Hypoism was first developed and proposed as a valid and testable hypothesis for the explanation for the disease underlying all addictions¹ and two related categories of symptoms² in 1992. At that time I sent a manuscript on Hypoism to twelve well known addiction journals. It was rejected out of hand with no valid reasons, explanations, or questions for clarification, by all twelve journals. One of the editors, a Ph. D. in education and a therapist in addictions as well as a recovering alcoholic, agreed with the Hypothesis but was too afraid to fight for it with his review committee. At that point, seeing the intense fear and bias (outright rejection absent discussion, argument, or dialogue) against Hypoism in the field of addictionology, a manifest bias reproduced countless times since then, I resigned myself to write the book that eventually became Hypoic's Handbook knowing full well it would be ignored exactly as was the original article on Hypoism. Despite the following addiction science history which is well on its way to proving all aspects of Hypoism, this is exactly what has happened. In fact, it continues in spite of all the science that is confirming the hypothesis and is in the process of proving it true right up to this very day. My opinion is that Hypoism has already been proven but addictionology is steadfastly refusing to acquiesce to this proof by fraudulently ignoring its own science that has already proved my hypothesis. By the end of this discussion you will see how this is happening to the detriment of all addicts and society; all because of a deep seated bias against the concept this science proves, a phenomenon I have named Societal Denial.

The participants and co-conspirators of this fraud are the NIH (National Institutes of Health), NIMH (National Institute on Mental Health), NIDA (National Institute on Drug Abuse), NIAAA (National Institute on Alcoholism and Alcohol Abuse), the medical addictionology field headed by ASAM (American Society of Addiction Medicine), APA (the American Psychiatric Association), all other groups dealing with addictions including the National Council on Alcoholism and various addiction rehabilitation groups bought and paid for by the rehabilitation industry. The immense size, power, and wealth of these groups make them formidable opponents, but they will fall as all frauds do when and only when the public, addicts and nonaddicts, allows itself to be informed and forcibly overthrows their common enemies: fear, ignorance, superstition (belief without proof), and bias. I have contacted every one of these groups, informed them about Hypoism and the failure of their addiction theories but have been summarily and ignominiously ignored.

What is the history of addiction science that has proved Hypoism? It comes from several different areas which I will list and then discuss separately and finally consolidate at the end of this paper. I will stick to the high points merely to make this article readable and comprehensible to lay readers, but the scientific details are all available in the various field's literature resources.

The one concept that must be kept in mind while reading this article is: We are discussing the underlying disease causing all addictions, not each individual addiction separately. This issue has been the downfall of all previous discussions and explanations of addictions which have attempted to study and decipher each individual addiction as separate and distinct diseases rather than as symptoms of an etiologically complete neurobiological entity causing all of them. For the purposes of qualification, it must be stated that much of the information I use below has been derived from the study of individual addictions rather than the study of Hypoism because no one has yet agreed to study the complete entity as an entity because of their biases against this Hypothesis. Thus, the science is somewhat perverted by this lack. However, the science, as you will see, is close enough to provide proof that it is Hypoism that should be studied in future research rather than individual addictions, the current mistake being maintained in the field of addictionology today; a mistake that is preventing the actual entity from coming to fruition. One of my goals is to reorient addiction research in this direction to finish the proof of Hypoism.

• Genetics
• Behavioral Genetics and Twin Studies
• Neurobiology
• Neurology
• Evolutionary Psychology
• Psychopharmacology
• Animal Addiction Studies and Genetics
• General Medicine - Concept of Pathophysiology

A Warning: Anyone presenting a hypothesis on addictions, either for a specific addiction or an underlying entity explaining all addictions, must reconcile all the following material. If you cannot, your theory is invalid and you must abandon it publicly and restart your search for such a theory. If you ignore this material and continue to propound your theory, you are a fraud, a liar, and a charlatan.

