Craving (14 page)

On the other hand, we have to be careful not to entirely dismiss the value of brain-behavior research findings. As we learn more about the correlation between behavior change and the brain impact of actions and experiences, we are able to suggest actions and experiences that might be helpful in alleviating some problematic behaviors, including cravings. That’s not as far of a stretch as it might sound, because many successful interventions for neurological and psychiatric conditions were developed based on their expected impact on brain function.

The research findings that are key to becoming free from cravings are that thinking changes the brain, actions change the brain, and experiences change the brain. And while your goal is not really to change your brain but rather to change your life, gaining a deeper understanding of how simple actions can change your brain may be helpful as you design your program for healing.

So the verdict is in: thinking clearly changes the brain. There are many examples of brain matter being altered by the act of thinking, whether it’s brain changes that result from certain types of psychotherapy
⁷⁵
or the effects of meditation among Buddhist monks (their brains produce gamma waves during meditation).
⁷⁶
In a stunning confirmation of “mind over matter,” for example, Emory University researcher Helen Mayberg demonstrated that the brain changes that occur when depression is adequately treated by antidepressants also occur when talk therapy is successful. Furthermore, in a University of Wisconsin study of monks selected by the Dalai Lama, it was found that meditation produced persistent, favorable changes in their brain wave activity.

So, certain types of talk therapy heal the brain, and meditation also produces both temporary and persistent changes in the brain. In the
next chapter
, when I lay out some specific recommendations for dealing with cravings, you will see that I recommend them for people who are distressed by their cravings. What about positive thoughts and emotions? While we know a little bit about the effects of positive emotions on the endocrine system, and there is some brain imaging and brain wave research on the effects of positive thinking, unfortunately such research remains in its infancy (scientists tend to focus more on problems than on successes). For example, we know from both EEG (brain wave) research and functional brain imaging research that positive emotions tend to induce brain activity in the left prefrontal cortex, and negative emotions tend to activate the right prefrontal cortex. One fascinating study actually showed that positive and negative emotions affect decision-making in different ways and that the differences were visible when looking at functional images of the brain (researchers call this the framing effect).
⁷⁷

However, even without understanding the brain science of positive emotions and positive thinking, there are good reasons to focus on the positive. The entire discipline of positive psychology is built around the notion that attention to the positive can make a significant difference in people’s lives. Happy people function better than unhappy people; they are more productive; and some research even shows that they live longer. Mood research shows that positive emotions improve your ability to think and remember, and to socially engage with others—skills that are pretty important to finding relief from cravings. The mere act of being conscientious, for example, improves your ability to rebound and recover from negative emotions.
⁷⁸
Research also shows that positive emotions lead to increased resilience, positive thoughts, improved memory and thinking capabilities, and improved social relationships; plus, positive thinking improves emotions, memory, social relationships, and cognitive function. You’ve probably heard of people who are depressed being in a downward spiral. Well, what I’m describing is an upward spiral, and it is reason alone to do whatever you can to keep your thoughts and emotions focused on the positive as much as you can.

Actions Change the Brain

Actions also very clearly change the brain. Consider, for example, the role of physical fitness among older adults in improving thinking and memory abilities. Many studies (both animal and human) have examined the relationship between physical fitness and the ability to think more clearly. A recent meta-analysis of eighteen studies on this subject showed that physical fitness improved cognitive abilities and, in particular, the effect was strongest on executive function (as we’ve explained in
chapter 3
, this brain function is critical in addiction and recovery).
⁷⁹
There are many other examples of actions that change the brain. The parts of your brain devoted to certain activities change depending on how often they are used. Violinists, for example, have a greater proportion of brain activity devoted to their fingering hand than to their bow hand, and the amount of brain matter dedicated to the fingering hand is much greater in violinists than in non-violinists. So, the complex actions of the fingering hand actually result in alterations in the structure of their brains. Remarkably, this is even true of people who begin learning the violin later in life, which confirms that while it may be easier when you are younger, it’s never too late to change and improve your brain through simple actions.

Experiences Change the Brain

In
chapter 2
, we learned that a rod shot through the brain of Phineas Gage produced significant changes in his judgment and decision-making ability. Strokes and certain diseases can do that too. It’s not a stretch to see that various types of physical damage to the brain can produce changes in thoughts, emotions, and behaviors. But can experiences themselves alter brain matter and affect decision-making ability? You bet they can. The most obvious example of this is the brain disease post-traumatic stress disorder (PTSD). People with PTSD (many of whom have never actually been bodily injured, but in some cases were merely threatened with injury) have sustained actual damage to their brains from the experience itself. Combat veterans who develop this condition should be considered wounded warriors. Their prefrontal cortices have reduced blood flow, their hippocampi show structural changes when compared to people who don’t have PTSD, and their amygdalae (recall that the amygdala is involved in connecting thoughts with emotions, particularly fear) are overactive. Clearly what they experienced changed their brains, and not just temporarily. In fact, there are some remarkable similarities between people who have PTSD and people who have experienced traumatic brain injury (TBI), that is, physical damage to the brain.

