E192 | What Matthew Perry's Story Reveals About the Psychology of Addiction

0:00 One of the most striking things about Netflix's new Matthew Perry documentary isn't just how devastating his addiction became, but what might have made him psychologically vulnerable to addiction in the first place. As a psychiatrist with a sub-specialty in addictions, I think sometimes we focus too much on the drug itself and not enough on the whole person.

0:20 Addiction isn't just about drugs, it's about the psychological needs that those drugs are serving. In this video, we're gonna discuss some of the often overlooked but really important lessons about addiction that can meaningfully change how someone approaches addiction and recovery. So, as I mentioned in the intro, when I've worked in addiction services, one of the problems I see quite a lot is there's a huge amount of focus on the drug itself, like say the person's addicted to alcohol or heroin or cocaine, and there's a huge amount of focus on that substance and how they're gonna get off and how they're gonna detox.

0:58 Are they gonna detox at home or in hospital and what procedure they're gonna use? And you see a lot of this in this Matthew Perry documentary, there's a lot of focus on rehab and getting the right immediate medical treatment and how to taper off drugs and stuff like that. And that's obviously really important.

1:15 But I think what this approach misses is we miss the whole person, we miss the person's relationship to that habit. Because often, when it comes to addiction, it's not just about the habit itself, but what is the person's relationship to that habit? What is that person's relationship to alcohol or technology or cocaine or whatever the thing is.

1:36 And I think this is one of the most important things we can learn from this new Matthew Perry documentary. The documentary starts with Matthew Perry talking about fame, and he recalls how before he made it big on friends, he prayed to God and said, God, I will do anything, you can do anything to me, but please just make me famous.

1:55 And when you hear something like that, you're immediately wondering why might someone want anything so badly, and in particular, why might someone want fame so badly? And there's an interesting study about this. So there's a study from 2010 by Moltby and colleagues looking at like why people might desire fame and what that might say about them and their personality.

2:16 The study shows that people might approach fame differently. In particular, it shows that when people approach fame from like a psychologically vulnerable place, a place of insecurity, that tends to be associated with three things. So, firstly, higher neuroticism or what we could call emotional sensitivity, lower self-esteem and self-worth, and potentially more insecure attachment patterns.

2:42 And we'll talk about attachment a bit later on the video. Of course, we don't know if that's what was going on for Matthew Perry. We're not here to diagnose him, but again, what this highlights is it's not just about the thing, in this case fame, but how you approach fame. And what you see in this documentary is clearly Matthew Perry wanted to be famous uh very badly, and crucially, it shows fame didn't work.

3:05 So you got the sense that maybe he thought fame was going to transform his life and make his problems go away. But when you hear him talking about his rise to fame, he says, actually, it was wonderful for a few weeks or a few months, but pretty quickly it began to subside. And he actually said, quote, it didn't fix what's inside of me.

3:24 So again, you're getting the sense that there's something internal that he's trying to fix uh with something external. And we can obviously relate to this. This is so common. We we reach out for the things in our life externally to try and fix some kind of problem that we're feeling internally, and that could be any of the habits that we engage in day to day.

3:45 In this particular situation, perhaps you could say fame itself did become kind of a drug. So, what do I mean by that? When people get into trouble with drugs, it's usually because they're what they're addicted to is that short-term relief, but in the medium to long term, it just makes things worse. And it seems like that's kind of what happened for Matthew Perry.

4:07 The fame, as I said earlier, offered some temporary relief, but then the come down from that was just as bad, if not worse. And then he obviously wanted to continue to try and seek fame and professional success in other arenas after Friends finished. He tried doing other movies and other shows, and when those didn't work out, the feeling wasn't okay, this is a career disappointment, but it seems like his reaction was something more like there's something fundamentally wrong with me that I need to fix, and if only I can make another show work or make a movie that becomes a hit, then again, this would fix this problem that I'm carrying around.

4:45 So, that being the case, I think the question we need to ask ourselves, whether you're dealing with an addiction of some kind or someone you know, is what psychological need is this addiction serving? As human beings, we have to live these complicated, difficult lives, and we have needs, and some of those needs conflict with each other.

5:06 We all need some level of stability, we need some level of novelty or excitement, we need feelings of appreciation, we need feelings of significance. We have all these needs, and how are we going to meet them? And addictions like drugs come to be some of the ways that we meet some of our needs and solve some of our problems.

5:28 I think the issue is again when people are working with addiction or trying to recover from addiction, they just see the addiction as bad. If I drink too much, alcohol is bad. If I do too much cocaine, cocaine is bad. And of course, it is having a harmful effect on them, but that what that approach misses is it doesn't take into account what are the needs that that addiction is serving, and therefore you're not really aware of how it is you need to meaningfully change your life so that you can be less vulnerable to addiction in the first place.