Addictions have long been recognized to run in families (the apple doesn't fall far from the tree) but instead of being thought of as hereditary traits, genetically based, were viewed as taught and learned. This view was reinforced by the prevailing environmentalist paradigm of human behavior stressed but not proved by clinical psychologists and psychiatrists. If any deficiency was connected to this phenomenon it was considered a moral one rather than a physiological one. These two beliefs led to what I call the Psychological/Religious paradigm of addictions, the P/R paradigm for short. Another name for this is the Psychobabble paradigm of addiction where the most mythologically imaginative theory wins with no need for proof (religion). In fact, the P/R paradigm has directed all thinking about all human behavior for over a hundred years. Lacking and ignoring all proof to the contrary, the P/R paradigm has biased thinking, opinion, and research on addictions over the same time period. Moreover, in the history of medicine, no theory on any human ailment has lasted as long with as little proof or rational basis as has the P/R paradigm of addictions. Breaking through this paradigmatic bias is the barrier any realistic theory on addictions must accomplish. This barrier is not only biased and prejudiced but unfair and unscientific as well because the paradigm it replaces has never been subject to the proof its successor is being made to accomplish. Additionally, even with the proof readily apparent, the P/R paradigm will not relinquish its position as the reigning paradigm, the addict and the public be damned. Principle: Consensus does not equal proof.

Present me with the proof of the P/R paradigm and I'll shut up. If not, then you must dump the P/R paradigm and start dealing honestly with Hypoism. Absent this, you have no integrity or credibility.

Enough editorializing.

The first scientific information implying the disease basis of addiction was the work done by Goodwin delineating, however poorly, the heritability of alcoholism, what is really not a disease in itself but actually alcohol addiction in a hypoic. Assuming the genetics of addictions for the moment, the data will be forthcoming, what does it mean and imply that addictions are genetically transmitted? It means that there are specific alleles (different forms of the same gene, mutations) of normal genes in the population that work within some brain mechanism that increase the likelihood the carriers of these alleles will be addicts at some point in their lives. One genetic principle needs to be clarified: Specific behaviors are NOT inherited, physiologic mechanisms that eventuate in behavior of one sort or another are inherited. Or, genes don't cause behaviors in a vacuum and heritable behaviors must be based on a pathophysiology, an altered brain mechanism. This concept is translated to mean that addictions, although their heritabilities may be measured and quantified, are not inherited, only the mechanisms that cause addictions are inherited. This scientific misconception, the % heritability of an addiction such as alcoholism, for example, alcoholism is 67% heritable, has confused the field of addictions for as long as heritabilities have been quantified. Because behaviors and addictions are not inherited, only their pathophysiology (altered mechanism), the % heritability of an addiction is meaningless except to infer that a high heritability of a specific addiction implies the existence of a brain mechanism that when altered by allelic genes has a high probability of causing an addiction. Thus, the importance of high heritability of addictions is that they infer the existence of an underlying brain mechanism that causes addictions and that we need to look for such a mechanism as well as the genetic alleles working within this mechanism. Make sure you understand this paragraph before moving on. Hypoism is this mechanism, a mechanism that exists nowhere else in current addictionology.

The above medical genetic pathophysiological principle has been misunderstood by addictionologists over the last 100 years and is a large part of the misconception of addictions today. The reason it has been misunderstood is that the people working in the field of addictionology have never comprehended this principle, they are not doctors in the true sense of the word because all doctors know this principle. It is the principle that rules modern medicine. All of modern medicine is based on the principle of pathophysiology. That psychiatrists and psychologists, the main players in addictionology, don't understand nor use this principle is why addictionology (and psychiatry in general) has been in left field for all these years. Hypoism is a pathophysiological mechanism, the first of its kind in addictionology! For a full discussion about the need to deal with addictions from its pathophysiology, see: http://www.nvo.com/hypoism/thirdmilleniumn4aconferencekeynoteaddressonhypoism/

The next milestone in the science of addictions came about in a 1988 paper by Koob that demonstrated the fact that every drug known to be addictive in humans (this was later extended to animal addictions as well) stimulates cells or receptors within what is known as the REWARD SYSTEM (or reward cascade) of the brain. The end result of this reward system stimulation is the release of dopamine in the nucleus accumbens, the pleasure center, at the terminus of this cascade. This is the exact same reward cascade that when stimulated by electric shocks in man and animals causes intense feelings of pleasure or, in animals can be used to reward practically any learned behavior at the expense of any other behavior, such as eating, sex, and avoidance of pain. This is obviously a very reinforcing neurological circuit when electrically stimulated. Over the last 12 years, this reward cascade has been studied extensively and related to all known addictions (chemical and behavioral) in animals and man. This is a part of the science of addictions but isn't sufficient to explain everything about addictions since it is just where the pleasure is elicited, but not why addicts need this continuous pleasure and why nonaddicts don't. It doesn't explain why some people will always be addicts and others will never be addicts, a known fact even among people (and animals) who experience the mood elevating effects of addictive drugs and either do or don't get addicted. The current P/R paradigm can't explain this while, as you will see, Hypoism does.

