If you weren’t completely sold on the bicycle analogy. Try this one. The point is the same, and it’s not complicated: addiction is a mental habit, it grows, stabilizes, and gets difficult to reverse. But it’s not permanent. It can be reversed — with practice. Unfortunately, the good habits that replace it may not be permanent either.
Mental habits become stable and resilient, hard to switch out of, when they are practiced repeatedly. That’s the case with piano lessons, pizza night, bicycling, and heroin. (I don’t distinguish “cognitive” habits from motor habits like bicycling — they’re all grounded in the same brain.) It’s possible to switch out of one mental habit and settle into another incompatible habit; that’s all well and good. Except that you might switch back into the old habit if you’re not careful. Because the synaptic configuration that held that pattern in place isn’t gone. It’s just been “deactivated.” Synaptic patterns take a long time to fade — through a process known as synaptic pruning. And the only way that’s going to happen is if other habits are practiced in their place.
Until that occurs, you’ve got these two habitual mental frames, let’s call them drug-wanting and drug-shunning. I recently referred to them as “two you’s.” They’re incompatible. One disappears when the other takes over. And it’s not hard to switch from one to the other — either by accident or on purpose.
So here’s another example: the Necker cube. (I don’t know who Necker was….maybe the guy who discovered this cool optical illusion.)
Take a look at it:
Pretty, isn’t it? Now try seeing the face that includes the lower left corner as the outer face — the face facing you. Easy enough, right? Just stare for awhile. Get used to it. Then imagine a different orientation: imagine that that face is actually at the back, and the front face is the one pointing up and rightward (and including the top rightmost corner) rather than down and leftward. Can you do it? It might take a while, but if you blink a few times and/or move your head around, you should get it. But it’s delicate — like early recovery. Blink again…and your former interpretation might spring back to mind, making the second interpretation highly effortful once more.
Of course these two “interpretations” of the structure of the cube are incompatible. They can’t coexist. Just like the you who eagerly anticipates getting high can’t exist at the same time as the you who is in control, centered, and connected to the future. These two you’s are incompatible! But they can switch. So watch out!
Now take a look at this diagram:
This represents, in a very simple way, that each version of the Necker cube can be represented by the same group of neurons. Here there are only six neurons involved — obviously an unrealistic number. But line (b) is showing us that a different pattern of activation on the same set of neurons projects a different interpretation of the cube.
Now imagine that you have one (much larger!) group of neurons representing the two interpretations you have of your drug of choice: let’s say cocaine-good and cocaine-bad are the two versions. A different pattern of activation on that same macroset of neurons will produce one or the other version. And the two versions can easily switch, as the activation of the neurons shifts, due to….well, due to the way you’re feeling, the way you’re thinking, how much you slept last night, whether or not your dealer just called, whether you had a coke dream recently, whether you just got a raise at work…or lost your job. I’m sure you know what I’m saying.
In some ways addiction is very complicated. But in other ways, it’s pretty simple. Mental habits can be considered, reflected on, worked with, played with….and they can ultimately be controlled — with practice — though perhaps not entirely.
Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis’s The Biology of Desire effectively refutes the medical view of addiction as a brain disease. A bracing and informative corrective to the muddle that now characterizes public and professional discourse on this topic.” —Gabor Maté, M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
I think that ‘s why the biggest reason for relapse I see in long term recovery (multiple years, decades), is devastating loss, usually of a loved one. The brain can’t deal with the extreme emotion and heads back to its old standby coping mechanism. Less extreme or more gradual stressors can easily be headed off at the pass. In earlier recovery, if one isn’t practiced and paying attention, more mundane eventualities can lead us down the emotional garden path to the old behavior. This is where mindfulness and paying attention to what you’re telling yourself can really be of benefit
Brilliant. This really resonated for me (more so than the bicycle). Perhaps because I could experience “Necker’s Cube” it’s a vivid analogy of what happens to me sometimes several times a day: that switching back and forth between my two minds. And Matt’s comment resonates, too, i.e., how an intense emotion might be the force that would drive one side (of relapse) to dominate.
Now, how to use this insight…
Denise, there’s a simple answer to that. I don’t know if it’s a good enough answer, but it’s simple. The way to fortify one version of the cube in your visual brain is to thicken the pencil lines that compose the “outer face” that you want to remain the outer face. Thicken them, color them, hang Christmas lights on them — whatever. You could also try minimizing the lines of the other face. In the demo above, dotted lines are used. They help reinforce the sense that that face is truly in the background.
