Sunday, October 5, 2008

Part Three: The Neurological Nature of Addiction

The mind, body and spirit are not separate entities. However, in order to understand the battle you are facing, you must understand what happens biologically in the brain.


The Neuron

The neuron is the basic unit of the neurologic system. It is composed of a body, axon (the "arm" of the neuron that reaches out to interact with other neurons and body parts), and neurotransmitters (the chemical substances of the neuron that transmit signals from one nerve to another or to a body part). The synapse is the cleft between one neuron and another body part (or neuron) where neurotransmitters are released to pass the nerve signal on to other cells. Neuroreceptors, the receptors on the receiving cell which bind neurotransmitters, are sensitive to other circulating hormones in the blood and brain. Nerves do not synapse with just one other nerve or cell type either. They may interact with 200-200,000 other cell types or neurons. Considering that there are an estimated 1 trillion neurons in the brain, there are innumerable synapses present, which represents an incomprehensible and unmappable electrical system to send and receive information. Add to this that neurons may contain multiple neurotransmitters, may stimulate, inhibit, or facilitate the subsequent neuron's activity, and provides feedback information to the signalling neuron, the complexity is infinite in nature, and any explanation can only be described as oversimplification. However, the biology of addiction is important to address as it gives explanation and helps answer "how" and "why" questions, which provides for us who are addicted more knowledge of our enemies battle plan, thus facilitating our plan of attack.

Equilibrium and Stress

The body lives in a delicate balance. If there is one neuron or transmitter that is affected, due to its large number of connections to other neurons and systems in the body, it ultimately affects the entire ecosystem, which is that person. This is the process of reverberation. The body also has to maintain equilibrium, and when it is thrown off, the result is stress. Stress includes both the alarm responses that signal disequilibrium and the coping mechanisms that seek restoration of equilibrium. Neurons respond to imbalances through three primary responses: feedback, habituation, and adaptation. These are also the three neurological dynamics of attachment which lead to addiction.

Feedback

This is the first line of defense against stress, the reaction to imbalance. It involves a cell receiving feedback regarding its activity by other cells. It can occur in one of three ways: overactive cells may be inhibited, under-active cells may be stimulated, and cells that are doing well may be facilitated. Our brains are wired primarily for action, so to maintain its balance, a near-constant inhibitory influence is exerted over it. We are not just reactors, but rather initiators, constantly creating.



Habituation

Technically, this refers only to the process by which nerve cells become less sensitive and responsive to repeated stimuli. It is the neurological cause of tolerance. Immediate habituation occurs when cells force their receptors to not accept signals from sending cells. This is exemplified best by our near-constant ignorance of background noise. Because it takes a lot of energy and resources to suppress the transmission of unwanted stimuli, the body has a secondary habituation response. In this response, it actually destroys its own receptors so it can no longer be over-stimulated. This is actual physical change in the nerve, designed to protect the equilibrium of the system.


Adaptation

This is a new normality that is established when feedback and habituation no longer work. It is the process of attachment. If attempts at habituation have failed, the receiving cells will increase their responsiveness. They join in the process rather than continuing to try to tune out, which produces stress. If this lasts a prolonged period of time, the rest of the system must adapt to it. When complete, the stress goes away because all systems have been reset to a new equilibrium. This is actual physical change within and between nerves and other cells. Subsequently, you are attached to whatever makes things normal for you at that time. We are very adaptable, but this has also made us very prone to attachments. When a new attachment forms, a new normality is born. With each new normality, addiction exists.


Withdrawal

Withdrawal is the result of adaptation. Because the body has established a new balance based on the new environment provided by the addictive behavior, when that addictive behavior is stopped, the body reacts with stress. Usually this stress is the exact opposite of the effects of the addictive behavior due to the neuroadaptive response of the the neurons involved. Thus, for example, sedative withdrawal causes agitation. Nicotine withdrawal causes somnolence. Stimulant withdrawal causes somnolence and fatigue. Withdrawal from attention causes uneasiness and attention seeking behavior.