Moving on: Two parallel roads of research began to converge during the 90's.

1. Animal addiction experiments were showing that certain inbred strains of mice and rats would voluntarily get addicted to various addictive drugs including alcohol (drug preference experiments) in a variety of different ways from simple ingestion of the drugs in water solutions to pressing levers that released these drugs in particular places in the brain and not others. These places in the brain were in and connected to the reward system and led to release of dopamine in the nucleus accumbens. When these animals were studied, it was found that they had various deficient alleles of genes programmed to direct the building of parts of the reward system: Their reward systems were genetically deficient in functional activity. A wide variety of genes have been found that cause this phenomenon in these animals.
2. Kenneth Blum published a paper, The Reward Deficiency Syndrome, claiming proof which was never reproduced but is still quoted today as fact that severe forms of alcoholism and other genetic syndromes such as Tourette's were associated with a deficient gene called the A1 allele of the Dopamine D2 receptor, a specific receptor for the neurotransmitter dopamine located in various places in the brain, but particularly in the reward system. Thus he proposed that a deficiency of this receptor caused alcoholism and other repetitive behavioral syndromes. Although it was never reproduced and validated, this theory was the beginning of a concept of genetic allele deficiencies as being responsible for addictions in humans. This concept has grown and is widely accepted with multiple alleles rather than a single one being hypothesized a being etiological in addictions. This explains the variations in strength of addictions as well as in type.

These two approaches in animals and humans have come together and are continuing in a variety of directions. They will be the mainstay of the biology and genetics behind addictions in the future. This is all part of the neurobiology and genetics mentioned above. Many genes are being looked at. None have been definitively shown to be responsible for human addictions but this work is quite embryonic and will explode soon. Additionally, the human genome project will help immeasurable in identifying more genes responsible for addictions. The main deficiency in this research is that it hasn't recognized the need to find the mechanism in the brain where these genes work to ultimately result in human addictions. This concept, mechanism, is derived from a different direction altogether, a direction I utilized in Hypoism, that of evolutionary psychology.

Evolutionary psychology is just the well known concept of evolution as it relates to brain mechanisms, rather than body mechanisms, and their evolution to produce cognitive and behavioral survival adaptations in animals as distant as worms right up to primates and humans. Evolution doesn't work in a vacuum, but needs genetically engineered mechanisms to produce the physical variations required for these adaptations to exist and on which natural selection can work to produce what we know as evolution of species. Brain mechanisms (evolutionary psychology) work the same way as body mechanisms (somatic or body evolution). Most people don't realize it, but the brain isn't a black box of neurological mush. In fact, the brain is a well organized and connected group of neurological machines that do specific functions (The Modular Brain of Restak). Crick, one of the discoverers of DNA, wrote a book called The Astonishing Hypothesis about the machinery of the visual apparatus. The fact is that all parts of the brain evolved through mutations and natural selection of previous brain machines from the simplest to the most complex of functions. A paper I wrote on this issue is on my web site at: http://www.nvo.com/hypoism/thehypoismaddictionhypothesis/ and details the evolutionary psychological story of the Decision-Making Apparatus (DMA), the machine that evolved to deal with human instincts and the machine out of which pours addictions in the presence of addiction associated genes. This is the mechanism that is missing from the P/R paradigm that takes alleles of genes all the way to addictions in animals and humans. Without such a mechanism in place to perform the functions it was intended to, and perverted by various genetic alleles, the ones alluded to in the last section on genetics, there couldn't be addictions. This mechanism, the DMA, has evolved to make decisions concerning built-in human instincts, and exists for that reason, but because of the way it works, and the changes that certain low activity genetic alleles exert on it, it becomes an addiction producing machine in those people with the right combination and activity of these genetic alleles. This machine reconciles all parts of the genetics, neurobiology, pathophysiology, and evolutionary psychology of addictions. The P/R paradigm has no such mechanism and because of this sees addictions coming out of a vacuum, something that just isn't happening. Of course, when there is such a vacuum, any hypothesis can be invented on which to blame addictions such as environmental, moral, antisocial, ignorance, and learned reasons. The P/R paradigm is derived from such a vacuum, a reason why it is so wrong and so full of psychobabble explanations of addictions that can't differentiate the science that exists today from the psychobabble.

