The tragic death of Phillip Seymour Hoffman has once again brought drugs back into public consciousness. His death is very sad. Life is precious. This is most pertinent to those who knew him and loved him. That does not include you or me. The only reason we even know about his death is because he was a celebrity. We do not know Phillip Seymour Hoffman. Some anonymous person dies a sordid heroin death just like his every two hours. It is happening right now as I write, and more will have died as you read. His death is not anymore tragic (or any less tragic) than those who are dying right now.
I don’t know anything about his actual life. And neither do you. As a psychiatrist, I have had the occasion to learn the real truth about many lives. I do know that the actual story behind every life is very different than its public image. I have treated celebrities, and they are no different from you or me. We all have the same human struggle.
Every patient evolves a character adaptation from early childhood which reflects the way his temperament fields his emotional environment – responsiveness, abuse, and deprivation. With a good enough foundation we are then able to traverse the temptations of adolescence that we are all susceptible to. Thus we construct our characters. Why do some kids experiment with and then stop self-destructive behavior, while other kids go deeper into the dark side of life? The teenager who has had good-enough loving in childhood retains the presence of his Authentic-Being as the core of his self. The Authentic-Being is the rudder by which one navigates through the smorgasbord of experience and life’s temptations. When this adolescent strays too far in a self-destructive avenue, as all kids do, there is a quiet voice inside him that says, “What am I doing? I’ve got to stop this.”
Substance abuse is but one among the many temptations of adolescence that to one degree or another we are all subject to. The list is not long: sex, drugs, drink, gambling, eating (from gluttony to anorexia), reckless action and sensation-seeking, stealing and cheating, egotism, and sadomasochistic attachment and anger.
So I don’t know Phillip Seymour Hoffman’s story. But I do know he is no exception, just because he is a celebrity. He did not have that voice inside and he came by it honestly. Even though I don’t know what they are, I know he had problems at his core. Remember, a person who is real good at pretending that he is another person isn’t necessarily the model of a fulfilled self.
I do know that it was not his dealer’s fault that he OD’d. He’d have found another dealer. He is responsible, like anyone, for putting the needle in his arm and disregarding the welfare of his children, of the mother of his children, of his friends and those who loved him. He is not just a victim. As much as this is a tragic loss, Phillip Seymour Hoffman is not a hero, and he is not a model. This is not meant to be cruel. His death is a tragedy and I feel bereft by it. I am very sensitive to the pain one must face to mourn and recover one’s core in therapy. I certainly know how difficult addiction is to deal with. I treat it every day.
There are many misleading myths of popular and psychiatric culture today. Addiction is not a disease. The temptations of addiction can be almost anything, even your cell phone. But it is not a neurobiological disease. Yes, I know this sounds like a heresy. Being old, I was there when substance addiction was falsely granted ‘disease’ status. It began as a ploy on the part of Alcoholics Anonymous to further the idea that alcoholism is not your fault, and you can’t control it. In the seventies the disease idea was promoted. It wasn’t so before then. It was a conscious decision, known to be a metaphor and not really true. [In fact, of all the addictions, alcoholics do the thing they allegedly can’t do: They successfully stop drinking at a very high rate.]
Then as psychiatry falsely developed its own (faulty) disease ideas regarding depression and anxiety, etc., suddenly alcoholism and substance abuse, like all the rest of them was considered a real biochemical disease. Then with the neuroscience explosion, these ideas became even more cemented as facts. But it is not true. It is a house of cards. The human condition is as it always has been. And now we aren’t just dealing with the relatively small and horrific heroin epidemic, but a huge pharmaceutical epidemic that reaches far more people and brings in over $75,000,000.000 a year to big Pharma.
Robert A. Berezin, MD is the author of “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain.