Recognizing the brain’s role in addiction

As neuroscience explodes with new ideas, new technologies, and new findings, ordinary people have a hard time absorbing the information that emerges. We are learning more details about networks in the cortex responsible for different kinds of thinking, reflecting, observing, and we know about regions lying beneath the cortex responsible for emotion and motivation. What are we supposed to do with this knowledge? Why is it so hard to integrate into our daily lives?

feather brainI think the main reason is that our thinking and feeling, our personalities, and consciousness itself are so immediate, so personal, that we can’t entertain the idea that they emerge from electrochemical pulses among a bunch of cells. Our experience is so intricate, nuanced, and private — it’s difficult to imagine that it comes from a remarkable bodily organ. This paradox has been a real problem for philosophers ever since the time of the Greeks. It was made famous by Descartes, who said there must be some part of us that does not come from our bodies: this was termed “mind-body dualism.”

What’s that got to do with addiction? you might ask. The thing is, most of us continue to see addiction as a personal problem, a nastiness that comes from our inner being, a reflection of the dark places we’ve been and the prisoner headdark things we’ve thought and done. The dishonesty that often comes with addiction (the lying, stealing, etc) feels like an incontrovertible personal failure, unforgiveable (at some level) because…well because shouldn’t I be a better person?

The darkness, confusion, tragedy and destruction do belong to us. There’s no denying it. But they also belong to a brain that is an organ of our bodies. The brain functions empty personaccording to the codes built into it over millions of years of evolution, most critically: attempt to minimize suffering and maximize relief. Stave off deprivation. And it puts those requirements above other goals, like obeying social conventions. This brain of yours has been adjusting to whatever has happened to you every single day since (and before) your birth. And some of what’s happened to you has no doubt been frightening, uncontrollable, and perhaps deeply traumatic.

Through all this your brain continues to adapt.

To accept that our thoughts and actions really do arise from our brains does not get rid of personal responsibility — that’s not what I’m trying to say. But it can be a crucial step in understanding that the things we do that we’d brain holdingrather not do aren’t simple choices between right and wrong. They arise from a sequence of developmental adaptations in an organ that does its best to keep us going in a hugely challenging world.

To accept that your addictive impulses come from your brain opens an avenue to self-forgiveness. But remember: brains have developed incredible capacities to think, plan, and reason about consequences. Self-control is one of the brain’s crowning achievements. And since addiction leads irrevocably to suffering, maybe you can work with your brain, sort of as a partner, to make your life a lot happier than it is.

 

………………..

………………..

 

P.S.  Thanks for the comments so far, guys. I love this community. Meanwhile, I wanted to share a link to a work-in-progress dramatization (a theatre piece) of a very serious gambling problem, especially in the UK and Australia. The problem is the deployment of rapid-fire electronic gambling machines called Fixed Odds Betting Terminals — a new generation of machines that can take enormous amounts of money in a very brief time. These things are destroying lives as quickly as any drug. Take a look at this.


By the way, the title “Crack Cocaine” is a misnomer — they plan to change it soon.

 

 

 

 

35 thoughts on “Recognizing the brain’s role in addiction

  1. matt April 18, 2017 at 2:15 pm #

    The brain is such a complex configuration of all kinds of things, each an integral part, but none of them the whole. On the other hand, the brain is just a mass of stuff like other complex phenomena out in the world. There are cells and synapses and circuits that correspond to vital reflexes that keep the organism alive– things like breathing. There are other higher functions that interact to produce complex behaviors– like gymnastics or poetry or kindness. But you can’t point to any one part of the brain and say that this is where those behaviors come from. Nor can we locate the mind. What is– where is– the mind? This is a question that continues to baffle science. Where do things like intention, belief, spirituality come from. Are we all independently and collectively programming the circuits of our selves?

    One thing that intuitively seems to be happening in addiction: our physical brain is messing with our mind.

    • matt April 18, 2017 at 2:56 pm #

      …self-control and self-discipline are the brain reining itself in… an additional, hard won benefit of addiction and recovery.

    • Nancy Minden April 19, 2017 at 7:38 am #

      Humbling.

  2. Mike Searles April 19, 2017 at 7:11 am #

    Excellent piece Marc – thank you.

    Neuroscience and its discoveries has me hooked (pun intended).

    I also get insight and better understanding of the topic from reading (and studying) Dr Joe Dispenza… I found his book ‘Breaking the Habit of Being Yourself’ very helpful – as I did your own ‘The Biology of Desire.’

  3. Mark April 19, 2017 at 7:37 am #

    The more I study how the brain works, the more I feel like personal responsibility, while not quite a myth, is so extremely vulnerable to all sorts of things that go on inside us and outside us all the time, that it might as well be.

    I’m currently reading Lisa Feldman Barrett’s book, How Emotions Are Made. She only confirms my personal-responsibility-as-mostly-myth bias with some of the most recent and mind-opening research I’ve come across in awhile. Emotions appear to be learned not unlike addiction is learned. And unlearning is not something contemporary culture devotes very many educational resources to.

    • Ryan April 19, 2017 at 10:49 am #

      I don’t think there even is such a thing as “unlearning”, unless I’m out of the loop when it comes to theories of language and cognition. Some of the newer theories like Relational Frame Theory suggests that the human mind is always additive, not subtractive so that any changes must come from more learning (i.e. acquiring new learned responses to stimuli).

      More accurate to say “contemporary culture does not devote much, if any, time or resources to help people notice what is going on within themselves and even less time to learning and practicing new, more prosocial responses”?

      • Karen T April 19, 2017 at 4:47 pm #

        How about the idea that emotions arise from thoughts and beliefs, and thoughts and beliefs can be questioned, changed or replaced, leading to different emotions arising? Over time, the old thoughts and beliefs fall into disuse, and the new ones become habitual.

        Also, the idea that thoughts and beliefs can be changed, is itself a belief. Which gives rise to an emotion. Hope?

  4. Richard Henry April 19, 2017 at 8:31 am #

    Always a pleasure Marc…

    Yes and I am always doing just that.

    I like the Buddhism teaching where as, you separate the Mind for the Brain and become a none partial observer of the Brain from the mind.
    Even when I feel an emotion of empathy and feel I want to cry. I say whoops… Theirs a rush of serotonin, looking at the brain as an organ that produces chemicals in a way that creates feelings.
    In the same way, when I feel a craving, a want, a desire, I can look at and come to terms that it is a lack of or an increase in some kind of chemical in my brain that is activating that feeling.
    So therefore I can respond in such a way in recognizing the desire, and acting accordingly eg: Is it something I really need? What are the consequences of following through with those feelings etc…
    When we come to realize the make-up of the brain and the chemicals that trigger a certain feeling, we can then… by observing the brain from out side (The Mind) we can then be that none-partial observer and act accordingly..

    Happy Thoughts Happy Heart, Happy Life..
    It’s our beliefs in what we think, that give us that chemical rush, which trigger some type of feeling.
    Respect Richard Henry

    P.S Here’s my latest event on PASSION PROJECT T.V
    .https://www.facebook.com/LIFEINTHEGAME/videos/1486379978073626/?pnref=story.
    Much Love my friend…

    • Marc April 19, 2017 at 8:55 am #

      And it’s always a pleasure reading your comments, Richard. You’re absolutely right that there are specific chemicals activating the feeling of craving. When you see it that way, view it completely from a biological perspective, it can free you to act differently. I stressed the self-forgiveness aspect, but this shift in perspective can empower new response habits, just as you say.

      It’s great to see you live! Thanks for sharing the link.

    • Marc April 19, 2017 at 9:11 am #

      P.S. This is a delightfully honest and intimate interview. Richard talks about how he developed from social anxiety and humiliation as a young child, to hiding his feelings, to becoming aggressive as a defense, and on to alcohol. Watch the video to see what became of Richard after that.

      • Richard Henry April 19, 2017 at 10:38 am #

        Thanks for your support over the years.
        You have not only been an insperation for me in moving forward and making a diffence, but your knowlege has touch me and help out in so many ways..
        God Bless..

