Shownotes
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:
- Why Ryan became interested in addiction
- What phenomenology can tell us about addiction
- Why Ryan moved away from describing people experiencing addiction as simply "impulsive"
- How addiction can change a person's experience of time
- What happens when the future becomes harder to hold in mind and the immediate becomes increasingly important
- The relationship between addiction and pleasure, reward and relief
- Why Ryan believes dishonesty can begin with the relationship we have with ourselves
- The stories and narratives we construct to make sense of difficult experiences
- How those patterns can affect relationships with other people
- What some of these ideas might reveal about ordinary human behaviour and our tendency to choose short-term relief over longer-term consequences
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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Transcripts
Ryan Part One
[:[00:00:06] grounded in behavioral science with practical ideas you can [00:00:10] actually use.
[:[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.
[:[00:01:36] Background
[:[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.
[:[00:02:43] 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.
[:[00:04:10] 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.
[:[00:04:27] 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] [00:05:20] adventure to push myself yeah. And it took, it took quite a long time, about 10 years to do it really.
[:[00:05:39] What is phenomenology?
[:[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.
[:[00:07:09] Ross: [00:07:10] Wow
[:[00:07:12] Has that phenomenological perspective changed over the years for you?
[:[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] 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...
[:[00:12:12] 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.
[:[00:12:29] [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] Ross: rather than thinking about how or who do I want to be in the long [00:12:50] term
[:[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.
[:[00:14:04] 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.
[:[00:14:23] 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,
[:[00:15:42] 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.
[:[00:16:58] 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...
[:[00:17:30] 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] 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.
[:[00:21:04] 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.
[:[00:22:05] 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?
[:[00:23:14] Ross: addicts
[:[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."
[:[00:24:16] 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] Ross: views on that?
[:[00:24:27] Ross: Or the, or well let's start with organization or [00:24:30] national
[:[00:24:49] Is here the end of part one - to act as a teaser
[:[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
[:[00:25:58] 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.
[:
