The Brain Story Certification: Module 14
Module 14: Addiction & the Brain, Part B – Process
Addictions
Excerpt from “Food & Process Addictions”
Mark Gold, MD
University of Florida
- Cocaine addiction changed how we look at addiction.
- Withdrawal looked like depression.
- Pathological attachment despite the harms.
- This opened the doorway to process addiction – pathological attachments.
- Gambling is the first “process addiction.”
- Commonalities between substance and process addictions:
- Characterized by a drive for attachment to the activity/drug that is pathological
- A loss of control, leading to lying about the increasing time spent on thoughts, getting, or carrying out activities related to the addiction.
- Continued use of the substance/process despite its serious consequences.
- Process addictions include gambling, sex, food, work, exercise, internet addictions.
- Early access to pornography can cause developmental changes that influence addiction.
Excerpt from “Food & Process Addictions”
Mark Gold, MD
University of Florida
- continued use despite consequences – we are using messaging similar to the early days of smoking (quit smoking or you’ll get cancer, & quit eating, or you’ll get diabetes). Working with food addiction needs new messaging.
- Influences the costs of healthcare
- D2 dopamine receptors downregulation is equally produced by obesity.
- Animal models can be used to look at obesity medications – we have habituated new sizes of food portions
- 12 minutes for a healthy individual to get a food signal in the brain as opposed to 25 minutes for someone who is obese.
- Prevention through proper taxation on certain foods could be framed as no different than a tax on cigarettes or marijuana.
- Sugars, fats, and sodium are the trifecta of food desirability and addiction.
- Brain associations of food activate based on experiences with the food.
- Factors that contribute to obesity
- Prenatal environment
- Child-rearing and culture
- Genetics
- The relation between the intake of food and expenditure of energy.
- sedentary lifestyle
- abnormal eating behaviours.
- Sugar and salt are addictive components of foods/drinks
Excerpt from “Drugless Addictions”
James Montgomery, MD
Pine Grove Behavioral Health and Addiction Services
- Addiction may lead to offending behaviour, offending behaviour is not an addictive process.
- etiology of addictive disorders can include:
- Accident
- neurochemistry
- Family – both genetics and dysfunction
- Anxiety and stress reduction
- Repetition of trauma
- Arousal of affect
- Failure of courtship (sex addiction)
- Survival/sensorial Matrix – (mapping along with a survival and sensorial axis. The greater of either factor, the more addictive.
- Dopamine is a key component of addiction.
- Near misses in gambling are treated similarly to a win by the brain.
- A mesolimbic reward system is involved in addiction – this also happens in romantic love.
- When we interact at that level, the one in love changes how they behave around the other. Being dumped creates a craving for the object of desire – fight harder to get back into that addiction – they crave the figure they have attached to.
- Follows all other markers of addiction (such as preoccupation, developing tolerance).
- See the DSM-V for Hypersexual Disorder.
- Eating disorders:
- Anorexia Nervosa – fear of gaining weight despite risks
- Bulimia Nervosa – Recurrent binge eatinh
- Binge Eating Disorder – eating a more considerable amount of food each time, with a lack of control.
- For sex addiction – despite STI or other risks, the process continues.
Excerpt from “Drugless Addictions”
James Montgomery, MD
Pine Grove Behavioral Health and Addiction Services
- Blackhole – Addiction interaction
- Arousal/pleasure -> Numbing/satiation -> Deprivation ->Disassociation Fantasy/Escape
- This is a circle that repeats itself.
- Affective states – shame, misery, rage, self-loathing, despair
- We don’t like change and we respond to it with rage.
- The more entrenched we are in the behaviours, the more socially isolated we become. The ritual becomes more prominent, and we continue with the addiction. The ability for normal routine diminishes.
- Risk increases as novelty decreases – seek new novel experiences to get the same impact from the activity.
- Cross tolerance- simultaneous increases in addictive behaviours in to or more addictions
- Withdrawal medication – one addiction is used to soften the effects of withdrawal from another.
- Replacement of one addiction with another (sex to alcohol to cannabis)
- Alternation of addiction cycles
- One addiction can be masked by using another one to cover it up.
- Ritualizing – frequently repeated behaviour in one addiction leads to another.
- Intensification – act out more intensely under the influence.
- Numbing – numb the pain with another addiction
- Disinhibiting – one addiction lowers boundaries to another.
- Combining
- Inhibiting – alcoholic uses cocaine to fight off the drowsiness of alcohol.
- Using two or more addictions to achieve things not possible independently (synergistic effects)
Excerpt from “Drugless Addictions”
James Montgomery, MD
Pine Grove Behavioral Health and Addiction Services
- What are the other things that are going on in the client’s life
- Trauma reactions – deal with a physiological arm of unresolved experiences.
- Trauma pleasure-seeking – finding pleasure in the presence of extreme danger, violence, risk, or shame.
- Trauma blocking – efforts to numb, block out, or overwhelm residual feelings due to trauma
- Traumatic Splitting – blocking traumatic realities by splitting or dissociating from painful experiences and not integrating into personality or their daily life.
- Trauma abstinence – compulsive deprivation that occurs, especially around moments of success, high stress, shame, or anxiety. One end of the extreme (avoidance of sexuality).
- Trauma shame: a profound sense of unworthiness and self-hatred rooted in a traumatic experience.
- When someone works through trauma, the repetition of behaviours was likened to childhood when children repeat actions to try and see if a different outcome will occur. This reenacts what hurts the individual without solving the underlying issue.
Excerpt from “Sex Addiction & How the Internet is Changing Everything”
Patrick Carnes, PhD, CAS
International Institute for Trauma and Addiction Professionals
- Many modern technologies are relatively new – the rapid changes in communication technologies have magnified sexual access.
- What went into making successful recoveries:
- Attachment
- Abuse emotional/physical/sexual
- Trauma
- Stressors
- Correlations with substance use.
- Relapse interconnected with substance use.
- Digital connection with sexual behaviour has become more prominent.
- The online world impacts what people see as acceptable to do. Think of the social learning theory.
- Learning and memory, along with the reward centre of games, is described as setting a template for addiction – more time, more risk, more challenge, more to gain. At puberty, the model for the reward centre of the brain gets transferred to sexuality.