  5. Peter Sheath April 19, 2017 at 9:01 am #

    Hiya Marc
    As always a great blog. I was talking about this only yesterday to a friend of mine who is currently at the tail end of a buprenorphine detox. He hasn’t used for over a year but is currently experiencing a real emotional roller coaster. He gets really sad, sees the world as very grey and just can’t seem to muster up any enthusiasm for anything. It got so bad that he sought help from his GP who prescribed him antidepressants. He doesn’t really like taking them, doesn’t feel they are helping him and says they probably are making him worse. I spent over an hour with him explaining his experience in very simple neurological mechanisms, related to his long term opiate use and not developing emotional resilience as a result. I also explained about the importance of social connection, relaxation/meditation, nurturing environments, self care, nutrition and exercise. He said that its the first time anyone has given him time and space and explained his lived experience in a way that made sense to him. He phoned me later last night, full of confidence and thanked me for giving him the time. He also asked about stopping the antidepressants to which I explained all in good time.
    I’m really grateful to you and the work you do because I firmly believe that it has equipped me with a way of working that enables people to gain the power of knowledge. Many thanks my friend

    • Marc April 19, 2017 at 9:17 am #

      Geez Peter, your anecdotal account here is exactly the fuel I need to keep going. What a great feeling to watch this web of care and retuning spread out from stuff I write. Many thanks to you as well, and I sincerely mean that.

  6. Marc April 19, 2017 at 9:18 am #

    Peter, and anyone else who read today’s post before 3 PM European time: please take another look to catch the PS at the bottom. Especially folks in the UK. Just take a look.

  7. robert hafer April 19, 2017 at 9:50 am #

    If we in the addictions field can teach(help people learn) that chemicals in the brain cause many actions and reactions then they may be able to separate the thoughts that come with the chemicals and change them so the chemicals do not overwhelm them. Interesting theory and will try this today at my group.
    Thanks for this info
    Best regards Bob

  8. Clifford April 19, 2017 at 1:35 pm #

    Nice work Marc,

    Your description leads us to that awkward question that it seems not many of even want to ask. You alluded to it with the Descartes observation, and this paradox lies at the heart of Buddhism. We can observe ourselves, and often do this with another aspect of ourselves. This will give us a broader view of our character. Yet is there something beyond or before character, body, mind, or personality? Is there something that can observe the observer?

    In much the same way as an eye cannot see itself or a camera cannot take a picture of itself, (only as a reflection). There may be something eternal in all of us, something that is not personal.

    Even the idea is interesting to me and I must say that I do not buy into it too often as it’s a bit like pondering eternity: the mind cannot cope with it.

    Whether it’s true or not is there for observation yet I can say with some conviction that whoever I have witnessed engaging in this route (Psychotherapy or self-observation included), I have noticed a sense of ease and an increase in their well-being. They tend to take things ‘less personally’. I have even noticed glimpses of such states in myself!

    Clifford Edwards
    Co-founder
    banyantree21.com

  9. Peter Sheath April 19, 2017 at 1:40 pm #

    Just seen the gambling/fixed odds machines/crack cocaine thing. It’s a really serious problem around where I live. Bookmaker shops are allowed to have only a few machines on their premises so they simply open another shop not too far away. It’s really noticeable in my town, which has a poor north, affluent south divide. I live in the poor north and within a 4-5 mi ute walk from my house there are six bookmakers shops with, I think, 3 machines in each. Go to the affluent south suburbs and there’s one shop with one machine. I’ve seen guys on the machines totally zoned out, oblivious to their surroundings and probably spending all the housekeeping monies. It’s just like what Natasha Dow Schull says in her book gambling by design, these machines have been specifically designed to either attract problematic gamblers or entice people into patterns of gambling that soon become problematic. Scary.

    • Marc April 20, 2017 at 5:03 am #

      Peter, and everyone, read this passage, which I lifted from a journal article by Kent Berridge. Kent is a highly respected researcher into the neural bases of addiction. But the guy’s got a heart as well as a brain. Especially note his use of the word “frenzied” in describing the rat’s behaviour.

      “Even when [the addicted] rats actually received their sucrose
      reward, they typically paused pressing and nibbling the
      [sugar]-associated lever only momentarily, just long enough to recover
      and consume the sucrose pellet (i.e., 1–2 s) before then
      immediately returning to the….lever again and resuming
      a frenzied [my italics] bout of pressing and nibbling of the metal lever
      (even though no further sucrose could be earned for at least the
      8 s timeout period while the laser was still illuminated).”

      Note that these poor rats get very attached to the metal lever they have had to press to acquire a sugar snack. (In this experimental setup, the rats have been half-starved before they are put in the (ahem) dining chamber — so it’s meant as a literal parallel to addiction. All the same brain areas light up, etc, etc.)