More important, we now also know that healing from PTSD changes the brain in remarkable ways. For example, a recent study showed that when veterans with combat-related PTSD underwent a certain type of therapy called exposure therapy (where veterans are gradually exposed to some of the images and thoughts associated with the trauma in a controlled and safe way), their amygdala activity was suppressed.

Similarly, there is ample evidence that experiences in childhood affect brain development, both on the negative side (poverty, physical abuse, emotional/mental abuse, sexual abuse, neglect) and on the positive side (love, compassion, engagement/interaction). Preverbal children whose mothers speak with them develop language sooner than those whose primary source of language is the television, for example. Early childhood interventions have demonstrated improvements in intelligence and functioning, even decades after the intervention was completed.

There is every reason to believe that it’s no different when it comes to cravings. One of the key goals of this book is to help you change your thoughts, actions, and experiences to support your release from cravings and their associated self-destructive behaviors. The actions you take will help you reduce your cravings, improve your behavior, and develop resilience, so you are less vulnerable to stress and other factors that create or intensify cravings. The next chapters describe the specific actions you can take to reduce your cravings and, when you do experience cravings, reduce the chance that you will act on them.

…

6

Spirituality and Recovery

How Twelve Step Recovery and Other Spiritual Approaches Reduce Cravings

“I have treated many hundreds of patients. Among those in the second half of life—that is to say, over 35—there has not been one whose problem in the last resort was not that of finding a religious outlook on life.”

— CARL JUNG

There is a deep connection between religion, spirituality, and addiction. Many major religions prohibit or discourage the use of intoxicating substances.
Spiritus contra Spiritum,
the ancient expression quoted by Carl Jung in his letter to Alcoholics Anonymous cofounder Bill Wilson that relates spirit and alcohol, reflects this connection. Jung points out to Wilson that in Latin the same word is used to describe “both the highest religious experience and the most depraving poison.”
⁸⁰

On the other hand, many world religions and mystical and spiritual practices involve the use of intoxicating substances or behaviors to attain deeper spiritual connections. Consider the importance of wine in Christianity, tobacco in Native American rituals, or cannabis in the rituals of Hindu saints. I have also seen cases of what might best be described as a sort of religious addiction, where people who are profoundly miserable seem to require increasing levels of religious participation, giving up nearly everything else that matters to them, and even attempt to reduce their involvement but cannot, as they cannot tolerate the process of lessening their obsessive participation. These cases, although exceedingly rare, have had devastating effects on the sufferers and their families.

Furthermore, many methods for addressing and treating addiction emphasize spiritual, and in some cases, religious devotion. This is certainly true today with nonreligious Twelve Step fellowships such as Alcoholics Anonymous and Narcotics Anonymous. There are also organizations that have purely religious approaches to addiction, as well as modern hybrid Twelve Step/religious approaches such as Celebrate Recovery, a Christianity-based approach developed in the early 1990s. Taken together, these observations confirm that there is a long-standing and deep connection between religion, spirituality, and addictive behaviors.

Carl Jung was an early twentieth-century psychiatrist who, like many singular thinkers, explored some ideas that were clearly unpopular among his peers. Notably (and, to be sure, grossly oversimplified by me here), he explored the relationship between spirituality and the human psyche. His ideas, along with the methods of the quasi-religious movement known as the Oxford Group, were later shown to be instrumental in the birth of the Alcoholics Anonymous movement. One point that Jung made was that
the greatest and most fundamental problems of life cannot be solved, only outgrown.
He pointed out that this type of growth requires a new level of consciousness and that these problems are usually outgrown when some new, broader interest appears that causes the original problem to fade as a person explores this new transcendent direction.

In many ways, this describes the technique that Twelve Step members have used to “solve” their various problems. Alcoholics, whose problem on the face of it appears to be the inability to control their drinking, employ a solution that does not, ostensibly, have anything to do with drinking. They focus on altruism, helpfulness to others, and a broader spiritual aim, and as a result, in a seemingly unrelated vein, their desire to drink fades, much as Jung described. Marc Galanter, professor of psychiatry at New York University and a noted expert on addiction treatment, describes this process as a “relief effect,” noting that the manner in which people acquire (through group participation) and attribute spiritually oriented meaning to their experiences can be reinforced by the resulting relief from psychological distress.

How exactly does this work for alcoholics and other addicts, and how can it work for you?

Spirituality, Religion, and Addiction

To answer this question, it may be helpful to understand the difference between spirituality and religion. It’s important to note that there is really no agreement on a definition for spirituality. Dr. William Miller from the University of New Mexico-Albuquerque has written extensively on the relationship between religion, spirituality, and addiction. I consider him to be the world’s expert on this topic. He notes that in the last few decades, the terms “religion” and “spirituality” have grown further apart from each other. There seems to be a trend, especially among Americans, for people to describe themselves as “spiritual but not religious.” This is, interestingly, also a central tenet of the AA approach. Miller points out that, in modern psychological thinking, spirituality seems to be an individual characteristic, akin to personality, and that religion is best described as a social phenomenon defined by membership, belief, and practice.