Non-substance Addictions

These addictions behave in a very similar manner to chemical addictions. Whether it be a specific routine, a special someone, or a certain image that you are addicted to, lack of that addictive substance leads to withdrawal presenting as irritability, grouchiness, and a sense that something is wrong. The symptoms may not be as severe, but the process of the addiction is the same. However, because personal things such as people and identity issues are so deeply ingrained in who we are, withdrawal of those substances of addiction can deeply affect a person's sense of meaning and self hood.

Multi-system involvement

Addictions affect multiple systems. The body adapts to defend against the initial imbalance, fails, and re adapts to a new normality, causing its subsequent system to go through the same process until all systems are affected. This is how addictions come to rule our lives. They are never a single problem. It has become a way of life. Thus, braking an addiction requires changes in multiple areas of life. Multi-system involvement is also responsible for the temporary experience of freedom when a person's environment changes. When the triggers of addictive behavior, the associations, are withdrawn, there is less stimulus to perform the addictive behavior. When on a mountain without your usual societal influences and triggers, one's addiction may not seem so tough. However, when one returns to society all associations are triggered afresh.

Permanence

Addictions and associations become so entrenched that we don't forget them. They lay at bay in the deep psyche of man. Thus, the potential for attachments exists forever in us, even after breaking the habit of acting upon them. The permanence of addiction is ready to come back to us with only the slightest encouragement. We never completely overcome our attachments. From a psychological standpoint, this means we can never become so well adjusted that we can stop being vigilant. From a neurological standpoint, it means the cells of our best-intentioned systems can never eradicate the countless other systems that have been addicted.

Summary

Our bodies and nervous system are wired for attachments. We are highly adaptable, but our adaptability makes us prone to attachments. Our bodies are also designed to work in an equilibrium, a balance. Things that upset that balance and result in stress cause our systems to adapt and re-establish a new balance of normality. This is the neurologic process of addiction, and it involves feedback, habituation (the cause of tolerance), and adaptation (the cause of withdrawal). Addictions never involve just one area of life. They become life because they affect all areas of life through associations and various attachments. Our addictions and associations are permanent. They are always lurking in the background, ready to make themselves known at the first impulse. The brain does not forget. But hope does remain alive for freedom and peace.

Friday, October 3, 2008

Part Two: The Mind and Addiction

The mind is one of the major battlegrounds where addiction is fought. The attack occurs on the will (our capacity to choose and direct our behavior) and our self-esteem (the respect and value with which we view ourselves). Addiction splits the will in two parts, one desiring freedom and the other desiring to continue the addictive behavior. This causes internal strife, which erodes self-esteem. The major blows to self-esteem, however, come from repeated failures at trying to change the addictive behavior. The blame for failure falls on the self, which destroys self-respect. Every attempt at control results in eventual failure, and in a society where the major source of behavior is the self, self-respect and self-esteem suffer.

As discussed in a previous blog, the mind has multiple methods of tricking one into continuing the addictive behavior. In order to understand the places of attack to beat addiction, we must understand how the mind tricks us, via self-deceit, into continuing the addictive behavior.

Self Deception

Denial and Repression
This often occurs in the initial stages of addiction. Denial is the lack of recognition that a problem exists or that there is attachment occurring. Repression occurs as evidence of attachment mounts, and the mind keeps the realization of attachment out of awareness. The knowledge of addiction is realized, but repressed in the unconscious. This takes considerable mental energy to both live in denial and repression, and repression results in a person who is not comfortable with himself/herself. The mind must stayed occupied or dulled, so that the realization of addiction stays out of the conscious. This results in avoidance of quiet times of reflection and peace. Prayer, meditation, and quiet relaxation are discontinued or filled with activities that will occupy attention, causing a busied and dulled mind. This results in alienation from oneself. You avoid being present to oneself, and this eventually results in a phobia to quietness, being alone, and of possible boredom.

