John Oliver Critisizes the Pharmaceutical Industry Over America’s Overwhelming Opioid Epidemic

Please watch John Oliver deliver a harsh rebuke of the pharmaceutical industry for its dishonest marketing of opiate-based pain medications. But the problem is even bigger than that. The healthcare system our doctors work in only permits seven minutes per patient visit. How could our doctors do anything else but prescribe a pill with so little time? Our medical system is the most expensive in the world, and, simultaneously, delivers the least value for that money when compared to other first world nations.

Be forewarned that he does get political and is crude at times. I think these issues do deserve attention, however.


About HSP’s — Highly Sensitive People

My wife Lynda and I just watched a fascinating documentary titled: Sensitive – The Untold Story. It turns out, the genetic trait of high sensitivity is found in 20% of the population. It is found equally in men and women and in over 100 animal species. The scientific term for the trait is SPS or Sensory Processing Sensitivity. This trait is not a disorder, but it does pose challenges for people who possess it, as well as those with whom they live.

What SPS means is, certain people are more tuned into subtly of words, emotions, environments, threats, meaning, sounds, beauty, loss, poignancy, world events, human suffering, the list goes on. On other words, the brains of highly sensitive people (HSP) not only process more information, but they also process it more deeply. High sensitivity can be a blessing or a curse. Because practically speaking, HSP’s feel more. So their emotions are not only more keen and profound, sometimes they’re more gripping. For this reason, HSP’s can get easily overstimulated in environments that are chaotic, loud, or otherwise intense. Overstimulation is the challenging aspect of this trait, both for the HSP and for those with whom they live. I imagine many stress-related illnesses – addictions, depression, chronic pain, anxiety disorders, and more – are correlated with HSP.

Mark as a babyI am a highly sensitive person. I even joked about it in my guided meditation booklet when I wrote:

“When I was a kid, I don’t remember people thinking that I was spoiled, but I do remember being overly sensitive. I would throw a fit if there were wrinkles in socks when my mom put on my shoes. I’ve always liked things to be just so. I can recall my Dad even telling me to “unfuss myself.” So I guess that’s my life’s journey, learning to accept and allow.”

Being an HSP has been a journey – an educational one – where I’ve had to learn about myself. Learning to meditate and be more mindful has been a big part of that journey. Since I started meditating, my sensitivity has not toned down. Rather, it’s even stronger than ever. But the remarkably positive difference now is in the quality of my sensitivity. I’m no longer reactively sensitive, throwing a fit when I get tired, hungry, uncomfortable, or otherwise when circumstances don’t go my way. Instead, now, I can sit for extended periods of time, experiencing relative discomfort with composure. I’m still sensitive, but now, I’m groundedly sensitive. That’s the blessing that makes all the difference. I now know how to open up and have complete experiences, riding the waves of energy around me. In this way, I can experience the fullness of my gift for sensitivity without it throwing me into an emotional tailspin. The blessed gift of grounded sensitivity heightens one’s senses, and that, in turn, makes life more precious. If you are an HSP, you have the potential to make the shift from reactive to grounded sensitivity yourself. If you need support, I’m here to help.

If you think you’re an HSP, let us know. Add your comment to this post. We want to hear your stories. Also, if you know other HSP’s, share this post with them. They want to know they’re not alone.



Kids These Days!

“Kids these days.” How many times have you heard someone speak these words? How many times have you thought or spoken them yourself? We adults are perfect projection machines—chastising children for their behavior while at the same time forgetting it is a reflection of our own. Sure, each person is born with a unique temperament. Nevertheless, the environment of the home and culture radiates a powerfully influential force that molds them as well.Fighting Children

It might be helpful to think of children as biological recording devices. As such, they come into the world equipped to record and playback everything they experience. How do we imagine children learn to feel, sit with, and process their emotions? Clearly, it is through the process of modeling the emotional responses of those closest to them. Kids learn to speak kindly to others or not, depending on whether or not they hear kind words spoken to them. They may learn to respect others and their feelings, but only if their feelings receive respect first.

Likewise, by modeling the adults in their lives, children learn to become anxious, depressed, aggressive, distracted, impatient or disinterested. Unfortunately, most often our medical system treats these emotional issues as medical conditions. Pharmaceutical companies create pills for dampening all such “symptoms.” This misguided polypharmaceutical approach has no endgame. Lab testing our kids by pouring psychoactive chemicals into them is not the answer. Don’t get me wrong, I’m not implying in all cases. Sure, in rare instances medicine can be a solution. What I’m saying is that pills won’t solve problems related to an unsafe environment, or the unavailability of tuned-in, emotionally skillful caregivers.

