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Elisha Goldstein, Ph.D.

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The Neuroscience of Bad Habits: Dr. Nora Volkow

Posted: 05/14/2012 11:09 pm

Why are bad habits so hard to break? What if the bumper sticker "Just Say No!" actually works against us? Dr. Nora Volkow, head of the National Institute on Drug Abuse, may just have the answer.

If you have 10 minutes or so, watch the 60 Minutes video below to understand why habits are so hard to break and what is being done about it:

Volkow also was part of a 25-minute documentary on HBO around a range of issues related to addiction.

In the 60 Minutes video, Volkow tells us that if it were so easy to just say "no," then we wouldn't have drug addiction or obesity. There's something going on in the brains of addicts where they literally lose the ability for self-control.

Because of this Volkow calls the phrase "Just Say No!" "magical thinking."

The fact is, drugs affect learning, memory and self control. It's a chronic disease that physically changes the brain; these changes are long-lasting and persist over time even after the person stops taking the drugs.

To get more specific, dopamine is one of the main chemicals regulating the pleasure center of the brain. At the most basic level, it regulates motivation -- it sends signals to receptors in the brain saying, "This feels good!"

Whether you're a heroin addict and you see an association to heroin, you're a caffeine addict and you see a cup of coffee, or if you're hungry and you see some good-looking food, your brain rushes with dopamine and that is now caught on brain-scanning machines.

So what about the problem with obesity in our society? Volkow says that images also affect the rise of dopamine in our brains. So if we pass a McDonald's and see the arches, our brain associates that with a tasty hamburger (for some) and shoots up dopamine. That good feeling will unconsciously drive the motivation to go in and get a Big Mac. It's a conditioned response.

The big news that Volkow has found is that most addicts share a reduction in levels of dopamine receptors. This isn't just for the hard drugs; this includes people who regularly smoke marijuana and cigarettes. The brain isn't wired to handle these highs, and a shut-off valve kicks in and reduces the number of receptors available. So the ability of the drugs to stimulate pleasure continues to decrease. That is why eventually addicts no longer use to get high, but just to feel normal.

On top of that, drugs have been shown to damage the prefrontal cortex, this is the area that resides in the front of the brain, our executive function that allows us to exert free will. When this is damaged, it makes it more difficult to regulate emotions and self control.

It makes sense why more and more addiction centers are integrating mindfulness into their curriculum. Mindfulness practice has been shown to activate the prefrontal cortex and even grow the hippocampus, the area involved with learning and memory. It's also been shown to grow areas of the brain associated with empathy that might come in handy when addicts start to experience a sense of failure and shame when not being able to "Just Say No!"

Another reason mindfulness is helpful in terms of recovery is that it yields The Now Effect, that "aha" moment of clarity where we enter into a choice point, a moment where we access possibilities and opportunities we didn't know were there before. This is crucial when it comes to our addictive behaviors to take a step back, "think through the drink" and recognize the various options that lie before us.

We can learn to step into the pause, notice the sensation of the urge that's there and as the late Alan Marlatt, Ph.D. said, "surf the urge" as it peaks, crests and falls back down like a wave in the ocean.

Just because our brains have been altered by addiction, doesn't mean we're destined to fall into the same habits. With the right skills, community and support we can learn how to break out of routine and into a life worth living.

And at the end of the day, if we got addicted to mindfulness, would that be so bad?

As always, please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.

Adapted from Mindfulness and Psychotherapy.

For more by Elisha Goldstein, Ph.D., click here.

For more on addiction and recovery, click here.

 
 
 

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02:42 PM on 06/08/2012
If people 'lose self-control' then how are they able to not use sometimes and use only when the opportunity makes it relatively safe most of the time? Perhaps the brain changes don't lead to a total loss of self-control, but rather lead to the experience of strong cravings and urges which most people with serious addictions respond to by using. Effective treatments and self-help groups suggest riding out the urge despite the discomfort. That is one of the effective approaches that is taught in SMART Recovery (meetings, website, Handbook).