6:00 What does my life need to look like so that I'm not tempted to drink alcohol or I'm much less tempted to drink alcohol? Again, this is something I found that was hugely missing in addiction services. I would talk to people about detoxing from alcohol, and I'd ask them, you know, have you given any thought to what life is going to look like after the detox?

6:22 And very often they hadn't. And so, what that means is you're gonna go through the whole detox process and then just go back into your life as it is, pretty much, and you may not even have major problems, but you may still have some deep underlying needs that aren't being met. And if if that's your situation, then you're gonna be much, much more vulnerable to relapse.

6:43 So, usually, when I'm working with someone to help with addiction, I'll I'll try and get them to understand how is this addiction serving them? For some people, the addiction is alleviating boredom, and for some people, it is providing a sense of novelty. For other people, it's actually providing a sense of emotional stability.

7:03 For others, still, it's just providing the sense that, you know, I have this feeling of like not being good enough, and it just kind of quells that disquiet. And so, really important to understand that as you approach uh recovery. Uh, there's a particularly revealing moment in the documentary where one of Matthew Perry's friends actually says, you know, when he was going through the recovery process, it was often when things got quiet that pain would come to the surface.

7:30 And again, this gives some sense that perhaps for Matthew Perry, the issue was something, some some deep discomfort being in his own skin, something about being with himself that he found difficult. And this brings me back to attachment theory. So I talked about attachment at the beginning of this video.

7:50 And when people think about attachment theory, they're usually thinking about it in the context of romantic relationships, and attachment helps you form good romantic relationships, and of course, that's true, but attachment really encompasses a lot more than that, that is even relevant for something like addiction.

8:09 So the general idea with attachment is that when we form a good, secure attachment with our parents or primary caregivers when we're babies or young children, that doesn't just mean we have a foundation for good relationships, although it does, but it also means we have a sense of stability and faith in the world.

8:29 Because when we're young, for all intents and purposes, our parents are a proxy for the world and for life itself. So when we when we have a good attachment and our parents are reliable, we get the sense that the world is reliable and that the world is going to be able to meet our needs like our parents can meet our needs.

8:48 And if our parents give us enough unconditional love, we can internalize that and that helps us sit with ourselves. We can have a reasonable amount of like positive self-regard, self-compassion. We don't have a huge amount of like self-loathing, we're not at war with ourselves because we've internalized this unconditional love from our parents.

9:07 That's how attachment theory goes, at least. And on the other side, when people have insecure attachment, usually again down to relationship with parents or the primary caregivers, they meet, they may feel this sense that maybe the world isn't gonna meet my needs, maybe the world isn't such a reliable place, maybe I don't have a place in the world, maybe I don't belong in the world.

9:31 And that can even lead to something like self-criticism or self-hatred at the extreme. Maybe there is something fundamentally wrong with me, and that's why the world isn't meeting my needs. And there is another interesting moment in the documentary where one of Matthew Perry's relatives said he had this complicated relationship with intimacy that he really craved intimacy and closeness, but at the same time he pushed it away.

9:58 This would be typical of something like anxious avoidant attachment, although we can't say this definitively from the documentary alone. But this kind of difficulty with intimacy and closeness won't just be about your relationship to others, but also about your relationship to yourself, and can contribute again to this sense of I'm not good enough as I am, there is something fundamentally wrong with me.

10:22 It can present as like deep feelings of like shame, self-consciousness, embarrassment that can make it very difficult to be by yourself. People often talk about there's this difference between being alone and being lonely. You can be alone but not feel lonely, you can be uh amongst a huge amount of people but still feel lonely.

10:42 And I think a lot of that comes down to how comfortable, how okay are you with yourself on some level. And when people are feel really insecure about themselves, of course that makes someone more vulnerable to addiction, but all sorts of problems and besides that. So it's something really important to address if you are thinking about trying to recover from an addiction.

11:02 What was Matthew Perry's core pain at the end of the day? Ultimately, we don't really know, and his childhood isn't discussed in that much detail. And I think that's a good thing. Uh, the documentary doesn't go out of its way to try and diagnose Matthew Perry, and neither are we gonna try and do that here.

11:20 Ultimately, I think the best thing he can do when a tragic story comes about like this is try and learn from it and prevent as much as possible other people from falling into this trap or this situation, and in terms of this core pain, it's very, very common. Many, many people walk around with this sense of inadequacy, uh, that they're not good enough, and the reasons why will be different for everyone.

