Medical thinking usually sees stress as highly disturbing but isolated events such as, for example, sudden unemployment, a marriage breakup, or the death of a loved one. These major events are potent sources of stress for many, but there are chronic daily stresses in people's lives that are more insidious and more harmful in their long-term biological consequences. Internally generated stresses take their toll without in any way seeming out of the ordinary.

A long-term substance abuser, a few months before his death, penned this poem: Went downtown, Hastings and Main, looking for relief from the pain. All I did was find a ticket on a one-way train. ... Give me peace before I die. The track is laid out so well; we all live our private hell; just more tickets on the hell-bound train.

A hurt is at the center of all addictive behaviors. . . . The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there. As we’ll see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain

The very same brain centers that interpret and feel physical pain also become activated during experiences of emotional rejection. In brain scans, they light up in response to social ostracism, just as they would when triggered by physically harmful stimuli. When people speak of feeling hurt or of having emotional pain, they are not being abstract or poetic, but scientifically quite precise.

Medical thinking usually sees stress as highly disturbing but isolated events such as, for example, sudden unemployment, a marriage breakup, or the death of a loved one. These major events are potent sources of stress for many, but there are chronic daily stresses in people's lives that are more insidious and more harmful in their long-term biological consequences. Internally generated stresses take their toll without in any way seeming out of the ordinary.

We may not be responsible for the world that created our minds, but we can take responsibility for the mind with which we create our world.

In the real world there is no nature vs. nurture argument, only an infinitely complex and moment-by-moment interaction between genetic and environmental effects