What can addiction teach us about being human?
In this episode, I'm joined by Dr Ryan Kemp, a clinical psychologist and Director of Therapies at a large NHS Trust. Ryan is also an author and Honorary Professor of Clinical Practice at Brunel, University of London.
Ryan has worked in the field of addiction for more than 20 years. When he was last on People Soup, we talked about his journey into psychology and some of the pivotal moments in his career. This time, I wanted to understand something I'd never really explored with him: why addiction has held his interest for so long.
Ryan has developed a distinctive approach to addiction based on phenomenology — starting with the lived experience of the person.
In this first part of our conversation, we explore:
We also begin to explore what this might mean for workplaces and organisations — and that's where we'll pick up the conversation in Part Two.
One of the ideas I'm taking away from this conversation is Ryan's description of addiction as an experience in which time can become compressed into the now.
We don't have to be experiencing addiction to recognise the pull of the immediate. The quick win. The avoidance of an uncomfortable feeling. The path of least resistance. The thing that gives us relief now, even when we know something else might matter more in the longer term.
I'm not suggesting these ordinary behaviours are the same as addiction. But I do think Ryan's perspective gives us an interesting lens through which to examine our own behaviour.
This is Part One of a two-part conversation with Ryan.
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Ryan Part One
[00:00:00] Ross: hi there, and welcome to People Soup. Real conversations about work, leadership, and being human,
[00:00:06] grounded in behavioral science with practical ideas you can [00:00:10] actually use.
[00:00:11] Ross: I'm Ross McIntosh and I'm really pleased to welcome back Dr. Ryan Kemp Ryan is a consultant clinical psychologist and director of [00:00:20] therapies at a large NHS trust. He is an author and honorary professor of clinical practice at Brunel University of London.
[00:00:29] Ryan has worked in the [00:00:30] field of addiction for more than twenty years And has developed a particular interest in understanding addiction through the lived experience of the person. So [00:00:40] in this conversation, we explore what addiction is, what it feels like from the inside, and what happens when our experience of time becomes compressed around the [00:00:50] immediate.
[00:00:50] And as you'll hear, that takes us into some fascinating territory around avoidance, reward, honesty, the stories we tell ourselves, and [00:01:00] some very human behaviors that we might recognize in our own lives So let's crack on. Get a brew on and have a listen to part one of my conversation with Dr. Ryan [00:01:10] Kemp Now, Ryan, last time we talked quite a [00:01:20] bit about how you ended up working in psychology and then almost accidentally found yourself working in addiction. But I don't think we really explored the question of why [00:01:30] addiction has held your interest for so long. So what is it about addiction that fascinates you?
[00:01:36] Background
[00:01:36] Ryan Kemp: Well, I, think I, I [00:01:40] chose a career in psychology because I wanted to be challenged. I wanted to find something that was hard and really put [00:01:50] my mind to it and try to, um, come to work every day feeling I had, I had something to do.
[00:01:56] I didn't want a job that would be, straightforward and [00:02:00] routine, et cetera, et cetera. So I certainly found that in specializing in addictions, that's definitely true. But I think there's also a personal story there, which is about, my [00:02:10] early life and, I think growing up in a community which, probably drank too much and, where alcohol consumption was, just, uh, expected, [00:02:20] even sort of a re- a reward.
[00:02:21] It was a, a daily thing. I think my parents ended up drinking drinking very heavily and, were essentially [00:02:30] functional alcoholics, which shortened their lives, which, which is a very sad thing for me. So I think I grew up in that environment. So I think I, I kind of, felt comfortable when [00:02:40] I started working with people, particularly people who drank too much.
[00:02:43] I kind of understood what they were about. Also one of the first jobs I got when I finished school, [00:02:50] again, somewhat fortuitously, is I got a job working for a bookmaker, doing horse racing work. I knew nothing about it. I had no interest in it whatsoever. But it was a good job, and it [00:03:00] paid quite well, and I happened to be quite good at maths. so working out the odds and paying out the, the winnings, et cetera, was quite easy for me. So, I did that for, six or seven [00:03:10] years during my education. Again, you know, what it taught me was, here are these people. they come in every week. Many of them spend spend way too [00:03:20] much money. Sometimes they win, you know, so then they're very happy.
