Filling The Void

The U.S. news is rife with headlines about overdose deaths from heroin and prescription opioids like OxyContin and fentanyl, a synthetic opioid forty to fifty times stronger than heroin. The nationwide scare has doctors, therapists, social-service agencies, policy makers, law enforcement, and communities looking for solutions.

Bruce K. Alexander, author of The Globalization of Addiction: A Study in Poverty of the Spirit, thinks we need to look far beyond conventional views to understand addiction. Unlike most, he does not view addiction as a disease; he sees much of it as a way of adapting to the alienation and disconnection produced by modern, westernized societies.

Born in 1939, Alexander trained as an experimental psychologist and became a pioneering researcher of heroin addiction at Simon Fraser University in Vancouver, British Columbia, Canada. There he was skeptical of studies in which rats were kept in small cages with a lever they could press to get morphine or other drugs; they would self-administer the drug until they stopped eating. Alexander noted that the rats, who are social animals, were under extreme duress due to isolation in these experiments. He and his research colleagues designed their own experiment, creating what they called “Rat Park” — a big container with wood shavings, tin cans, running wheels, and soft nests, where rats could romp around together. When these rats were given access to morphine, they tried it but did not become addicted. His findings challenged the prevailing belief that exposure to an overwhelmingly addictive substance automatically creates insatiable cravings for more.

After Rat Park, Alexander focused on the history of addiction. In addition to The Globalization of Addiction, he cowrote, with Curtis P. Shelton, A History of Psychology in Western Civilization. Alexander retired from teaching in 2005 but continues to be an outspoken activist. (brucekalexander.com)

He lives in Vancouver and spends much of his time writing on nearby Pender Island. He and his wife share their home with one of their grown sons and his family. In their urban neighborhood, which Alexander describes as “the best place I’ve ever lived,” the houses are close together, homeowners plant vegetable and flower gardens, and neighbors frequently interact with one another.

In 2011 I did a telephone interview with Alexander for my Living Hero radio and podcast series, and he and I have corresponded ever since. For this conversation we met in rural Massachusetts. He had come to the U.S. to give a keynote speech for the Maine Harm Reduction Alliance Conference.

 

Chevalier: What’s currently going on in mainstream addiction research?

Alexander: I don’t think there is a mainstream. Addiction research is a vast field that includes biomedical, psychological, and sociological studies based on countless conflicting theories. It can be bewildering even to try to catalog it all: willpower theories; genetic theories; brain theories; trauma theories; immune-deficiency theories; vitamin-deficiency theories; psychological theories pointing to misplaced love or a forlorn attempt to keep one’s parents together by giving them something really big to worry about. There are innumerable hypotheses. But no one has solved the mystery to everyone’s satisfaction.

The one common assumption today is that the answer to the problem will be found in science and modern medicine, which locate the cause of addiction in the fallible individual and in the drug itself. This view can be traced back to the nineteenth-century temperance movement and even earlier. The assumption is that drugs transform human beings into addicts who single-mindedly seek out more drugs. In the nineteenth century addicts were called “demon-possessed” and “degenerate.” In the early twentieth century they were called “drug fiends.” Now biomedical researchers speak of drugs as putting people “beyond willpower” or “hijacking the brain.” Despite the differences in language, I’m not sure there’s been any change in the fundamental assumption.

Chevalier: But the neuroscience of addiction is widely touted as groundbreaking and vital.

Alexander: Yes, it’s brilliant research, but what’s found in the brain might not tell us anything about the underlying causes of addiction. Neuroscience usually doesn’t take into consideration the situational and social factors. And if the neurologists are right that addiction is no more than a neurological process, why haven’t they found a cure?

Chevalier: Can you give a specific example of social analysis being more robust and reliable than neuroscience?

Alexander: Precontact aboriginal people had virtually no addiction. Of course, they had other problems, like war and torture and insanity, but not addiction. When forced out of their natural environment and put on reserves, however, most of them became addicted.

Anyone who knows addicted people personally and sees them in their surroundings will eventually conclude that the standard medical view is an oversimplification. But it can seem true because of the persuasive power of high-tech research and the way it is endlessly dramatized in popular media.