Come to think of it, that’s not a bad analogy. We quite simply reinforce the desired interpretation by highlighting it in various ways. Tell everyone you know that you’ve quit, fill your day with events that won’t leave time to score, make it an attractive day, fill it with things that give you some pleasure. That might be the way to hold onto that pattern until it finally takes root and finds its own momentum.
I know how you feel. May your outer face remain YOUR face!
The new book: Your Outer Face
🙂
And how!
…let it dominate your thoughts, feelings and behaviors, etc. as much as possible…and try to be ready to be blind-sided (distracted by intense emotion) and respond accordingly
I think the Necker cube is a great analogy, Marc. My understanding is that the old neural patterns never die. I am happy to hear that they weaken. And for sure that we are capable of constructing new ones that conduce to happiness. The highlighting you refer to also makes great sense and happens when we get somewhat obsessed with the new neural patterns, feeding them on a daily basis. In addition to mindfullness, staying conscious, is staying connected with a network of friends who are more recovered than we are – breaking the isolation of the old patterns. An emergency list of tools when we notice antecedent thought patterns that lead to old behaviors.
Hello there! I’m glad you like the analogy and I strongly agree with your extension of it. There are few things as valuable as a network of friends who have the capacity to hold the healthy version in mind….for those moments when you lose it. And mindfulness allows many forms of reinforcement, such as the strengthening of attention to the strong, positive, even joyful aspects of just being here in the present.
Maybe I should do another post to highlight the “what to do about it” part of the picture. How do we highlight the “good” instantiation of the cube, when the other version can flicker back to life so easily? This is exactly the anxiety faced by many recovering addicts: When will it strike next…? When will this hard-won image of a strong me crumple into nothing, only to be replaced by a tidal swell of craving?
I think one of the challenges for people who are trying to change is that they often have to leave behind former friends and even sever contact with family or radically change the terms of engagement, so it takes time to acquire and develop new friends and loved ones. During the interim the person in transition has to rely more than ever on themselves (unless of course they have support). This is why I strongly advocate the “thickening of the lines” approach, by means of engaging in rewarding, absorbing, and challenging new pursuits. The “Brain Lock” model of turning your attention to a diverting and “wholesome” activity for 20 minutes seems like a sound basis for introducing other activities for longer periods on a structured basis. (I realize Brain Lock has a different purpose, but it is mindfulness based). In addition, and I’m speculating as a lay person without scientific back up, the release of BDNF that occurs when paying close attention while learning new things is a positive for the brain and a mood booster. So while the person is undergoing change, plunging into a medley of new learning situations is a really good strategy. This doesn’t have to be ultra-serious learning of the graduate school variety, and many people feel intimidated by doing new things, but if it is approached in a hobby-fistic spirit of curiosity it can work. I’ve taken up playing the piano, clay sculpture, language courses, voice lessons, and it has all served to shift life, even if I haven’t proven myself to be outstanding in any domain. I’ve discovered that it’s possible to acquire skills you didn’t know you could acquire and it creates a sense of life expanding.
HI Robin. What good ideas! I’d forgotten about this Brain Lock technique but just googled it. For those interested, here: http://www.ocduk.org/four-steps The fact that this cognitive-therapy style approach was developed for people with OCD makes it perhaps even more apt. The overlap between OCD and addiction is well recognized by some experts, and it includes both psychological and neural features. I’ve posted on it here.
But whether through this or other means, focusing, refocusing, identification, evaluation, and recognition are key cognitive factors for directing our thoughts and perceptions… They are the tools we have to control — if only temporarily — what gets played on the screen of the mind.
BDNF (a neural growth/regulation protein) may well play a key role. I wonder if anyone has looked at the problem in exactly this way.
Seems to me the “two yous” is another way of saying that the “rational brain” (drug shunning) is in conflict with the “emotional brain” (drug wanting).
But I think you may go to far when you say, “One disappears when the other takes over.” My experience has been that they’re both lurking, contesting, probing all the time, especially in early sobriety or times of extreme stress. Neither disappears. As you say, the “synaptic pattern” of drug wanting remains and can be resurrected, despite being deactivated while your “rational brain” asserts its primacy.
The trick is to combat the drug-wanting you, keeping the “rational brain” in control of your actions no matter how much the “emotional brain” craves drugs.
Yes, that’s just what I’m saying. That’s why I offered the Necker cube analogy. The fact that they can keep switching (with or without your consent) is proof that neither “disappears”.
