Addictions and Compulsions


Working
with

Addictions and Compulsions


Jana Squires Flake, M.Ed., LPC


As I have studied various therapists and brain researchers and worked with clients over the years, I have come to some conclusions about addictions and compulsions that I wish to share.  Brain research has shed more light on this subject in the last few years than ever before and I believe this knowledge is the key to overcoming these challenges.  This paper is written to help in understanding these concepts and to aid in promoting personal growth.   It is my hope that this information will assist in the journey to "build new pathways" to happiness.    -  Jana S.  Flake

In 1996 I began applying the principles found in Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, by Jeffrey M. Schwartz, M.D. to my clients with Obsessive Compulsive behaviors.  In 2002 Dr. Schwartz wrote another book, The Mind & the Brain, The Neuroplasticity and the Power of Mental Force, wherein he examined his Brain Lock program in light of recent brain research.  In addition to his work, Drs. Daniel J. Siegel and William Glasser are also quoted.  These are the brightest minds in America today with regard to understanding the brain.  When we see how our brain (the structural organ) is wired and how our mind (the volitional dimension) can create new wiring for a healthier, happier life, we can gain some control over our behaviors.  


Four Basic Concepts

There are four basic concepts that will be useful to understand before one begins to work on overcoming addictions or compulsive behaviors.


1.  What fires together, wires together

Obviously, if we are trying to overcome an addiction/compulsion, we want it to go away.   Addictive/compulsive behaviors are the way our brain/body has of reacting to certain stimuli, whether external or internal.  But we want that reaction to stop.  We need a new reaction.  As we understand how neural pathways are formed, we can learn how to make new pathways.  That is the essence of this therapeutic approach.  A person who has responded to stress or stimuli the same way over a long period of time, builds a neural pathway so that when the stimuli presents itself, the brain/body automatically goes to that response.  "What fires together wires together" is the most basic and important tenant of this philosophy.    

Daniel Siegel, M.D. in his book, The Developing Brain, states: "If a pattern has been stimulated in the past, the probability of activating a similar profile in the future is enhanced.    If the pattern is fired repeatedly, the probability of future activation is further increased.  The increased probability is created by changes in the synaptic connections within the network of neurons."  p. 24.

For example, if we become stressed, agitated, angry, or upset and take a drink of alcohol or view pornography, the physiological changes that take place (i.e., sense of euphoria or sexual stimulation) reduce the anxiety or stress.  After that has happened repeatedly, the cells wire together so that when we experience the stressor again, the brain will naturally fire on that pathway toward drinking or viewing pornography.  The more it occurs, the stronger the synaptic connections become in the brain.  Those connections can become so strongly linked that it takes very little to get them firing.

"Cellular-memory groups can be activated without our seeing or hearing something from the outside world.  The information contained in a cellular-memory group may be activated independently from any internal or external sensory stimulus.  This is called imagination.  Once a person has used Internet pornography as the means to heighten his or her sexual fantasies, all he or she need do in order to call up these same feelings and images is express the desire or intention.  Once this intention or desire is expressed, a whole network of cellular-memory groups is activated."    The Drug of the New Millennium, by Mark B. Kastleman p. 83.

THEREFORE, it is important to understand that we are dealing with the wiring that has formed in the brain over a period of time that automatically takes us to the negative behaviors.   That is why it seems so difficult to change.  The good news is "the brain is plastic. It can change.  It can rewire.  As Dr. Schwartz says, "But the neuroplasticity I'm talking about extends beyond the formation of a synapse here, the withering away of a synapse there.  It refers to the wholesale remapping of neural real estate;" and "The brain could change even if all patients did was use mindfulness to respond to their thoughts differently.  Applied mindfulness could change neuronal circuitry."  Jeffrey M. Schwartz and Sharon Begley, The Mind & the Brain: Neuroplasticity and the Power of Mental Force, pp. 223 and 236).  Change is possible.  We can rewire our brains!
 