Rationalization
This occurs after the realization that a problem exists. It is, by definition, making excuses in an attempt to justify the addictive behavior. One tries to convince the self of the truth of the excuse, or attempts to justify the behavior. It results in increased internal distress and self-alienation. This discomfort becomes the occasion for increasing the addictive behavior. The object of attachment becomes the tranquilizer for the psychic distress it itself is causing.

Hiding
After realization occurs, one can no longer hide the truth of addiction from the self, so they hide it from others in order to protect their identity. This results in isolation from others as time spent on the addiction is time away from others. A depressive, guilty, self-disparaging atmosphere pervades nearly everything the person does as they lead a double life. It results in feelings of inadequacy for being unable to control the behavior and lack of personal integrity.

Delaying Tactics
This occurs as one realizes that a problem exists. The mind comes up with inventive strategies to continue the addiction. These are delay tactics, that put off addressing the addiction until one gets busy with something else or doesn't feel as guilty about the behavior. Common delay tactics include resolving to resolve to quit, identifying the ideal time to attempt to quit, rationalizing a plan of attack, etc. The details end up becoming so complex that they distract one from actually focusing on addressing the addiction.

"I Can't Handle It"
When repeated failures at attempts to stop the addictive behavior are realized, the subsequent admission of defeat can take on two forms. In the passive response to defeat, shame, remorse, and guilt abound, resulting in self-hatred and surrender to the addiction. The aggressive response to defeat is characterized by an embittered and cynical reaction that seeks to bring everything in life down to its own sense of worthlessness. It is a "Who cares? I'm going to do whatever I want because nothing really matters anyway" attitude. Both are ploys to continue the addiction.

"I Can Handle It"
This occurs after the first success of quitting an addictive behavior. A person becomes prideful, thinks they can handle the addiction, and experiences an impulse or harmless notion of retrying the object of addiction. This leads to the temptation to try it again under the false muse that one could handle it without becoming enslaved to it. This leads to a repeated excuse of "it's under control," when in all actuality the control is being issued by the addiction.

Breakdown
The fall, where one realizes that they are addicted once again, brings guilt, remorse, and shame. Self-respect disappears and pride is toppled. Addictive behavior increases as a backlash, and internal reasoning is thrown to the wind. Secondary addictions my develop. Desperation for a way out develops and unreasonable and unrealistic schemes are developed to free oneself. Reality is completely distorted.

Collusion

The process of addiction is never individual. Others are always involved. Some of their involvement helps to support their addiction. It is the process of co-dependency. They actually create their own interweaving webs of deception. They may unconsciously develop more inventive mind tricks for the addicted person to use. Medicines create secondary or substitution addictions. Psychotherapy may prolong addiction as it seeks to uncover past traumatic experiences that may not exist while providing an excuse to continue in addiction. Any action by others that does not support ending the addiction actually winds up supporting the addiction instead.

Psychoanalytic Insights

Freud, Jung, and others have contributed the following insights in regards to addiction. Attachments form through the investment (cathexis) of psychic energy in certain activities, things, or people that bring us pleasure or relief from distress. Many of these cathexes are kept unconscious by means of self-deception, so our motivations are never completely pure and may be quite contradictory.

Behavioral Insights

These insights involve the cause and effect observations of behavior and are based on objective data. Pavlov's dog is the classic example. It involves the law of effect, which includes positive reinforcement and negative reinforcement. The most important lesson is that attachment takes place through a process of learning. If something is pleasurable, one is more likely to do it again. This process is repeated until a habit is made of it. You become attached to the behavior. This happens at a deep physical, subconscious level, and usually is not recognized until it is a habit, an addiction.
Addictive behavior is established via attachment. We attach pleasure or relief from pain to a specific behavior in a maladaptive manner, which leads to addiction. This occurs in 3 stages.

Stage 1: Learning
This stage is characterized by associating a specific behavior with a feeling of pleasure or relief from pain. Subsequently, the brain associates the effects with the behavior. Subsequently, each time the behavior occurs, the association is reinforced, making it more likely to be repeated and habitual in nature. This is the process of conditioning; it is the way our minds learn to become addicted.

