For those of us who have been looking for some scientific answers about the theory of addiction, the film Pleasure Unwoven is something of a revelation. The writer and presenter of this documentary, Kevin McCauley, is a qualified medical doctor and he focuses on an issue that has been a daily question for me for nearly a decade: Why is addiction a disease?
The film takes you through the best argument against the disease theory – that the addict has the freedom of choice when given sufficient motivation not to drink or use. Surely addiction is a behaviour, not a disease like diabetes or cancer? Early on in the film he counters these arguments with his own medical opinion: addiction is a disease of choice. In other words, addiction is a dysfunction of that part of the brain which is responsible for making our choices.
The rest of the film explains the science of how the brain works with pleasure, memories and reward – and how these functions break down when the brain chemistry becomes unbalanced by drugs and alcohol.
The metaphor he uses for the topography of the brain is the spectacular landscape of Utah. At the beginning of the film Dr McCauley says “I wonder what it would be like if I could wander through the brain like I can hike through Utah? The brain has bumps and grooves, the same way this land has mountains and canyons.” Initially this felt like a bit of a stretch but by the end of the film it made sense and helped bring all the ideas together.
As a fellow addict, I could never understand why I did such stupid things at the exact moment when I should have been at my most responsible. Providing one of the key conclusions of the film, McCauley proves that relapse is an unconscious process brought on by certain chemicals in the brain which reacts to stress and the altered survival settings that drugs and alcohol create.
He gives a logical and scientific explanation for exactly why addiction happens: the process, the chemistry and yes, hope of a solution through recovery. By understanding the things that have caused the damage, we can alter our lives and allow our damaged organ to heal. But this requires professional help, certainly in most cases, and a caring environment where a programme of treatment can be developed for the patient — and continued towards permanent recovery through abstinence.
Above all, this film has allowed me to give clear answers to my friends and family about my disease (and the fact that it is one) that I really struggled with before. Those who have not suffered from addiction are completely baffled, as we were ourselves, by the unpredictable and inexplicable nature of it.
I can recommend this film for all those people who see addictive behaviour only as selfish and self-destructive, not as symptoms of a disease. In this regard, it is an important educational tool.
You can watch the trailer of the documentary here:
Tony Gray wrote a longer version of this article which is published on his blog, to see it please click here.
Page last reviewed and clinically fact-checked | July 27, 2021