Toward a Unified Field Theory of Human Flourishing | Frameworks #1
Playing around with frameworks for understanding recovery
This is post #1 in a series about “frameworks for understanding recovery.”
Post two talks about recovery definitions.
Post three addresses definitions of happiness and wellness.
Post four is about recovery capital—all the internal and external resources that can help overcome a substance problem.
Post five is about integrating positive psychology and recovery
Amid the looming uncertainty and crisis of the 1930s, a woman known today only by the pseudonym “Frau V“ wrote to Carl Jung seeking life advice. Jung responded, “Your questions are unanswerable, because you want to know how to live. One lives as one can.” He suggested that if she truly wanted a definitive prescription, she should join the Catholic Church. Otherwise, she had to find her own way: “the way you make for yourself, which is never prescribed, which you do not know in advance, and which simply comes into being itself when you put one foot in front of the other...if you do with conviction the next and most necessary thing, you are always doing something meaningful and intended by fate.”
This advice resonates so clearly with AA’s “do the next right thing” that many have attributed the 12-step slogan to this letter, especially considering Jung’s other connections to AA (though I haven’t been able to definitively trace the lineage of that slogan—does anyone know?). You may have seen some version of this quote recently, especially since Oliver Burkeman concluded his bestseller Four Thousand Weeks with it. I like Burkeman’s book and this sentiment, and I suspect his writing is resonant because there is something in the zeitgeist of today’s therapeutic and wellness culture that feels especially prescriptive, awash in roadmaps and protocols.
Yet, in times of trouble, we often do need plans and prescriptions. Jung wrote volumes about how to make sense of life, after all, and if you went to a psychiatrist and all you got was “do the next right thing,” you’d rightfully be pissed. Twelve-step fellowships are not just a social club but also include a set of suggestions about how to recover from addiction; not for nothing is AA called a “program.” People want to feel better, everyone wants to be happy, and many want help getting clear on how to change—they want a plan.
I’ve been thinking about this tension recently in the context of addiction and recovery. For lack of a better or more specific term, I’m interested in frameworks for making sense of recovery. For a while now, across various fields of research, clinical practice, and other less medicalized discussions of addiction, there seems to be an interest in understanding recovery in a more rigorous, systematic way. “Frameworks” might not suffice—other terms people use include model, theory, program, etc. The theorists and researchers weighing in here range from positive psychology to psychotherapy research and even further afield, adding to the terminological confusion. But whatever you call it, there seems to be interest in working toward a conceptually tighter understanding of recovery. What exactly is recovery? What are we doing when we’re working on it, in it? There’s a reason we keep returning to these questions, and there’s more work to be done.
Yet, I also wanted to start this post with sweet Frau V, who seemed (to Jung at least) to want more definitiveness about her life than was useful or wise. I identify with her. I have often erred on the side of overly rigid, prescriptive plans and expectations for myself. I was the guy in college who printed out mission and vision statements and taped them to my wall. In the last month before my alcoholic breakdown in medical school, I had a different wall chart tracking my meditation, yoga, journaling, and the other dry and joyless personal improvement tasks I had assigned to myself. These efforts didn’t get me far; they didn’t even get me to the end of “Sober October” without drinking.
What I am trying to say is we should be very, very careful about any intimations of definitiveness or finality. The question, I think, is not “what is the one framework to rule them all,” but rather, questions like “how far can we reasonably go in clarifying the phenomenon of recovery,” or “what are some varieties of recovery that people can try for themselves?” That said, this work does have more clarity to offer, and it can be useful. Once someone is repeatedly mystified by their failed efforts to control their drinking, or their phone use, or whatever addictive behavior has its hooks in them, they want something to hold on to; they want a plan or curriculum, or at least a framework for understanding and organizing their efforts. I’d like to see what it’s like to explore that topic in real-time, here on Substack, in a provisional way, and with thoughts, reflections, questions, and comments from you. Let’s see where it gets us.
Recovery matters
It’s a little past the midpoint of Dry January, and it’s worth pausing to consider what the point of it all is. Some people try a month off drinking because they are genuinely terrified by their inability to control their use, but others just want to feel a little healthier. There is no one-size-fits-all answer to how—or even whether—one should try something like this, but in my experience, there is something interesting about the practice, especially for people on the less-troubled side of the spectrum. Most people, even if they feel more energy or better sleep without ethanol in their system, still feel genuinely terrible in the early stages of Dry January. It is not unlike trying meditation for the first time, coming face-to-face with one’s own mind and having the terrifying sense of no escape. Yet, also like meditation, people who persist often come out the other side not just feeling better, but inhabiting a different kind of “better,” not in some animalistic, momentary hedonic calculus of pleasure and pain, but in a more meaningful and enduring way. I don’t mean to valorize Dry January too much, because it’s certainly not a cure-all. But it’s worth noting that even people who don’t qualify for a substance use disorder, let alone an addiction, often get something meaningful out of engaging with abstinence in an intentional way. Is their experience “recovery,” or something like it?