Chevalier: What are the most dangerous addictions in the U.S. and Canada?

Alexander: We are overwhelmingly addicted to consumerism and wealth and comforts, such as enormous houses and gas-guzzling cars, at the expense of our health and survival. We need a huge amount of oil for this lifestyle. How do we satisfy this? We frack the land in North Dakota and Saskatchewan, and the land collapses, and the farms go with it. We break families apart by putting oil-field workers on nearly impossible work schedules, like twelve hours a day for two weeks straight. We do all this to produce oil more cheaply than it can be imported. It wrecks both the physical and the social environment, creating serious unrest and causing the sort of political decline that tends to lead to tyranny.

Chevalier: What about the opioid epidemic?

Alexander: There is a crescendo of emotion about prescription opioids in the U.S. and Canada now. As with many previous drug panics, whatever drugs are most worrying to Americans have become difficult to obtain legally anywhere in the world. In the past this has led to terrible situations in which patients in the Third World died in agony because the Americans had made it so hard to get morphine or heroin. Here in North America people in pain suffered needlessly during an opiate panic in the 1970s. I’m afraid that this is happening again.

Chevalier: But people are overdosing. They are committing robberies to get money for drugs. Kids are being taken away from parents who are addicted.

Alexander: Those are major, terrifying problems, but extreme fear makes it difficult to think about them in perspective. Think of all the people showing up at emergency rooms for injuries from car accidents, and sometimes dying from them. Does the federal government close highways or ban cars? Type 2 diabetes maims and kills, and it’s often a result of a dietary addiction: some people can’t stop eating sugar, even after they’ve been told it’s killing them. Cars, sugar, cigarettes, alcohol — these can all lead to terrible consequences. Who’s going to jail for them?

There is a tendency to focus our fears on something we can put at a remove from us. If we focus on people who are using opiates — even if they happen to be our own son or daughter — we can say there’s an upsetting, awful addiction problem with them, over there, and deal with it in a prohibitive manner. In this way we minimize our vast social problems. We think all we need to do is be more distrusting of patients who report pain, punish doctors and patients who don’t comply with the new restrictions, and tighten controls on the Mexican border. But unconsciously we sense that our own addictions are not so different — and this terrifies us.

Chevalier: Isn’t opioid addiction more serious than addictions related to consumer society? Don’t opiates make a person dysfunctional?

Alexander: It depends on several conditions, including, of course, dosage. The best opiate experience you can have is if you’re in extreme pain. Not only does the pain stop, but you feel a great relief. If you take the opiate when you don’t have severe physical or emotional pain, the experience may be nothing much. Laboratory research has shown that more than 90 percent of people do not have a euphoric response in a research setting, because they were feeling OK in the first place. What makes it possible to have a rapturous opiate experience is existing pain, either physical or emotional.

Chevalier: I’ve heard that someone with chronic pain can become addicted to prescription opioids within ten days. What can people do for chronic pain instead of taking an opiate?

Alexander: Some suggest cognitive behavioral therapy or just lots of ibuprofen, but there’s no substitute for opiates in cases of severe pain.

At the conference I just attended in Maine, I challenged doctors who were saying we shouldn’t be prescribing opiates for chronic pain. One doctor sent me a report from the Centers for Disease Control [CDC], arguing that there’s no proof opiates work for extended chronic pain. Well, there may be no study that gives quantitative proof, but clinical experience shows there’s nothing better for relieving certain kinds of long-term pain than opiates. To ignore that fact is to start playing dangerous games. When people in chronic pain cannot get the treatment they need, that is cruelty.

That CDC paper is otherwise a well-researched, well-reasoned report. It says there are about 45 million Americans with chronic pain. It also says that the rate of people who are prescribed opiates for chronic pain and go on to have fatal overdoses is around 1 to 3 percent. The percentage of people who develop problems with addiction depends on the dose, but even at high doses it’s only 8 percent.

