Issue link: https://digital.copcomm.com/i/106392
The true malefactor however, is located in the midbrain, in the ventral tegmentum area. This is an area of primitive desires and has absolutely no regard for the frontal lobe's sense of ethics and identity. The midbrain is the center point of the brain's reward system, which is supposed to reinforce survival-related behaviors, such as love, sex and eating. It rewards us with a shot of the pleasurable neurotransmitter dopamine every time we engage in certain survival-related behaviors (commonly related to eating, love, sex and anger), and gets a spike of dopamine each time a substance is used. Chronic drug or alcohol abuse creates high spikes of dopamine release in the brain, setting the bar for pleasure higher and higher. Eventually, people feel less pleasure for all the simple things in life (such as good food or quality time with the kids), which is often referred to as "pleasure deafness." Brain cell structure and chemistry changes also occur as neurons increase receptor sites for the neurotransmitter dopamine. People with addiction are mentally and emotionally compromised until the brain begins to restore, which may happen between "doses" of alcohol or drugs. However, as a result of chronic abuse over time, they continue to experience some degree of impairment in all these functions even when they aren't using the addictive substance, whether that be alcohol or overthe-counter, recreational or prescription drugs. The frontal lobe becomes weaker as it gets continually short-circuited by the midbrain. Morals, the ability to reason, and the recognition of socially inappropriate behavior? Gone! Impulse control is compromised, judgment impaired, and the ability to regulate basic emotions is weakened. This state is sort of like a trance, seemingly putting decisive individuals on auto-pilot. You can look into your loved one's eyes and see he or she isn't there. The addiction has them; the self and its will have faded into the background. The neuroscience of addiction isn't an excuse for the destruction created in lives and communities of people struggling with addiction. But an addicted person needs to take ownership of the damage that has occurred. When a successful businessman and father with everything to lose gets in a car and drives drunk, he is making an unconscious decision. Literally. The key to success is learning how to remain conscious. Research in neuroscience, psychology and meditation-based techniques is showing promise in addressing the brain damage directly. The goal is to strengthen the frontal lobe, to return its rightful reign over the mid-brain by using techniques that involve mindfulness practice. One of the most effective tools is called "urge suring," a term coined by clinical Ph.D. and author Alan Marlatt as part of a program of relapse prevention. Here's how it works: Close your eyes for a moment and begin to notice the many leeting physical sensations such as an itch, a desire to uncross your legs or a thought about what errand you have to complete next. Each experience has a commensurate action—scratching the itch, uncrossing the legs or grabbing your keys to run off on your errand. Now, instead of acting, sit for a moment and simply observe the itch. The physical sensation will build, reach a crest, and then fall, just like a wave crashing onto the shore. Imagine yourself as a surfer, riding the wave until it fades out. The effect is that you don't get taken under by the wave, you stay on top of it. You observe it, accept it and let it pass. Ten to twenty minutes a day of urge surfing as a meditative practice can have a profound effect. The action of becoming vigilant, this meta-awareness of the whole addiction process taking place in the mind and body, actually helps to keep the frontal lobe activated. This is the important shift from unconscious domination to conscious control. The more aware one is of the subtle signs of a craving, the easier it is to observe without reacting to it. Research shows that both ighting cravings and ignoring them are ineffective strategies. The most effective approach is to acknowledge the impulse and ride the wave. Another important beneit of the urge-suring technique is the development of a self that is present and in control. This practice allows the loving parent or the clever businessperson to show up and de-identify with the addiction. The true self is what one will ind in the practice of daily sitting with one's internal experience. Using mantras such as, "I am not my addiction," or "I am greater than my addiction" can support this process. The goal is to build an awareness of the self as a consciousness larger than the addiction. Learning how to experience oneself in this way takes practice but ultimately leads to the development of a strong and healthy sense of self. n Brandy Engler is a practicing psychologist at the Center for Addiction Care in Los Feliz. Addiction_02.indd 29 February/March201329 1/25/13 6:26 PM