I’m not realy sure whether this piece should be refered to as a monologue, a soliloquy or simply the ranting diatribe of some old git but here goes…

Do you ever have one of those moments? You’re scrolling, more or less aimlessly, through an often-inane social media feed when you stumble across a post and think, “Hmm, that’s actually quite profound; it resonates with me.” I have those lightbulb moments fairly often, though sometimes they arrive with almost monotonous regularity.

Different versions of the quote below are currently circulating on social media. I’ve seen it, in one form or another, on LinkedIn, Facebook, Instagram and TikTok. It is presented variously as an original thought, guidance from a close friend or confidant, or—most often—as “advice from my therapist,” particularly, though not exclusively, in posts from American content creators.

Healing is so hard because it is a constant battle between your inner child who is scared and just wants security, your inner teenager who is angry and just wants justice, and your present self who is exhausted and just wants peace. (Various)

Some versions expand on the idea with a deeper explanation, along these lines: “There are three versions of you living inside one body, each fighting for something different, while you are still expected to function like a normal human being and manage a war nobody else can see.”

The passage resonated with me because it helps illustrate some familiar thought patterns: those often experienced by people navigating addiction treatment services while searching for an effective and meaningful path through recovery.

However, I do not personally subscribe to the dominant “disease model” of addiction, which is so often linked to ideas of “effective” recovery. I also find some of the quoted language slightly problematic. For example, the word “healing” suggests, to me, that addiction is being framed as an illness to be treated, rather than as a pattern of choices shaped by circumstance. Before the usual dogmatic objections start flying, let me explain what I mean.

I’ll begin with the familiar argument about “choice.” Sometimes, for entirely valid reasons, the choices we make can feel almost dictated by other people and by the situations we find ourselves in. When no real alternative seems available, and no other credible route appears possible, escape can start to feel like the only option.

I understand that; I really do. But in my experience of working in this area of healthcare, adopting that mindset—and the treatment models built around it—rarely leads to sustainable long-term change. Too often, people are described as being “in recovery” rather than actually “recovered”, many still carrying the unresolved experiences that contributed to their difficulties in the first place. Despite [rightly and deservedly] “celebrating” where they are now.

…if we only treat the part we can see, we may never reach the reason it became necessary in the first place. (Jason Shiers, The Infinite Recovery Project)

A problem does not disappear simply because we deny it ever existed—or because we decide, or are encouraged, to hide from it and hope it will fade with time. Avoidance is very different from confronting an issue directly and trying to resolve it. Too many people affected by addiction and other forms of social distress are surviving only by “white-knuckling” their impulse to reach for their chosen crutch, or by relying on yet another prescription that offers more of the supposed miracle solutions supplied by big pharma.

None of this cures the so-called illness. Much of it is simply another social sticking plaster: a convenient short-term clinical or social Band-Aid applied by people who are physically, psychologically, socially, and often financially constrained. The problem is then compounded by underfunded public healthcare providers operating with limited resources inside a system that is visibly fracturing. Worse still, many of these issues are rooted in the practices of commercial entities, particularly in the American model, that pathologise psychological pain in order to profit from rising levels of physical and emotional distress. “Don’t worry, we’ve developed another pill for that,” says the smiling snake-oil salesman, already thinking about his next bonus.

Nothing positive comes from pathologising our trauma experiences as mental disorders and personality disorders.  (Dr Jessica Taylor, victimfocus.com)

I understand the commercial and economic pressures at work today; I really do. I have had to search for resources to support both individual and wider social struggles, and that is a difficult position for any provider. It is especially hard to tell someone, “I can’t help you,” because the system will not allow it—whether because of limited resources, procedural rules, or budgetary constraints. What I still struggle to accept is the pursuit of profit at the expense of people. That impulse seems to underpin many [American] commercial business models, but it has never sat comfortably with my own moral compass.

