Journey to the Center of the Brain
Part 3: Compulsions and Addictions
“When I returned to partial life my face was wet with tears. How long that state of insensibility had lasted I cannot say. I had no means now of taking account of time. Never was solitude equal to this, never had any living being been so utterly forsaken.” – Jules Verne, Journey to the Center of the Earth
Welcome to the final installment of Journey to the Center of the Brain, a blog series posted through the Center for Family Transformation as a means of making sense of the brain activity behind common human experiences. In the first post of this saga, I outlined how the brain activates its individual parts harmoniously to cope with hardship. In the second post, I took that a step further, writing about stress management versus mismanagement. This last post will take on the same structure as the second, but I will consider what happens in the brain before, during, and after compulsivity and addiction recovery. Because of my training as a Certified Sexual Addiction Therapist (CSAT), I often help clients wrestle with this topic through counseling. I found that addiction is a misrepresented, misunderstood, stigmatized, and painful subject to approach, even within psychological circles, but particularly between recovering addicts and the outside world. Addiction is commonly reduced to a series of poor choices or unhealthy habits, and that is involved at a surface level. But when viewing it more deeply, compulsivity and addiction are not so simple psychologically or neurologically. Like the Jules Verne quote above, many people struggling with compulsivity and addiction feel alone, fractured, insensible, and forsaken; they want to stop their unhealthy behaviors but do not know how. This blog post can offer light on the matter.
Habits, Compulsions, or addictions?
It might help to begin with descriptions of compulsivity and addiction. What is the difference, and how do those two diverge from unhealthy habits? Like most things in present-day mental health, these three terms exist on a spectrum of behaviors. The spectrum defines repetitive actions that influence brain health, which in return, influences our actions. So, healthy or unhealthy habits, compulsions, and addictions are all related. That means that anyone with an unhealthy habit can relate in some form to an addict; in fact, neurological processes involved with unhealthy habits and addiction are the same! To best understand this, it is important to discuss how a brain learns new things. This is called accommodation and assimilation, terms originally coined by prolific psychologist Jean Piaget (1). Let me describe how accommodation and assimilation work. As humans, when we discover a new activity, our brain creates pathways that act as neural bridges for reproducing that endeavor in the future. Take brushing teeth as an example; for the child who is shown how to do this for the first time, her brain accommodates a new neural bridge for this information. The bridge begins like a metaphorical forest path; journeying down it is slow and deliberate. Fast forward to years later, when the child is an adolescent and she has brushed her teeth many times. Now, she can finish the task without thinking about it. At this point, the forest path has become a neural superhighway – even little variations in teeth brushing, like using a new toothbrush, are assimilated into this expressway. For the brain’s neurons, traveling down this superhighway is quick, easy, and thoughtless. This is how I might define a habit.
Here is where the habits turn into compulsions, which are mental yearnings to repeat that habit. The yearnings are like a magnet for the brain to use the superhighway versus the forest path. Compulsions occur when we over-engage in habits that activate our brains’ natural reward system (NRS) to increase pleasure or reduce pain. The NRS is part of the limbic system. Natural behaviors that activate the NRS are relishing foods, working out, having sex, enjoying conversations, being generous, learning interesting things, taking risks, etc. Less natural behaviors that prompt the same neural response are consuming addictive substances like alcohol, sugar, caffeine, marijuana, pain medication, cocaine, heroin, etc. The NRS begins when the hypothalamus orchestrates a release of neurochemicals causing pleasurable feelings. Some neurochemicals distributed are dopamine, serotonin, and norepinephrine; of those, dopamine is key (2). Typically, when doing something pleasurable, the brain increases dopamine uptake, then it resets to a homeostatic state or normalized level of dopamine. Over time, the more often dopamine is released for a particular behavior, the more the brain desires that behavior. This is called “incentive sensitization,” or craving (3). The brain disease known as addiction occurs when the cravings become so profound that our brain renormalizes to an allostatic state versus resetting to its homeostatic state (4). The brain is now so assimilated to the dopamine from the behavior or consumption that it expects it. The brain has reduced its natural production of dopamine, and it has become partially or completely dependent on the behavior or consumption. Thus, a habit turns into a compulsion, and a compulsion turns into an addiction.