So, for more than 90 percent of patients, opiates work fine and cause no problems. I say let’s figure out what we can do about the addiction or overdose risk for the single-digit percentage who do experience problems, but let’s not forget about the more than 90 percent of those 45 million people who have their lives restored.

Chevalier: What is the role of pharmaceutical companies in the opioid crisis?

Alexander: They make lots of money with patented opioids. Opium, morphine, and heroin are not patentable, but OxyContin is patented by Purdue Pharma, and they love to see their drugs prescribed widely.

Chevalier: Do you think they are being overprescribed?

Alexander: Opioids like OxyContin are certainly being overprescribed by some doctors, and the drug companies must be regulated, but the overwhelming majority of prescriptions still go to patients who truly need the drugs to control pain and who use them without any danger of addiction or overdose.

If we focus on people who are using opiates — even if they happen to be our own son or daughter — we can say there’s an upsetting, awful addiction problem with them, over there. . . . But unconsciously we sense that our own addictions are not so different — and this terrifies us.

Chevalier: So if addiction doesn’t arise from properties of the drug itself, what causes it?

Alexander: Drug addiction of all kinds arises primarily from the relentlessly increasing dislocation in our society.

Chevalier: What do you mean by “dislocation”?

Alexander: It’s a word political economist Karl Polanyi used to describe alienation or disconnection, a state of being ungrounded and ill at ease. People are dislocated when their vital needs for individual autonomy and belonging are unmet. Dislocated people don’t have a place in the established social order, and they fill that void with addiction. For instance, some young people can’t stop playing video games, because a virtual fantasy world provides the excitement, identity, and meaning that are lacking in their actual world.

Chevalier: What causes all this dislocation?

Alexander: The social and political system past generations struggled to create has been twisted into a cruel and stupid imperial system dominated by multinational corporations. This is hard for people to admit. Who can bear to face the fact that the consumer society we were raised to cherish is actually making us apathetic, crazy, and vulnerable to addiction? The disconnected, fragmented nature of our culture causes addiction, which causes further fragmentation. Most serious addictions are actually an adaptation to dislocation. To some extent addiction is a functional way of dealing with the problem. Of course, what people really need is to be genuinely recognized and accepted and believed in — to have a purpose.

In these times, large numbers of people become addicted to something at some point in their lives. Drug and alcohol addictions form a substantial part of this, but nowhere near a majority of it. More common are addictions to gambling, food, sex, shopping, dysfunctional relationships, Internet surfing, social media, wealth, power, exercise, and so on.

Chevalier: Is this what you call “psychosocial integration”?

Alexander: That’s a term I borrowed from psychologist Erik Erikson. It means the essential satisfaction most people feel if they live in a society that meets their basic needs for four things: belonging, identity, meaning, and purpose. When these needs are met, we feel a profound sense of well-being.

Lack of belonging is a feeling of being alone and neglected. Lack of identity is the unease of not knowing who you are and experiencing wild swings from one self-concept to another. Lack of meaning is a sense that the world is random or ruled by evil forces. Lack of purpose is boredom and a feeling of uselessness, of not having any reason to get out of bed. When all four of these needs are unsatisfied, life is hell.

The process of weaving together belonging, identity, meaning, and purpose is usually accomplished through a living culture, which we might say includes a mysterious spiritual component. We know that in cultures where everyone has a place and a purpose and a stable way of life, addiction is rarely found.

Chevalier: And this was supported by your Rat Park findings?

Alexander: Yes. In Rat Park the rats didn’t take morphine excessively, as they did when they were confined to individual cages. This suggests that the rats were not reacting to drugs like automatons. Instead their usage was affected by the conditions of their lives: Rats don’t compulsively take morphine if they live in anything like their natural environment. If they are caged in solitary confinement, on the other hand, they do rely on morphine.

Rats evolved as communal creatures and have what Charles Darwin called the “social instinct,” which is the need to be in the presence of others and to interact in a natural way. When social creatures like rats — or humans — are deprived of that contact, their basic needs are not being met, and they might take morphine or do any number of things that otherwise would be strange for them to do.

