The Kissinger Cross
I learned about the Kissinger cross from an economist named Jim Rickards (twitter: @JamesGRickards). You may have guessed that the Kissinger Cross was named after former Secretary of State Henry Kissinger, but you might be struggling to figure out what it has to do with addiction. No, it isn’t that it’s his cross to bear. It’s something else all together.
Kissinger said that when we enter a new situation we have all the options that exist but we don’t have any information on which option is best. As we learn more about a situation our knowledge rises, but with that knowledge comes a decrease in the options available. Some just don’t look good with that new knowledge. So he said there are two lines to be drawn as time moves on, the down sloping line of options and the up sloping line of information. The more we learn, the fewer options we have, so in the end, we know everything but can’t do anything. What the Kissinger Cross is, is the point at which the two lines cross. We no longer have all the options but we still have a lot, and we don’t know enough, but we know a good bit. It’s a chancy thing making decisions with incomplete information, but life is a chancy thing. What Secretary Kissinger gave us was a system with which to figure out when to act that is graphical, at least somewhat objective, and can be put on paper for clarity of thought. It’s a good idea, but what does it have to do with addiction?
Well, it has to do with everything, but that’s not the point of your question, is it? You want to know what the Kissinger Cross has to do with the problem of addiction in our society. Well, it can provide us with a solution, but only if we use it correctly. To illustrate that, you’ll have to come with me on a little thought experiment.
A World Without Addiction
So imagine that we live in a world with no addiction, or, since you won’t be able to imagine that, just imagine that we’re not from this world. We arrive here and see addiction for the first time. We don’t know anything about it; it’s a completely new situation. We can do anything about it we want. We can shoot people, give them lemonade, pet the dog, or go home. We have all the options in the world, but we don’t know what to do. We’ve never seen addiction before. We don’t know what it is, what causes it, what it costs. We just know we’re in a new situation. So we start to gather information.
Being not from around here, we aren’t hampered by old ideas about addiction. We see it for what it really is in nature, and as we learn more about it, our options decrease. We pretty quickly figure out that a bunch of options won’t work, like shooting the dog or making lemonade. At some point we’ll have learned enough that we can pick a course of action, and having a lot of information, we’ll probably pick a pretty close approximation to the best thing to do. So why don’t we just do that? Well, we are from around here, and we are hampered by our old ideas, so what happens is that our cross isn’t in the right spot.
Instead of our knowledge line starting at zero, it starts somewhere else, and not necessarily along the right line. Instead of following a line of knowledge as we learn, we start in a pre-determined place arrived at, not from knowledge, but from preformed prejudice. We hear something from an adult as a child, and it is as if God spoke to Moses on Mount Sinai. We believe that and aren’t as open to learning about this new thing as someone from another planet would be. It’s good to be an alien sometimes, to come at a problem with the empty mind of a newcomer. Unfortunately, that’s not the mind we’ve been using to solve the problem of addiction.
And because of what we think we know, the option line doesn’t start in the right place either. There are options that are ruled out by the false knowledge we bring to the situation. There are assumptions that aren’t correct, and under these assumptions we rule out options that could be considered if we had started with open minds.
Now this is not just a problem in analyzing addiction, but in all analysis no matter the subject. We come to all subjects thinking we know something about them. Gun control, drug use, economic inequality, racism, low productivity, international terrorism, the list of problems we face as a country on a daily basis is endless. But for the purposes of this article, let’s stick to addiction. We know that if we start with our prejudices our options line and our knowledge line won’t start in the right place, so the Kissinger Cross won’t be in the right place either. We won’t get the best answer if we start from the wrong place. But how can we start from someplace we aren’t?
We can’t. So the first thing we have to do is get to the right place to start. We commonly say that we should start from where we are, but the quickest way isn’t always the most straightforward. It will always pay us to make a detour to first get to a clear minded starting place where we have challenged all our assumptions and can start with an open mind, a beginners mind. And if you think I’m making this up, I’m not. It’s a very old concept of Buddhist psychology that has worked for over 2500 years. That’s really good that it is that old, because it means there are a lot of good techniques that people have come up with to get to beginner’s mind, more than I can put here. But I will mention my favorite; the Theory of Constraints (TOC) gives us a wonderful set of thinking tools to help us get to beginner’s mind.
I have treated a lot of patients, I have worked with many organizations, I have supervised many doctors and counselors, and there’s something common to this work no matter at what level I’m doing it. Whether it’s working with an individual patient, an individual clinician, or an organization, everyone is in a hurry to start from where they are without understanding how they got there. I don’t know what it is or why it is, but we rarely want to look at our assumptions. When I work with people and I wonder aloud about the assumptions they are making, they are often affronted. “I’m not making assumptions,” they say, “this is the way things are.” We all think that, like we all think we’re above average drivers. We’re not. And we aren’t without preformed assumptions either.
Let’s look at some of our preformed assumptions about addiction. The American Board of Medical Specialities says that addiction medicine as a specialty deals with “individuals with substance related health conditions.” What if addiction also works via other things besides substances? From the NIDA website: “The first time a person uses drugs, it’s usually a free choice they’ve made.” What if it isn’t? What if addiction is a primary disease that shows itself first with things besides substances? That’s just two examples that took me 5 minutes to find on the internet. Here’s another one that is just accepted in society so much that it doesn’t need citation. “Addiction is very hard to treat.” What if it isn’t hard if only we use the right model?
Everywhere I look I see arguments about addiction. Mostly they’re the wrong arguments. I watch people with differing sets of assumptions ignore their and others’ assumptions and argue over minutia in a pointless waste of energy. I like Goldratt’s definition of science: “the process of discovering the fewest assumptions that explain the largest number of observed phenomena.” Goldratt knew we all had assumptions, even if those assumptions were things we all take for granted, like time moves in only one direction and the speed of light is constant. He was a physicist and so he knew that even our most deeply believed fact is still an assumption.
Henry Kissinger gave us a really great tool, but its one that works best when we approach the situation with beginner’s mind. To do that, we need to surface our assumptions and deeply held beliefs and hold them up to the light of day. They aren’t right or wrong; they’re just assumptions. And if we know that they are only assumptions, we can begin to journey to the Kissinger Cross.