The known science of addiction genetics and twin studies, as fuzzy as they are because they are studying the genetics of behaviors, a scientifically invalid endeavor, absolutely requires a mechanism for these epidemiological statistical phenomena to occur. As mentioned above, though the statistics from epidemiological studies on the genetics of addictions are ungrounded, they do point toward a heritable underlying mechanism from which these statistical phenomena can be taken into account. Eventually, the heritability of Hypoism, instead of the particular addictions, will be studied and will prove the perfect inheritance of the various forms the hypoic DMA takes and which cause the different kinds of addictions from drugs to instinct (behavioral) addictions. Until then, we will have to rely on imperfect data to infer the etiology of addictions. From this, and from the only Hypothesis that can reconcile this data, will come demands from the public to scientists to perform the correct research necessary to prove Hypoism. see the articles below which raise these issues in three different ways: http://www.nvo.com/hypoism/15replacingalanleshneristheonlywaytoendthedrugwar/ http://www.nvo.com/hypoism/21congressmisledandliedtobyniaaa/ http://www.nvo.com/hypoism/16thebrainaddictionmechanismandthecogastudy/

See the following group of addiction epidemiological studies done from a large group of twins in a Virginia twin registry: http://www.nvo.com/hypoism/recentgeneticstudiesonvariousaddictionsfromalargetwinregistr/ For the first time, including the work from Harvard at the end of the page, statistically valid heritability studies have produced results consistent with what we've all known for years: All addictions, from drugs to behavioral addictions, are highly heritable and unrelated to environmental issues such as learning, morality, and other previously biased and confounding nonsense. That these studies haven't been publicized by the addictionology community or the press is evidence for their bias against it and against the mechanistic model out of which Hypoism originates, a model they abhor because it removes blame from the addict.

Another thing the Hypoism model removes from the addict and from addictionology, and one which they don't want removed for reasons of bias, control, and revenge, is the critical concept of choice and the volitional nature of addictions. One is hard pressed to hold dearly onto the volitional nature of addictions in the face of the demographically homogeneous nature of addictions in our population. Somehow, and against all reason, the P/R paradigm must reconcile the existence of equal numbers of good and bad people who end up as addicts. How does the learned, moralistic and volitional theories make sense out of the higher percentage of Kennedys who become addicts than most other families even coming from the poorest of moral and economic situations? How about the equal number of CEO's and homeless addicts, the doctors, pharmacists, and nurses, all upstanding members of our communities? Of course, it can't, but sloughs it off and ignores it. This phenomena of equanimity of addictions across moralistic, economic, and career borders implies one and only one fact: That addictions come from inexorable genetic forces and arise from an unconscious part of the brain where morality, intelligence, economic security, social savvy, and good family upbringing are irrelevant. In other words, addictability is completely dissociated from such environmental causations as morality, religious training, education, economics, philosophy, role models, etc. That this is true is well known. That it is ignored and left unreconciled is a fraud and a lie perpetrated on all of us by biased addictionologists, most of whom are recovering addicts or family members of active and recovering addicts themselves. Why would they do such a thing? Personal biases and personal denial about their own families and selves while simultaneously being highly prejudiced against other addicts and families of addicts. Hypocrisy.

What could possibly be the neurological explanation to reconcile the above information on demographic equanimity and the absence of environmental causation other than that addictions originate from an unconscious part of the brain inexorably? In the paper to which I referred previously, the evolutionary psychological perspective of addictions, I emphatically showed that for addictions to originate from the DMA, a mechanism derived from evolution of the brain and a part of the brain the directs survival instincts, instincts that can't be interfered with by consciousness for them to work as natural selection intends them to work, the controller of this part of the brain has to be essentially unconscious. Is there any evidence for this? A lot. I will just cite the work of Joseph LeDoux and his book The Emotional Brain. After some 25 years of work on the workings of various parts of the Limbic System, the part of the brain in which the DMA resides, he summarizes it as follows. It is so important that I include the entire summary and have quoted it in blue from my book. This is a key concept that the P/R paradigm can't account for, explain or utilize correctly:
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footnotes:
1. Click addictions to go to a list of addictions. Click back on your browser (NOT the blue word back at the bottom of the list) to come back here. Addiction defined: The use of substances, people, beliefs, and behaviors to change how one feels against one's will.
2. The three symptoms of Hypoism are addictions, decision-making disasters, and evaluation mistakes of self, others, and situations.