2.  How we look at ourselves

It is important to understand that as human beings we have the ability to stand back and observe what is going on in our personal world. We are not our thoughts; we are not our behaviors, or our feelings.  We have thoughts, behaviors, and feelings.   An essential element of this approach is that there is a part of us that is in the driver seat.  Dr. Schwartz calls it the Impartial Spectator.  It could also be called our Will, our Intelligence or the Observer.   We can observe our thoughts, actions, emotions and physiological state.  If you think about a blue sky and I tell you to now think about a yellow car - you can do that.  You can change your thoughts.  Therefore, we are not our thoughts.  There is a part of us that is not addiction or compulsive but can observe the addiction or compulsion.

"In this way of thinking about your emotions, you sense feelings, sensations, and thoughts from the perspective of the Impartial Spectator.  You regard your thoughts and feelings as passing, ephemeral 'mental events' rather than as accurate reflections of reality.  Instead of reacting to negative thoughts and feelings as 'these are me,' you come to regard them as 'events in the mind that can be considered and examined.'  You recognize that thoughts are not facts, but are instead 'events that come and go through the mind."  The Mind and the Brain, p. 248

Aaron T. Beck, the foremost cognitive behavioral psychiatrist in America, writes: "Merely telling patients to become more aware of their thinking can be sufficient.  This is similar to the suggestion that one consciously chooses to remember one's dreams. The patient may be unaware of his thinking because he has considered it unimportant.  The therapist needs to stress the effect thinking has on one's life.  Automatic thoughts can be presented as being similar to subliminal advertisements: by learning to detect them, the patience can free himself from their effects."    Anxiety Disorders and Phobias, a Cognitive Perspective, p. 192.

This is an absolutely essential element of this approach.    If we do not believe that there is some part of us that has the ability to view our addiction, to observe our thoughts and emotions and behaviors, then it will be very difficult for us to believe that we can change them.

To illustrate this concept, a person addicted to pornography could, by using his Impartial Spectator, manipulate his thoughts by:

Exercise 1:

"Rather than gazing at a woman's body, look her in the eye and say to yourself, 'This is a human being, not an object.  This is someone's daughter, sister, mother." ( Kastleman p. 356).    If you have an image come to your mind, make it wavy like you are looking in the mirror at an amusement park; make the image very skinny or really fat.  Use your will to change something about the picture.  You will then see that you have the ability to gain some control over the thought by making an alteration to it. 

Exercise 2: 

"Do a series of exercises in which you sit and practice telling yourself, '"I am not my body - I have a body," and "I am not my thoughts - I have thoughts," and "I am not my emotions - I have emotions."  In this way, you begin to identify more with your awareness instead of with what you may be thinking, acting or doing at any moment."   Beck. p. 245

Exercise 3:  

Name the behavior.  An important part of this Impartial Spectator concept is to be able to name the urge or compulsion when it arises.  This helps us to recognize the reality of the situation but not be quickly moved into the feelings and physical sensations that follow.  Naming the urge also moves the energy from the mid-brain where appetites and passion resides, to the pre-frontal cortex where higher thinking takes place.  The next time the obsessive thought or urge arises, just call it what it is: "This is my urge to drink alcohol or view pornography."  Once you have stopped to look at it, you can ask some questions that might be helpful, such as "Why has this come up right now?"  "What just triggered this urge?"  "What happened just before I had this thought?" 

THEREFORE, once we believe we have the power to rewire our brain, that rewiring begins by us becoming observers of what is going on in our minds and bodies.  We begin noticing our triggers.   We put a name to our urges.  We become the observer, not the victim.


3.  Total Behavior

It is important to understand that our addictions and obsessions are made up of four components.  

We may be focusing on just the final behavior (doing component) of drinking, overeating, gambling or viewing pornography and not realize that there are more.  The four components of every behavior are:  

1.  Doing (or active behavior):  This is the behavior or action we do with our body.  (We turn on the computer, drive to the liquor store, or open the refrigerator.)

2.  Thinking:  These are the thoughts we have before or after the behavior.  "I deserve to be happy," or "I don't get much joy out of life," or "I am a failure at everything I do," or "I will never get over this so I might as well not try." 

