It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behaviour.

It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behaviour.

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

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

Autonomy is impossible as long as one is driven by anything.

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.

Not why the addiction, but why the pain.