But I wouldn’t say one version (one voice, one you, etc) is cognitive and the other emotional. Both are emotional. The determination to remain abstinent can be passionate and heartfelt, just as can the wish to take drugs. Both involve strong desires. What’s different is the kind of reward, immediate vs. long-term, that each provides. And yes, one is more “rational” when seen in this larger perspective.
Thanks for this Marc. Really interesting. I guess I wonder what this insight means in terms of using moderately, once the neuronal pathways have become weaker. If say, for example, the pathways have weakened to levels of a recreational user after a few years of recovery, would that person not be able to establish a more moderate drug/drink habit?
HI Damien. I don’t see a problem with controlled using…even of a substance that you have been addicted to in the past. Of course, people can be pretty deluded when they tell themselves that it’s “controlled” — that’s another kind of illusion, isn’t it.
But it’s like those rides that use centrifugal force to hold you to the outer rim…when they slow down enough, you slide down, because now you’re responding to good old gravity. When you start to slide, you KNOW that you have changed from one state to another.
So the Necker cube is no longer the right analogy. More like a teeter-totter, where continuous movement slows down OR speeds up, and that change in acceleration actually PREDICTS which way things are going to go.
Or to go back to the centrifuge analogy, you can tell if you’re sticking or sliding….it’s pretty obvious.: if you’re sticking and not sliding…you can do anything…except maybe juggle.
This is a very interesting and apt analogy and certainly fits, much better, the Vietnam vets’ data reported by Robins, than does the reversed bicycle analogy.
It too fits a recent experience of mine in a 2 week vacation to a distant Asian country. Most signs of sexual obsession disappeared entirely and instantly; they reappeared upon my return.
Most people, I gather, tend to see the cube in one way, usually. That’s the dominant pattern. Likewise for the ‘addicted’ person there is a dominant pattern– as if some lines of the cube were darkened and large pots of flowers depicted nearby.
I would love to hear your comments on Robins’ criticism of Hyman. Her point that
long lasting, almost irremediable corruption of brain chemistry/circuitry does NOT fit the data (e.g that on spontaneous remission). Volkow’s current position, to which
you have taken exception, is similar.
Marc, it’s very valuable that you are situating addiction and so-called addiction in a larger context. While AA folks are correct, in a way, in saying ‘not just a bad habit,’ they are incorrect in making alcoholism too special, just as the SA folks make so called ‘sexual addiction’ too special. One feature of this alleged ‘specialness’ is the claim that ‘the disease is progressive’ and has, usually, over time, a downward course–leading to death or institutionalization.
That said, one sees the utility of telling the addict or ‘addict’ that. It scares the bejeezus out of him or her. Indeed, as I recall, Bill W’s physician (Shoemaker?) said just that to Bill: that the most effective approach is NOT to say, ‘You need moral reform,’ but to say, You have an illness that going to kill you.’
Isn’t it ironic that this ‘reaches’ people and ‘works’ for some, whereas “You’re in a persistant ‘frame’, seeing a Necker cube in one way” may NOT furnish much motivation!
Well, I wouldn’t say “ironic”…. the thought that what you’re doing could very possibly kill you ought to have more impact than any moral imprecation. (though it doesn’t seem to work that way on cigarette boxes)..
I get what you’re saying about making our prized addictions “too special” — that’s just what we do. As though cognitive biases and illusions were some rare visitation from the Thousand and One Nights. No, they’re quite common, actually, thought they can vary in how much destruction they unleash. I would imagine that the illusion that you’re going to have seventy-something virgins waiting for you in Heaven can be immensely destructive, both for you and for those around you.
Our minds are feeble. Illusion is their natural habitat. What the Necker cube phenomenon shows is that illusions are, well, illusions…they flicker with the tilt of one’s head. Other more pedestrian illusions (like: I need to do this/take this in order to feel happy) are somehow harder to recognize. All the worse for us….
NN, the most accurate data suggests it does’t work at all if one discounts the placebo effect and at best the data TSF is simply the only real after-care groups we currently have data for.
Also, I suggest if we take into consideration all the “collateral damage” being reported in the history of the 12-step groups (predation and the suggestion it is a “life-long fatal disease”) cognitive bias, we might ultimately find Bill W’s groups have a negative effect on society AND the individuals overall.
Very useful tool for us ‘visual’ people.
