When Professor Judith Grisel sat down to write her book Never Enough (a guide to the neuroscience of addiction that has been her life’s work), she didn’t expect to share so much of her own story. Nevertheless the resulting chapters are a collision of the personal and professional, detailing the deep links between her work life and the decade of drug and alcohol addiction that almost destroyed her.
On paper, Grisel was an unlikely candidate for going off the rails. One of three children, she describes a privileged upbringing in a progressive, suburban area of New Jersey. With an airline pilot father and a mother who was a registered nurse, Grisel remembers growing up in a “perfect-looking family”.
As her research would go on to help demonstrate, there was no single factor that predicted her drug problems. Neuroscientists have found a complex blend of nature and nurture at work in addictive tendencies and their research shows that many genetic, epigenetic and environmental factors work together in complex ways that often remain elusive.
“Why me?” is the question that underpins much of Grisel’s research, and she continues to wonder why friends who drank heavily with her in high school were spared addiction. In Never Enough she offers a smorgasbord of theories behind her own and others’ predisposition to addiction: an “extreme” personality and love of risk-taking, trying drugs at a young age, lower levels of endorphins in the brain, potential hypersensitivity to the neurological rewards of drugs alongside, more surprisingly, her own parents’ strict response to her behaviour.
“If they had just been a little more lax, if I hadn’t been the first child, I probably could have been normal,” she reflects. Grisel did not experience the childhood poverty, insecure housing or abuse we have come (rightly) to associate with some drug users’ histories. Instead she believes the misery within her parents’ relationship and the pressure she felt to keep up appearances had the greatest impact on her trajectory. “Their marriage was so dysfunctional that my mother eventually got an annulment from the Pope but we never acknowledged it at the time. As a kid I felt like a prop in this play of the perfect family.”
A pivotal moment came when, aged nine or 10, Grisel found her mother crying at the kitchen sink. “I asked her what the matter was and she answered that she was crying because she was so happy. My stomach sank a thousand feet because I knew it wasn’t true but I also knew there was no way to reach the truth.” Her mother’s insistence that the family ignored the reality of their problems and instead went along with a pretence of happiness had a profound and negative impact on the way Grisel herself came to understand her own emotions and place in the world.
“What I learned to do in that moment,” she explains, “was to doubt my reality; to realise that what was critical in life was the story, the veneer. And that felt like dying.”
So began Grisel’s search for a way to escape her everyday life, a life that felt false and full of pressure to go along with the pretence, and instead to find a way to feel something that felt like the truth. It started with an obsession with reading books, “I would read constantly, upside down if I had to,” and then aged 13 (reaching a key developmental point when the teenage brain is primed for risky behaviour) she had her first drink. “I thought, this is how people get through life. I can pretend all this stuff, because I can have this little secret where I’m nice and warm inside,” remembers Grisel. “It was the first time in my life I remember feeling relaxed.”
Grisel swiftly progressed to the “solace” of daily drinking, smoking marijuana and regular drug use. “I loved being able to connect to my true self and I only seemed to be able to do that when I was wasted,” she explains. Unsurprisingly, she was soon in trouble at home and school, trouble that escalated through her teenage years until she was “kicked out” by her parents when she was 19 – dropping out of her first year of college at the same time. After years of trying a range of ways to stop Grisel taking drugs her family now withdrew financial support entirely. As she left home, despite her “brawny high school football player brother” crying in the street, she felt exhilarated: “I felt like all the restraints were off and things got very bad after that.”
Increasingly detached from her parents, who she barely saw over the next four years, Grisel’s life became entirely focused on drugs. “I was scraping by on nothing but lies and evasion and my only priority was staying loaded.” Now injecting cocaine, her dedication to the next hit led to frequent homelessness and unemployment. When she did find work she stole from the till, she regularly took credit cards from strangers and ruthlessly stole money and drugs from friends. Soon she was “facing lunatic dealers and DEA agents” with a single-minded determination that she also credits with her subsequent scientific tenacity.