Happily, there’s another alternative to taking our children to the doctor. Humans never exhaust the capacity for growth and evolution. Meaning, grace is embedded in the practice of parenting. But, progressing along the path towards positive change requires pulling yourself out of your routine, and then, learning something new. Happy ChildrenIf you want to change your child’s behavior, start by working on yourself first. When you learn to experience your emotions more skillfully, speak more kindly and respectfully, be more compassionate, you’ll become perfectly enabled to model that skillfulness for your children. Then they’ll change.

Dr. Mark Pirtle is a meditation and mindfulness teacher who works in the recovery field. He contracts for Sierra Tucson, Miraval and is a faculty member of the Center for Integrative Medicine Fellowship Program at the University of Arizona. He teaches Skillfully Aware, a 6-week class that teaches the brain science of emotional literacy and the practice of meditation and mindfulness. For more information on classes go to

Everything is Workable

Time Magazine Mindfulness

Hi all, I wanted to share an example of a back and forth Q&A between myself and a client with whom I’m working. He’s learning how to use meditation and mindfulness to heal anxiety and depression. Here’s our email string from today:

Time-Mindfulness-020314Client: “Hey Mark, good morning. I just wanted to ask you a question. So I am reading the book “The Path of Individual Liberation” by Chogyam Trungpa. He stresses the importance of focusing on nothing besides the out breath. So now when I meditate I get very anxious and doubt myself, thinking I am doing it wrong. I was thinking maybe it would be better for me not to read any more meditation books because they just mess with my mind, and stick to our practice. Do you have any advice/thoughts?”

Me: “Great question. Reading good Dharma is always a good idea, and Trungpa is good Dharma. If you have questions, just ask. Daily spiritual reading will take you far, so keep going! The advice to watch the out breath is given because it’s so subtle. It’s a “doorway to emptiness.” But the truth is, so are all meditation objects. It’s strange, but the more carefully you observe them, the more ambiguous they become. May I suggest that you do the same with what you think is your anxiety, depression, or a strong emotion or urge. Get in the habit of asking yourself, “what is this?” but don’t answer. Go looking for it. Is it a thought? If you think so, then ask: “what is a thought?” Keep probing. Is it a sensation? What’s that? There’s a saying, “everything dissolves in awareness.” And it’s true. You’ll never actually find the thing you’re looking for. All that exists is experience, which is ephemeral, fleeting, or as the Tibetans say, “empty”. Sit with that, and let me know what you find. Your practice will reveal the truth and that’s where you’ll find your healing.”

So if this type of back and forth support is what you want, and you’d like to learn to use meditation and mindfulness to change and or heal, join us. For a limited time, I’m running a holiday and New Year’s special. Until December 31st, receive $100 off both the Skillfully Aware Meditation Program for Stress Relief, and or the 6-Weeks to overcoming Stress, Pain, Strong Emotions and Urges (Tucson residents only). This offer is not available on the website. To take advantage of it, please call 520-981-9911, or email

Wishing you all healthiest and happiest holiday,


Robin, it didn’t have to be this way

Were you as shocked as I was when you heard the tragic news of Robin Williams’ suicide? I just stood motionless for a time, wondering why. Of course, people are complicated. I didn’t know Robin Williams. Sure, the comedian and actor that struggled with addictions and depression, but all that’s just surface stuff. His wife and kids knew he was in pain. But not even they knew how much. One’s struggles are so deeply personal. I’m sure they were as shocked as we were, probably more so. My guess is that he hid his pain from them too, out of love.

I’m sad. My heart breaks for him and his family. It breaks for all of us collectively too. The world just lost a unique and wildly creative perspective. Few people ever see the world as idiosyncratically as he did. We need perspectives like Robin Williams.’ People like him help the rest of us open our minds a bit further. His creativity was such a gift. Not as obvious though, but way more poignant now, was that he also carried its curse. There’s a dark side to creativity.