Stage 2: Habit Formation
This stage is characterized by associating the behavior or its effects with other experiences in life. In other words, when the desired effects of the addiction are sought in response to other stimuli, a habit has formed. It is the process of repeating the behavior for its own direct effects and also seeking it as a reaction to stress or discomfort in other areas of life.

Stage 3: Struggle
This is the stage where the habit is well established, and any distress in life causes the desire to do the behavior to reflexively appear. Withdrawal is well established, as lack of the behavior causes intense feelings of needing to repeat the behavior. Tolerance is established, as the behavior is craved more and more with less and less effect. Interference for the behavior occurs, whether it is lack of supply, attempting to hide it, or attempts to quit it, and this leads to internal distress. The habit is now its own source of distress.

Summary

The behavioral and psychological nature of addiction is strong and is a major contributor to addiction. It is the battlefield where the war over addiction is fought. The mind is responsible for our addictions through abnormal attachments of desire and effect, resulting in habits through subconscious habituated responses. The mind uses multiple ploys and tricks to continue the addictive behavior no matter what, including denial, repression, rationalization, hiding (creating a false self), delay tactics for quitting, surrender, pride, and ultimately the fall. From a behavior standpoint, addiction is the process of abnormally associating a specific behavior with pleasure or the relief of pain. This attachment is learned through reinforcement and conditioning, leading to habit. Once recognized, attempts at destruction of this habit leads to an internal struggle, eroding self-esteem and identity, and increasing the effect of the abnormally associated behavior.
It may seem hopeless. The only solution to ending the addiction is to stop the behavior. However, with addiction well established and craving occurring at every attempt to quit, an internal war occurs, a war within the self. Self-esteem crumbles as loss of identity occurs, and will and desire fade into the black smoke of this internal war. Our minds are wired for addiction. We are made for addiction. The problem is, due to sin, our attachments have occurred to the wrong things. We cannot wiggle our way, will our way, or work our way out of addiction. The only solution to ending the addiction is to replace the addiction with that which is right and true and congruent with who we are. This will be detailed in future blogs, so read on to become strong in your battle for freedom and peace.

Tuesday, September 16, 2008

Part One: What is Addiction?

As an addict, I find that my addiction is a daily, continuous battle. It is a battle between my true desires and my addiction. In order to win a battle, you must know your enemy. You must know their characteristics, their trends, their origins, how they fight, and their weapons in order to fight them appropriately and have a chance at winning. Thus, in order to begin my battle, I must understand my enemy, my addictions. Because addiction can be defined and its characteristics described in many ways, I thought a list of definitions and characteristics would be appropriate.

Addiction is, in its essence, any compulsion.

Addiction is desire gone amok.

Addiction is co-dependency.

Addiction is any preoccupation or obsession.

Addiction is any compulsive habitual behavior or thought that limits the freedom of human desire, and is caused by chaining, or attachment, of desire to specific objects.

The object of addiction is any thing, behavior, thought pattern, or relationship that controls our decisions and actions through craving, control loss, and continued use is an addiction.

The object of addiction is whatever you sacrifice things for to obtain or do.

If we truly examine ourselves, we can see that everyone is an addict to something, whether it be relationships, chemicals, activities, adrenaline, exercise, food, media, thoughts, attitudes, et cetera. It is not a moral failure, a personality disorder, or a medical disease in and of itself, but it is all of these interplaying that creates addiction.


There are 5 essential characteristics that mark true addiction. These characteristics can be used to determine areas of addiction in our own lives and to distinguish addiction from freedom.

Tolerance
Tolerance is always wanting more of the object of attachment in order to feel satisfied. It is essentially the process of becoming accustomed to the object while still being obsessed with it, leading to a desire for more.

Withdrawal Symptoms
This is a physiologic and psychologic stress reaction due to withdrawal of the object of attachment. It involves the acute phase stress reaction, a physiologic response that causes irritability and uneasiness to extreme agitation with physical symptoms and panic. It also involves rebound, a backlash of symptoms opposite those caused by the addictive behavior itself.

