Our sponsor is the brain, of course. So, before getting to Part 2, here’s an important message, also excerpted from the final chapter:
The term neuroplasticity has been bandied around a lot in recent years, but it’s been understood for at least a century. In Donald Hebb’s (1940s) memorable words: What fires together wires together — neurons that activate each other become more strongly connected — through adjustments (increased efficiency) in their synapses. Neuroplasticity is the brain’s natural starting point for any learning process. This includes the development of addiction. But is it also the springboard to recovery?
Neuroplasticity is strongly amplified when people are highly motivated. Which is why all learning requires some emotional charge, and entrenched habits like addiction grow from intense desire. Clearly, the desire to recapture a potent experience of pleasure or relief is the motivational on-ramp to addiction. But does desire also cultivate recovery?
In The Woman who Changed her Brain, Barbara Arrowsmith Young describes the many cognitive exercises she devised for herself, in order to overcome her very severe learning disabilities. She practiced these exercises prodigiously. As a result, she went from a high-school student who could not comprehend history, who even had a hard time understanding simple sentences, to a writer and teacher who has set up roughly 70 schools for learning-disabled children across North America. I met this remarkable woman in Australia, at a book fair, and I became convinced that her intuition, creativity, and determination to triumph over her learning disabilities were precisely the means by which addicts recover. I also learned her delightful phrase for the neuroplasticity needed to replace bad habits with good ones: What fires together wires together, and what fires apart wires apart. In other words, new mental patterns can fashion new and divergent synaptic avenues.
In 1993, Mogilner and colleagues looked at the brains of people plagued with webbed fingers. That means that some of their fingers were connected and could not operate separately – they functioned in total unison. After surgery was performed to allow the fingers to move on their own, these authors looked at changes in the (somatosensory) cortex. What they found was that clusters of neurons that had always fired together now fired partially independently.
The presurgical maps displayed shrunken and nonsomatotopic hand representations. Within weeks following surgery, cortical reorganization occurring over distances of 3-9 mm was evident, correlating with the new functional status of their separated digits.
So the brain adjusted its wiring, breaking down the coherent habit it had assumed, based on the details of repeated action patterns, and replacing it with new habits, based on novel action patterns. In fact these changes were observable just weeks after the change in action patterns took place! Might recovery work the same way?
Just in case you think the webbed-finger analogy is far fetched, you should know that it’s not an analogy. That’s exactly how neuroplasticity works, whether dealing with severe learning problems (which no doubt involve the prefrontal cortex) or reversing a physical anomaly that took hold during prenatal development (involving the sensorimotor cortex).
When people recover from strokes or concussions, the same sort of rewiring takes place in many regions of the cortex. Even language, one of the most basic human functions, can be relearned after it has been demolished by brain damage, through the synaptic rewiring of cortical regions that previously took care of other business. Thus, neuroplastic change can and does occur, in real life, with a speed and vigor we rarely imagine.
Back to addiction. People learn addiction through neuroplasticity, which is how they learn everything. They maintain their addiction because they lose some of that plasticity. As if their fingers had become attached together, they can no longer separate their desire for wellbeing from their desire for drugs, booze, or whatever they rely on. Then, when they recover, whether in AA, NA, SMART Recovery, or standing naked on the 33rd-floor balcony of the Chicago Sheraton in February, their neuroplasticity returns. Their brains start changing again—perhaps radically. Just as in Mogilner’s study, their brains begin to grow new synaptic patterns to allow for those distinctions, to hold onto them over time, and thereby acquire new vistas of personal freedom and extended wellbeing.
The take-home message here is simple: Recovery involves a major change in thought and behavior, and such changes require ongoing neural development. Without developmental adjustments in synaptic patterns, we would stay exactly the way we are. Which raises the question: If the high-beam of desire is what drives the synaptic shaping of addiction, is it also the necessary ingredient for finding the road out?
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
Hey Marc,
Stanton Peele was discussing your work on his facebook page this morning, and I alerted them to your upcoming book, which I am jumping up and down in anticipation for.