Williams_Robin_USGov_cropI’m reminded of the famous Jack Kerouac quote, “the only people for me are the mad ones, the ones who are mad to live, mad to talk, mad to be saved, desirous of everything at the same time, the ones who never yawn or say a commonplace thing, but burn, burn, burn like fabulous yellow roman candles exploding like spiders across the stars.” The burning, that’s what I want to explore. Because Robin, you were a Roman candle too. We all burn out eventually. I’m just wondering if maybe you didn’t snuff out your light too soon? I may be wrong. Again, each of our struggles is so deeply personal. But I can’t help but think it didn’t have to be this way.

I watched Wolf Blitzer interview Dr. Sanjay Gupta on CNN this week. Wolf astutely hit on this Jack Kerouac theme by asking Sanjay, ‘if the traits that made Williams a great comedian might also have contributed to his deep depression?’ Sanjay speculated this was so, and I agree. It’s easy to imagine how an innately strong, inborn passion could push a person’s emotional pendulum from manic to depressive and back. In fact, it’s so common that it’s almost cliche–the depressed and addicted comic, musician, artist, or writer. Sanjay went on to remark that there are no easy answers. And he’s right again. But if we’re to understand this problem better and hope to prevent the next artistic genius from killing himself, we’re going to have to make sense of the shadow side of creativity, and learn to work with it. I’ve found Jungian and Buddhist psychological to be very effective in this respect.

Secondarily, may I suggest that we start by thinking about disorders like depression and addictions more critically? Sanjay started the interview by reminding us that depression is a disease. I’m not criticizing or even contending with Dr. Gupta. The subtext of his comment was that depression is a serious condition and that it warrants serious treatment. I wholeheartedly agree. Yet, I cringe when I hear the word disease. I know, it’s my issue. But I do so because I know that words are powerful, and in this specific case, it can be misunderstood. Everyone regards cancer as a disease. But does the word disease mean the same thing when applied to depression and addictions? To anyone listening, it carries the same weight. Sure, depression and addictions meet the definition: a particular quality, habit, or disposition regarded as adversely affecting a person. But are we talking about the same thing?

Cancer is primarily a disease of the body. The most-effective treatments for cancer target the body. Psycho-spiritual-emotional interventions may help on the margins. But affirmations, prayer, healing touch, meditation, group therapy and the rest can’t hold a candle to the power of the latest biological and chemotherapies. Depression and addictions are different. They are primarily diseases (qualities, habits, and dispositions) of the mind and heart. Yes, they affect the body too, it’s a whole system. So brain circuits do malfunction. But these conditions are primarily diseases of meaning (thoughts of self, needs, wants, losses, threats, urges, inadequacies, injustices, etc.). For that reason, they are extremely context dependent. That is why a change in meaning can result in a change in being.

Long and short of it is lumping all these disparate conditions together under on label seems like a mistake. If we continue to call both cancer and depression diseases, then we need two categories: one for the diseases of the body, and another for diseases of the mind and heart. Treat the former with biologic and pharmaceutical interventions supported with integrative approaches for symptom management. Treat the latter primarily with integrative interventions, talk and group therapy, shadow work, and most especially meditation and mindfulness. Then, offer pharmaceuticals to manage symptom intensity. That’s what makes the most sense.

The myriad ways humans manifest repetitious patterns of suffering require us to be a little more thoughtful in our approaches to curing them. I’m going to miss Robin Williams. Had the context shifted somewhere in his past, through mind training, I believe things could have been different.

If you found this post interesting or insightful offer your comments. Please also tweet and retweet and otherwise share it within your social media networks.

Mark Pirtle


How to Heal Addictions with Mindfulness–In the Realm of Hungry Ghosts (Post 8)

In The Realm of Hungry Ghosts Cover

Hello and welcome back. Thanks for joining me as I read and discuss Gabor Mate’s insightful and inspirational book, In the Realm of Hungry Ghosts.”

Last time we talked about what Mate calls the “process” of addiction, which I likened to a network function, or “system dynamic.” Where pre-programed actions (process) affect present moment processes, parts, and patterns. In addictions, the whole system therefore gets caught up in self-reinforcing feedback loop from which it is very difficult to break free. Earlier, we discussed the lack of evidence for a person’s genes as being the primary cause of addiction.

Today, we’ll discuss how early childhood experiences plays a much larger role in predisposing a person to addictive behaviors later in life. Before we do, it’s important to understand why experience plays a larger role in developing humans than it does in all other animals.