[00:03:23] but quite often they lose. And, you know, it's sort of a puzzle to me as to why you would want to pursue [00:03:30] week after week, year after year, a hobby where you almost always lost your money. So that, that sort of lingered in my mind, but I never really gave it any sort of [00:03:40] professional thought. and then I was, applying for another job, which I didn't get, and they offered me this job in addiction, which I decided to take, just 'cause I thought, "Well, I can do that for a [00:03:50] while." uh, I was lucky enough to work with some amazing colleagues, at a time when, there was a lot of investment into treatment. We were developing things. The [00:04:00] evidence base was less less developed than it is now, so we were able to try things, experiment, i-improve. and that was just exciting and, [00:04:10] interesting.
[00:04:10] And I realized after a couple of years, actually, I was enjoying myself, and, I think I would make that my specialty, uh, which had not, not been my plan.
[00:04:19] Ross: Thank you. [00:04:20] Because you've got quite a distinctive way of thinking about addiction. could you explain to us what that is, please?
[00:04:27] Ryan Kemp: when I first started working, [00:04:30] I, I obviously taught myself all the established evidence-based, theories and techniques, so CBT, motivational [00:04:40] interviewing, et cetera. But I had a, long-standing interest in, phenomenology, which is a nice big, fancy word, which I'll explain in a second. so while I was [00:04:50] obviously reading around the subjects of addiction, and psychotherapy, which were my, sort of my interest, I also was reading books around that, subject of phenomenology, and I read a [00:05:00] particular book. and I thought, "Well, wouldn't it be great if there was a book like this on addiction?" But there wasn't. then my more, um, sort of [00:05:10] ambitious side of myself kicked in and said, "Well, why don't you write it, Ryan?" and so I set off on that task partly just to give myself an intellectual
[00:05:19] adventure,
[00:05:19] [00:05:20] adventure to push myself yeah. And it took, it took quite a long time, about 10 years to do it really.
[00:05:25] So, so it was a long, it was a long project. but it was, it was good. So yeah, [00:05:30] so my-- you could say my distinctive take on it is, is to think about it through the lens of phenomenology. and it's not as esoteric as it sounds.
[00:05:39] What is phenomenology?
[00:05:39] Ryan Kemp: [00:05:40] So essentially it means taking the lived experience of people as the foundation or the starting point. So it's quite easy in [00:05:50] many disciplines to start with, ideas about the brain or about biology or about relationships, those are all valid starting points. I'm not [00:06:00] critiquing them. But phenomenology says, "Well, what do we do?
[00:06:03] What happens if we start with the experience of people?" [00:06:10] So, just to be clear, 'cause sometimes this is-- gets confused, it, it is about the experience of, of so-called addicts or people who misuse drugs, alcohol, gambling, et cetera. [00:06:20] But it's also the, the experience of other people who, who surround them, so their family members, people who might treat them in a, in a [00:06:30] clinic, the police, social services.
[00:06:32] So everyone experiences this phenomena, which is addiction, and they all [00:06:40] react to it and engage with it in different ways. So it's, it's taking that experience as the foundation from which to start. [00:06:50] It doesn't mean you end there. You can go from that platform and then think about biology from there, but you start from there rather than saying, for [00:07:00] example, biology is fundamental. So it's-- it sounds quite simple, but when you get into it, it starts to get a little more complex and, and can be quite challenging
[00:07:09] Ross: [00:07:10] Wow
[00:07:10] Fascinating. And
[00:07:12] Has that phenomenological perspective changed over the years for you?
[00:07:18] Ryan Kemp: Yeah, I think [00:07:20] so. I, I you know, I think when you first start working with addicts, it's quite hard work. And, um, know, I, I've often joked that it's not a career for someone who [00:07:30] wants to be successful because most of the people you work with relapse. In fact, relapse is by definition what addiction [00:07:40] is. you're going to face the fact that you're gonna, see someone you worked with a few months ago, and they made good progress, maybe they [00:07:50] stopped using, et cetera, back in your waiting room just a few months later. Now, at first, I took that quite personally. first, I, I felt like a [00:08:00] failure myself.