Two thoughts:
In regards to Gabor Mate, once the brain is hi-jacked it needs to be consciously realized before being acted upon-his do vs don’t argument (free will vs free won’t) based in the current understanding in which these type of deep habitual behavior/thinking patterns have already relapsed/occurred (brain chemicals) before we take the first illicit chemical or even in Mate’s case purchase of a classical dvd/cd. EG: Subconscious visuals flashed to test subjects which show the spike in brain activity to “using” pictures which happen w/o the test subject even realizing they are already getting high in brain chem terms.
To put it in the article’s/comments parlance, therefore: We have to FIRST realize the front face of Necker’s Cube is lit with Xmas lights. The person has to, at first at least, manifest a conscious effort to restring and or move the colors or erase/recolor darker the “back” back face.
Thanks Mark and y’all.
KC
Hi Kevin. Consciousness sure does help. In the early stages it’s mandatory… Otherwise the cube dances into whatever configuration your habitual thinking has made into “home”. Philosophers and cognitive scientists say this is the “purpose” of consciousness: to effortfully apply perspective, to change the way we see things and do things. Without consciousness there is nothing but habit. Or, to put it differently, habit is where we live most of the time, until consciousness comes along and says “hey wake up. You don’t have to keep doing what you’re doing.”
Great stuff Marc
I always enjoy your Analogues — they resonate with me quite easily.
When my stinking thinking side of the Necker Cube is trying to dominate me, I force myself to think of other more appropriate visions of satisfaction.
Like my grandkids and what I could get them and how happy they would be playing with it, what ever it might be. I put myself into a fantasy world of thinking to switch that Necker Cub to a more favourable, happier state of mind or thinking pattern. This helps me hold onto the other vision of the Necker Cube. Over time it becomes easier and easier to switch over to the new version of what can become a new life, a happier life.
P.S playing a good old country song works sometimes too…Hahaha..
Thanks Marc
Respect Richard
And I always enjoy the way you take my abstractions and put them into workable steps. You’ve got it. These simple things that we do, just to feel happy, or generous, or to tap our feet to something….these are the very things that decorate the face of the cube that we want to rely on. There’s no mystery and no magic — at least not for you and me — because we already have our cube face jutting out of the background, sitting there year round, waiting to be adorned with lights at Christmastime (don’t know why I’m thinking Xmas so much — that’s not even my religion — maybe it’s from listening to the Pogues a couple of nights ago: https://www.youtube.com/watch?v=j9jbdgZidu8)
Hi Marc…
I think change, in terms of addiction recovery, is a bit more like the “Rubik’s Cube”, at least in the beginning. Once a person develops a healthier way of thinking and living it usually translates into a more stable life. Depending upon the type of drugs used and duration of use impact level of ability to change. In some brains the ditches are deeper, however, certainly due to neuroplasticity we can change. I do think that “highlighting” the lines or really developing a support system is essential in being able to sustain change. Post acute withdrawal can be extremely cunning and powerful acting as a trigger. Change can be as hard or easy as you “Think” it is. “Controlled using” certainly wouldn’t be recommended from my perspective especially where Nicotine is concerned. Change is an inside job and first we have to “make-up” our minds in order to begin. We are usually getting what we want but do we want what we are getting?
Okay, but I still don’t get the analogy with Rubik’s cube. You mean because it requires a lot of effort?
Yes! Indeed!
Unless we are in a teachable state due to “Hitting Bottom” or open to the idea of change, it may seem so far out-of-reach litteraly impossible to attain. It can take a long time to even imagine that we are a prisoner of our own demise. Peeling back the layers, imagining another way, can take years and for some, unfortunately, it never happens. The complexity of simplicity, “just don’t drink”, “just don’t use” etc…, though it is simple is not easy and so! like a Rubik’s Cube it can be a real struggle in trying to figure it out!~
Now I get it. That works for me. In fact it’s growing on me the more I think about it. I have often thrown down Rubik’s cube in disgust: this is just too damn hard and I’ve tried so many times, and it seems like it should work…but it doesn’t!
I may write an article using the cube analogy. Maybe I can sneak in a double analogy and include Rubik’s cube. Thanks!
Exactly! …my apologies for not explaining it from the start.
I “assumed”, which I know I shouldn’t, that you would have picked up on it. However, as you stated, I was referring to just how hard and frustrating it can be to overcome an addiction with repeated attempts and “Good” genuine intentions, only to feel like a failure and/or doom not to get it right.
I wanted to add to my comment further. As I was writing my explaination and thinking about the complexity of simplicty Portia Nelson came to mind and the wise words she wrote in “Autobiography in Five Short Chapter”! The first time I read this “Autobiography” It actually penetrated the deepest part of what makes me human.