A human child at the end of its gestation possess a relatively large head compared to the limited pelvic size of its mother. Given that biological fact, the human brain completes the predominance of its development outside the womb. Where a new born colt can run within minutes, a human baby takes months just to roll over and the better part of a year to take its first tentative steps. Such extreme helplessness leaves human children extraordinarily dependent on a safe environment, and on competent, caring and connected adults. Proper brain development depends on it.

AddictAbuse and neglect leave brain systems responsible for attachment, emotional self-regulation and maturity woefully underdeveloped. Children grow into adults. Adults who suffered childhood traumas or neglect are the ones who develop a harsh inner critic, lack self-compassion, can’t focus, make and keep long-term goals or plans, have trouble in relationships, and are predisposed to medicating away the hurt with externals substance or behaviors.

And yet, despite the fact that these dysfunctions were born out of neglect and abuse, large parts of our current treatment system seeks to punish the addict for their thoughts, feelings and behaviors. Such a stance is both strategically and morally wrong. Understanding, as Mate argues, the larger context from which addiction springs allows one to use both evidence and compassion in devising a more heart-centered approach to treatment.

Thanks again for joining me. In the next few posts I’ll delve more deeply into the evidence for blending mindfulness with compassion-centered approaches to addiction treatment.

If you find these posts helpful, please share them with your social networks. To learn more about me and my work, please visit my website: If you’d like me to speak to a group or organization in your city, email:

Be well,


Have you ever felt like this?

In The Realm of Hungry Ghosts Cover

In The Realm of Hungry Ghosts CoverOne of my patients once said this to me: “When I get triggered, either by a site or a sound, or by my own thoughts or sensations, I start losing touch. It’s like a curtain falls over my mind, or more like tunnel vision where I can’t see anything outside the narrowing beam of my attention. I want to tell you that the urge to act out overwhelms me to the point where I can’t resist. But there’s always a part of me that knows what I’m doing, and I think I could stop and do something different, but I just don’t know what that might be.”

If you’ve experienced the same, join me as I explore Gabor Mate‘s amazing book on the causes of addiction–In the Realm of Hungry Ghosts. Please share this information with anyone it may help.

Be well,


How to Heal Addictions with Mindfulness–In the Realm of Hungry Ghosts (Post 6)

In The Realm of Hungry Ghosts Cover

Hello again and thanks for joining me as I read and blog about Gabor Mate‘s book “In the Realm of Hungry Ghosts.” Last time I detailed four functional centers in the brain that malfunction in addiction:

1. The dopamine “motivation” circuits
2. The opiate attachment/reward circuits
3. The frontal executive control circuits
4. The stress response circuits

Dopamine and the body’s own opiates, endorphines, are powerful neurotransmitters. Concentrations of these internal chemicals tend to be low in an addicted brain.

Brain Reward Circuit

Dysfunction in the dopamine and opiate circuits can therefore lead to feelings of malaise, which may then stimulate an urge to use substances or engage in behaviors that boost brain levels of these same lacking neurotransmitters. Accompanying dysfunction in the executive, or impulse control and stress response areas represents a double-whammy. Addicts in the throws of an addictive fixation find it hard to think rationally. This is why dysfunction in all these circuits makes it exceedingly difficult for addicts to resist their persistent urges.

The CerebrumWhen I teach about addictions, I lump them together with many other similarly dysfunctional, repetitious and persistent bio-psycho-social patterns that I call “stress illnesses.” Stress illnesses include depression, anxiety, eating disorders, PTSD, OCD, ADD–the whole alphabet soup. I’ve written extensively about stress related illnesses so I won’t go into a further explanation here. The point I want to make is this: thinking of addiction as a may disease limit how we perceive it and treat it.

Yes, Yes, Yes, as I’ve explained above, an addict’s brain is operating dysfunctionally. That dysfunctional processing is inclining the addict to engage in repetitious and harmful behaviors. But be clear; nothing determines what an addict decides to do. There’s always a potential for turning away from a substance or behavior. The brain is not the only decisive element in addiction.

Mate suggests, and I whole heartedly agree with him, that we open our minds and begin to think of addictions as “processes.” A process is a flow of actions. Therefore, an addiction is more like a verb than it is a noun. Another way to describe the word “process,” is through the language of living systems theory, as a “self-making” system. A systems approach to thinking about addictions would take into account the full flow of the actions of the whole system–the actions in the addict’s environment, actions in the addict’s mind, and actions in the addict’s body. Actions in all three domains (world, mind and body) contribute conditions that reinforce the “state” of addiction.