[00:08:01] I was questioning myself. Somewhat, if I'm honest, quite angry at the person, feeling like, "Why haven't they done the things that [00:08:10] we agreed they'd do? obviously, when we start to talk properly, " why didn't they stick to their recovery plan," et cetera. So those emotions, were real for me at that [00:08:20] point. later, I think I got to realize that that's not a very mature way for a clinician to do addiction work because this is built into the work, and [00:08:30] you have to have a position where you're almost expecting this to happen. When it doesn't happen, that's great. That's like a nice surprise. But failure [00:08:40] and multiple attempts to get into recovery are part of it. I would say yes, undoubtedly it, it's changed. I think when I first [00:08:50] started, work, I would use a term like, impulsive a lot. And what I've discovered through thinking [00:09:00] through the sort of lived experience of it is that I started to change that language. So I could perhaps give you an example of something from the phenomenology.
[00:09:08] Example from phenomenology
[00:09:08] Ryan Kemp: So one of the, [00:09:10] dimensions of lived experience the passing of time. if you, take a step back and try to think about what you experience in [00:09:20] any moment, partly what you're experiencing is yourself, partly what you're experiencing is the world. there's always a world out there [00:09:30] that you're engaging with, and always there is the passing of time. So these are quite fundamental dimensions of our lived [00:09:40] experience. Now, I was thinking, "Well, what is this passing of time?" It's-- I couldn't understand that that had anything to do with addiction. I was sat there [00:09:50] thinking, "Oh, this is, this isn't gonna work. I can't work this out." this was, this was one day at work, and then I realized to myself, "Where is that client who was supposed to be [00:10:00] here at three o'clock? They... It's like quarter past three. Where are they? Why haven't they turned up on time?" And suddenly the penny dropped. Lots of my clients [00:10:10] would be late. Lots of my clients would be What we s- often called chaotic, but I realized was actually their [00:10:20] inability to live a kind of regular rhythm of life. So suddenly I could see the time dimension [00:10:30] playing out in the lives of addicts. what it led me to realize is that for addicts, they live their experience of time very close to [00:10:40] them. in other words, they're thinking about their behavior and the consequences of their behavior in a dimension of time that's really near. [00:10:50] So they don't think, "Okay, if I smoke for the next twenty years, I'm gonna get all these health problems, cardiovascular, cancer, blah, blah, blah." No, [00:11:00] they think, "I really want a cigarette, and I, I, I want it now. I, I don't wanna wait fifteen minutes for my cigarette," or, I'm desperate for a drink. [00:11:10] really, really want it, and I'm...
[00:11:12] You know, I can't wait, et cetera. And I certainly struggle to think about how I might suffer from [00:11:20] this in the future." So this is a very now-orientated frame of reference, and that means that it's quite difficult when you're [00:11:30] doing therapy and thinking about why you're motivated to change when people really struggle to think about the future. So that's, that's [00:11:40] o- that's one example of how phenomenology can just reorientate you a little bit. So I stopped saying these people are [00:11:50] impulsive because that's a kind of pejorative judgment. You know, I, I came to think, you know, a quick hand way of saying actually [00:12:00] They're all to blame, but actually through addiction, their, experience and orientation to time has been, compressed into the [00:12:10] now, and that orientates them.
[00:12:12] And part of my task as a therapist, as a clinician, is to expand that time horizon, to stretch it out [00:12:20] so that they're seeing not just the immediacy of, their actions, but what are the medium and longer term, implications.
[00:12:28] Ross: That's so
[00:12:29] [00:12:30] interesting Ryan, because thinking about just general behavior and, and workplace behavior that I, I work with, often see people taking that path [00:12:40] of least resistance for short-term gains
[00:12:44] Ryan Kemp: Hmm.
[00:12:44] Ross: rather than thinking about how or who do I want to be in the long [00:12:50] term
[00:12:50] Addiction oriientation - Is it built into culture?
