{"id":9547,"date":"2011-08-03T13:22:10","date_gmt":"2011-08-03T20:22:10","guid":{"rendered":"http:\/\/www.goodtherapy.org\/blog\/?p=9547"},"modified":"2015-11-03T08:20:14","modified_gmt":"2015-11-03T16:20:14","slug":"love-drugs-primitive-brain","status":"publish","type":"post","link":"https:\/\/www.goodtherapy.org\/blog\/love-drugs-primitive-brain\/","title":{"rendered":"Love, Drugs, and the Primitive Brain"},"content":{"rendered":"

\"CoupleThe most common question I get in my work and sometimes from my friends is \u201cAm I an alcoholic?\u201d This is usually followed by \u201cDoes this mean I have to go into rehab?” or “Will I ever be able to have a drink again?\u201d<\/p>\n

I believe that treatment for addiction<\/a> should be individualized to take into effect each person\u2019s individual needs, complexity, and readiness to change. Every case is different. Sometimes the answer is undeniably complicated. I was trained to apply systematic screening and assessment in order to determine if alcohol abuse<\/a> vs. dependence is present based on Diagnostic and Statistical Manual of Mental Disorders<\/a><\/span>\u00a0criteria and make treatment recommendations based on the American Society of Addiction Medicine placement criteria.<\/p>\n

But sometimes I encounter cases of addiction that do not fit anywhere.\u00a0After the tragic death of Amy Winehouse, there was a lot of speculation online—even by professionals in the addiction field—as to who was to blame. There was actually one article I read that seemed to imply that if she had been able to drink in moderation maybe she would still be alive. I honestly cannot comment on that either way.<\/p>\n

Understanding the Harm-Reduction Model<\/h2>\n

I will say the harm-reduction model of treating addictions is not popular among people who advocate for abstinence as the only acceptable treatment outcome and people who support the 12-step program<\/a> approach. Having worked at a methadone clinic for years and witnessed powerful positive change, I am not a big fan of one-size-fits-all treatment approaches, nor am I into labeling.<\/p>\n

I have found one view on addictions very helpful for people who do not seem to fit the traditional medical model of addiction:\u00a0the Stanton Peele approach.\u00a0Here\u2019s a summary of his view on addiction:<\/p>\n

\u201cAddiction is not unusual, although it can grow to overwhelming and life-defeating dimensions. It is not essentially a medical problem, but a problem of life. It occurs for people who learn drug use or other destructive patterns as a way of gaining satisfaction in the absence of more functional ways of dealing with the world. Therefore, maturity, improved coping skills, and better self-management and self-regard all contribute to overcoming and preventing addiction. Addiction is a way of coping with life, of artificially attaining feelings and rewards people feel they cannot achieve in any other way.” —Stanton Peele<\/p><\/blockquote>\n

\n\t

Find a Therapist for Addiction<\/a><\/h2>\n\t
\n\n\t\t\t\t\n\n\n\t\t\t\n\t\t\t\n\t\tAdvanced Search<\/a>\n\t<\/form>\n<\/div>Of course, I think harm-reduction does not work for everyone. In fact, it can be detrimental to one\u2019s recovery. But that\u2019s a subject for another article.\u00a0One area I find Peele\u2019s theory to be applicable is in explaining how addiction and intimate relationships<\/a> are so closely interconnected.<\/p>\n

Jim always ends at the bar drinking after a fight with his wife. Anna\u2019s drinking always gets out of control after a break up. John had experimented with pain pills on and off in college but did not get addicted to them until after the devastating loss of his long-time lover and best friend. Travis\u2019s sex addiction<\/a> gets worse after feeling rejected by a love interest.<\/p>\n

In the words of one of the people in my therapy sessions, \u201cI was lost before I found love<\/a>. I was on a path of self-destruction with drugs, alcohol, and women; but with my wife I have found what I was always missing. I have been clean and sober since. Now I\u2019m high on life.”<\/p>\n

Addiction As a Way to Respond to Unsafe Relationships<\/h2>\n

By unsafe, I don\u2019t mean physically violent—although that is the most obvious case. Unsafe means threatening to the ego as much as threatening to the body. What I\u2019m talking about here is emotional safety. When we feel loved, accepted, nourished, protected, and part of someone else, we feel safe. That safety is often threatened when we feel unloved, not cared for, betrayed, lied to, yelled at, abandoned<\/a>, neglected, rejected<\/a>, and violated.<\/p>\n

To understand where we are going, we have to understand where we came from.<\/p>\n

