Category: Connect

Here’s a little postscript. Some of you have questioned the liking vs. wanting paradigm, because these states are imputed by the experimenter. Where’s the evidence that the rat is actually feeling liking — or not feeling it, as was the case with the salt-delivery lever? Who’s to say what rats are feeling, anyway? I mean we don’t ask them to report on their inner states or to fill out questionnaires following the experiment.

So here’s a little video provided by Kent Berridge. It shows facial  movements that are thought to correspond with liking — mainly based on the assumption that sugar is a natural and fundamental source of pleasure, for rats and humans both. But also based on similarities between rodent and human facial movements.

Berridge has used rat facial expressions to impute pleasure in a number of experiments. And the second expression shown — displeasure — would be what the rats showed to the salt solution, despite their strong attraction to the lever that delivered it.

Baby & rat taste ‘liking’ Berridge lab video 2010

I want to start unraveling the talks I heard, beginning with Kent Berridge’s talk. If you haven’t been following this blog or read my book, here’s some background: Berridge has made two major contributions to the study of addiction. The first is the idea that “wanting” and “liking” are independent neural systems. Wanting (or craving, as we understand it in addiction) is mostly fueled by dopamine, which is sent from the midbrain to the nucleus accumbens (NACC; or ventral striatum), a major center for goal-directed pursuit, lying in the middle of the brain, deep within the cortex and surrounded by the limbic structures. Here’s that slide once again. The NACC is represented by that yellow explosion, to convey the growth of craving over a matter of seconds or minutes. On the other hand, liking (or pleasure) is provided by — guess what? — opioids, whether they come from your local dealer or from the natural processes of your own brain (the hypothalamus produces opioids, which are critical for calming us down and relieving pain). The idea that wanting and liking are truly dissociable is pretty radical, both in psychology and in neuroscience. In the present post, I want to tell you about Kent’s recent research, as reported in Boston two weeks ago, where he demonstrates this independence — in that pristine way scientists have of breaking things down to their fundamental components.

Berridge’s other main contribution is the idea of incentive sensitization. This is the notion that particular cues or stimuli (whether out there in the world or generated from our own fantasies, memories, daydreams, etc) become strongly associated with our drug or drink of choice. And those cues — all by themselves — activate the wanting circuit. They directly release dopamine to the NACC, so that we find ourselves suddenly beset by craving, simply by exposure to a cue. The strength of that incentive sensitization obviously increases the more often we use, because the experience itself serves to reinforce the association with the cue. But I won’t discuss this further for now.

Okay, so Kent gets up in front of this group of 15 or so people, including only two other neuro people (Davidson and me). And he’s explaining his recent research with rats, in which he’s set out to show that wanting and liking truly are separate systems. He wants to get his message across to the group, of course, but the main goal is to develop a talk that will be of interest to you-know-who. He wants, we want, the Dalai Lama to say: Hey that’s really cool! Now I get how you can want something without even liking it! For Kent, and for me, this issue gets to the heart of the problem of desire — a problem which is as central to Buddhist psychology as it is to addiction psychology.

So here’s the experiment: The rat is “trained” to press a lever that delivers a sweet solution. This is a very typical “Skinnerian” learning paradigm. Rats love sweetness — don’t we all? — and it’s been shown that sugar speaks directly to those opioid-fueled cells in the NACC. So here’s a rat that has experienced liking which has led to wanting, in the very natural way that we are “trained” to go after rewarding experiences in life. So they are willing to press the lever many times over, as motivated by their wanting for the sweet taste — and as shown, through other studies, to depend on the flow of dopamine following that initial opioid rush.

But there’s another lever in the cage. When the rat presses it, just in the process of exploring its environment, it delivers a very salty taste. Kent is sitting in front of his computer, at the end of the table near the screen, and he looks up at us, wanting to get across how very nasty this liquid tastes to the poor rat. Imagine the taste of sea water, he says. Now imagine something that’s at least 10 times saltier — beyond the level of the Dead Sea. And I feel like I’m glimpsing the soul of this scientist. He is right there in the minds of his rats, trying to imagine — and communicate — what they are experiencing. Because that’s the necessary link here. The connection between experience and behavior. And if you’re studying it in rats rather than humans, you’d better be able to imagine what it’s like to be a rat. Anyway, the rats don’t need another trial to learn to stay away from lever #2. They hate what it gives them. There is no pleasure to be had there.