Further, there is a lot of evidence coming in that Mindfulness is very helpful in accepting and riding out cravings. Kelly Wilson's new self-help book: "The Wisdom to Know the Difference", is based on Acceptance & Commitment Therapy and offers this approach, as does my SMART Recovery Handbook, amongst other useful and effective techniques and tools.

Perhaps if we focused more on what works, rather than why nothing works (which is not true), we would see more success in leaving addictions.

I'm rather disappointed that Dr. Goldstein, who wrote a book on mindfulness, is giving credibility to this strickly pessimistically biological theory. Note too that Volkow is not looking to help addicts, but rather for a vaccine to prevent addiction. That seems so far off base that I need not explain my doubts about it as the problem with that approach should be obvious.
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khanti
Cultivator
02:28 AM on 05/22/2012
Rigt Concentration holds the mind together in focus. A concentrated mind develops calm and clarity. From here develops insight to see things as it is, the thus ness of how things comes to be through many causes and conditions.
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khanti
Cultivator
02:23 AM on 05/22/2012
Right Mindfulness is the guardian of our six senses against falling into craving/addiction. Remember we always have a choice and Right Mindfulness help us to make the right choice.
It is like a person stranded on a small island and seeing salvation on the other shore decides to make a boat to cross the sea. But the boat has six holes which leaked water so he must plug those holes lest bailing the water will sap his energy and he drowns before even reaching halfway.
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khanti
Cultivator
02:14 AM on 05/22/2012
Right Effort
With Right Thoughts there arises Right Effort to do good, avoid evil and purification of the mind.
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khanti
Cultivator
02:11 AM on 05/22/2012
Right Thoughts
Is the beginning of mind development. For all things start from the mind.
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khanti
Cultivator
02:08 AM on 05/22/2012
Next three are Right Action, Right Speech and Right Livelihood
To discpline yourself is to lead a righteous life so as not to harm yourself nor others through way of action, speech and livelihood.
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khanti
Cultivator
02:02 AM on 05/22/2012
Overcoming addiction through. the Eightfold Noble Path
The first one is Right Understanding.
To understand that your 'high' on drugs is imnpermanent, temporary and causes much suffering to yourself and all those who care for you.
To understand that your craving for that 'high' is the cause of your sufferinng.
To understand that there is a way out of your suffering.
To undersdand that the way out is to discipline yourself and develop your mind.
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khanti
Cultivator
12:47 AM on 05/21/2012
It can be done. A matter of training the mind. The Eightfold Noble Path of Buddhism is exactly for that purpose. One cannot forget but can let go. As long as there is an ego then there is memory. Memory are mind impressions of our registered like and dislike experiences when come into contact with external and internal phenomenon. It is our built in natural survival instinct for life preservation.
12:56 PM on 05/18/2012
This article and the video from 60 minutes are helpful descriptions of the complex neurological bases for addiction -- stressing that addiction is a treatable disease, which can give hope to those struggling with it.

For those who might want more detail on the science of addiction in accessible English (what makes it a chronic, progressive disease; what parts of the brain malfunction; how that malfunction results in addict behaviors; how addicts' decision-making and motivation is skewed by substance abuse; why some get addicted while others don't; how treatment works; why relapse is common; what family and friends can do; etc.) please click on www.AddictScience.com.
Mark from atlanta
Unity through Diversity.
09:57 AM on 05/15/2012
Mindfulness can lrad to an evolution of the mind, body, society and species to one that values coroperation over competition, empathy over envy and love over hate.
06:12 AM on 05/15/2012
Thanks, Elisha for a blog my addiction clients will understand. The key for them, I believe, will be the easy to swallow research that the brain turns down the volume of receptors. That original high they seek to re-establish isn't in their emotional psyche alone; it's generated in their physical brain. Knowing this will make them feel less like a failure when they decide to stop using. After euphoria there is no where else to go but down. Super blog, and thanks for telling it the way it is in terrific format.
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Elisha Goldstein, Ph.D.
Psychologist and Author of The Now Effect
04:57 PM on 05/15/2012
You are most welcome Judy! Nora is doing some very important work, let's all keep sharing and learning from one another. ~ Elisha