      Doesn’t it all sound familiar? The “enticing” Peter describes is for real, and the companies use it with real cunning. And the rats are “zoned out” by the activity itself, just as Peter describes. It’s repetitive and hypnotic. And they don’t just lose “housekeeping monies” — they lose their houses! Their attachment to the stimulus (the lever) is like gamblers getting attached to the screen and all the imagery on the screen, or the button itself, not just the financial reward that may or not come. This psychological mechanism is milked methodically and creatively by the designers. Or heroin users growing terribly fond of the needle itself. It’s called a secondary reinforcer, but we can think of it as a ritualistic stand-in that becomes the object of desire.

      Berridge sometimes uses descriptive language in his studies of addicted animals, and the word “frenzied” comes up again and again.

      • Peter Sheath April 20, 2017 at 5:59 am #

        That’s a pretty good description Marc, as you know I watched as my daughter went through this. Her drugs of choice were a sustained cocktail of online gambling, speed and alcohol. Unfortunately she won pretty big but then proceeded to lose it all, and some. Five years later she’s still paying off her consequences. She describes the “sugar coated lever” in the constant offers to extend her credit or entice her to other sites with £200 free bets. I watched her, tranced out, as every 3 second spin of the wheels cost her another £15. It was almost like she couldn’t wait for the wheels to stop to press the button. Her activity could certainly be described as frenzied, hypnotic, and ritualistic. I’m pretty certain, much like the tobacco and alcohol industries, the gambling industry are well aware of all this. The way how it’s all orchestrated, targeting fixed odds machines to poor communities, focusing advertisements on lonely, marginalised people especially women and designing machines that seem to harmonise and resonate so well with the human brain, coincidence?? Horse shit! The gambling industry are using the same, tried and tested, legal techniques as tobacco and alcohol. Flooding Cash into the ever welcoming pockets of politicians and political parties to such an extent that they can’t function without them. I’ve heard it said that the NHS would crumble without the tax revenue it picks up from big tobacco, big brewers, big gamble and big Pharma. So how can you maintain an uncorrupt political agenda that seriously and independently evaluates the wider damage caused to our communities by these people? Your local smack or crack dealer pales into insignificance with these lot yet who is always painted as the bad boy!?
        Pull the poor and dissatisfied into the deceitful and controlling flashing light web of the promise of riches beyond your wildest dreams. Rinse every penny out their purses, then introduce the quick fix oblivion of white cider and the comfort blanket of nicotine. When the money finally runs out and the shit has surely hit the fan, off you pop to your nearest doctor for the very latest mood enhancing pharmaceutical miracle. Consumerism run a mock.

  10. helen April 19, 2017 at 2:50 pm #

    Marc,

    As always, pondering your scientific insights, hopefully leading me to become a more informed purveyor of recovery. Which leads into my question. If new connections develop during periods of abstaining and adopting a harm reduction model includes continued use, how would the new “rerouting” connections be established successfully? Or at least have a foothold in?
    Thank you,
    Helen

    • Karen T April 19, 2017 at 4:37 pm #

      New connections are established by repetition; the more times a new connection fires, the more likely it becomes to fire in the future.

  11. Karen T April 19, 2017 at 4:34 pm #

    As soon as I reached an age where I could think independently, I loved the idea of the brain as the organ of thinking and feeling, and the idea that I could shape this organ by choosing thoughts and beliefs. This idea enabled me to survive to adulthood, even though my emotional / developmental needs were not met in childhood.

    Is there a ghost in the machine, or does the machine produce something that looks like a ghost? I don’t think it matters. This model encourages self-compassion, because much of our experience is inflicted on us, especially as infants and children. It also encourages self-responsibility, because we can choose thoughts and behaviour, and therefore experiences.

  12. Carlton April 23, 2017 at 7:03 am #

    Marc,
    By saying;

    “..since addiction leads irrevocably to suffering, maybe you can work with your brain, sort of as a partner..”

    You could also do a post titled;

    “Recognizing the brain’s role in recovery”.

    • Marc April 29, 2017 at 3:44 pm #

      Sure, Carlton. That I could do.

      • Carlton May 1, 2017 at 7:46 am #

        Marc, a full-length book by a leading authority in the addiction/recovery field could being a much needed change to the understanding of Addiction and Recovery.