Now here comes the essence of being a good scientist: being clever enough to find the fracture point where you can split a phenomenon into its parts. We’ve got liking and wanting for lever #1. And zero liking or wanting for lever #2. Then the experimenter gives the rat a drug that reduces their blood level of sodium way below normal. They become salt-deprived. And now the punchline: The rats immediately go to lever #2 and start pressing like hell. Kent and his assistants have completely bypassed liking to get to wanting. There is clearly a high degree of wanting present, but there was never — not even once — an experience of liking that led to it.

Half the people in the room didn’t get it at all. So…the rats were salt-deprived. So they went after the salt lever? So what? Kent read their blank expressions and tried his best to convey what was so cool here. I sensed his disappointment. Who wants to go to all that trouble and have the punchline fall flat? The rats didn’t know they were salt-deprived, he explained. But the wanting circuit was immediately activated by something, some change in their biological state. It doesn’t really matter what activated it. The point is, wanting does not have to arise from liking. It’s an independent process, in mind and brain. It can arise from anything!

For me, the parallels with addiction were immediately striking. That sudden wanting, craving, compulsion that we experience for our drug of choice doesn’t have to depend on how much we liked it in the past — either the distant past or the recent past. You can crave something that you’ve never liked — just because, at some level, you need it. Granted, with drugs and booze, there is usually pleasure the first many times, then the pleasure fades, and after awhile there is no pleasure. Not even the anticipation of pleasure. The wanting comes from needing it, not from liking it. (Mind you, with tobacco, it seems you never have to experience any pleasure to graduate to craving.) So addiction is sort of like the rat experiment with a hunk of time subtracted out. After we become addicted, wanting has nothing to do with how much we do or did like it.

Following some questions and discussion, I think most of the group got it. You had to go right into Kent’s world — the world of a scientist as clever as he is determined. The point wasn’t what caused the sudden wanting. The point was simply that wanting and liking can be shown to be totally independent processes. Will the Dalai Lama get it? Will it help him, and the rest of us, understand something crucial about addiction?

Let’s hope so.

Hi you guys! I finally got back here to Holland last week. It’s good to be back. Isabel and I really missed each other and made up for lost time before she picked up the kids and I crashed out. She left for France two days later — for meetings with colleagues. (yeah, right!) The unavoidable reunion scrapping was mild and short-lived. Isabel: how badly was I going to screw up the military precision with which the kids were obeying her every command? Marc: why don’t you just trust me? It’s not like this is the first time. And it was great to see the kids — they are so beautiful to me. Julian’s teeth have almost filled up his mouth again, the better to argue with, my dear. Ruben is still a wild man when he kicks a ball and a lamb when you ask for help.  And they liked the presents I finally remembered to get, last minute, at an airport store that sells useless things to guilt-ridden parents.

So about the last three weeks: where do I start? Maybe with the culture shock of being back in the USA. Of course North America is where I come from, but the Marriott in Boston boasted new heights of excess. There were fully 50 TV screens in the one and only restaurant. Two banks of them, entirely circling the seating area. The drinks had so much ice in them, my mouth felt loaded with novocaine. And every server seemed compelled to smile brilliantly, ecstatically, whenever making eye contact. They would say things like “And how are we doing today?” And I wanted to say “I have no idea how you’re doing. But where can I get some of whatever you’re on?” Or was this just Pavlovian conditioning of some network of facial muscles in response to the smell of a tip? What a weird country. But I must admit that some of the most interesting people in the world happen to live there.

After spending a week at that Mind and Life conference/retreat, and driving around New England with my dear daughter, I finally found myself in Boston for the main act — the “pre-meeting” for the meeting with the Dalai Lama (who they call His Holiness: I’ll just call him HH in this post.) I’m sitting there at a long table, it’s 9 AM Monday, and I hadn’t slept very well. A true case of “opening night nerves.” Today we were supposed to run through all the talks and I was slated to go first. They wanted to start off with a real-life portrayal of addiction. Just in case HH and/or the couple of hundred monks and scholars who would be there in the room, sitting behind the inner circle of us, or the 5,000 or so camped down the road in front of a jumbotron, or the tens of thousands who’d watch us live on the net — just in case some of them didn’t know an addict or weren’t one themselves — seems rather unlikely.

