On “The Motivation” by Carl Eric Fischer

Carl Eric Fischer, author Motivation: Our History of Addiction, a personal account that masterfully combines the genealogy of the concept of the title, becoming an alcoholic and dependent on Adderall during his medical stay. After he finished his studies at Columbia University Medical School, he began to drink regularly and heavily. Fischer had the achievement that his first addiction might be his constant need to shine, and he began drinking wine at the big leagues, and day in and day out came to the point where the promising young doctor was coming late in bouts with shaggy looks again. Celebrated on the eve of the year. The newborn doctor tried to hide the hole he was digging in himself, but his supervisors did not miss the symptoms and spoke to him. At that time, the wall of cheerful denial was impenetrable.

Instead of giving up Liquid Peace Island, Fisher got a prescription for the Adderall stimulant. Despite all their commitments, Uppers is a true steroid for endurance jumping while retaining the ability to function, at least for a while. Temporarily, Adderall provided enough internal backup for Fisher to find Leithy in the bottle and still carefully care for his patients. But drugs and alcohol eventually pushed him to the edge of the razor. It was known.

One night, Fisher broke into his apartment building for help, prompting a neighbor to call 911. When Fisher resisted, the SWAT team was called, and after finally reaching his home, the Kevlar-clad chief officer calmly asked:[A]Will it come off well? Fisher barked: “Probably not!” He was soon shorn, tied up, and taken to the hospital. Fisher, still considering himself recovering, was eventually sent to a rehab center for doctors, and with some setbacks and long periods of observation, he pulled together years of sobriety.

Among the many virtues of this study is Fisher’s honest acknowledgment that in his long foreplay with self-destruction, he had a great advantage in what he calls “redemption capital”—the money, prestige, and patience of his supervisors of work. This capital city is exactly what most people lack in stifling their conflicting desires. For this reason, Fisher notes, “Suffering with addiction is not an individual disease—it also comes from deep, inherited wounds,” that is, inequality.

For a general history of mind-altering concoctions, Fisher reminds us that booze played an important role in subjugating Native Americans, by making them addicted to spirits and religion, and by hampering their ability to wage war. Of course, the eggs also became trapped in their trap. According to Fisher, some of Washington’s troops were so dressed up from the rum they harvested in their surprise Christmas Eve victory at Trenton that they virtually fell into the sea back across the Delaware Glacier.

During the early 1800s, most Americans met not coffee in the morning but with a strong drink. “By the 1820s, drinking had reached an all-time high: the average American drinks about seven gallons of pure alcohol annually,” Fisher wrote. Translated into daily consumption, it amounted to “more than five standard drinks per day for every person fifteen years of age or older.”

From liquor to opioids to crack to the veritable army of legally prescribed “mood stabilizers,” Fisher masterfully describes the response of schizophrenia in the United States to drunkenness and later drug use. In the early nineteenth century there were widespread abstinence movements, and much later, among many other things, Prohibition, Alcoholics Anonymous, Nixon’s War on Drugs, “Just Say No” to Nancy Reagan, and eventually the crime of “Incrimination Therapy” “. Not blowing up his identity (or mine, when I also go to meetings), but perhaps the most compelling pages in Fisher’s history are those devoted to Alcoholics Anonymous – for their complex roots, evolution, pros and cons.

An older Nietzsche taught that “truth is a mobile army of metaphors.” For binary-minded Americans, the main metaphorical combatants have long been the idea that drunks lack willpower, and the belief that alcoholism is a “disease” in which whiskey, wine, or something else “hijacks” the brain. The disease paradigm is ruling today, perhaps stemming from the widespread belief that it removes the stigma of drug use and prompts troubled souls to seek help. However, Fisher remains unconvinced that hypnotizing people into believing they have lost their agency is disturbing stigma. He cites research suggesting that the “disease” label and combo are largely ineffective at helping people avoid automated trips to the liquor store. It may be so, but just as the ubiquitous ADHD diagnosis has provided a narrative that some have used to stop tearing themselves apart due to their inability to focus, so has the label “illness” freed many heavy alcohol drinkers from signing their lives with Sir John Barleycorn.