        It could offer people a different take on the brain’s role in recovery, and though light on whether addiction is a disease, which compelling works like “Pleasure Unwoven”, by Kevin McCauley, seems to confirm.

        • Carlton May 1, 2017 at 10:08 am #

          I meant a full-length DVD/VIDEO version of your work, which may make it more accessible to people, especially those in the throws of Addiction.

          • Marc May 6, 2017 at 6:16 am #

            Thanks for the suggestion, Carlton. I’m not sure that I have the time or resources to undertake such a venture myself. But as you see by the P.S. at the bottom of my post, I support that work when conducted by others and get involved as much as I can.

            • Carlton May 7, 2017 at 11:12 pm #

              Ah, understood.
              But of the major players in the, something-other-than a-disease camp, you seem be the best positioned and medically qualified to counter the “proof” this persuasive and user-friendly presentation presents that addiction is. beyond a doubt, a disease.

              With over 100k views and who knows how many DVD’s sold, its unsettling to realize another sound and medically viable view does not have as high a profile or attraction as this;

              Dr. Kevin McCauley — “The Neuroscience of Addiction”

              https://www.youtube.com/watch?v=wxiKVQR90VM&list=PLA8F89537FD4C3FD1

  13. matt April 26, 2017 at 2:47 am #

    It’s not just about self-control. It’s about self-control coupled with denial– denial of the reality that we could die. For good or ill. Man’s greatest achievements and most heinous atrocities have all arisen from this… of trusting the organism will not die while knowing full well that it could…and the eventuality that it will. Of trusting the expectancy of something better, while denying the reality that it could be worse…or that in reality, there is nothing better. Just this. Addiction and recovery are two sides of the same coin. Both are informed by denial and acceptance that somehow fuel the motivation to soldier on…

  14. Jhon Mullar May 1, 2017 at 10:51 am #

    The given article points are helpful to detox the drug addiciton process. For more Just refer the detox of south florida articles.

  15. Nicole Clarke May 12, 2017 at 6:00 pm #

    I think a good word to implement in the mix is “mindfulness.” Knowing your body’s limitations, how your body responds, what triggers your body’s impulses, and etc. Self-control can go a lot further when a person is mindful and aware of themselves. The idea of addiction and recovery can get complex and more than what meets the eye. One should never assume that it’s a lack of willpower.

  16. Jess May 31, 2017 at 7:58 pm #

    I really like the idea of self-forgiveness through understanding how the brain works in decision-making. I read somewhere recently how drugs and alcohol affect the brain’s frontal cortex and it can take two years for the brain to heal from this. Two years?! This is why so many people relapse while trying to get sober. Thirty day programs for rehabilitation are not enough. I think it would be very beneficial to people trying to overcome their addictions to learn about how their brains have changed and that they need to give themselves time to heal. Hopefully, this knowledge could ease some of their frustrations.

    If anyone’s interested in, I found this information on hayver.com. It’s a really informative website that proposes a new way to beat addiction. It’s an app that uses drug and alcohol monitoring and allows users to chose their own circle of support. I think it could be really helpful in keeping people on track for the long run.

    • Marc June 5, 2017 at 2:12 pm #

      Thanks for this contribution, Jess. Long-term readjustment of the brain following abstinence is certainly an important factor. In other blog posts I’ve described research showing how synaptic density in the prefrontal cortex increases “back to normal” in an average of one year following quitting. Mind you, I think this has more to do with learning or re-learning different ways of seeing the world (and yourself) and acting on it, or self-regulation strategies, than recovery from the effects of toxicity per se. In any case, these changes certainly take time.

      The app idea is good, but I’m wary of mandatory urine tests. I think that sets up a presumption of dishonesty and a sense of being disciplined by a parent-figure.

    • Shantell June 11, 2017 at 1:05 am #

      Wow, two years? I knew it took a while for the brain to recover, but not that long. Is there any advancements in individualizing treatment for addicts, since not all people respond to rehabilitation treatments (medical and behavioral)?

      I couldn’t agree more that those overcoming addictions need to learn to forgive themselves and give time to heal. An understanding that it takes time for the structure of the brain to heal and to essentially relearn pathways could go a long way in rehab programs.

      • Marc June 12, 2017 at 2:31 pm #

        Exactly so. That’s one of the huge benefits of a biological perspective.

        By the way, I said one year, not two!

Leave a Reply

Your email address will not be published. Required fields are marked *