My nerves start to mellow while I’m giving my talk. People seem engaged. Here’s one of the slides I like best. I wish I knew how to include the animation, but you can imagine these different stages of the cycle popping up consecutively.

But then I get to this slide…

This image was created by John Harper. Used with thanks.

…and I’m pointing out how the cycle of brain states involved in addiction fits so nicely on the cycle of states in the Buddhist wheel of suffering, or whatever it’s called, when this guy thunders out from the far end of the table: “That’s not Buddhism! I don’t know where you got that but it’s not Buddhism.” And I sagely reply: “Well I looked through about 200 Google images and this was the only one in English.”

But what raised my pulse the most was the presence of some very renowned brain scientists. There was Richard Davidson, across the table. He’s the guy who first put Buddhist monks — long-term meditators — in the scanner, to see what brain regions light up when you’re not thinking about pizza. And Nora Volkow was present on Skype from Washington. She’ll be coming to Dharamsala in the flesh, so that should be interesting. She seemed relatively tame, at least on the screen, but when the “disease vs. learning” issue came up, she got right into it. Spunky for sure, but also willing to listen to other opinions.

And who should be sitting beside me but Kent Berridge. If you’ve been following this blog or read my book, you know I worship the ground he walks on. His theory of addiction is unique and it’s pretty much universally acknowledged to be in first place. He divides “wanting” from “liking” and describes them as independent neural systems that work together in normal learning. In addiction, however, the “wanting” network, which is fueled by dopamine, gets highly sensitized to drug (or alcohol, food, or whatever) cues — so addiction is a runaway of process of “wanting” and has little to do with “liking”.

So this brilliant guy is sitting next to me. And he seems so…human. Humble, shy, self-effacing. But most obviously a kind and compassionate man. How do I know? When he, Davidson and I were walking to lunch, Kent continued to drop back a pace from walking shoulder-to-shoulder with Davidson so as to keep me in the loop, so that I was with them rather than following them. That’s a kind of social sensitivity you don’t often get from strangers, or from anyone, and I immediately liked him for that if nothing else.

On my other side is a guy name Jinpa — a very poised and polished Tibetan who apparently serves as the interpreter for HH in these dialogues. HH speaks English fairly well, I’m told, but misses some of the technical bits. So there’s Jinpa, a Harvard grad, or was it Oxford? Definitely in his element with this crew. And then comes Joan Halifax, a famous Western Buddhist scholar who apparently spends her days helping people in the process of dying. No kidding. That’s what she does. And then Vibeke Frank from Denmark, who looks at addiction as a social construction. In other words, you’re not really an addict unless you’re defined that way by your culture. Next, at the end of the table, sits this grandiose philosopher dude who told me my slide was wrong. And then, on  the other side of the table, Sarah Bowen, who heads up the Mindfulness-based Relapse Prevention (MBRP) camp — a very cool approach to addiction treatment that uses mindfulness/meditation to get through to the other side of craving episodes. And someone named Wendy Farley who talks about  some ancient body known as Christian contemplatives. I thought her stuff was terrific — certainly a face of Christianity that emphasizes forgiveness rather than sin, and that sees “desire” as a good thing, until it gets overly focused on filling yourself up. Then some Mind & Life staffers. Mostly people in their thirties, but including one very seasoned Buddhist scholar, who later sat me down and explained what was wrong with my slide. She showed me how incredibly complex the Buddhist cycle actually was. What I thought (and I guess I wasn’t alone) was a cycle of consecutive states actually looked more like a 12-sided sphere, with all twelve sides linking to one another, so that it ends up looking something like this!!

I told her I’d dropped out of Hebrew school when things got too complicated, so maybe she should just give me the dumbed down version. I think she finally did.

Now you’ve got the setting and the characters. Next comes the content. I’ve taken care of a few pressing matters, so I can put up another post in a day or two. There’s lots more to tell.

Just finished day 1 at the Mind and Life conference. What a beautiful building this is for a conference. The corridors seem to echo with the shuffling feet of Christian monks. But now, in our modern age, there are a lot of shaven-headed guys with orange robes walking around. It’s strange to see them in the washroom with everyone else, shaving, brushing their teeth. Very corporeal. But most people here are young scientist types, assistant profs or post-docs in psychology or neuroscience, but incredibly friendly and warm-hearted. And a few old guys, like me, except that they look like they’ve known each other for decades. It’s weird to meet a guy with a name like Saul Weinstein who turns out to be an expert on meditation.