Bruno’s brain journey
Since Dan Siegel (5) describes stories as tremendously valuable in accommodating new information, let us take that complex, previous paragraph and use a story to summarize how habits, compulsions, and addictions might play out. In this story, I refer to a fictional character named Bruno. Bruno is a young adult male living in Chicago with two elder siblings. Bruno loves theater. With Bruno’s organic giftings and staunch work ethic, he was accepted into a fantastic acting university post-high school. When he is not attending school, Bruno works at a local restaurant to pay for his education. Bruno’s dreams are big – his family taught him that excellence is important, so important that it is not OK to show weakness. This was modeled for him versus verbalized to him. Bruno’s brain is also still growing, so he is prone to taking risks, seeking adventure, and achieving accomplishments. For those reasons, Bruno engages in a work hard, play hard lifestyle. On school nights, Bruno drinks multiple energy drinks and plays video games for hours. On weekends, he attends night clubs or parties with his brothers and friends, regularly gambling on sports events or MMA fights. Bruno grew up with these behaviors accepted by his family and community, so he saw no moral objections to them. What Bruno did not realize was the inner workings of his brain as he played out this cycle every week.
In Bruno’s situation, his brain created neural superhighways for several behaviors and substances, notably energy drinks, video games, gambling, and overworking. His mind architected habitual or compulsive desires for study, work, and risk taking as well. Now, there was a natural progression as to how Bruno arrived here. Remember that in Bruno’s early life, he was taught that weakness is not acceptable. Bruno instinctively created a double life – the one he felt inside (which was human and flawed) and the image he showed the world (which he projected as flawless). Humans are not meant to experience mental fractures like this! The human system (brain, body, spirit, and soul) functions most optimally when unified. To upkeep his flawless image and manage the expectations of his endeavors, Bruno uses energy drinks, video games, gambling, overworking, study, and risks to off-set or numb the tense experience within him. On top of that, Bruno feels that many of those activities are fun…but regarding how these impact him, Bruno is only aware of the latter. Therefore, Bruno does not feel a need to stop. He believes he can adjust his behavior at any time, not noticing that if he tried, his brain would fight against his willpower. Bruno’s story is like so many of my clients, whether they are recovering from poor choices, unhealthy habits, behavioral compulsions, or clinical addictions. Their responses to their external system (i.e., their upbringing, relationships, expectations, and stressors) has caused dysfunctional core beliefs and expectations, leading to coping in unhealthy ways that ultimately changes their brain architecture and neurochemistry.
Bruno’s break to freedom
Bruno may come to a breaking point when his sense of internal pain is so great that he cannot continue with his lifestyle. He may do something that causes disruption to his routines (e.g., dropping out of school, being hospitalized, suffering a financial loss, etc.) that he decides his brain’s allostatic state can no longer dictate his behaviors. This is what often brings people to therapy. Counselors like me teach clients like Bruno about what is happening inside them psychologically, neurologically, and physiologically. We educate clients on how trauma leads to dysfunctional core beliefs, which then causes irrational thoughts, and this ultimately results in a need to cope with (a double) life in typically unhealthy ways (2). The unhealthy coping creates the compulsion or addiction cycle translating into the brain disease I referenced above. [For more details this cycle, reference my 2020 blog series on pornography addiction called An Insidious Affliction]. In therapy, Bruno’s counselor will take a dual approach to help him recover from his trauma while showing him the steps to reset his brain back to homeostasis through abstinence or harm reduction. This withdrawal process can be grueling for some, but once the brain is reset, the therapist can help the client become whole again psychologically. I mentioned in my first post of this series that treating the brain like a muscle will be advantageous; helping clients retrain their brain is a major factor here. It is also imperative to note that recovery requires outside assistance from professional guides and natural supports like family, friends, twelve-step groups, etc. This is because those stuck in compulsion and addiction will normally deny it even exists. This denial stems from toxic shame, a crucial consequence of dysfunctional core beliefs and attachment trauma. Some clients, without knowing it, can even be addicted to the shame itself.
Conclusion
This final blog post within Journey to the Center of the Brain covered how the brain works amid unhealthy habits, compulsive behaviors, and clinical addictions. The brain is a fascinating organ, one that we still know little about. Nonetheless, with the information we do have, we can understand and even reprogram our neurology (to an extent) to shift our habits for the betterment of everyone in our lives. For more information on these topics, reach out to a counselor today. We look forward to aiding you in your personal journey to the center of your brain.
References
- Block, J. (1982). Assimilation, Accommodation, and the Dynamics of Personality Development. Child Development, 53(2), 281–295. https://doi.org/10.2307/1128971
- Carnes, P., Carnes, S., Adams, K. M., & Sarr, E. (2020, March 25). Certified Sex Addiction Therapist (CSAT) module 1 training manual [PDF]. Carefree, AZ: International Institute for Trauma and Addiction Professionals (IITAP).
- Robinson, T. E., & Berridge, K. C. (2008). Review. The incentive sensitization theory of addiction: some current issues. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 363(1507), 3137–3146. https://doi.org/10.1098/rstb.2008.0093
- Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. The New England Journal of Medicine, 374(4), 363–371. https://doi.org/10.1056/NEJMra1511480
- Siegel, D., & Hartzell, M. (2003). Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive. New York, NY: Penguin Group.
