You are currently browsing the category archive for the ‘Compulsive overeating’ category.
So, assuming you are someone who has surrendered to the idea that you are powerless over a given behavior or
situation (drugs, alcohol, overeating, bad relationships, gambling, shopping, sex, etc.) which has caused your life to become unmanageable (Step 1) and you are willing to embrace the idea that something “bigger than you” can help restore you to sanity (relieve you of the cycle of dependency – Step 2) and you are willing to take suggestions regarding this process (Step 3), then you are ready to take the emotional sobriety steps (Steps 4 – 9).
In these steps, you are asked to take inventories of yourself, admit your shortcomings to other people, ask for impediments to be removed and to make amends to people you have harmed.
And, the immediate response is generally: “what does any of that have to do with my eating, drinking or drugging?” The answer is: “Everything.”
A very wise man once said that he spent his life trying to get to the Sears Tower in Chicago using a map of Detroit. Steps 4 – 9 are the Steps where addicts come to accept that it is the “thinking behind the drinking” that leads to the unpleasant outcomes. Step 4 through Step 9 is where we learn to stop, examine our behavior and learn to ask directions from the gas station attendants who have been through the bad neighborhood and know the way out – the folks who spend a great deal of time enjoying the view from the observation deck at the top of the Sears Tower.
From the perspective of the literature in psychology and the disease of addiction, these steps are associated with explanatory style and coping mechanisms. (Seligman, 1990) As I mentioned in my previous post – there are two sorts of triggers for addictive behavior, physical (falling dopamine levels) and emotional (how a given situation is interpreted and reacted to). Steps 4 – 9 address the emotional work that must be done in order to get sober and stay that way.
The Twelve Steps are about self-awareness and metacognition– coming to understand what the emotional triggers are and developing strategies that will help you not react to them. The first few words of Step 12, “having had a spiritual awakening” have a direct link back to the language found in the Big Book of Alcoholics Anonymous which identifies those the characteristics of those who don’t succeed in recovery: “men and women who are constitutionally incapable of being honest with themselves…” (Alcoholics Anonymous, 2001, pg 58).
This must mean that the “spiritual awakening” necessary for long-term sobriety is the result of improvements in self-honesty.
Here is the basis for Step 4 through Step 9. These steps are the process by which someone learns to identify the patterns of thinking and behavior that contribute to the emotional triggers of addiction.
Resources:
Step 1 – Saturday Morning Live – Sandy B.
Step 2 – Saturday Morning Live – Sandy B.
Step 3 – Saturday Morning Live – Sandy B.
Works cited:
Alcoholics Anonymous. (2001). Alcoholics Anonymous (Fourth ed.). New York: Alcoholics Anonymous World Services, Inc.
Seligman, M. (1990). Learned Optimism: How to Change Your Mind and Your Life. New York: Vintage.
Next up: How it works
The human brain is a prediction generator. Every action initiated, every piece of information stored as knowledge, virtually every thought a human has is related to a prediction – an if/then statement (these are stored like “Microsoft macros” in the human brain to repeat as needed. Consider the number of if/then statements a toddler works 
through in order to perfect the art of human ambulation). The animal brain works in this capacity as well. “If I do X, then I’ll feel good.” Or, “if I do Y, then I’ll feel pain.” Guess what, humans like pleasure better than pain so the things that keep us alive generate a reward in our brain. That reward is a wash of a neurotransmitter called dopamine.
Each time the human organism participates in an activity that supports the longevity of the species the brain is washed with dopamine. Respiration is the single most important function of the human body. The second most important activity an organism can participate in is nourishment. The reward circuit is integral in keeping the human body alive.
Addiction “hijacks” the reward circuit. Through a process of prediction and reward, the human brain begins to see certain substances as acceptable strategies for dealing with life. Things that “take the edge off,” “relieve the stress,” or simply “taste or feel good.” Over time these become conditioned (albeit ineffective) life management skills.
The first step of a Twelve Step program is:
“We admitted we were powerless over [alcohol, drugs, food, people, places, things, situations, money, sex, etc.] – that our lives have become unmanageable.”
Coming to understand that a person in the throes of their addiction is totally powerless over their behavior is an important first step in the recovery process. Addiction is not an absence of will or a reflection of bad judgment, it is a process associated with neuronal pathways in the reward circuit that have been established over time. Addiction is a neurologic disorder. Addicts are as powerless over the cycle of craving that they face as they are over their own breathing. Their addiction is associated with a neurologic phenomena that they will never overcome (which is why people who relapse go crashing back to the depths of their disease). While the craving and response may never go away, addicts can learn how to live their lives in such a way to limit the triggers that set off the neurologic cascade and enjoy normal, highly productive lives. Addicts can learn how to build a defense against the first drink.
I’m proof that it works.
Next up: Your Brain on Stress…
References:
LeDoux, J. (1993). Limbic forebrain structure in emotional memory: Emotional memory systems in the brain. Behavioural Brain Research , 58 (1-2), 69-79.
Sigurdsson, T., Doyere, V., Cain, C. K., & LeDoux, J. E. (2007). Long-term potentiation in the amygdala: A cellular mechanism of fear learning and memory. Neuropharmacology , 52, 215-227.
Zull, J. (2002). The Art of Changing the Brain: Enriching the Practice of Teaching by Exploring the Biology of Learning. Sterling: Stylus.