The dictionary definition of the word “recovery“ suggests a return to “normal” functioning, but in everyday language in communities of recovery, it means something more like meaningful ongoing changes: not just resolving a problem with addictive behaviors, but also continuous work toward thriving and well-being. In that sense, recovery is not actually “recovering” anything in the true sense of the word, because it usually refers to an effort to go beyond one’s starting point.
Interestingly, working toward thriving in recovery is not just a bonus but might be an effective form of relapse prevention in itself. Patton and Best (2022) have recently published a qualitative study examining the role of what they call “push and pull factors” in addiction recovery. Push factors are the pains of addiction motivating people to change, like the danger of losing custody of a child or the possibility of incarceration. Pull factors are the positive rewards, like hope, meaning, and connection. In contrast to some of the previous literature, as well as what is probably the stereotypical view of change in addiction, the authors found that positive pull factors were most effective in promoting stable recovery. It’s not rock bottom moments but the promise of a better life that pulls people forward, at least on balance.
This growth-oriented perspective is at odds with most of addiction treatment, which is typically organized around an acute-care model that focuses on suppressing obvious symptoms (i.e., promoting abstinence) over a short duration of treatment. For years now, folks like William White (2008) have been calling for an organizing philosophy of ”recovery-oriented systems of care” that focuses more on the quality of long-term addiction recovery, including recovery maintenance and quality of life. Boutique programs here and there have taken up some of those practices, but overall, it’s hard to say there’s been much success on that front. There are many barriers to implementing such changes at the cultural, political, and economic levels, but one significant barrier is the continued lack of agreement on “recovery” itself, with various definitions proposed by researchers, clinicians, health care organizations, and people in recovery.
There have been what feels like countless attempts to define addiction recovery, and I don’t want to get too bogged down in this post, but just for today I’ll mention in passing that some definitions center on abstinence and sobriety, while others more broadly discuss functioning in life and processes of change. Related but different concepts like recovery capital take stock of the internal and external resources supporting recovery processes, while frameworks like CHIME (connectedness, hope and optimism, identity, meaning in life, and empowerment) purport to categorize the main processes of recovery.1
The point of this short list of examples is not to overwhelm you with jargon but to show how these discussions quickly get muddled. There are so many definitions of the concept that even the word “definition” begins to collapse in on itself. In scientific and philosophical contexts, we can meaningfully distinguish between different types of definitions and problem analyses. These definitions above range across things that are meaningfully different, such as: causes, constitutive elements, the features used for identification, present functional status, aims and aspirations, processes of change, outcomes, and more. For example, recovery capital is about “resources,” but CHIME is about “processes,” which are meaningfully different. Even within CHIME, I can see how “connectedness” can be conceptualized as a process, but is “meaning in life” a process or an outcome? If meaning is an outcome, why is it in the same framework as processes, and what does that actually mean about what we should be doing as clinicians or people in recovery? I could go on about this definitional stuff, but I hesitate to meet abstract theory with even more abstract theory, so let’s put this aside for now.
The point is that recovery matters, and we desperately need more conceptual clarity. Some (no doubt nice and well-meaning) people have made one of those damnable word clouds from different definitions of recovery. It’s a good representation of the various ways recovery has been defined, but looking at it doesn’t help much. It’s a mishmash of words about general well-being, with incidental mentions of substance problems. Surely we could do better.
Addiction is in all of us
When does recovery simply become positive psychology? Most people in recovery sense a meaningful distinction between recovery and what we could call general well-being, but drawing that distinction is unclear. I’ve asked several researchers and clinicians on my podcast this question; we’ve had productive discussions, but we haven’t gotten too far. One issue relates to understanding the nature of addiction.
In my book, I describe one dangerous idea that nearly killed me, and fueled denial and resistance within my family: the notion that addiction is a discrete, bounded, essential condition. The idea that addiction is a thing, a status, in the sense that some people have it and some do not. This is the stereotypical and dominant view of addiction, which, while beneficial for some, has significant drawbacks. Let me try to recap a bit.
This view of addiction as an essential thing is partly a historical accident, as it waxes and wanes across historical epochs. Today, however, we live in a time that emphasizes addiction as a status and not an action.