3.  Feeling:  These are the emotions we generate as a result of the thoughts we think or the behaviors we do, such as depression, guilt, sadness, disappointment, disgust.

4.  Physiology:   As a result of our thoughts, actions and feelings, the brain releases neurochemicals and hormones that cause a physiological response in the body.  This body response is generally pleasurable for the moment.  The chemicals released by the drug cause a euphoria that sends a wave over the body.  This body response can then drive more of the behavior as the body builds up a tolerance.  (William Glasser, Control Theory)

Betty is a compulsive over-eater.  Let's examine her behavior in terms of the Total Behavior picture:

As Betty sits in her chair (doing component) and thinks about her life, her disappointments and failed relationships (thinking component), she begins to feel depressed, sad and lonely (feeling component).   She eats some high carbohydrates food to help herself feel better (doing component).  Because of the serotonin (feel-good neurotransmitter) released in her brain as a result of the carbohydrates she has eaten, she actually feels relief (physiological component).  Because she does this so often, (what wires together, fires together) this pattern is strengthened in her brain so that whenever she starts thinking negative thoughts, she automatically returns to the same behavior - overeating.  

Betty wants to tackle her depression, which she thinks is responsible for her overeating.  However, to break this cycle, she is most likely to be successful if she changes the doing component.  "If we want to change a total behavior, the way we can do it is to choose to change its doing and thinking components...I have no ability to change how I feel, separate from what I do or think, but I have almost complete ability to change what I do, and some ability to change what I think, regardless of how I am choosing to feel."  (Glasser, p. 50).

"Because we always have control over the doing component of our behavior, if we markedly change that component, we cannot avoid changing the thinking, feeling, and physiological components as well."  (Glasser, p. 51)

THEREFORE, if Betty gets up and goes outside into the fresh air, breathes deeply and goes for a walk, the doing component will change the other three components.  This will also redirect the firing/wiring brain pathway that is so deeply entrenched.

Exercise:

"Right now, while reading this, please try this simple experiment.  Try to feel angry.  Go to work at it and try to generate rage.  You will probably find it impossible.  Because there is no sense feeling angry right now, you can't arbitrarily choose to anger.  Try as we will, it is almost impossible to choose a feeling that makes no sense.   Now try to think green; blot out all else and think green.  This may be possible, but it takes a great deal of concentration.  If you relax even for a moment, green will slip from your mind because it makes no sense.  Now raise you right hand  - pick it up and raise it above your head.  Immediately you see that this doing behavior is easy to accomplish because the doing component of our behavior has come almost completely under our voluntary control whether what we do makes sense or not.  Therefore, as you sit trying to change your feeling to "anger," you can't do it.  You may be able to change your thoughts to "green" for a short while, but then it will slip away.  But deciding to raise your right hand in the air is something you can do indefinitely regardless of whether it is satisfying or ridiculous."   (Glasser, pp. 50-51)

THEREFORE, the best way to change our neural pathways is to change our actions.   It is much easier to change what we are doing than what we are thinking or feeling and certainly easier than changing our physical response.  The next time you have an urge to do an addictive behavior, notice the urge, name the urge, and do a different behavior first.  


4.  Unleashing Mental Force

Our goal is to build a new neural pathway to replace the old one that is addictive, compulsive and destructive.   The more we fire the neurons on the new pathway, the weaker the old ones will become.  

However, this cannot be a casual replacement.  The only way for the brain to really change, is to pay attention to the new behavior with all the force of will and mind power available.  Brain research has shown that "selective attention reflecting willful activation of one circuit over another can nudge the brain into processing one signal and not another."  (Schwartz, p. 331).

"It often takes real effort to maintain the appropriate focus, which is why it takes so much concentration to get into the proper exit lane at a complicated freeway interchange.  But once you muster the appropriate focus, you can literally direct your brain to filter out the suppressive effects of distracting signals.  Willfully directed attention can filter out unwanted information - another example of how directed mental force, generated by the effort of directed attention, can modulate neuronal function."  (Schwartz p. 330).