One of my favorite questions to ask people I am working to help in recovery is the question, “so how old do you really think you are?” The answers provided can be really amusing. I generally chuckle and respond, “No, you are really somewhere between ten thousand and 2 million years old ” (depending on subscription to creationism or evolutionary theory). That is how long the human brain has been in engineering. The people present today are simply the latest iteration of the evolution of this amazing technology.
Unlike the technology we develop today where newer, smarter, faster components replace outdated or cumbersome previous technology, the human brain works with what is present and develops structures to improve on “humanity 1.0” technology. This means that even the brightest and most reasonable among us are working with an animal brain operating system upon which higher cognitive function is built.
The human brain – at its most basic level – exists for one reason and one reason alone. Its sole function is to keep the human organism alive. That’s it, that’s all. How does it accomplish this? First, it avoids pain. Second, it rewards behaviors associated with maintenance of the organism. In other words, it avoids what hurts and rewards what feels good.
Emotion is the language of the brain. The limbic system is the emotional “wiring” of the human brain. It is really important to note that the limbic system underpins the entire cerebral cortex and that there are more neurons running from the limbic system into the cortex than there are neurons running from the cortex into the limbic system. This might explain why our “emotions” so often seem to rule our thinking rather than the other way around. Many neuroscientists believe that emotion developed in the human brain well before higher cognitive function.
The reward circuit exists within the limbic system. There are two regions of the limbic system that are particularly influential in the reward circuit, they are the amygdala (fear) and the basal structures (nucleus accumbens & ventral tegmanetal area (VTA) associated with pleasure).
ttp://www.cdc.gov/nchs/data/hestat/overweight/overweight_adult.htm
We’ve all said it…why doesn’t she just stop drinking? Why won’t he simply go on a diet? Would that it were that easy for any of us…For most people, some choices are not choices.
In October 2008, I read an article that I felt was a long time in coming. It was a small blurb in a local paper about some research that had been conducted at Brookhaven National Laboratories in New York. Several scientists made the decision to compare advanced imaging studies of the brains of two study groups: cocaine addicts thinking about cocaine and obese people thinking about food. The neuronal circuitry of the brains of the subjects in these two groups was similar illustrating that obesity is the consequence of addictive behaviors associated with food just as liver disease is the consequence of addictive behaviors associated with consumption of alcohol. (Volkow, Wang, Fowler, & Telang, 2008)
Drug abuse and addiction, and … obesity can be understood as resulting from habits that strengthen with repetition of the behaviour and that become increasingly harder for the individual to control despite their potentially catastrophic consequences. Consumption of food, other than eating from hunger, and some drug use are initially driven by their rewarding properties, which in both instances involves activation of mesolimbic dopamine (DA) pathways…The repeated stimulation of DA reward pathways is believed to trigger neurobiological adaptations in other neurotransmitters and in downstream circuits that may make the behaviour increasingly compulsive and lead to the loss of control over food and drug intake…repeated supraphysiological DA stimulation from chronic use is believed to induce plastic changes in brain (i.e. glutamatergic cortico-striatal pathways), which result in enhanced emotional reactivity to drugs or their cues, poor inhibitory control over drug consumption and compulsive drug intake. (Volkow, Wang, Fowler, & Telang, 2008)
Why do I include this here? There are three reasons.
- It is important for me to convey that addiction is a disease associated with underlying neurophysiologic changes. But at the same time, addiction is a disease associated with behaviors and attitudes. As the cited article states, “[addiction] can be understood as resulting from habits that strengthen with repetition of the behavior and that become increasingly harder for the individual to control despite their potentially catastrophic consequences.” (Volkow, Wang, Fowler, & Telang, 2008)
- Addiction is more common than most people understand. There are more overweight or obese adults in America than there are adults at a healthy weight. Most adult Americans – even those that are successful at dieting – cannot maintain a healthy weight over time. Chances are, based on the scientific study cited above, two out of three of your friends are participating in addictive behaviors that even a $50 billion annual investment in the weight loss industry cannot overcome.
- Understanding and learning to modify the behaviors that contribute to reinforcing the pathways associated with addiction is the key to overcoming addiction. This underscores the importance of the journey to emotional sobriety. As the literature I will include in this discussion will illustrate, self-awareness is a significant component in the journey of recovery.
The neurotransmitter, dopamine, plays a significant role in normal brain function. Dopamine plays an important role in adult learning. Dopamine is also associated with the creation of pathways for compulsive behavior. Dopamine doesn’t discern that the pathway under construction is healthy or unhealthy, it just knows that it makes your brain feel good and that is justification for repeating the behavior…
Next up: Hijacking the reward circuit and the animal brain.
Works Cited
Alcoholics Anonymous. (2001). Alcoholics Anonymous (Fourth ed.). New York: Alcoholics Anonymous World Services, Inc.
Alcoholics Anonymous. (1952). The Twelve Steps and Twelve Traditions. New York: Alcoholics Anonymous World Services.
Centers for Disease Control. (2010, 2 25). Healthy Aging: Improving and Extending Quality of Life Among Older Americans. Retrieved 11 17, 2010, from National Center for Chronic Disease Prevention and Health Promotion: http://www.cdc.gov/chronicdisease/resources/publications/aag/aging.htm
Goleman, D. (1994). Emotional Intelligence. Bantam Books.
Goleman, D. (1997). Emotional Intelligence: Why it can mean more than IQ. Bantam.
Volkow, N. D., Wang, G.-J., Fowler, J., & Telang, F. (2008). Overlapping neuronal circuits in addction and obestiy: evidence of systems pathology. Phil Times R Sec B , 363, 3191-3200.
The Spiritual Experience 