Anil Seth is a neuroscientist whose main research interest is consciousness – a vast topic beyond the intent of this writing. I once attended a conference lecture Anil gave on consciousness during which Anil described a phenomenon I found very striking and I have never forgotten.

To skip my verbal description of what Anil showed us, jump down to “Try it yourself!”, watch the brief video clip, and then resume reading.

In the demonstration, without saying a word, Anil presented a video of a flat checkerboard of dark gray and light gray squares. Toward the top right corner was a cylinder sitting upright. The cylinder cast a shadow toward the bottom left corner.

Anil then claimed that the shadow was not making the light gray squares in the shadow seem darker. He said our minds were deceiving us. He said the light gray squares inside the shadow were the same color as the darker gray squares outside of the shadow. He claimed the lighter color of the squares in the shadow was placed upon those squares by our expectations, and that the squares were the same color.

I was totally confused because the shadow was so obvious to see and the shadow clearly made the light gray squares it fell on look darker. Anil said the squares were not lighter, our minds that made them look lighter because the shadow was there, and he could prove it.

Anil’s claim seemed silly. When he asked the audience if we thought he was very wrong we all agreed he was very wrong.

Then he produced a second checkerboard and slid a gray color stripe overlaying the gray squares in the shadow across the second board, and onto the first. As he slid it into place on the first board, the gray squares inside the shadow on the first checkerboard became the same color as the darker squares outside the shadow, and the shadow vanished. If he slid that stripe out of the way again the shadow suddenly returned, and the squares inside the shadow again looked lighter.

It was truly puzzling.

Try it yourself!

You can hear a minute of explanation and watch the demonstration here.  If you have an extra minute, let it run and watch the next demonstration too.  The second one is important because it has to do with what we hear, instead of what we see.

Anil explained we have enough experience in our lives with such images that our brain makes us perceive what our brain expects is there, instead of showing us what is there.

For example, when you read the title of this blog post you might have read part of it as “One-Size-Fits-All” instead of what it actually says.

During the presentation I attended, he explained that the difference with this phenomenon involving the checkerboard is that no matter what you do with your eyes or mind, or what anyone says, you cannot see anything except the color difference that is not there.  You are stuck seeing it incorrectly. Anil went on to say that type of error in perception results in what is called an “impenetrable cognition” where the person just can’t be convinced otherwise.

How does this apply to our efforts?

When I heard Anil describe all of this, I immediately wondered if some instances of what some people call “denial” are this phenomenon of impenetrable cognition instead. And I wondered if there are experiences that could be helpful — instead of things that cannot work in these instances, like attempts at verbal convincing?

In other words, as Norm Hoffmann sorts diagnostically using the Big 5, so we could sort therapeutically by the presence or absence of impenetrable cognition. 

Perhaps one day cognitive neuroscience and our field will have unified research inquiries toward helpful clinical methods where we are currently stuck.

We are pleased to announce the release of our newest Tips & Tools for Recovery that Works! video Unconditional Life Acceptance.

In this next episode of the Unconditional Acceptance series, we learn that while we may not have the ability to change our life circumstances immediately, we have the power to change the negative ways we think about them, learn what we can and cannot reasonably control, and how to work towards acceptance.

Click here to watch this helpful video on our YouTube channel.

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Provided by Roxie Jo, guest contributor

Due to the global pandemic, services and care centers have become less accessible to individuals recovering from substance and behavioral addiction. Rehabilitation centers have limited the number of admissions and some clinics have even shut down to prevent the spread of the virus. This has caused significant disruption to the daily routines of those recovering from addiction; many families may be unsure of how to support their loved ones. Some medical professionals and institutions have adopted telemedicine as a treatment method during these times, which can help mitigate consequences such as relapses and overdoses. Despite limitations, online and remote resources such as virtual meetings can help provide some much-needed support to affected communities.

