good experience. At no point am I ever in a position to assess exactly how much my early years are still shaping my current actions and perceptions right now.

So: today, I will do the best I can, as if I were no longer limited by the consequences of my origins. Tomorrow will show me why I got as far today as I did, achieving no more and no less than my level of maturation could permit. The psychotherapy that helps me understand the tragedies of my young adulthood also equips me to improve my future, not only because it helps me learn from experience, but because it explains why I suffered from the particular ignorance that I did.

Today’s ignorance will be tomorrow’s knowledge. As I contemplate the ways I fell short in the past, the more compassion I can muster for my youthful self, the less regret I must endure today. From present contemplation of my past mistakes, I must learn both prudence in dealing with the outside world, and mercy in dealing with myself.

Of course my history limits my choices. But exactly how much? I don’t know, and that’s a good thing. Our ignorance of the precise nature and extent of our constraints is part of our freedom. And just as a temperate optimism can enhance my odds of success in the world outside, my inner life will likely go better if I let myself assume I have achieved more growth and healing than I can readily prove. “With every mistake,” wrote the Beatles, “we must surely be learning.” In the absence of an impossible certainty, we are better off trusting in the human spirit’s innate powers of development.

One way to have that experience, to grasp for that faith, is to “see” your elderly future self kindly smiling down on you from the future. You might as well… look.

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.