Today the talks were on heady Buddhist topics, loaded with Sanskrit and Tibetan words for different traditions. I had to struggle to focus. I’m still a bit jet-lagged and my mind is buzzing with worldly things. In fact today’s meditation session was a total write-off.  Tomorrow’s talks will be on neuroscience. That should wake me up.

What’s most strange about this event is that I’m staying in a small room with another guy. Two beds side by side, and four tiny shelves for our stuff. I haven’t shared a room with a stranger since boarding school. He’s a prof in religious studies at a university in Pennsylvania. A nice guy, actually. Still, he’s very close.

Anyway, not much more to say for now, so what I’ll do is post the second half of an article I just wrote for the Mind & Life newsletter.

To prepare for the meeting [with the Dalai Lama], I’ve been trying to think like a Buddhist for the last few months. And what strikes me most is that the Buddhist perspective on personal suffering, based as it is on desire and attachment, captures addiction surprisingly well. So well, in fact, that addiction comes off looking like a fundamental aspect of the human condition.

Buddhism sees attachment, craving, and loss as a cycle — a self-perpetuating cycle — in which we chase our own tails and lose sight of everything else. What Buddhists describe as the lynchpin of human suffering, the one thing that keeps us mired in our attachments, is exactly what keeps addicts addicted. The culprit is craving and its relentless progression to grasping. First comes emptiness or loss, then we see something attractive outside ourselves, something that promises to fill that loss, and we crave it. And the next thing we do is grasp — reach for it. Grasping leads to getting: a brief moment of pleasure or relief that reinforces the attachment. But it’s never enough, we crave more, and that’s what keeps the wheel going round. Whether the goal is success, material comfort, prestige — the more respectable human pursuits — or whether it’s heroin, cocaine, booze, or porn, hardly seems to matter. Either way, you’ve locked your sites on an antidote to uncertainty, a guarantee of completeness, when in fact we never become complete by chasing after what we don’t have. And, incredibly, the pursuit itself is the condition for more suffering. Because we inevitably come up empty, disappointed, and betrayed by our own desires.

Now that sounds a lot like addiction to me. Yet the Buddhists are talking about normal seeking and suffering. Isn’t addiction something abnormal? What about all those brain changes I mentioned? [which took up the first half of the paper.] Those brain changes suggest to most scientists and practitioners that addiction is a disease — an unnatural state. But a Buddhist perspective might cast it quite differently, as a particularly onerous outcome of a very normal process, a sadly normal process: our sometimes desperate attempts to seek fulfillment outside ourselves.

So what about those brain changes?

It turns out that the brain is designed to change.  Every advance in child and adolescent development requires the brain to change. The condensation of value and meaning in adolescence corresponds with the loss of about 30% of the synapses in some regions of the cortex. As with addiction, normal development involves a lasting commitment to a small set of goals: I’m going to make money, I’m going to live in a secure neighborhood, I’m going to find a life partner. And that involves the formation and consolidation of new neural networks at the expense of older ones. In fact, every episode of learning, whether to play a violin, move in a wheelchair, or see with your fingers after going blind, requires the growth of new synaptic networks. Such cortical changes ride on waves of dopamine, in normal development as in addiction. Gouts of dopamine, with its potency to narrow attention and grow synapses, are highly familiar to lovers and learners alike. That palpable lurch for sex, admiration, or knowledge is always dopamine driven. The brains of starving animals are transformed by dopamine, when, as in addiction, there’s just one goal worth pursuing. And successful politicians achieve dopamine levels that would make an addict swoon. The brain evolved to connect desire and acquisition, wanting and getting, and that connection depends on the tuning of synaptic networks to a narrow range of goals with the help of dopamine.

For both normal development and addiction, desire acts as a carving tool, collapsing neural flexbility in favor of fixed goals. So our understanding of addiction may benefit more from a Buddhist-style perspective on normal development — with its tendency to become fixated on attractive goals — than the disease model favored by Western scientists and doctors. Yet the Buddhist perspective offers another advantage: an emphasis on the value of mindfulness and self-control to free ourselves from unnecessary attachments.