[00:12:50] Ryan Kemp: Yeah, indeed. And I think you could make an argument, and I certainly have that this is now starting to be built into our culture. [00:13:00] So I think our culture is a very addiction-orientated culture. It's a very now, do it, enjoy it, live for [00:13:10] the moment, and quite a lot of this kind of quasi-spiritual stuff, you know, that you, you see, on, um, stickers and, um, people's [00:13:20] tattoos even.
[00:13:20] You know, live in the moment. now is the only, y-the, the only experience you've got, this type of thing. Yes, I, I kinda get it, but, there's a, there's a [00:13:30] deeper implication there, which I think, we see playing out in the way our politics is unfolding, the way our, relationship to the planet is [00:13:40] unfolding. And I think these things then make it much more easier for, for people who are perhaps susceptible to addiction to fall [00:13:50] into that because the culture and the, the way the narratives and the expression that we give to our lives, is sort of folded in on that. So it, it sort of [00:14:00] scaffolds, and makes it easier for people to fall into those, into those issues.
[00:14:04] Ross: I've never thought about it like that as the scaffolding that supports this, this type of behavior [00:14:10] because in the workplace, some of the addictions we're thinking about are, as you've mentioned, drugs, alcohol, gambling, and maybe technology too.
[00:14:19] [00:14:20] how do they show up for, for humans at work?
[00:14:23] Ryan Kemp: Well, that's quite a that's quite a question. I'll, I'll, I'll highlight a few things. I mean, one is obviously, you [00:14:30] know, if you're struggling with addiction, it's gonna disrupt your life. and your health. So I think absenteeism is gonna be an issue. So if you've got someone [00:14:40] who's absent from work quite a lot, at the back of my mind, I'd be wondering about that. obviously, that, that could be sickness, and it doesn't necessarily have to be [00:14:50] directly addiction sickness, but, it could be. So I had a colleague once who was, notorious for being off sick on a Monday a lot. had a, quite a party lifestyle. So, [00:15:00] those sorts of things, I think we're all, we're all aware of that. But I think beyond absenteeism, presenteeism, people who, who make it into the [00:15:10] office but aren't really functioning properly, at their top of their game. and, it's not altogether gonna be a revelation to hear me [00:15:20] say that, you know, if you, if you take drugs or drink a lot, your, your cognitive functioning is not gonna be at the, best drugs and alcohol are really bad for sleeping, so people are [00:15:30] gonna, sleep quite poorly. So that's gonna affect their ability to, um, to function. I think, um, there's, there's, there's an estimation that [00:15:40] i-in the US,
[00:15:41] Ross: something
[00:15:42] Ryan Kemp: like ninety-two billion dollars is lost through productivity, of employees who are affected by addictions just [00:15:50] through presenteeism, so turning up but just not doing as good a job. but I mean, also there's things like accidents and safety issues so that, you know, I think workplaces are really [00:16:00] trying hard to make them safer. But, if you're not, really, capable of being fully present in the workplace, then those sorts of things are [00:16:10] more, common. I think some of the things that are hidden, which we don't, really think about are stuff like staff turnover. So, my experience is these people who, who [00:16:20] struggle, often then get under pressure from their line managers, and they're, they're more prone to move jobs more often. There's quite a hidden cost to [00:16:30] turnover, often not thought about, lost productivity, the actual cost of, of recruiting, et cetera, et cetera. would say one of the things that we don't, we don't think about [00:16:40] enough is, is about relationships in the workplace and how those affect each other. So you've got people really-- When they're, when they're struggling, other people are having to take [00:16:50] on their work.
[00:16:51] I think interpersonal conflict is an issue I think that all those things are, are really relevant.
[00:16:58] Never mind, you know, when you [00:17:00] actually discover that someone is or admits they've got a problem and you've got to work with them, around that issue, I mean, it's, It hasn't happened to me a lot, but I [00:17:10] have, I have known people to come to work actually intoxicated. That has-- I have known that, and I'm sure most people have worked a a long career of, of known colleagues who, you know, where [00:17:20] you've-- you're in the situation of having to say, Are you, are you actually...
[00:17:23] I feel like I can smell alcohol on your, on your breath." You know, that's, and it's mortifying for both [00:17:30] parties.