Regular check-ins can provide a sense of structure

Staying connected with others has a positive impact on overall mood and well-being. Connection is even more vital for those recovering from addictive behaviors. Stress related to work and environmental instability can trigger a return to pre-treatment attitudes. Providing a sense of routine can help bring those in recovery back out of the shadows and reduce the likelihood of temptation. Scheduling regular check-ups through voice or video calls can bring back some structure and ease some mental health challenges. Encouraging individuals to set aside time for work and play, even if they’re at home, can also improve the process of recovery.

Access to educational tools can boost awareness

For families who are new to the process, there are plenty of online resources that provide a background on the factors linked to addictive behavior and help guide individuals through the process of recovery. With video conferencing, families gain a deeper understanding from professionals as they lean on the skills these practitioners learned at university. Most graduates who entered the field studied human development and family studies in college, equipping them with the ability to communicate and support individuals going through the complex process of treatment and recovery. Learning about the psychological principles behind addiction from skilled professionals will instill a greater sense of confidence in family members and friends.

Smartphone apps can build a sense of community

While online resources do have limited accessibility for some, connecting with like-minded individuals through apps can provide significant aid to those in vulnerable situations. Many of these apps have been developed in response to the pandemic and have a series of useful features that add value to the recovery process. Some apps include social media features, 24/7 access to licensed therapists, and the ability to join virtual group meetings specific to your area. Other apps also collect and analyze behavior patterns, which can provide personalized insights into the process of long-term recovery. For many individuals, having the ability to take their healing in their own hands can be a powerful tool.

Many resources are economical and easily accessible for newcomers

For those who are taking the first step towards seeking behavioral help for addiction, many online resources are free to sign up for or require a minimal fee to join the program. Some individuals might suffer from social anxiety or other factors that can prevent them from seeking in-person aid. Online chat rooms and group meetings can provide a greater sense of anonymity for some. In addition, these allow newcomers to seek guidance at all hours of the day as opposed to in-person forms of treatment. However, all individuals should be mindful of any information found on online communities and verify whether it is backed up by scientific research.

During this pandemic, families and individuals are especially vulnerable to the unpredictable nature of events. However, there are plenty of online resources that can provide remote aid for those on the path to recovery. Setting a regular schedule, joining online meetings, and making use of online forums are all great ways to prevent the rise of addictive behaviors. Family & Friends meetings can teach affected families key skills on self-protection and non-confrontational communication to help their addicted loved one through this process.

About SMART Recovery Family & Friends

SMART Recovery Family & Friends helps those who are affected by substance abuse, drug abuse, alcohol abuse, or other addictions of a loved one. Our program is a science-based, secular alternative to Al-Anon and the Johnson Intervention, and our method is based on the tools of SMART Recovery and CRAFT (Community Reinforcement and Family Training). CRAFT aims to teach family and friends self-protection and non-confrontational communication skills to help their addicted loved one find recovery.

You can find Family & Friends meetings in-person and online.

If you are interested in starting a Family & Friends meeting in your local area, we would love to hear from you. Please click here to learn more about starting a Family & Friends meeting.

Click here to read more about SMART Recovery Family & Friends.

Strengthening and supporting long term recovery for diverse communities across multiple pathways of recovery is a goal that would reap huge benefits for our entire society. As I have written about before, the single most important focus of substance use treatment and recovery policy in the United States should be on getting as many people as possible into long term, stable recovery.  As I noted in a Statnews piece in January, few Americans get anywhere near 90 days of care, which is the minimum effective dose for the average person. Within the confines of existing insurance networks, short-term treatment of 28 days or less is all that most Americans are offered — if they can get any help at all. It is an inadequate care system designed to deliver less than what people need because we still moralize addiction and do not value people who have substance use disorders. These dynamics has created fragmented care with large gaps. We are not properly focused on the ultimate goal, achieving and sustaining long term recovery for all persons who are addicted. One way to look at how this has unfolded is to view it in terms of a tragedy of the commons.