But addiction is also an action, as seen when the word first entered the English language in the 16th century (“young man, addict yourself to study!”). The extreme forms of addiction are just the place where our universal human vulnerabilities are most clearly on display.
There’s a discrepancy here, and my sense from speaking to various audiences is that people are really struggling to make sense of it: We are swimming in the dominant view of addiction that it is an awful disease that happens only to the most sick of us, those doomed to powerlessness because of some single, simple cause that explains everything: a genetic problem, a profound trauma, exposure to a hijacking substance, or some other outside agent. We are surrounded by images and messaging that rely on and feed this narrative, especially regarding the overdose crisis.2
But, here’s the discrepancy: at the same time, so many people feel out of control. We are surrounded by evidence of subtle, everyday addictions, and we naturally attach the word “addiction” to many common behaviors that don’t neatly fit in the essentialist model. Phone use. Compulsive eating. Media consumption. Consumption in general. Conspiracy theories, division, hatred, and polarization. Money, status, power, anger, distraction/oblivion/escape. Judson Brewer has usefully written about how viewing anxiety as an addiction (especially in the sense of worry and perseveration). The core mystery of addiction is the same as the mysteries of the will, self-control, and sin, explored since the earliest days of philosophy and theology. This is the akrasia explored by Aristotle, in which you find yourself doing something even though you truly believe it would be better not to; i.e., of recognizing in the moment that you are acting against your better judgment. I propose that if you have ever felt out of control, you have felt this. The difference between everyday addiction and severe cases is a matter of degree and not kind.
Addiction is in all of us. This argument has come to matter a great deal to me. The reason I care about it is that when I truly felt this notion in my bones, reading accounts of addiction and recovery from across history, it was profoundly reassuring and comforting. As I write at more length in the book, I developed a sense of fellowship with all those who have struggled with self-control, and it helped me to accept my addiction as something serious, important, but also “profoundly ordinary: a way of being with the pleasures and pains of life, and just one manifestation of the central human task of working with suffering.”
This view, however, complicates the notion of recovery. If there’s no bright and clear divide between serious addictions and the everyday addictions of, e.g., digital distraction and consumption, what makes recovery special? Is it that we are all in recovery, and that too is a matter of degree and not kind? Many people have made that point, at least since the recovery enthusiasm of the 1980s. Or is there something special about being in recovery from addiction?
If addiction is universal, general lessons from disciplines like positive psychology should be central to understanding recovery, and yet there’s little dialogue between these fields. This is a missed opportunity, as there’s growing interest in organized frameworks for understanding well-being in those fields too. One paper that caught my eye and started me down this rabbit hole came from research in the field of meditation and contemplative science. Richard Davidson, best known for his research with Buddhist monks on the neural effects of meditation, authored a recent paper titled “Mindfulness and more: Toward a science of human flourishing,” (2021) What struck me at first was it sounded an awful lot like a unified field theory of human flourishing! Also, though, it offered a somewhat deflationary perspective about mindfulness as a well-being strategy. Here we find an éminence grise of the mindfulness movement explicitly acknowledging that mindfulness is not a panacea and advocating for the development of a comprehensive approach to human flourishing. His group has proposed a framework for understanding well-being, organized around four key pillars: Awareness, Connection, Insight and Purpose. This is just one example of such a framework, and there are several others in the fields of psychology and psychotherapy research, as well as some more unconventional yet valuable additions like Ken Wilber’s Integral Theory and other concepts verging on “new age.” The new age connection shows that we’re actually stumbling across, or perhaps back into, an ongoing quest for a “theory of everything,” a quest that dates back at least to 15th century efforts to outline a prisca theologia, an overarching, singular, and universal universal theology permeating all religions. (HT to Ben Breen, who is enjoying a triumphant and well-deserved publication week for his wonderful new book on psychedelic history.) So, let’s not rush too far ahead; there’s much to unpack here, and more to come.
Niche creation
I named this newsletter Rat Park to suggest that understanding addiction requires a broader focus than just the individual, and simultaneously, to argue that there is no single explanation for addiction that reductively captures the phenomenon. This sometimes requires open-ended, even ambiguous approaches, which is why I’m drawn to the arts and humanities, especially personal narrative. However, and pace Burkeman and Jung, there is also a role for prescriptive planning in designing a life in recovery.
The behavioral psychology of animal research has a concept called “niche selection:” many animals are able to select beneficial environments to thrive, like a rat nesting down in a cozy burrow that has access to grain. Some lucky animals, like us, are able to go a step further and engage in “niche construction:” we get to create our own physical and social environments. It’s good to have a construction plan. The trick seems to be to find the wise middle ground. My aim in this writing, and in my life, is to find a balance between rigid prescriptions and more laissez-faire and indeterminate approaches to recovery and life.
