Topic: addiction and the brain
The best answer is the one we came up with to explain the selectivity of alcoholism: Differences in individual susceptibility.
Suppose we could develop cognitive techniques and train the patient to use them whenever symptoms reappeared?
In fact, it’s often difficult to convince the trauma patient to seek treatment, in part because of fear of having to re-experience the event.
Of course, the drinker isn’t aware of having entered a blackout. Far as they’re concerned, things are proceeding as normal.
We can’t predict in advance which user will turn out to be in which category, and frankly, neither can they.
If addiction really is a brain disorder based in complex adaptations to a substance, then who’s to say those adaptations won’t occur with a different drug?
There’s no blood test, no scan to aid diagnosis. Knowing intellectually that one in ten will succumb is very little help; it has no practical value in terms of predicting an individual outcome.
The way addicts and alcoholics themselves talk about their condition (“an emotional disease,” “a parasite the feeds on our emotions”, “an emotional cancer,” “a fear based disease”) is rarely considered in theories of addiction.
While it may have similarities to other disorders, the emotional dysregulation that characterizes addiction is not the same.
The personal story that recovering folks tell at 12 Step meetings is a reconstruction of episodic memories.