[00:17:30] Ross: And yes, you've talked a little bit about the scaffolding that can support this, but I am interested in that interpersonal relationships in terms [00:17:40] of the phenomenology. could you talk a little about that?
[00:17:43] Interpersonal relationships and honesty
[00:17:43] Ryan Kemp: Yeah. So one, one of the dimensions of lived experience is the fact that [00:17:50] we are connected to other human beings, so we're in relationship. It's very, very, very rare that humans are completely isolated. [00:18:00] So much so that in old cultures, the, the worst punishment that you could give was to, it was to basically eject someone from, from the tr- clan or [00:18:10] the tribe or whatever. And often what, anthropologists report is those people wouldn't live very long because interpersonal isolation is almost death. we are always [00:18:20] interacting with other humans like ourselves. what I discovered, is that, one of the biggest issues in addictions is an inability for addicts [00:18:30] to be in a truthful relationship with other people. So they lack and utilize dishonesty very [00:18:40] commonly. And at first, I just used to think they were just, a bad person. it's just simply that. But I came to realize it's much more complicated [00:18:50] than that. if you take a step back and you think, "Why does somebody take a drug or drink alcohol or gamble, et cetera?" Well, really what they're doing is [00:19:00] they're trying to change the way they feel. They're trying to alter their sense of being in the world. all those behaviors do that, and they [00:19:10] do it really quickly. you know, if you take a drug or you drink alcohol, you can have the effects within seconds mostly. one of the reasons why tobacco is [00:19:20] so addictive is because when you take a drag of a cigarette, it hits your brain within less than a second. You have very immediate impacts. You can [00:19:30] maybe connect here back to what we were saying a little earlier about time. But yeah, so immediate impacts are more addictive than longer term impacts.
[00:19:38] So just to [00:19:40] give you another example, if you play a game, a gambling game that's very quick, like roulette, so lots of, lots of spins very quickly, much more addictive than [00:19:50] playing the lottery, which only happens once a week. So the amount of time between, things really matters, yes. so What you're trying to do is change the way you [00:20:00] feel. Now, in a sense that is understandable. I think a lot of us, we wanna celebrate, so we have a drink. We- we're feeling a bit like we've had a hard day, wanna have a [00:20:10] drink. it's not to be too surprising, I think. but is it the truth? When I come home from work and I've had a really, really hard day And I'd have a, a glass of wine. [00:20:20] I'm in fact doing is destructing that experience. I am changing the way I feel artificially. And in doing that, I'm [00:20:30] entering into a relationship with my experience, which is characterized by a lack of honesty, I would say. Way before I'm dishonest with any person, I'm dishonest with myself. [00:20:40] I am not willing to linger and stay in relationship to that feeling that I've got and to think about it, make [00:20:50] changes, et cetera. No, I just want it out the way, so I take a quick, easy way to do that. What happens with addicts when they do that a lot is they then start [00:21:00] to also construct narratives, stories which make sense as well.
[00:21:04] So they start to tell themselves initially stories about things. [00:21:10] Now, we all do this. You know, your boss gives you a hard time, and you go away and think, "Oh, you know, they're just, you know, difficult. So we tell stories to make sense of our experience, and [00:21:20] often when we have negative experience, we tell stories about other, other people impinging upon us.
[00:21:25] It's very rare. Takes a little while for that sort of internal [00:21:30] monologue thing to come round to, "Well, maybe, Ryan, you didn't do that job well enough. You didn't actually deliver on that project, therefore, actually the responsibility is really with you, and your boss [00:21:40] is actually just helping you out here." takes a little while. If you have drunk between the blaming the other person and getting to that point of responsibility, [00:21:50] you never get to the point of responsibility because you've destructed. You've taken care of that feeling before that point. So my experience is there are lots of narratives, lots of [00:22:00] stories about them that's not altogether accurate when addicts tell their story.