I think we have discussed the Connolly paper before which says in the abstract: “Conversely, higher grey matter volumes associated with abstinence duration were seen in non-overlapping regions that included the anterior and posterior cingulate, insular, right ventral and left dorsal prefrontal cortex. Grey matter volumes in cocaine dependent individuals crossed those of drug-naïve controls after 35 weeks of abstinence, with greater than normal volumes in users with longer abstinence. The brains of abstinent users are characterized by regional grey matter volumes, which on average, exceed drug-naïve volumes in those users who have maintained abstinence for more than 35 weeks. The asymmetry between the regions showing alterations with extended years of use and prolonged abstinence suggest that recovery involves distinct neurobiological processes rather than being a reversal of disease-related changes.”
Of course, I don’t see the initial process towards addictive use as disease, because if it was, then recovery would be a disease as well!
Having visited one of the Arrowsmith Schools in Vancouver, BC, and seen first-hand Barbara’s work in person, I have to say I came away with a whole new appreciation for what’s possible in terms of human learning and development.
One of Barbara’s exercises involves using a computer to teach kids to read an analog clock. I watched over a student’s shoulder as first they worked with one hand – the hour hand. After attaining 90% correct, they move on to two hands. Once two hands are mastered, on to three. As I watched three hands, I realized that telling time using three hands on an analog clock is a significantly complex mental operation that I have mostly taken for granted all of my life. But here’s the mind-blower: these kids learn, practice and master … 12 hands!!! (Each hand representing differing units of time).
And guess what: when you can easily and accurately tell time on a clock that has 12 hands, you grow brain circuitry that processes energy and information MUCH differently than a brain that struggles with a single hand. One apparent ancillary benefit: demonstrated improved motor skills in the form of significantly improved handwriting legibility.
I believe Richie Davidson has shown neuroplasticity changes within hours of developing a new learned behavior
And of course its all about desire – its called motivation
Hence, the oft heard remark “You have to want it” in some recovery programs…
Marc, It’s really a cliche at this point, when working with drug addicted and MICA individuals: “He/she has to WANT to stop.” There’s nothing new under the sun. But wait, to me as a lay person with regard to the brain’s involvement and the potential for treatment of various conditions via changes made to the brain, there is something very new. In fact it’s got me looking somewhat differently at my son who has Down syndrome and never acquired language the way most of us do. I’ve been pondering this for twenty years now and hope that the current brain research will perhaps in the future have a major impact on individuals like him.
Hi Denise. I think that’s so true. The “You have to want it” reflects the oversimplification of the “one size fits all” programs bent on helping the greatest number of people for the least amount of dollars, instead of looking more closely at what’s happening neurologically AND behaviorally. How do you objectively measure someone’s intention and motivation, particularly with all these competing, primal neurological processes at work? The desire for relief? the desire to quit?
Marc, I can’t help but think about this subject a lot as it applies to my own struggles. As a person of “appetites” (and aren’t we all to varying degrees) and always struggling against them, your writing makes me think, if craving begins in the brain then shouldn’t there be a chemical means of counteracting them. But then, doesn’t that already exist in the form of say, Chantix, supposedly removing the desire for cigarettes? And aren’t some of the SSRI’s supposed to remove or reduce the desire for whatever? I wish there was a pill I could pop (typical addict) that would rid me of my desires.
I adore reading about the science of this! I do hope that you have addressed the psychology of it at well. The fact is if you have a disease like cancer it is what it is. If you are faced with the understanding that you have created an adaptation for alcohol, drugs, sex, gambling….. I, personally, think it is very important to understand why so you can correct the thoughts behind that in order to create a long lasting change in the neuroplasticity. It takes a marriage within the sciences. I post this with the assumption that your book are written with an intention to guide and help.