The tragedy of the commons originally focused on environmental concerns and the dilemma created by the pitting of short term self-interest against long term whole community interests. In more recent years the concept of tragedy of the commons has been applied to decision making processes and social policy. They are problems that generally transcend solutions using the tools at hand using the systems in place. Long term recovery is well within the tragedy of the commons as achieving it benefits all institutions but individual, short term interests prevent us from focusing on these needs. A related concept is the free rider problem, in which individual interests are to take advantage of work done to strengthen community resources but to not be contributive towards those ends. An example of a free rider problem in respect to substance use treatment is the tendency for private insurance entities to provide minimal care and shift costs to the public system as the person loses their job because their drug use begins to interfere with job performance. As noted by Griffiths and Kickul “there are two practical ways to try to overcome any Free Rider problem: compulsory participation (taxation) – a form of regulation, and secondly, linking the public good to a desirable private good (getting people to pay voluntarily).” We may well need to develop policy that strengthens addiction recovery and support that benefits the commons of long-term recovery that assist us in navigating around the tragedy of the commons.

We have an existing support fellowship model historically set up intentionally to avoid these dynamics. Mutual aid support groups such as AA focus on the needs of the commons by design. They are decentralized, autonomous and focused on the common goals of the community through group consensus. In reflection, the development of these mutual aid societies, while now ubiquitous were nothing short of miraculous to have occurred here in America considering our highly individualistic culture. As noted by Ernie Kurtz in his interview with Bill White on the history of AA. “AA, I think could have only come out of the American 1930s—after the crash of 1929 and the Great Depression taking effect. For the first time, this “go get ‘em” optimistic American culture hit bottom. Some people who had been titans of business and were doing very well—suddenly they were rummaging through garbage pails outside of restaurants….People who had been used to controlling things learned that they were powerless, and I think that it was in this clash that some first discovered AA . . . that level of business-people who had to confront their powerlessness…AA could have only come out of the American 1930s.” Mutual aid rose out of an era in which the tools of self interest were not working that well even for the most privileged and as a result there was a heightened sense of communal need.

What is “in the commons” in respect to long term recovery?

• Long term, whole person recovery focused research that examines recovery over the long term in order to understand what works for whom and under what conditions.
• Focused effort to reorienting our entire addiction care system to fully create and sustain the five year recovery care model as the research is showing us is that this is the point at which 85% of persons will remain in recovery for life.
• Full inclusion of persons in recovery in the design, implementation, delivery and evaluation of services in order to ensure that care meets the needs across the full spectrum of diverse persons seeking help.
• Tools to hold our care systems accountable when disparate, short term care is provided to ensure that applicable laws around access and duration of services are consistent with applicable laws.

Developing the commons of long-term recovery services has not as successful as we had hoped. We have made progress in some areas, but even the gains made tend to degrade back to baseline over time. Non-Government Organizations who have attempted to focus on developing the infrastructure to support long term recovery quite often end up suffering from mission creep away from holistic strategies focused on long term recovery into more narrowly focused goals. This occurs because grant funding and foundation money tends to have more narrowly focused goals and focus skips from funding source to funding source in ways that reduce the development of a cohesive system. They can also get trapped in fee for service models that make it difficult to achieve the goals that were originally envisioned. Over time, pursuit of these resources moves organizations away from their holistic focus on long term recovery.

So how do we move forward with the work of long-term recovery in ways that stay true to the vision of developing an infrastructure to support long term recovery in America?  Government has traditionally been a resource for developing and sustaining the commons. For it to work, there needs to be the vision and inclusiveness over the long term to develop it. Fundamental to achieving that end, it is necessary for governmental institutions to possess deep understanding about recovery and a commitment for inclusion of communities of recovery. History also shows us that private interests and politics can interfere with these dynamics as they have more narrow interests.

Despite all of the challenges, the vision of a long-term care and support system is well worth the effort. It would have dramatic benefits for our entire society. Benefits to pursing a long-term recovery care and support model include reducing social costs like incarceration, reducing healthcare expenses and slashing social service demands. This could happen if, our era is in some ways parallel to the dynamics of 1930s in which there is recognition that our traditional models of responses are not working and more community wide solutions are needed. As we collectively work to build out long term care and support infrastructure, we need to pay attention to building out and protecting the commons. We will need to consider how are actions and efforts are contributive to the larger goal and work with each other to build out a cohesive, multiple pathway care system that supports recovery for all communities across the nation.  Lets do this and support a recovery commons that ensures that recovery is the probable outcome for the next generation!

