Addiction is a behavior, not an identity.
– Fredric Schiffer, MD
Addiction is often framed as a failure of willpower or a fixed identity. But according to Fredric Schiffer, a psychiatrist on the faculty of Harvard Medical School, that framing may be doing more harm than good.
In his clinical work with people struggling with anxiety, depression, PTSD, and substance use, Schiffer has come to see addiction not as a defining trait, but as a state-dependent behavior driven by unresolved trauma. At the center of his research is a model he calls dual brain psychology, which suggests that the brain’s two hemispheres can carry different emotional states — and, in many cases, different levels of psychological burden.
“When people feel trapped in compulsive behavior, it’s often because one side of the brain is still operating from an earlier injury,” Schiffer explains. “That side is seeking relief. The behavior makes sense once you understand the pain behind it.”
Two Minds, One Brain
Neuroscience has long established that the brain has two hemispheres. What Schiffer observed clinically — and later studied using neuroimaging — is that each hemisphere can support its own emotional perspective. In many people, one side is relatively regulated and adaptive, while the other remains more reactive, shaped by earlier experiences of fear, neglect, or shame.
When the more traumatized hemisphere dominates, cravings and compulsions tend to intensify. When the healthier hemisphere is activated, people often report feeling calmer, more empathic, and more capable of making deliberate choices.
This shift can happen quickly. In clinical demonstrations, Schiffer has shown that simply changing which visual field a person uses — by partially covering one eye — can alter emotional intensity and craving levels within seconds. The effect is not psychological suggestion, he says, but a measurable change in brain activation.
Why Shame Makes Addiction Worse
One of Schiffer’s central concerns is the language used around addiction. Labels such as “addict,” he argues, can reinforce shame and deepen the very patterns that keep people stuck.
“Addiction is a behavior, not an identity,” he says. “When we collapse a person into a label, we freeze them at the level of their wound.”
In his practice, Schiffer sees people who are acutely aware that their behavior is harming them — and yet feel unable to stop. This internal conflict, he notes, is a hallmark of addiction: one part of the mind knows the risk, while another is urgently seeking relief from distress.
Viewed through this lens, addiction becomes less about moral failure and more about an unmet need for safety, regulation, and understanding.
Hidden Trauma and the Search for Relief
The trauma underlying addiction is not always dramatic or obvious. Often, it stems from experiences that were never named as traumatic at all: emotional neglect, chronic criticism, bullying, or growing up feeling unseen or unsafe.
“These experiences don’t disappear just because they weren’t acknowledged,” Schiffer says. “They continue to influence how the brain responds to stress.”
Addictive behaviors, he explains, often begin as attempts to soothe this internal distress. Over time, the brain learns that the behavior provides temporary relief — even as the long-term consequences become increasingly destructive.
From Understanding to Treatment
Schiffer’s work extends beyond theory. He is currently involved in an NIH-funded clinical study — designated by the FDA as a breakthrough device trial — exploring the use of near-infrared light to stimulate the healthier brain hemisphere in people with severe fentanyl addiction.
In earlier research, participants receiving active treatment showed significantly greater reductions in craving compared to those receiving a sham intervention. The treatment is brief and noninvasive, and many participants report feeling calmer afterward.
The goal, Schiffer says, is not to suppress behavior through force or fear, but to reduce the internal pain that drives it.
A More Humane Model of Recovery
Rather than demanding that people “fight” their addiction, Schiffer encourages a different approach: helping the healthier part of the brain communicate with the wounded one.
“When the regulated side can say, ‘I understand why you’re hurting,’ symptoms often begin to soften,” he explains. “The two sides don’t need to be at war.”
Over time, as the healthier state becomes more familiar, people often find it easier to remain there — even when cravings arise. Recovery, in this view, is less about conquering an enemy and more about reintegrating parts of the self that were left behind by trauma.
Seeing Addiction Through a New Lens
Schiffer’s work challenges a deeply ingrained narrative — one that equates addiction with weakness or moral failure. Instead, it invites a reframing: addiction as a signal, not a verdict.
“When we understand what the brain is asking for,” he says, “we can respond with compassion instead of condemnation.”
And in that shift, he believes, lies the possibility for lasting change.