Safety and the Primitive Brain<\/h2>\n

Let\u2019s start with the evolution of the brain<\/a>. In the base of our brain, we have the reptilian brain. We share this part of the brain with animals including alligators and lizards. The reptilian brain takes care of those things we don\u2019t usually think about: heartbeat, digestion, and breathing. It also is concerned with survival, and if it\u2019s dangerous, it will help us respond in one of five\u00a0basic ways: fight, flight, freeze\/play dead, submit, or hide.<\/strong>\u00a0I also view these as the five basic survival skills of couples. Couples may fight, flee (leave), play dead (stare right through their partner), submit (OK, whatever you want, just stop the nagging!), or hide (go to another room).<\/p>\n

On the other hand, if the reptilian brain is safe, we will do one of five\u00a0things: play, nurture, mate, work, and be creative<\/strong>. Remember when you first met your partner? How you played, nurtured each other, and had more sex? Do you remember being more creative<\/a> and productive at work? \u00a0As animals evolved, a second part of the brain developed called the mammalian brain. This brain developed when animals began to live in groups and take care of their young. This is the part of the brain where feelings are stored. That\u2019s why most animals experience some feelings and live in groups.<\/p>\n

Several million years ago, a third part of the brain developed: the cerebral cortex. In humans, this part of the brain is five times bigger than the other two parts combined and is where all logical processes happen: speech, writing, logic thinking, math, etc. The three parts of the brain work together simultaneously. If a tiger is coming at you, your logical brain says, \u201cThat\u2019s a tiger,\u201d your mammalian brain says \u201cI feel scared,\u201d and your reptilian brain says \u201cRun!\u201d or \u201cFreeze!\u201d<\/p>\n

But in relationships, it is often hard to articulate or identify who or what the \u201ctiger\u201d actually is. We know something is not right, and we are left analyzing the behaviors we can clearly see but can rarely understand. How is it, for instance, that when Jim and Linda fight, he ends up getting drunk at the bar even though he knows that is not going to help the situation at home but only confirm Linda\u2019s insults?<\/p>\n

Sometimes fighting, fleeing, or hiding involves addictive behaviors—particularly sexual behaviors, but also gaming, internet addiction<\/a>, and alcoholism. Often past experiences with these behaviors make a person more susceptible to restarting\u00a0(if they have stopped) or increasing the frequency of these behaviors. This explains why people engage in addictive behaviors even against their logical thinking. It appears that the primitive reptile brain has taken over the cerebral cortex. This is why people logically know it doesn\u2019t make sense to engage in behaviors that often make the already troubled relationship even worse. They are \u201cthinking\u201d with their primitive reptile brain, which often means they are not actually thinking at all.<\/p>\n

Sometimes we are not simply chasing a drink or a drug. Sometimes using is a maladaptive way of coping with unsafe relationships. In this case, treatment should focus on the relationship and reestablishing safety more than on changing addictive behaviors themselves. I have found that establishing safety and learning to evoke mental images of safe places\/mental states is crucial in learning to calm oneself and coping with highly stressful situations<\/a>, which in return helps the addictive behavior dissipate.<\/p>\n

In my opinion, this should also be the main focus of relapse prevention in more traditional addiction treatment.<\/p>\n

References:<\/strong><\/p>\n

    \n
  1. Clifford, R. (n.d.). From Reptiles to Humans: A Three Brain Odyssey. Retrieved from http:\/\/www.starchiefpress.com\/articles\/article42.html<\/li>\n
  2. Luquet, W. (2007). Short-term couples therapy the Imago model in action<\/i> (2nd ed.). New York: Routledge.<\/li>\n
  3. Peele, S. (1990, March 14). Cures depend on attitudes, not programs. Retrieved from http:\/\/lifeprocessprogram.com\/lp-blog\/library\/cures-depend-on-attitudes-not-programs\/<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Addiction can have a profound effect on relationships. How can understanding the evolution of the brain help us to understand and treat addiction?<\/p>\n","protected":false},"author":2477,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[],"tags":[447,141,25,41,57],"class_list":["post-9547","post","type-post","status-publish","format-standard","hentry","tag-addictions-compulsions","tag-addiction-drug-alcohol","tag-psychotherapy-issues","tag-marriage-counseling-relationships","tag-the-human-being-of-therapy"],"_links":{"self":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts\/9547","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/users\/2477"}],"replies":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/comments?post=9547"}],"version-history":[{"count":0,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts\/9547\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/media?parent=9547"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/categories?post=9547"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/tags?post=9547"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}