Chevalier: What troubles and addictions have you faced in your own life, and how do they relate to your theories and your work?

Alexander: I was alienated from my peers as an adolescent. I was the shortest kid in my classes, smaller than the smallest girl, and the last to go through puberty. I had severe acne. I was an outcast with no real meaning in my life. I resolved that situation by falling in with the criminal kids. They were more accepting of me because I was reckless and would take dangerous risks.

I got in a lot of trouble with the police as a teenager. This delinquent behavior was a self-destructive adaptation to not fitting in. My biggest crime was when two friends and I attempted to blow up a railway bridge in Morristown, New Jersey. We made a time bomb out of a single stick of dynamite and set it on the bridge with the idea of bringing the bridge down. I was sitting in a parking lot with my friends afterward, with the bomb still ticking, and I thought, If that bridge comes down and the train comes along, hundreds of people will die. All of a sudden I was sweating blood.

We were very lucky: the bomb didn’t go off. If it had, people would probably have died, and I might still be in jail. That experience changed my life. I’d seen the abyss.

Eventually I went to university, met a girl, and got married in a rush. Both of us were only eighteen, and we soon had two children. We got divorced after nine and a half years of struggle, but even before she and I split up, I was well on the road to becoming an alcoholic.

My divorce occurred during the Vietnam War. I understood for the first time that my country, which I had loved unconditionally, was doing something horrible, and it felt desperately important to stop it. So I became part of the antiwar movement. Now I belonged to a group of like-minded people. I found belonging, identity, meaning, and purpose, and the alcoholism went away, just like that.

Later I went to Canada. I certainly could have been called a work addict then. I was also a love addict: I had a string of passionate relationships, but they could never make me whole. I’ve gradually managed to find a balance. I am happily married to Pat, my wife of seventeen years. I’m a much better father to my grown children. And I love being a grandfather. I’m not claiming perfection; I’m just saying I’ve reached a state of balance by being lucky, creating a socially satisfying life, and doing meaningful work.

Chevalier: Do any current studies and statistics support the idea that dislocation is at the root of addiction?

Alexander: Statistics alone are insufficient. The full picture comes from clinical, historical, anthropological, biographical, and autobiographical evidence. The truth is that, in these times, large numbers of people become addicted to something at some point in their lives. Drug and alcohol addictions form a substantial part of this, but nowhere near a majority of it. More common are addictions to gambling, food, sex, shopping, dysfunctional relationships, Internet surfing, social media, wealth, power, exercise, and so on.

A 2010 study of addiction in 948 Canadian university students found 1.7 percent addicted to tobacco, 10.2 percent to alcohol, 8.5 percent to illicit drugs, 14.9 percent to food bingeing, 9 percent to gambling, 10.3 percent to sex, 25.6 percent to exercise, 12.4 percent to work, and 21.8 percent to shopping. Many students had more than one of these addictions.

Addiction is pervasive, and we’re focusing on a tiny corner of it when we approach it as a drug problem.

Chevalier: One way we’ve tried to solve it is through the War on Drugs. How would you evaluate its success?

Alexander: The War on Drugs is a colossal, expensive failure. It has done way more harm than good. If you have harsh penalties for drugs, the thinking goes, then you’ve nailed your problem. The War on Drugs serves commercial and geopolitical purposes by diverting attention from the true source of drug addiction: a society organized around the quest for wealth and geopolitical power, which creates enormous dislocation. This pursuit of wealth and power inevitably produces widespread addiction, which we insist on calling a “drug problem.”

Now, there’s nothing wrong with restricting access to drugs at the local level. Parents have the right to control their children’s use of drugs. Religious groups should be able to forbid members from using drugs. Towns and villages may decide to prohibit drugs. All of this is fine as long as the punishments are not excessive. A town in British Columbia with epidemic alcoholism has instituted alcohol prohibition and is doing well with it. Their punishments are reasonable. No one goes to jail for life or faces a three-strikes-and-you’re-out policy.

By contrast, the draconian laws inspired by the War on Drugs include long jail sentences for possession and even longer ones for trafficking. And these incredibly bad laws triple the punishment for possession of some drugs associated with racial minorities.