On that note, I’ll end by touching on a provocative experiment recently published in PLOS1, a prominent scientific journal [and brought to my attention by Shaun Shelly on this blog]. It’s well known that cocaine addiction causes reduced grey matter (GM) volume — thought to represent a loss of synapses — in certain regions of the cortex. But these researchers found increasing synaptic thickness in cocaine addicts who had abstained for several months: and the longer the period of abstention, the greater the growth. Most striking of all, the new growth wasn’t simply a reversal of what was lost, like a pruned bush growing back its leaves. Rather, synaptic growth was observed in new areas — areas known to underlie reflectivity and self-control. In fact, this growth surpassed levels reached by “normal” (never-addicted) people after a period of 8-9 months, indicating the emergence of more advanced mental skills. If these results are replicated, they’ll provide solid evidence that recovery, like addiction, is a developmental process, which may benefit from the advanced cognitive capacities facilitated by mindfulness training.

Based on studies such as these, and filling in the blanks with subjective accounts, addicts, scientists, and contemplatives have a lot to learn from each other. I hope that this theme will help guide the discussion with the Dalai Lama in October. Ater all, addicts and meditators make use of the same brain, with all its vulnerabilities and strengths. It makes sense that the brain changes underlying suffering and healing have much in common, whatever their source.

I’m still half asleep, and I should do some yoga and I should meditate and I should put something more than coffee down my throat. But I wanted to share my  excitement and anxiety about the steps leading to my October visit with the Dalai Lama. It all starts in a week. I fly to Boston one week from today, then spend five days in New York State at the Mind and Life summer research institute.

Click on that link if you haven’t already. “Research institute” is a bit misleading, because those five days are spent doing meditation and stuff (some of which is guided by pros) as well as listening to scientists present their findings. They even have concerts. I went once, about five years ago, and the last evening was spent listening to a singer who was able to sing harmony with himself. I mean literally. He could produce two or three different pitches at the same time, and they worked together. He even had a backup band of six or seven weird-looking dudes, singing and chanting, one of whom played the didgeridoo. Bizarre and beautiful. Much melting and bonding among the 200 or so people in the audience.

Mind and Life  is amazing. They’re  the group that organizes the DL’s interactions with scholars, and especially with scientists, and especially especially neuroscientists. They’ve been doing it for more than 20 years. The DL is particularly interested in linking Buddhism, neuroscience, and social problems — which seems like a pretty ambitious project. They get a lot of donations and they do a lot of very good work. Their projects include these special annual meetings with the DL, like the one I’ll attend in October on “Craving, Desire, and Addiction.”

So I applied to this 5-day New York event so I could get my myself a bit more “cosmic” (as my brother and I used to call it in the 70s) in preparation for a meeting in Boston — the “premeeting” for the meeting with the DL in October. I want to be at my best. And that’s the part I’m nervous about. I guess there’ll be a couple of contemplative/Buddhist types there, but the group includes at least three top neuroscientists, two of whom are stars in the addiction field: Nora Volkow and Kent Berridge. I’ve linked to Berridge quite a few times on this blog. I think his theory rocks, and he seems like a good guy anyway. But Volkow scares me a bit. She’s a very famous person, head of the National Institute on Drug Abuse (NIDA) for quite a few years, and a crusader for the “disease model” of addiction, which I’ve made it my business to refute. This premeeting goes on for 3-4 days, and we’ll each get up and say whatever it is we think we have to say to the DL. So I’ll no doubt talk about why I think addiction isn’t a disease. And then — will she squish me? Like a bug?

But it’s not only Nora Volkow. The whole thing makes me nervous as well as excited. These guys are the DL’s Palace Guard, at least in the intellectual world. Everyone’s a pro. So I feel like I should do about two more years of prep — especially reading in neuroscience, and maybe learn something about Buddhism — before I’m ready to hold forth. Not only that, but I’m the one presenter (out of 8) who’s, um, supposed to represent the “experience” or “phenomenology” of addiction as well as some thoughts about what’s behind it. Translate: I’m the druggie in the bunch. Not sure how to roll with that one.

Anyway, I’ll be back home July 4th. I’m planning a road trip with my daughter between the two meetings. But I’ll try to keep you posted while these events are unfolding. They are the steps to my meeting with you-know-who, and it’s all still like a dream.