[00:22:05] So that's a challenge for therapy to get beyond that and to, [00:22:10] not engage in an, in a immediate of like, " this doesn't make any sense." If you do that, you're gonna damage the relationship, but you do need to get there in, in due course. But [00:22:20] what happens next? So we've got take the drug, feel different, construct a narrative to make sense, which is not altogether truthful, then gets quite easy to [00:22:30] extend that to, " when I'm interacting with a person, I can tell them a story that isn't altogether truthful either." Because I'm comfortable with dishonesty in relation to myself, [00:22:40] it gets really comfy to have dishonesty in relation to other people So I'm, I'm not talking about massive lies, but, you know, over time these [00:22:50] things start to build up. And when you're maybe a family member, maybe a, a partner, a husband, wife, maybe a, a son or [00:23:00] daughter, it starts to get tricky you're having conversations about, can you trust what this person's saying?
[00:23:07] Can you trust that they'll do what [00:23:10] they say they'll do? And obviously we can see that in relation to addiction itself 'cause
[00:23:14] Ross: addicts
[00:23:15] Ryan Kemp: make lots of promises about things they'll do. But even beyond that, into other [00:23:20] spheres of life, starts to spread.
[00:23:23] Ross: it's fascinating that it's that inner uncomfortable experience that we [00:23:30] want to get rid of, that we're not really prepared to just sit with or, or, or accommodate. And as you were speaking, I was [00:23:40] thinking, I've witnessed the normalization of drinking in very formal meetings in a workplace where people-- maybe people are sitting around a meeting table and, [00:23:50] and someone makes the comment, "Oh, I think it's a two-glass-of-wine evening tonight."
[00:23:54] Or someone, someone else will then say, "Hmm, I think it's probably the whole bottle." And [00:24:00] it's normalizing this sort of avoidance of, of the actual feeling and the re- the reflection, as you were saying, of actually maybe that comment from my [00:24:10] manager was just trying to, to help me and help me grow. So it impacts on organizations.
[00:24:16] It can impact at a national and even a global level. [00:24:20] I'm not sure I can quite get my head around that, but could you share your, your
[00:24:24]
[00:24:24] Ross: views on that?
[00:24:25] Ryan Kemp: On the global impact?
[00:24:27] Ross: Or the, or well let's start with organization or [00:24:30] national
[00:24:31] Ryan Kemp: Yeah. So I think, well, look, I think if you've, if you've got a culture, a heavy drinking culture, let's take the city in London, right? [00:24:40] Notorious for having a heavy drinking, and drug-taking culture, actually, quite honestly. seen enough of those people in my clinic room, so do know that that's-- there's some truth to that.
[00:24:49] Is here the end of part one - to act as a teaser
[00:24:49] Ryan Kemp: [00:24:50] Yeah. Look, that's gotta have impacts, and the impacts are not just that somebody, like we were saying earlier, might turn up to work and not be, completely, [00:25:00] able to function 100%, but also that the relationship to pleasure and reward also starts to get somewhat [00:25:10] affected. You know, we're all at work for reward, let's face it, on multiple levels. You know, we want our pay at the end of the month. Maybe we want our bonus at the end of the year. we want that [00:25:20] positive reinforcement we get from, our colleagues, from our bosses, from our customers. We're there, for the pleasure of that. But what happens if [00:25:30] we derive that pleasure too quickly?
[00:25:38] Peace supers, that's [00:25:40] it. Part one of my conversation with Dr. Ryan Kemp in the bag. in part two, we'll continue this fascinating conversation
[00:25:48] you'll find information about Ryan's [00:25:50] work and his book, Transcending Addiction, in the show notes, along with the details of this episode and links to the People Soup website
[00:25:58] One idea that's staying with me [00:26:00] from this conversation is Ryan's description of addiction as compressing our experience of time into the now. it made me think about how often at work and in our everyday [00:26:10] lives we can get pulled towards what's going on to give us relief or reward in the immediate moment, rather than thinking about what matters in the longer term I'm not [00:26:20] suggesting that ordinary human behavior is the same as addiction, but I think Ryan's perspective gives us an interesting way of looking at some of our own behavior.
[00:26:28] as ever, thanks for [00:26:30] listening and thanks for sharing People Soup with others. You're helping us bring real conversations about work, leadership, and being human to more people. until next time, look after yourselves, [00:26:40] Peace Soupers, and bye for now