“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” – Desmond Tutu

However, many of the problems we keep facing seem rooted in the short-term thinking that now dominates leadership across organisations, public services, governments, and the societies they are meant to serve. We have built systems shaped largely by prevailing American business models, which have encouraged—and rewarded—an increasingly common and deeply troubling “Fuck you, I’m all right Jack” mindset. That attitude is reflected, to some extent, in the thankfully waning support for some of the figures at the top of American business and political life. But that is another story.

Another driver of short-term thinking is the tendency of each new generation to believe it has reinvented the wheel, perhaps most visibly in some American cultural and commercial contexts. Once an old idea is repackaged as a “new” invention or so-called life hack, it is often commodified and monetised almost immediately. Much of its subsequent commercial success seems to rest on limited awareness of history, geography, and earlier achievements. The insularity of some systems, and of some individuals within them, can encourage a narrow worldview, making it easier to overlook the fact that many supposedly new ideas were commonplace long before modern America existed. This helps explain the emergence of a new kind of online “healthcare” industry: one built around the not-so-humble social media influencer.

Shocking, perhaps, but these digital tendencies are not confined to America. They appear elsewhere too, including in the UK, where they can affect public services and some aspects of healthcare provision. With this in mind, I often find the sarcasm-laden words of the author and coach Ian Callaghan running through my head, especially when I’m considering the impacts of the modern “life hack” and influencer phenomenon:

“Social media has spent years telling everybody to be authentic, but only recently clarified that authenticity must use an approved phrase, a fashionable font, a trending audio track and exactly the same emotional arc as sixty thousand other allegedly unique people.” (Ian Callaghan)

Ian is probably correct when also he points out; “Individuality has become line dancing for people with ring lights” as opposed to them personally doing the required work on their personal issues.

At this juncture, whilst I ponder the situation, I’m struggling not to adopt a monologic tone and utter something about Hamlet suffering from his “slings and arrows of outrageous fortune”. Because “to be, or not to be” is a lynchpin within the solutions for these issues; something which has long been one of my strongest drivers for my lifelong work ethic, and the desire to support others less fortunate than me, until I retired. OK, so none of this is my problem any longer but that doesn’t mean that I can’t keep pondering the situation.

It seems clear to me that we will continue to feel the consequences of all this short-term [financial] self-interested – often digital and binary – thinking for some time. In fact, I am not sure we can ever fully escape it, certainly not in my lifetime, and not while we remain so focused on the immediate rewards of the present. Nor will we move beyond it while we continue to measure personal, institutional, and social worth through financial wealth, status, and the power to influence or restrict other people’s choices.

Constantly chasing the dopamine hit, continual short-term thinking, profit-driven models, and status-based measures of worth are all impacting upon more humane solutions; both for now as individuals, and for our collective futures. We need to start shifting our attention upstream: to focus more upon prevention, earlier interventions, trauma-informed support, stable housing, meaningful work, community connection, and social inclusion. Many would probably argue that’s all easier said than done, me included.

We need to address causes, not just symptoms. Systems should be designed around people rather than money alone, with services that respond more effectively to individual and social trauma: poverty, isolation, shame, and the lack of agency that often sits behind people’s struggles. We cannot keep trying to medicate society out of the harms we help create. Instead, we need sustained investment for our public services, including person-centred, properly funded health and social care, and community support that is not limited to crisis response.

We also need to reduce the profit-driven harms created by business and healthcare models that commodify distress or prioritise revenue over long-term wellbeing. That means challenging those models while measuring success differently: valuing stability, dignity, connection, autonomy, and quality of life—not only abstinence, the absence of problematic behaviours, service discharge rates, system productivity data, or short-term savings. Frontline workers also need the time, resources, supervision, and flexibility to respond humanely, rather than simply manage rising demand. Because they’re all rushing around from one crisis to the next – most have personal desires around providing high-quality person-centred care with empathy – stymied by the frameworks which they’re obliged to operate within.

Unless we develop long-term, people- and community-centred thinking – not driven solely by financial gain or loss – many of our public services will continue to fail. And sadly, we will all continue to feel the profound consequences of those failures. And so “to sleep: perchance to dream… for in that sleep of death [not yet I hasten to add] what dreams may [yet] come” true?