There’s an old Yiddish saying I just made up, “Every chicken comes from an egg.” I have no idea if anyone ever said it in Yiddish or if anyone said it a long time ago. It just occurred to me and it sounds just like an old Yiddish saying, short on words, long on meaning. It's not every day you get to invent an old saying, and you're probably wondering what it means.

It means that every problem, no matter how big and complicated it is, has a single cause. Or actually, at most two causes, and I guess brings the rooster into this, which is a completely different old Yiddish saying. For now let’s keep it simple, every problem, no matter how big and complicated has a single cause.

On its face it’s a ridiculous notion. World poverty, addiction, cancer, racial tensions, unemployment, government corruption, and the list goes on and on. All of these huge horrendous problems have single causes? It is ridiculous. If it were true, wouldn’t we have found these by now and rid ourselves of these difficulties? Well, we might have, if we’d believed it was that simple.

It isn’t the complexity of the problems we face that makes them unable to be solved, it is our belief in their complexity. We have a lot of other sayings that tell us things aren’t so simple. For instance, H. L. Menken said, “For every complex problem there is an answer that is clear, simple, and wrong.” And he’s right. Menken was talking about the solution, the answer. I didn’t say the answer is simple; I said the cause is simple. We’d like the answer to be simple if the cause is simple, but that doesn’t make it so. The truth of Menken’s words also doesn’t negate the fact that all things come from simple causes.

Let me give you an example from my own world, addiction. The word addiction conjures up a complex interaction of injurious attachment to all manner of drugs and behaviors including alcohol, cocaine, heroin, sex, gambling, spending, etc. It’s been a major thorn in the side of society for hundreds of years and we’re spending billions trying to make it better every year just in this country. It has genetic and learned factors; it has associations to social class; it seems to be different in different groups. Let’s face it, it’s complex, it couldn’t possibly have a simple cause. Yeah, no.

Here’s the simple cause, biological attachment at the level of the midbrain. I’ll explain. We all have a system in our brains that’s incredibly old. So old that all mammals have the same system. It’s the system that gives your dog that special sense of loyalty, and it’s the system that allows you to fall in love. I know that at a deep level it hurts you to hear this about your falling in love, but it’s just biological. And so is attachment to a drug or behavior.

I’m going to simplify this explanation for the sake of brevity. There’s a place in the midbrain where a chemical messenger called dopamine is sent out. When something special happens that we should come back to again, dopamine spikes to create a cascade of chemical signals that eventually end in attachment. This spike is why you like your favorite color, and why some foods don’t taste good. You don’t get a dopamine spike when you eat them.

Now we all have dopamine spikes because attachment is a part of life, but we don’t all have addiction, no matter what some reality TV host told you. Addiction is a biological brain illness, and we don’t all have it. If you don’t have it count yourself lucky. If you want to say you’re attached to having Ford F150’s and it’s the only car you’ll buy, you aren’t addicted to F150’s. You just have an attachment to them. So what makes the difference between attachment and addiction?

Most of us attach to things loosely all of the time. We like and enjoy a lot of things. But if we don’t have enough dopamine tone to have a good spike when we eat a delicious apple or see a sunset, we don’t attach to much around us at all. The normally rewarding activities of life aren’t rewarding and we feel pretty empty. Then along comes something that produces a bigger dopamine hit and actually makes the bell ring. It could be anything from high fructose corn syrup to heroin. But when it hits, there’s an attachment, and that attachment happens even if we don’t enjoy the thing. Addiction isn’t about liking, it’s about attachment, even attachment against our will. That’s why it’s called addiction.

So, if I’m right, and addiction has a simple cause, low dopamine tone leading to decreased attachment to normal things and over attachment to high dopamine rewards, then there ought to be a simple solution. Hey, why don’t we raise dopamine tone? That’s a great idea, you ought to treat addiction. Here’s the problem, it’s not very simple to raise dopamine tone.

Well, it’s simple in the short run, that’s why drugs are so useful to people with addiction. They are a simple quick way to increase dopamine tone, but they don’t last long and are so powerful they actually drive dopamine tone down over time. So what we’re looking for is a way to increase dopamine tone slowly and just enough for each person to be able to enjoy and attach to the rewards of life without drugs. That’s where it gets complicated.

You see not everyone needs the same amount, and not everyone has low dopamine tone for the same reason. There are those who have low tone because their receptors are suppressed by social factors, there are those who don’t release enough when the time comes and those who don’t make enough in the first place. If that weren’t complicated enough, there are those who actually had high dopamine tone in the first place and still do in much of the brain, but have low dopamine tone from drug induced damage in the reward center, and others who have a dopamine spike that’s set too high so that increasing dopamine tone alone will actually make them worse. You see, there’s no single treatment, no simple answer. Everyone needs what they need, in the order they need it, for as long as they need it, until things change and they need something else. That’s medicine. That’s treatment. It’s not simple.

But what is simple is the cause, and without understanding the simple cause we don’t see addiction as the unified illness it is. We miss the core phenomena and get lost in the weeds. We end up trying to stop this drug and that drug; we develop treatments for this behavior and that behavior. We make the answer even more complicated than the problem and more complicated than it needs to be. We end up in a place from which we will never solve the problem.

But if we remember that every chicken comes from an egg, we’ll look for the common simple cause. It will drive us to see the core phenomena of the problem. We’ll see through the complexity to the real issue and be able to create a solution, no matter how complex it needs to be, that really works. So next time you have a complex problem to solve, remember Menken, but also remember that every chicken comes from an egg.