The depravity of Grisel’s addicted life, described in the memoir chapters of Never Enough, illustrates the vicious cycle of the “A and B process” she explains in the scientific sections of her book. When humans engage in any mind-altering activity, the effects are known as the “A process”. Whether it’s the sedation of alcohol or the rush of cocaine, users often feel pleasure from the initial use of their drug of choice. But as Grisel is at pains to explain, “There is no free lunch.”
She believes people might make better choices if normal brain function was more widely appreciated. “The brain adapts to any addictive substance or activity by producing the exact opposite effect,” says Grisel. This opposite state, known as the “B process”, is led by the brain’s drive to return to its baseline state – and it’s why hangovers and comedowns are such unpleasant experiences. Our brains are so efficient at returning to normal that with regular use we need more and more of the drug or activity to feel the “A process” and the oppositional “B process” kicks in almost instantaneously. Soon, as Grisel herself experienced, we need the drug just to feel normal and without it we only feel the negative impact of the “B process”.
With addiction rates rising steeply, helping people avoid being imprisoned in this cycle is a priority for many worried parents, case-workers, researchers and Grisel herself. But, just as a simple set of causes of addiction doesn’t seem to exist, there doesn’t appear to be a magic recipe for recovery either. Grisel describes her own transformation from addict to sober scientist as a collection of coincidences and luck. “I was inexplicably fortunate. I think I was carried through by circumstance,” she says.
A lucky break led to better housing and a move away from injecting cocaine. After a “terrifying encounter” with her reflection in the mirror, the final push she needed to start her recovery came from her parents. In a crucial moment of compassion from her father, he told her he wished only happiness for her life and the 23-year-old finally realised just how unhappy she was.
A drug-treatment facility in Minnesota was followed by a three-month stay in a women’s halfway house and then Grisel began to repair her life. A key motivation for staying sober was her determination to find a cure for addiction. At the beginning of her career, Grisel and others in her field were convinced they would swiftly find that cure, but as neuroscientific understanding has deepened it has revealed just how much we don’t understand. “In the book,” Grisel reflects, “I was shocked that I couldn’t say that neuroscience is making great strides. It didn’t seem true to me.”
Though she can’t yet offer a magic switch to turn off addiction, She now believes much of the answer lies not in manipulating DNA but in encouraging human love, compassion and connection. With more high-potency drugs available more widely than ever before, alongside a sea of addictive technology enticing adults and children to “fritter away our lives checking updates just like users fritter away their lives snorting cocaine”, Grisel believes we need a range of tactics to tackle the global problem of addiction. “The people right next to us are an obvious place to start,” she adds. “Human relationships and connections are the low-hanging fruit.”
With her own 16-year-old daughter and grown-up stepsons she and her husband have prioritised staying emotionally connected to their children and, when they are worried about behaviour, sharing their own feelings rather than telling their children what to do. “I will say, ‘I love you and I’m really concerned about this. If you need help, I will give it to you,’” Grisel says. “But I will also be clear that I am not going to enable the behaviour.” Despite choosing to parent differently from the way that she was brought up, Grisel now reflects on her parents with compassion, believing that if you have a child who is an addict, “It’s an almost impossible situation to be in and very hard to know what to do.”
Decades of research and experience have led Judith Grisel to believe that the dominance of addictive substances and activities in contemporary life are leading society to the brink of an addictive black hole and that it is only by connecting with each other that we can avoid being sucked in. “Right now we’re in a rising phase of escapism and pharmacology – this epidemic of addiction is really an epidemic of avoidance. Above all we need better ways to cope with life and to be present to our experiences.” Despite her concerns, she does have hope. “Ultimately you can’t avoid yourself. It didn’t matter how high I got, I was stuck with myself. I think we’re soon going to get to that point as a society and then we might finally have our moment of truth.” Then, Grisel believes, we’ll discover that the way out of addiction was actually inside us all along.
Never Enough: the Neuroscience and Experience of Addiction by Judith Grisel is published by Scribe, priced £9.99. Buy it for £8.79 at guardianbookshop.com