This morning I happen to be working with my own pattern of learned helplessness. I hadn’t actually identified it as that until reading your article. My email address has recently been hacked and used to spam others, and my website host provider is not responding to support requests. This morning I found myself spinning in my victim place, feeling violated, helpless, powerless. Your article reminded me that I activated an addictive pattern of firing together.
Hey Marc
I was just wondering if, when you say “What fires together wires together” could be true in that when a person dose not have his or her choice drug, and is going through withdrawals and dwelling on the past, That their past (Hurt, Pain, regret, etc) and withdrawal are some how wired together? This being said, For me, that is what I believe kept me in the loop of using for so many years. Finding the underlying issue of my past and bringing closure to them, has somehow broke the cycle or loop as I called it. Today I live in the light of Recovery, I’m taking the Smart Recovery Course on line, and have learned so much over the years, that I can maintain a life of balance and moderation. I will be facilitating a Smart Recovery program in the future, and having some other little insight that just may help someone understand themselves can make a world of difference.
Respect Marc
Very interesting material…in terms of “you got to want it” in order to change and/or perhaps “learn” with respect to recovery only makes sense. However, for me, somehow it begins with one’s “Imagination” thus without it one may be Hopeless. The thought has to take fruition in one’s consciousness first. There was also another “proverb” in the self-help community that really resignated with me…”Make Believe Until You Come To Believe”. The possibility has to be born into one’s consciousness in order to see alternate alternatives, in my opinion.
“In order to see we open our eyes, in order to understand we must close them”!~ G.G.
I’d like to share an article on the possible benefits of resveratrol in recovery from meth addiction: http://www.sciencedaily.com/releases/2013/11/131119131446.htm
Also, I’ve recently been reading about and Indonesian botanical called Kratom which is supposed to help with opiate withdrawal. It supposedly can help with depression as well. I’m interested in trying in it for that reason.
Another botanical I recently read about is Sceletium Tortuosum, or Kanna. It’s purported to ‘Improve cognitive flexibility and executive function in healthy adults’:
http://cms.herbalgram.org/herbclip/512/121451-512.html
If anyone has experience with either of these two botanicals I’d be interested in hearing your stories.
Morgan.
Here’s an interesting article on the mood enhancing properties of spicy foods:
http://www.npr.org/blogs/thesalt/2014/02/24/281978831/sriracha-chemistry-how-hot-sauces-perk-up-your-food-and-your-mood
i do this work as an addiction expert and this is the truth to addictions. Here are the results of my work. http://youtu.be/Lhh4Jsf_r90?list=PLOMFE_3uHvxxJIhCszavC_UknuON7k8nT
We also do incredible work with addiction. What the addict thinks about and believes plays a huge part in addiction as well as conditioning. We know how to change all of that quickly and the results are astounding. What the mind believes, the body follows. Addiction is a behavior, it is not really a disease. For the struggling addict, it can be completely different. We fill the neglected need, release the mindsets and harmful beliefs, memories, mental & emotional imprints and the behavior will change to meet another healthier need. We are much more capable than we are given credit for, even when suffering from addictions, we just don’t know it or behave in a way that promotes change and growth. Up until now, there has been a ton of misinformation and misdirection regarding addiction. We’ve figured addiction out and can help people completely overcome addiction.
We also do incredible work with addiction. What the addict thinks about and believes plays a huge part in addiction as well as conditioning. We know how to change all of that quickly and the results are astounding. What the mind believes, the body follows. Addiction is a behavior, it is not really a disease. For the struggling addict, it can be completely different. We fill the neglected need, release the mindsets and harmful beliefs, memories, mental & emotional imprints and the behavior will change to meet another healthier need. We are much more capable than we are given credit for, even when suffering from addictions, we just don’t know it or behave in a way that promotes change and growth. Up until now, there has been a ton of misinformation and misdirection regarding addiction. We’ve figured addiction out and can help people completely overcome addiction. There are many techniques we know to change neurology and “what fires together wires together.” Here is one that will change neurology fast: https://www.youtube.com/watch?v=hKzXqtxMSXY