Brain research has shown that there is a split-second of time between a thought or urge and the resulting action.  They call it "free won't."  "In a nutshell, free won't refers to the mind's veto power over brain-generated urges.  Making that attention mindful and wise requires effort of the highest degree.  That effort becomes causally efficacious on brain action through the mechanism of mental force...effort itself is the key to altering one's brain function."  (Schwartz  pp. 296-97).

In his landmark book on pornography The Drug of the New Millenium, Mark Kastleman adds a similar insight:  "In phase two, the addict learns to recognize his or her triggers and then to consciously interrupt the mindbody's automatic response.  New cellular-memories and pathways must be created and accessed until they become efficient and automatic, replacing the old addictive cellular-memory pathways.  In the past, unaware of the triggers leading up to acting out, the addict perceived that the wave or trance hit him without warning and he had no choice but to give in.  By learning new techniques, the addict regains his or her choice-point - that point at which he or she can decide whether or not to start down the funnel to acting out."   p. 352.

THEREFORE, if we want to change our brain pathways, we must be serious about it.  It requires real focus.  As Dr. Schwartz says, "Attention must be paid."  For any new circuitry to be created in our brain, we must use our powers of volition.  When the urge comes to take a drug or turn on the computer, or visit the refrigerator, in that split second after the urge bubbles up in the mind and before the behavior is initiated, the individual has the ability to refocus attention on another behavior.  

That other behavior - a healthier response - is selected and established at an earlier time.  At a time when you are in a safe place, select a behavior that you can do that will produce thoughts and feelings that are pleasurable and healthy.  Then when the negative urge arises, do this behavior first.  While you are doing this behavior, focus all your attention and willpower on it.  Become totally immersed in the sensations and emotions of the alternate experience.     

If you are in a situation where the addictive/compulsive thoughts are taking control of your mind, go in your mind to a specific location  (remember you are not your thoughts, you can change your thoughts) that you have previously established that is peaceful, pleasant and healthy.  

For example, John had viewed so much pornography, that the images were embedded in his mind to such a degree that he didn't need to go to a computer or magazine.  All he had to do was go to his imagination.  When the first thought or image came into his mind, he stopped and said to himself, "Oh, this is a pornographic image that has come up.  My brain is throwing up this image," (naming, observing, watching thoughts).  John knows that the sooner he refocuses his thought, before it has turned into emotion, behavior and physical changes, the easier it is to change.   He quickly changes the image by making the person wavy like they would appear in an amusement park mirror.  Then he goes to the image he had previously selected, by using his mental force.  It is an image of his wife and daughter on a family vacation at the beach.  He has relived this experience in his mind so many times that when he thinks of it, he feels the mist of the ocean spray on his face; he senses the warmth of the summer day; he hears his daughter's laughter, and the ocean waves as they break against the beach.  He sees the smile and contentment on the face of his wife. He feels the sensation of the warm sand beneath his toes.  His mind and body are totally immersed in the relived experience.  The more John goes to this image instead of the images he used to view in his mind's eye, the more he builds the synaptic connection and the weaker the old images become, until they eventually die out.  

Brain scans have actually shown that the firing of previous pathways die out when they are not stimulated.  What fires together does actually wire together.  What doesn't fire, dies.

Betty applies similar principles to her overeating.   She has committed to herself that before she opens the refrigerator to eat, she will walk around her house three times.  While she is walking, she is breathing deeply (changing the physiological component) listening to the birds sing and feeling her feet on the grass and the breeze on her face.   She is giving her full mindful awareness to this experience.  The circuits leading her to the refrigerator are weakening.  


Conclusion:  

A scripture beautifully illustrates this therapeutic approach and perfectly captures my intentions and desires regarding individual endeavors to overcome these significant challenges:  

"But this much I can tell you, if ye do not watch yourselves, and your thoughts, and your words and your deeds, (we are not those things, but we can watch them)  and observe the commandments of God, and continue in the faith of what ye have heard concerning the coming of our Lord, (replace the image of those thoughts, words and deeds with the picture of Jesus Christ, feel His love and forgiveness) even unto the end of your lives, ye must perish.  And now, O man, remember, and perish not."   Mosiah 4:30

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