“What I try to tell young people is that if you come together with a mission, and its grounded with love and a sense of community, you can make the impossible possible.” – John Lewis

This was originally posted in 2011 and seems like a appropriate follow-up to yesterday’s post.

I suppose the notion that the the recovery community is a useful fiction can take us in multiple directions.

• If the recovery community is a fiction, then it’s boundaries are also a fiction, not static, and can be changed (expanded) at any time.
• If the recovery community is a fiction, the connective tissue may be more brittle, and unity more fragile, than we imagine.

Ta-Nehisi Coates explores the challenges and political fiction of political movements by unpacking this passage from a feminist:

“She, who is so different from myself, is really like me in fundamental ways, because we are both”: This is the feminist habit of universalizing extravagantly–making wild, improbable leaps across chasms of class and race, poverty and affluence, leisured lives and lives of toil to draw basic similarities that stem from the shared condition of sex…

Inevitably, the imagined Woman fell short of the actualities of the actual woman it was supposed to describe, and inevitably, the identification between the feminist who spoke and the woman she spoke for turned out to be wishful, once those other women spoke up…

But although the Woman at the heart of feminism has been a fiction like any political fiction (“workers of the world,” “we the people”), it has been a useful fiction, and sometimes a splendid one. Extravagant universalizing created an imaginative space into which otherwise powerless women could project themselves onto an unresponsive political culture….

I’ve sometimes struggled with the recovery advocacy movement suffering from the same thing. I think you could substitute “woman”, “feminist”, etc with recovering people and it would be pretty accurate.

We often struggle with how inclusive to make definitions of recovery, who we include in the “community”, etc.

This push to universalize recovery has, I think, been helpful. It’s pushed many people in the recovering community to think of themselves as something larger than their small group and how more people might be helped. (It’s worth noting that Bill Wilson has been described as obsessed with how to reach and bring more people into recovery.) But, it has its limits and, at some point, I suspect it could be harmful. The same walls that inhibit inclusiveness also serve as a container for shared identities, concerns, sentiments, etc. So, I think some caution is probably a good thing.

Ta-Nehisi offers this thought:

But what I like about her analysis is that it doesn’t stop at noting the very obvious point, that political fictions don’t live up to realities.Instead she pushes on to assert that people create political fictions for actual reasons, and often those fictions have actual positive results.

Faces and Voices’ blog has a new post arguing that social justice advocacy is in the recovery advocacy lane.

We are pleased to announce the release of our newest Tips & Tools for Recovery that Works! video The DISARM Method. In this video we define DISARM, share its history, show how to objectify urges, and what to do when they happen . Checkout the SMART Toolbox for additional resources. Click here to watch this helpful video on our YouTube […]

Growing up, Betty Jacobs knew her family and the community would not be open and accepting of her sexual orientation, so she hid her true identity.  She followed the “normal” route and got married and had children because being a mom was something she always wanted.  But there was more to Betty that people needed […]

“What is past is prologue” as William Shakespeare once said. While this does not mean that history is fated to repeat itself, it does point to the tendency for patterns to echo. Understanding those patterns can help us understand the present and potential risks we face currently. Readers interested in learning about our history, the authoritiave work on the subject is Bill White’s Slaying the Dragon. One of these “echoes” is a tendency to marginalize communities in recovery participating in the development and implementation of the polices and processes related to treatment and recovery from substance use disorders.

There is evidence of erosion in the progress we have made to ensure that people in recovery whose role it is to focus on recovery are at the table when decisions are made about us. Our stories are still valued when they serve other’s needs, but our involvement in matters related to our care perhaps unfortunately less so. This kind of marginalization has occurred historically and so is a concerning trend at this juncture.

An example of marginalization that I observed occurred a few weeks ago for me when I was working with a group and the history of the CRS credential in Pennsylvania came up. The SUD peer credential for the state of Pennsylvania was developed through grassroots efforts by recovery community organizations for use within our communities for persons to engage in and sustain recovery. Our very development of the credential was missing from the body of work being reviewed. Additionally, all reference to recovery community organizations were also absent.