In my next post, I’ll talk briefly about the rules by which living systems operate. Once the rules are understood, it is easy to see how the system can incline itself towards deeper addiction, or, healing. Both are possible.

If you find these posts enlightening, please feel free to share them with your social networks. I wish you happiness.


How to Heal Addictions with Mindfulness–In the Realm of Hungry Ghosts (Post 5)

In The Realm of Hungry Ghosts Cover

Frustrated_man_at_a_deskHello again, and thanks for joining us as we read and discuss Gabor Mate‘s book “In the Realm of Hungry Ghosts.” Last time we looked at the factors that predispose a person to addictive thoughts and behaviors. We discovered that stress, especially toxic early childhood stress–even more than genetics–is the strongest predetermining factor for developing an addiction of any kind. The question then becomes, why? The simple answer is that early childhood stress negatively affects the emotional and self-regulatory circuits in a developing child’s brain. Mate writes that four brain centers are particularly affected.

1. The dopamine “motivation” circuits
2. The opiate attachment/reward circuits
3. The frontal executive control circuits
4. The stress response circuits

Very simply, overwhelming stress causes these systems to malfunction. For example, stress creates a lack of the powerful and necessary neurotransmitter dopamine, and also of the receptors that dopamine binds to. A person who suffers from an internal and persistent lack of dopamine will have a tendency to feel malaise, which can predispose that same person to seek out substances and behaviors that increase levels of brain dopamine. It’s strange to think that a person is not actually addicted to cigarettes or cocaine. Rather, they’re addicted to the surge of dopamine that these substances provide.

Normal neurotransmitter levels and well functioning emotional control and stress centers are necessary if one hopes to feel and function normally. Mate suggests that this fact illuminates the central dilemma in addiction treatment, “if recovery is to occur, the brain, the impaired organ of decision-making, needs to initiate its own healing process. An altered and dysfunctional brain must decide that it wants to overcome its own dysfunction… the very concept of choice appears less clear-cut (however) if we understand that the addict’s ability to choose, if not absent, is certainly impaired.”

The foregoing opens the space for many questions. Primarily, is addiction a disease or something else? Secondarily, can a dysfuntional brain hope to heal itself through it’s own efforts? I look forward to your comments.

If you find these posts enlightening, please share them with your social networks. Learn more about my work at

How to Heal Addictions with Mindfulness–In the Realm of Hungry Ghosts (Post 4)

In The Realm of Hungry Ghosts Cover

Hello again, and thanks for joining me as we read and discuss Gabor Mate‘s book “In the Realm of Hungry Ghosts.” Last time we talked about the hallmarks of all addictions.

InTheRealmOfHungryGhosts_coverThis post will explore the factors that tend to set a person on the path to addiction. Mate writes that there are three: a susceptible organism, a drug with addictive potential, and stress. Reading those predisposing factors made me think. It seems like these factors interrelate and influence each other, but one stands out as the dominant force. Research suggests that the susceptibility seems more tightly linked to early childhood stressors than with a drug’s addictive potential. Mice raised in a nurturing environment resist self-administration of cocaine and heroin as adults. Conversely, mice raised in a stressful environment and with little parental nurturing do tend to self-administer these drugs.

Additionally, so much emphasis has been placed on genetic predisposition as a causative factor for addiction. But the evidence just doesn’t bear this out either. Genes make proteins; they don’t determine behavior. The science of epigenetics tells us that emotional experiences change our internal biochemistry, and those biochemical changes then turn genes on and off.

So is addiction in the genes or the drugs? Or, is it more related to environmental stress? Seems like it’s the stress. The way I read it, stress creates an addictive susceptibility. Sure, once genes are turned on they can intensify craving. In such a case, and in a person who’s suffering, an addictive drug then feels like medicine for the pain. This reinforcing feedback also explains why addictions are not isolated to drugs. People get addicted to food, sex, gambling, and many other substances and behaviors. People use or act out in a misguided attempt to feel better. Which brings us back to a premise Mate articulated earlier in his book: pain or hurt forms the backdrop to all addictions.

Thanks for joining us for this discussion. Your questions or comments are welcome. Also, if you find these posts helpful, please share them with your network. Next time we’ll explore how early childhood stress affects the developing brain.

Best to you,