Self-deception
This is where your mind subconsciously or unconsciously subverts every attempt to control the addictive behavior. It includes such tactics as denial, rationalization, displacement, and every other psychological tactic known.

Loss of Willpower
This involves the true lack of ability to quit your addiction. Every time you try, it becomes harder and harder to quit, and the addiction gains a stronger foothold in your life. The failures make you question your ability, and your faith in your ability to control your own behavior gets smaller and smaller.

Distortion of Attention
All addictions grab and distort our attention, keeping us from pursuing and concentrating on love of God and others. You cannot have your attention on more than 1-2 things at a time. Your addictions distract the mind from love and holds attention captive. It is idolatry - the addiction holds primary concern and God is anything but the primary concern. Thus, at many points in our day, all people display this property of addiction - they give more priority to a concern compared to their concern for God and His will. It is not about our immediate concern versus our ultimate concern. They are one in the same. All we need to do is look at our actions to determine what our primary concern is at that moment

For where your treasure is, there your heart will be also. (Matt 6:21)

Make a tree good and its fruit will be good, or make a tree bad and its fruit will be bad, for a tree is recognized by its fruit. (Matt 12:33)

An example will provide us with realization that all of us are addicted. The example comes from the universal search for security.
The Bible is plain in its language that we we can and should trust in God for our ultimate security.

Therefore, I tell you, do not worry about your life, what you will eat or drink, or about your body, what you will wear. Is not life more important than food, and the body more important than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? Who of you by worrying can add a single hour to his life? ...But seek first his kingdom and his righteousness, and all these things will be given to you as well. (Matt 6:25-27, 33)

Trusting in God for our security leads to freedom.

If you hold to my teaching, you are really my disciples. Then you will know the truth, and the truth will set you free. (John 8:31-32)

The Spirit of the Sovereign Lord is on me, because the Lord has anointed me to preach good news to the poor. He has sent me to bind up the brokenhearted, to proclaim freedom for the captives and release for the prisoners. (Isaiah 61:1)

The things that secure us tend to bind us down, and those that free us often feel like risks. True freedom can only happen when we trust in God's ultimate care for us and we relax our grip on the lesser sources of security. In our society, the three gods we trust in for security are possessions, power, and human relationships.
Possessions occupy and preoccupy the mind, making us think we are securing financial freedom. However, the more we acquire, the more occupied we become with possessions. They become heavier and heavier burdens, leading to being more and more consumed by them and controlled by them rather than being free.
Power in this world involves seeking status, influence and control over our lives and living autonomously. The more power we have, the less vulnerable we feel in regards to others influencing us or oppressing us. However, it typically becomes egotistical and selfish; instead of serving freedom, we result to serving our own will.
Human relationships provide us with feelings of personal worth, value, and affirmation. They provide us with security and stability. But relationships can also make us too dependent and possessive; they can be a source of manipulation; our sense of personal worth, lovability, and goodness may become contingent on the approval of others. These are the signs of addiction. Our personal worth and value, our capacity for loving others and being loved, and our ultimate care and protection are all things that have been given to us by God. When we feel bound to extract these qualities from others, something is wrong and addiction is taking root.

The final thing that needs to be considered in determining the nature of addiction in order to help identify personal addictions is attraction versus aversion addictions. Thus far, we have only considered attraction addictions - those that draw us to them and we find pleasurable. However, desire has two sides, attraction and repulsion. Thus, there are repulsion addictions - those things which we are compulsively pushed away from. They are often called by other names such as phobias, prejudices, bigotries, resistances, and allergies. Some aversion addictions are just the opposite of attraction addictions (example: I'm addicted to cleanliness vs. I'm repulsed by dirtiness). Aversion and attraction addictions have essentially the same characteristics; in aversion addictions, however, there exists intolerance instead of tolerance, and instead of withdrawal symptoms, there are approach symptoms.

Anything in life can become an addiction. Yet there is a difference between having strong feelings about something and really being addicted to it. The difference is freedom. With most things which we care (and do not care about), we remain free to choose the depth and extent of our investment. True addictions are compulsive habitual behaviors that eclipse our concern for God and compromise our freedom and they must be characterized by tolerance, withdrawal, loss of willpower, and distortion of attention.