My arguments are modest. Thinking rigorously about recovery is worthwhile for clinicians, people in recovery, and everyone with addictions, which I also argue is all of us. Recovery is more than stopping addictive behaviors; it’s a holistic and multilevel process toward thriving and well-being—toward what we all want, a life full of enjoyment and meaning. This means the concept of recovery should intersect with and incorporate various insights from psychology, psychotherapy, and more. However, it’s worth noting that much of this thinking and work remains isolated from one another. As both my personal experience and Frau V’s demonstrate, we must always be aware of the limits of rigid, prescriptive methods or plans to change.
I wish I could write something more definitive. Many have (and it seems to pay.) Alas, I can’t do that in good conscience. I do suspect we can work toward a better heuristic—a rule of thumb, an understanding of recovery that goes beyond simple definitions or word clouds, toward a conceptually sound framework, if not all the way to a unified field theory. There are existing frameworks with excellent contributions, and the task is to find connections and bring order to the chaos. What comes to mind for you? Let me know. There are too many examples for one person to find and make sense of them all, so I genuinely appreciate your thoughts and feedback.
For now, thanks for reading. We’re still early days here at Rat Park, so if you’re liking this work and want to support it, please share and consider upgrading your subscription.
This is post #1 in a series about “frameworks for understanding recovery.”
Post two talks about recovery definitions.
Post three addresses definitions of happiness and wellness.
Post four is about recovery capital—all the internal and external resources that can help overcome a substance problem.
Post five is about integrating positive psychology and recovery
I’ll talk more about definitions of addiction recovery in the future, because the topic really does require its own post. In the meantime, I’d love to hear if you have found any frameworks or definitions that are useful to you? There are countless and ever-proliferating ideas about this, so your feedback is truly helpful.
Again, I also want to acknowledge that there are benefits to the essentialist view: it’s a double-edged sword. Many of us have experienced or come into close contact with people who at one point were completely and totally out of control, and in some happy cases, this binary view of addiction seemed to help them. It can provide some clarity for refashioning an identity and committing to necessary change. So if you personally ascribe to this view, more power to you, and I’m glad you found it helpful. I’m not trying to change your mind; I’m only trying to talk about the ways this view has also had drawacks.
I got some insightful notes from a reader who said it'd be ok to post these thoughts anonymously. I love this focus on virtue ethics, the self, and transformational change:
"A few quick thoughts: I think Bill White is right that our definitions of recovery should incorporate a changed relationship with the destructive behaviour (transforming your substance use, gambling, etc.), but also a cessation of unwanted negative consequences connected with the behaviour. In clinical terms, remission is not recovery, but (full) recovery should include remission. This is my response to the motto of "every positive change." As healers, we should support every positive change, but overtime these changes should lead to a cessation of unwanted suffering. That might take a lifetime. And it might not be fully possible for some people. But it is the horizon within which we should judge our efforts.
Another problem is the lack of a theory of self in most post-analytic psychology. Self is not just identity, or consciousness, or cognitive mechanisms, but something we build over the course of our lives through embodied practice. Self is at the core of virtue ethics, but is related to concepts like habitus (Bourdieu), and explored extensively in the late Foucualt's work. Once repetitive, destructive practices become incorporated within our selves (at the levels of identity, our social relationships, and embodied being-in-the-world), transforming the behaviour requires a transformation of self. It's blurry, but I think there is a genuine dividing line between behavior change that does and does not require this type of global transformation. And outside the language of recovery or religious language, I am not sure we have a language to describe this type of transformation.
I think part of what makes AA, but also a lot of New Age self-help, attractive is that they provide working models of self to guide a process of behaviour change--a model of an object to act on that also has meaning or is connected to the search for meaning. Not that these models are good--they are often harmful--but they give people a way to think about what they are changing that connects the effort to something larger. Much contemporary psychology is a cluster of processes, mechanisms, schemas--adding up to nothing, and divorced from the problem of how to live. That is why your starting with Jung resonates for me."
I would be interested in reading your thoughts concerning the disease theory of addiction so emphasized in the 12 step movement. For my part, I regard it as a useful fiction - useful because it helps some people drop the guilty feelings that only fuel the problem.
And I don't like turning my addiction into an identity. My blood pressure tends to run a bit high, but I have never introduced myself by saying "Hi. My name is Eric and I'm a hypertensive."