11:45 But the overarching point is the sense of basic anxiety, the sense of emptiness of not being good enough is something that you need to address because it's to make you vulnerable to addiction, but all sorts of other things besides addiction. One quote from the documentary which really illustrates this is that uh Matthew Perry actually wrote a play towards the end of his life about addiction, where he played the lead character who was addicted to alcohol.

12:10 And in the play, he actually says, When I'm not drinking, there is just blackness and despair. I'm nothing, and I need to be something. And again, that points us in the direction that there was some sense of emptiness that perhaps he was carrying around for a long time, that drugs um seemed to medicate.

12:32 And and this is also supported by the idea that Matthew Perry didn't just have one drug of choice, he actually went through different drugs, you know, alcohol, opiates, ketamine, and that again reinforces the sense that it's not just about the drug itself, but what is the function that the drug uh is serving.

12:51 Until you confront the feelings that you're dealing with, it's very hard to deal with uh this kind of addiction issue. This is also highlighted by another moment in the documentary where Matthew Perry's younger sister, who actually eventually trained as a therapist, says in the documentary, as a therapist, our job isn't to take the bad feelings away.

13:12 Our job is to help people sit alongside these bad feelings and work through them and not have to be alone in the process. And I think that's key. A lot of mental health is learning to be gradually more comfortable with bad feelings, learn how to gradually reprocess them, learn how to use them when you can and tolerate them and eventually work with them.

13:37 That's very important. This is something you see in other depictions of addiction. So you even think about a film like Train Spotting, where the main characters are trying to recover from heroin addiction, and there's one part in the middle of the film where they actually succeed and they detox off heroin, and everything's kind of fine, but the main character, even McGregor's character, actually says we ended up relapsing because of boredom.

14:02 Boredom was the thing. So boredom in this case was the bad feeling that drove to relapse. And so a lot of maturing and getting through life, and a lot of recovery is how do we deal with these bad, uncomfortable feelings, even the mundane ones like boredom? These are all problems we have to figure out in order to make ourselves more robust psychologically and less vulnerable to these kinds of problems.

14:27 Of course, it's important to mention that addiction isn't just about psychological needs, we also have to think about trauma, other comorbid mental health conditions like depression, ADHD. Need to think about genetic vulnerabilities, and there is evidence that genetics can make someone more vulnerable to alcohol or drug addiction.

14:49 We need to think about opportunity to actually use the drugs. So sometimes people fall into addiction because they have an opportunity to use the drugs where they otherwise wouldn't have. Like, for example, they get an injury that exposes them to opiates and stuff like that. So all of that stuff is important.

15:06 But ultimately, at the end of the day, when you're building the recovery plan, one really important question to ask is what does my life need to look like so that I'm much less tempted, much less vulnerable to falling back into a relapse pattern. I think this is the most important question that I don't think is asked enough.

15:25 The last point I want to mention, which is a tangent but still important, is that addiction can be really hard on close friends and family members as well. And this is something you see in this documentary. Clearly, when you're dealing with someone who's having a lot of relapses, it can be so hard, it can take such an emotional toll on friends and family.

15:45 So if you're friends or close to or relative of someone dealing with an addiction, it's really important to like seek support proactively. Don't feel that just because you're not the person carrying the primary problem that you don't deserve support or need support or space, and do it early, do it maybe even before it's absolutely necessary, because you not burning out and succumbing to emotional exhaustion is just as important as helping your loved one recover from addiction.

16:13 So that's an important point to mention as well. Personally, I felt tremendously sad watching the documentary. Addiction is a really serious issue, and some people struggle with it their whole lives, and some people don't manage to recover. But hopefully, we can get to a point where there's enough resources and information available for the people who need it.

16:33 Overall, I think the Matthew Perry documentary offers a great tribute to his life and his story, but also offers these really important reminders about addiction. Drugs aren't just dangerous because of their addictive properties. And yes, things like genetics and other things can play a role, but also what does that person psychologically need, and how can that make them more vulnerable to addiction?

16:58 And what do I need to change in order to make myself less vulnerable? If we focus exclusively on the drug, I think we really risk missing something important about why that particular person developed that addiction at that time, and this is important information that can help them recover and build a life for themselves that's a lot easier to live.

17:19 So I hope you found this video useful. If you did, hit the like button, subscribe. This channel is all about mental health, personal growth, and helping people live a higher quality life. I also work with people for self development coaching, whether that is something like dealing with relationship problems, work issues, self sabotage.

17:40 If these are the kinds of issues you're struggling with, there are instructions how to reach out for coaching in the description. In the meantime, thank you so much for watching and we'll see you here next time.