Fisher reduces the purely reductive accounts of drug abuse to rubble. First, there has been a widespread fantasy that addiction is found entirely in neurotransmitters. Then came the idea that cravings for whiskey are stable in the genes. According to Fisher’s estimation, “It is impossible to place the causes of addiction under one conceptual roof.” he is writing:

Some types of addiction […] motivated by more than rewarding the substance or behavior […] Some types of addiction […] Determined by trauma, whether it is personal, intergenerational, or societal […]

[A]These diverse influences intersect in a complex and dynamic matrix, changing drastically from person to person […] It’s not that addiction is or isn’t a brain disease, a social disease, or a global response to suffering – it’s all of these things and none of them at the same time, because each level has something to add but can’t define. the whole story […]

Addiction is very ordinary: a way of living with life’s pleasures and pains, and only one manifestation of the central human task of dealing with suffering.

Although Aristotle might consider it an exaggeration, Fisher’s usual means of self-regulation, such as an almost overwhelming need to ride your bike 75 miles a week, knit, or write every day would be classified as an addiction.

The way we talk to ourselves about ourselves plays a crucial role in the formation of the self. This is a truism but it deserves amen. Those of us who turn to the medicine cabinet and/or liquor to escape a funk must resist thinking of ourselves as “sick,” and instead remind ourselves that we have simply fallen into an extremely misguided human pattern of dealing with life’s demands, disappointments, and sometimes successes.

Really, is it no wonder then that a single mother, working two jobs, with employers as cheaply with their wages as with praise and mercy, might long for a few hours of drunken peace? Or, again, is it any wonder that a lonely person, filled with anger, fear, and disappointment, slips into the habit of seeking solace in a cold dark cave at a local pub?

Despite all his criticism of the disease model, Fisher maintains that the medical community has the means, some of which are drugs (such as methadone), to help people out of the path of doom and liver failure. However, to his credit, this same community was criminally negligent in making “rich recovery resources” available, especially to those who could not turn in their insurance card at the clinic office. In fact, today, even with an insurance card, it can take months to arrange a half-hour Zoom meeting with a psychiatrist. All this time the chant continues: “What the country needs is more mental health resources.”

according to National Institutes of Health in 2018, “Approximately 6.6% (or 16 million) of adults in the United States have used prescription stimulants in the previous year.” This does not mean counting the millions of young people for whom these powerful psychotropic drugs were originally intended. The author has been somewhat conservative about his past dependence on stimulants, except to say that, at his expense, when it comes to this class of drugs, there are fewer resources or strategies to try to help people withdraw from what were called “the pill.”

It’s Foucault’s point, but if there is a gap in Fisher’s historical narrative, it is the lack of focus on the influence of insurance companies and big pharma in dictating vocabulary and the way we think about our inner lives. It is no coincidence that the neurochemical understanding of our selves has been shaped by changing insurance reimbursement policies for psychotherapy in concert with inflated claims about the effectiveness of new psychotropic drugs.

“Studies show” is one of today’s piety. the desire With quotes from scientific studies, some of which come to fairly drastic conclusions, like this: “Nearly 70 percent of people with alcohol problems get better without any interventions.” Likewise, roughly the same percentages of therapists themselves apply to drug users, and the implication is that the need for recovery groups is exaggerated.

It may be the product of Fisher’s long practice of Zen, but with all the shaking of the fingers in this extensive text, his composed voice is clear and gentle. Filled with common sense and wisdom, Salmagoundi of history, science, and enlightened opinion, the desire It should spark a desire to have an active conversation and discussion about our current understanding and treatment of the disease you can catch from a corner-trapper – or a lab-enveloped doctor.


Gordon Marino received his Ph.D. from the Committee on Social Thought at the University of Chicago. He is Professor of Philosophy and Director of the Hong Kierkegaard Library at St. Olaf’s College. he is an author The Existential Survival Guide: How to Live Authentically in an Unauthentic Age (Harper, 2018).

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