Episode 395: How Culture Shapes the Way We See Addiction: Stigma, Willpower and Why Environment Matters with Dr. Maria Cichosz

Maybe you've watched someone you love do something that makes no sense, something that's clearly hurting them and everyone around them, and you've asked, "Why would anyone choose this?" Or maybe you've asked that question about yourself. It's such a human question. And the answers we come up with, the stories we tell about addiction, end up shaping how we treat people who are struggling... including ourselves.In this episode I sit down with Dr. Maria Cichosz, a writer, critical drug studies scholar and professor of literature and creative writing at Victoria College, University of Toronto. Maria isn't coming from a medical or therapy background. She has a PhD in literary and cultural studies, and she brings her own story: growing up as the child of Polish immigrant parents in a home marked by generational trauma and addiction, and her own relationship with substances over the years. Together we look at how our ideas about addiction have changed over time, from a choice, to a weakness of the will, to a disease of the brain, and what each of those stories gets right and what it misses.It's a big conversation, and Maria doesn't pretend there are easy answers. But there's a lot of hope in it. When you can see that our ideas about addiction haven't always been this way, you can start to imagine they could be different. More compassionate. More human.Key TakeawaysOur ideas about addiction have a history. The idea that addiction is a disease of the brain is only a few decades old. Before that it was seen as a weakness of the will or the soul, and before that, a behavior some people chose. Those stories affect how people get treated today.The brain disease model helps, and it's still only part of the picture. It takes blame out of the equation. But a brain scan is "a brain in a vat," as Maria puts it. It doesn't show poverty, trauma, isolation, overprescribing or punitive drug policy.Environment matters, a lot. In Rat Park, rats who had community, play and stimulation mostly chose not to take the drug. Rats aren't people, but we're social creatures too.Compassion and responsibility can live together. Duane and Maria sit with the hard question of how we hold people accountable for the harm they cause while also understanding the forces that brought them there. Neither of them has a clean answer, and that's okay.Stories can build empathy. Fiction lets us step inside someone else's head and see that they think, feel and struggle much like we do."I wish I could tell y