The War on Drugs has hurt lower-class people of all races the most. The ancestors of today’s white working class once did the hard labor in American factories and on farms. Now their descendants are struggling to get by in the automated, low-wage, service-oriented economy. The white working class shows high and increasing rates of addiction to all kinds of drugs — particularly alcohol, methamphetamine, and prescription opioids. They have increasing rates of overdose, suicide, liver cirrhosis, diabetes, mental disorders, and stress-related diseases.

Chevalier: You were just at a harm-reduction conference, which addressed heroin and opiate addiction. What is the harm-reduction approach?

Alexander: The harm-reduction approach provides safe injection sites and clean syringes to reduce the spread of HIV and hepatitis C; funding for treatment and counseling clinics; and injections of naloxone, an antidote for overdose, which are provided to law enforcement and even to family members of addicts. It also provides opiate blockers and opiates like methadone and Suboxone, which are safer than street drugs. And it runs programs in which communities organize voluntary take backs of unused prescription drugs. But harm reduction is only an amelioration, not a cure.

Chevalier: What about twelve-step programs like Alcoholics Anonymous? Do they work?

Alexander: These groups really do save some people’s lives. On the other hand, their implicit religious and coercive aspects can be offensive, and some people report being psychologically harmed by them. The twelve-step process requires dissolving the ego and giving over a great deal of control to the group and to a Higher Power, most often the Christian God. For many, the ego is all they have to cling to, and they are not going to give it up.

When twelve-step groups work, I believe they do so because they provide genuine fellowship in a compassionate environment. There are sponsors, meetings, and recovery houses where drug-addicted people live together and support each other’s recovery. They involve the whole community in the recovery process. And twelve-step groups are masters of patience. They will take a person back again and again and again. But no amount of patience will make those groups work for everybody.

Chevalier: Are there other reliable treatments that help people get over their addictions?

Alexander: There are a great many views of what constitutes valid treatment: acupuncture, megavitamin therapy, medication-assisted treatment, mindfulness meditation, individual therapy, group therapy, support groups. My current favorite, and a favorite of my wife’s, is Knit to Quit, in which smokers try to cure their addictions by participating in knitting groups. Many of these treatments can validly claim some success stories, but none of them works for more than a minority of addicted people.

Field studies and clinical studies in the U.S. show that about three-quarters of people who become addicted to a drug in their youth recover, usually without any treatment at all. More than half recover by the time they are thirty. Addictions usually last less than a decade and sometimes only a few years. Natural recovery occurs because people establish stronger relationships or find a sense of meaning in a new career or religion or family.

Of the one-quarter who do not get over their addictions naturally, some die, and others stay in a cycle of recovery and relapse. This last group receives the most public attention. They fill self-help meeting rooms and treatment centers. A large percentage of this visible minority are resistant to treatment, which creates the illusion that addiction is an intractable, chronic disease. This supposed intractability is then used to explain the marginal success of treatment regimes.

The field of addiction is stuck in endless debates about the merits of competing forms of treatment because it ignores the dilemmas human beings face in our fragmented world. Most alternative treatments also ignore this. For example, a number of nutrition experts claim that if we find the right supplements, we will no longer be troubled with addiction, depression, anxiety, and other ills. Likewise, there’s the widespread promotion of mindfulness meditation, which says the fallible individual will be made stronger by esoteric practices.

Chevalier: What would work?

Alexander: We need to get individuals out of the modern rat race and into less competitive communities where their work is valued and there is time for individual and group spirituality and celebration.

Chevalier: So a total cultural change is necessary?

Alexander: Yes. To break the cycle, we need to change the structure of society. Take our economic system, for example. We’re led to believe we have to support the banks, because if they fail, the whole economy fails. But if we could accept that banks are not sacred, we could let them fail and embark on an economic system centered around human needs.

We are in a period of rapid social change, and the nature of society itself is changing. But if it’s to have anything other than a catastrophic outcome, it must take into account the social instinct, which is built right into our chromosomes.