A few weeks later, I was working with another group on a document and a discussion of the definition of a recovery community organization occurred. Some non-recovering participants wanted to remove the word “authentic” from the definition of a recovery community organization. It is a central element of the definition  defined by Valentine, White, Taylor in 2007 where the authenticity of voice is highlighted as a critical component.

What does it mean twenty years into the new recovery advocacy movement when we must fight for the very right to define ourselves?

The vast majority of decisions made about persons with addictions are still made with no one in recovery in the room who are focused on the needs of the recovery community. When we are included, it is often in a token role or with persons cherry picked to reflect the desired outcome or share our story to highlight someone else’s agenda. It is by definition paternalistic and exclusionary. History shows us that this tends to move us away from policy (and resources) that serves our community and ultimately away from the very needs of the community. This is a fairly persistent historical pattern.

The opioid crisis and the influence of implicit bias have exacerbated these dynamics. The sad truth of the matter is that while we have made progress in making recovery more visible in society, we have not moved the needle very much on the underling dynamics of marginalization.  There remain deep biases against person in recovery which lend themselves to paternalistic processes that do not serve us well.  This play out in a variety of ways, including burgeoning administrative demands on our SUD care system and greater disparity in accessing care for an SUD in comparison to medical care and lower compensation for our SUD workforce than social workers or mental health counselors. It is still true here in Pennsylvania and beyond that having a substance use condition is viewed in a more negative light than a mental health condition. Until this changes, there will be a tendency to discount and marginalize our voices.

So what does inclusion look like?  According to this 2014 study focused on education there are five essential elements have emerged in looking at inclusion:

• Relationships with the individuals and groups that involve deep connection and awareness of their diverse needs.
• Shared experiences with these groups that bring them into the process in meaningful ways that foster deep insight and empathy for the affected community.
• Advocacy the absence of which not only results in non-participation but the lack of voice. Without an advocate to push for inclusion, and lacking the skills to effectively speak for oneself, a situation of exclusion more readily emerges.
• A sense of identity in which there is sensitivity towards and deliberate focus on fostering a sense of identity and understanding the shared focus of the group in a truly representative manner.
• Transparency, runs through the entire system and involves the seeing of what is present, but also seeing what is not. With an increased awareness of inclusion (and its flip side, exclusion), how values are put into practice in an open, intentional and respectful manner.

Policy that excludes the recovery community moves away from the needs of that very same community; it is the wrong path. Inclusion in deep, meaningful ways strengthen policy and supports recovery across all of our communities. This is what history teaches us. We should be wary of increasing marginalization and paternalism and seek ways to provide meaningful inclusion. Recovery ultimately occurs in the context of community and we cannot effectively support recovery without including the recovery community.

Nothing about us, without us is our historical rallying cry for good reason.

Our community deserves nothing less than full inclusion in matters related to our own care.

Is the person that is speaking relatively known or relatively unknown to us? 

• Do we hear their words, or do we hear them (their person)?
• As we listen, how do we determine if we hear or neglect their words?
• As we listen, how do we determine if we hear or neglect their person?

As we listen, do we apprehend the transcendent?

• Do their words obscure their person from us? Or do we hear their person?
• To the extent we know them, are either their words or person obscured by our knowledge of them?
• To the extent we know them, do we hear our projections instead of them and their words?

Is our history (personal or professional) in the way of hearing? 

• Do we hear with quality?
• Do we hear with coherence?

• Are we hearing the person’s desired outcome instead of hearing their person?
• Does our desired outcome for them obscure us from hearing their words? Or from hearing their person?

• What theory, tradition, or discipline of theirs is in their way?
• What theory, tradition, or discipline of ours is in our way?

• Are we employing an objective arrangement instead of listening?
• Are we hearing, or only following a narrative of words?

What is being said? 
What is the person saying?

Inspired by a fresh reading of:

Foucault, M.  (1969).  What Is An Author?  Lecture given at the Collège de France.