Here is a partial list of different types of addictions to help you realize that you are addicted and what you are addicted to so that you may come to know your enemy.

Attraction Addictions
Anger, Approval, Attractiveness,
Being good, Being helpful, Being loved, Being nice, Being right, Being taken care of,
Calendars, Candy, Cars, Causes, Children, Chocolate, Cleanliness, Coffee, Caffeine, Comparisons, Competence, Competition, Computers, Contests,
Death, Depression, Dreams, Drinking, Drugs,
Eating, Envy, Exercise,
Fame, Family, Fantasies, Finger drumming, Fishing, Food, Friends, Furniture,
Gambling, Gardening, Golf, Gossiping, Groups, Guilt,
Hair twisting, Happiness, Hobbies, Housekeeping, Humor,
Ice cream, Images of God, Internet, Intimacy,
Jealousy,
Knowledge,
Lying,
Marriage, Meeting expectations, Memories, Messiness, Money, Movies, Music,
Nail biting, Neatness,
Parents, Performance, Pets, Pizza, Politics, Popularity, Power, Psychotherapy, Punctuality,
Reading, Relationships, Responsibility, Revenge,
Seductiveness, Self-image, Self-improvement, Sex, Shopping, Sleeping, Soft drinks, Sports, Status, Stock market, Stress, Sunbathing, Suspiciousness,
Talking, Television, Time, Tobacco,
Weight, Winning, Work, Worthiness

Aversion Addictions
Airplanes, Anchovies, Anger, Animals,
Being abnormal, Being alone, Being discounted, Being fat, Being judged, Being overwhelmed, Being thin, Being tricked, Birds, Blood, Boredom, Bridges, Bugs,
Cats, Closed-in spaces, Commitment, Conflict, Crowds,
Darkness, Death, Dentists, Dependence, Dirt, Disapproval, Doctors,
Embarrassment, Evil spirits,
Failure, Fire,
Germs, Guilt,
High places,
Illness, Independence, Intimacy,
Mice, Messiness,
Needles,
Open spaces,
Pain,
People of different beliefs/class/culture/politics/race/religion/sex,
People who are addicted/competent/fat/thin/ignorant/messy/neat/rich/poor,
Public speaking,
Rats, Rejection, Responsibility,
Sex, Sharp instruments, Slimy creatures, Snakes, Spiders, Storms, Strangers, Success,
Tests, Traffic, Tunnels,
Vulnerability,
Water, Writing

So in summary, we are all addicted in some fashion or another, to some "thing" or another. This is the result of abnormally attaching our desire to an object, idolizing it, and that subsequent attachment enslaves us to the object. As our bonds to the object grow stronger with time (until broken), our freedom shrinks. Because we are sinful, we are all addicts. Breaking free from denial is the first step in the battle against addiction, and now is your time to take that first step.

The Purpose

We are all addicts. In every sense of the word, we are all addicted, because we are not perfect! We all have our "thing" we turn towards and indulge in for escape, pleasure, relief, and/or escape. It could be chicken wings, gum, a close friend, tobacco, alcohol, obsessive thoughts, illicit substances, books. You name it, it can be your addiction. The purpose of this site is to provide insight and learning into my struggle with addiction as I journey through the process of realization, instruction, struggle, and hopefully eventual freedom.

My sources for this blog come from 3 main texts, from which I will regularly plagarize. These posts are not my ideas or theories, but rather those things which help me see my addictions in a more concrete fashion, as real, and as addressable. Theses blogs are quotes, theories, thoughts and insights from these texts as well as my interpretations, and applications, which help me in my journey, my battle. Join me on my journey, learn with me, and seek the freedom we all desire.

Sources:
Addiction & Grace: Love and Spirituality in the Healing of Addictions. Gerald G. May, MD.
The Holy Bible. Our Lord God.
12 Steps with Jesus. Don Williams.