Chevalier: Have there been further studies since Rat Park that back up the conclusion that dislocation leads to addiction in human beings?

Alexander: A number of experimental rat studies have confirmed that social isolation makes rats more likely to consume drugs and that social enrichment makes them more likely to stop once they have started. But the most important data about addiction in humans is not found in animal experiments. It comes from human history, which shows a clear pattern of addiction arising from sudden cultural shifts away from cooperative cultures and toward a more modern way of life: the period of industrialization in England; the period of radical modernization following the American Revolution; the modernization of the Chinese economy in the late twentieth century.

There are times and places in history when addiction appears almost universal in a population, like during the fall of the Roman Empire in the fifth century.

Chevalier: What were the most prominent addictions during the Roman Empire?

Alexander: Alcoholism was a big one, but also addiction to the games, as odd as that sounds. The equivalent of being a TV addict during the Roman Empire was to go to the Colosseum nearly every day for a show. People would get terribly carried away with the slaughter that constituted the show, just like the murders now depicted on TV every night.

As the vicious cycles of dislocation and addiction continued, the capital city of Rome went to hell. People were devoid of moral inspiration. Intellectual life was degraded. Schools, law, and religion were corrupt and chaotic. Violence erupted. Political collapse was well underway. When bribes of bread and circuses — consumer goods and entertainment — failed to keep the people in line, law enforcement relied on brute force and the emperor’s despotism. Spies and secret police kept everybody under surveillance.

Saint Augustine describes the Romans of his time as “always rolling with dark fear and cruel lust, in warlike slaughters and in blood, which, whether shed in civil or in foreign war, is still human blood; so that their joy may be compared to glass in its fragile splendor, of which one is horribly afraid lest it should be suddenly broken in pieces.”

Chevalier: What happens when people live in cooperative rather than competitive societies?

Alexander: I would not categorize societies so neatly. Any stable, well-functioning society has elements of both. For example, cooperation is a key feature of tribal societies, but so is competition, though it’s generally kept outside the economic realm. People in tribal societies compete for social status and desirable positions in the group, but they distribute food and wealth in a noncompetitive way.

Chevalier: Do these societies last?

Alexander: Tribal societies tend to last a long time, unless they’re destroyed by intertribal warfare, disease, or colonial conquest. Modern economic and social cooperatives, such as the Mondragon co-ops in Spain, tend to be long lasting as well. Neither tribal societies nor cooperatives stand a chance, though, in an economic or military war with a modern capitalist society.

In my lifetime there have been many attempts to establish noncompetitive local societies in the U.S. and Canada. Most failed, sometimes with great rancor, I think because they were too simply conceived. It may be impossible to create a society from a theoretical blueprint. Social organization, like life itself, contains an element of complexity and mystery that we are not likely to fully comprehend anytime soon.

Chevalier: What is life like in economically cooperative societies?

Alexander: The native people Charles Darwin discovered on the voyage of the Beagle had village lives that were pretty idyllic. But when they attacked neighboring tribes, they became murderous. That has been the history of indigenous people in Canada, in the U.S., in Australia — everywhere. Darwin said that humans are, by nature, conflicted: we are capable of compassion and kindness and creativity, but we also destroy our enemies mercilessly. He believed the role of civilization was to provide less-damaging outlets for these murderous tendencies.

The War on Drugs is a colossal, expensive failure. It has done way more harm than good. If you have harsh penalties for drugs, the thinking goes, then you’ve nailed your problem. The War on Drugs serves commercial and geopolitical purposes by diverting attention from the true source of drug addiction: a society organized around the quest for wealth and geopolitical power.

Chevalier: If you had $100 million to devote to helping people, what would you do?

Alexander: I would divide the money into five-thousand-dollar packets and give them to small organizations that are creating opportunities for people who need restoration in their lives, such as setting up wilderness camps for inner-city kids or farms for people who have just been released from prison. There are thousands of such organizations, and each of them can point to small successes.

Chevalier: Are there any larger successes, examples of scaling back addictions in whole societies?

Alexander: There are many. But the best example of a radical, large-scale reform that reduced addiction is so controversial I hesitate to mention it: in China following the ascendency of Chairman Mao in 1949, and prior to the disastrous Great Leap Forward and the Cultural Revolution, opium addiction nearly disappeared.

Opium has been used in China since antiquity, but it started to become a serious problem only toward the end of the eighteenth century, during the Ching Dynasty. The problem grew to even greater proportions after the Opium Wars of the mid-1800s, which forced China to open its ports to Western trade, creating unprecedented modernization. Addiction started in the port cities and spread to the countryside. Civil wars and foreign invasions made it worse.

After Mao’s rise to power in 1949, opiate addiction was brought under control. This achievement is often dismissed in the West as a result of the mass execution of drug users and dealers, but that’s incorrect. The real reason is that Mao’s government restored social solidarity. Neighborhood groups, unions, and artists’ collectives flourished. Of course, they were all linked to communist ideology, but they were immensely popular and nearly eliminated drug addiction in the country for a while.

We need to imagine a new and unprecedented way forward that is also in keeping with ancient truths about what is best for people.

Chevalier: What’s happening with addiction in China now?

Alexander: There has been an alarming surge of drug addiction alongside the emergence of Chinese capitalism, beginning in the 1980s under the regime of Deng Xiaoping.

Certainly China is experiencing great success on the world stage, but under this economic system the Chinese people have fallen prey to mass dislocation and addiction. They are trying to solve their addiction problems by importing all the latest American treatment techniques, but none has worked. China’s addiction problem is worsening. To solve it, I predict China will have to restructure capitalism to reduce its dislocating effects.

Chevalier: What would that look like?

Alexander: In smaller countries capitalism can be reined in and domesticated, as it is in Norway or Denmark. These countries have government policies that prevent many of the excesses that fragment societies. Their addiction rates are lower than in other European countries, and far lower than in the U.S., Canada, and the UK. But can this be done in a superpower like the American empire? We haven’t yet demonstrated that this is possible.

Chevalier: You gave a lecture at Dalhousie University in Halifax, Nova Scotia, entitled “The Environmental Crisis and the Psychology of Addiction.” What was the gist of it?

Alexander: That our ecological problems and our addiction problems are linked. If we’re addicted to being consumers, we’re contributing to the ecological crisis and to climate change. And if we’re addicted to power and to making money, we’re either invested in corporations that rape the earth in order to sell consumer junk, or we’re working for those corporations as CEOs or managers or politicians.

I honestly don’t think we can solve environmental destruction without solving addiction, and vice versa, because the two problems are so intertwined. Globalization is reshaping the planet at an astounding rate and could render the biosphere unfit for humans and millions of other species.

Our systems are making the human social environment uninhabitable, too. We need to take back control from commercial and imperial interests. We also need to adapt to dislocation in healthier ways, by helping social and spiritual communities thrive.

Chevalier: When you say, “spiritual communities,” many people will think of churches, mosques, synagogues. Do you have other things in mind?

Alexander: Sure, I would say that social activism provides abundant belonging, identity, meaning, and purpose, based on my own experience. I think of political groups and neighborhood educational societies. There are lots of small groups like this. If you want to find one, you can just look around your neighborhood and see what people are trying to accomplish and ask how you can help.

Chevalier: In your textbook on the history of psychology you point to imagination as a requirement for moving ahead, both in the field of psychology and in the world.

Alexander: We need to imagine a new and unprecedented way forward that is also in keeping with ancient truths about what is best for people. This is how we can keep civilization from collapsing.

On a smaller scale, imagination might rescue the field of psychology from its doldrums and make it a powerful force for good. Where would such imagination come from? It can’t be engineered. I am inclined to say it will come by . . . what? The grace of God? I am sometimes shocked that my thoughts revert to the Sunday-school language of my youth.

The imagination we need might come from small, grassroots groups thinking independently about their local pieces of the global problem. Many ideas will fail, but through trial and error the best will rise to the top and be adopted. In my remaining years, I intend to devote more time and money to a few of these groups. They just might help to generate the bold, imaginative ideas we need.