Victoria Cooper, M.A. MBSR                                                  310.770.6064
                                                                              Marina Del Rey, California

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SHAME REDUCTION AND THE RESTORATION OF DIGNITY:

How learning about the neurobiology of addiction can help addicts and their families

rebuild their lives and regain their dignity and self-esteem.

 

    What has become painfully obvious to me, in my work as an addiction therapist, is how so few addicts, regardless of the amount of treatment received, have any knowledge about the neurobiology of addiction. Both Dr. Nora Volkow--Director of the National Institute for Drug Abuse--and Dr. Gabor Mate—a therapist and the author of In The Realm of Hungry Ghosts--have done a beautiful job of explaining the physiological aspects of this “dis-ease”.  Unfortunately, for the most part, this crucial and valuable information has not trickled down to the client population.

     The moment I explained the etiology of addiction and, more specifically, the neurobiological roots of the addict’s craving and obsession, I noticed a release of tension and what I call the “aha” moment for both the addicts and their families. They finally learn why--in defiance of all logic—the gambler continues to gamble and the drug addict continues to shoot up, even though they are aware of the dire consequences.

    I talk about the developmental aspect of addiction that makes clear why some people are more susceptible than others to addictive behavior.  I then describe and explain the reward circuitry of the brain that includes the ventral tegmental area, the nucleus accumbens, and the hippocampus. Once this circuitry has been tampered with--that is, exposed to addictive behavior, it is no longer able to function in a way that serves the individual. What happens is that the excessive amount of dopamine that is released during the addictive process is telling the brain that it no longer has to produce as much dopamine, since it is now coming from an outside source. From then on, when the hippocampus is stirred by a memory or a sensation associated with drug use, the reward circuitry lies in anticipation of its next hit of pleasure. Thus, the intractable craving.

    When the addict arrives at this juncture, the left cerebral cortex--the logical part of the brain--goes off-line and the craving takes over.  In effect, the person is no longer in what we refer to as “his right mind”.  Herein lies the answer to the conundrum of why a person would engage in behavior that he knows is destructive. This realization can be a vital first step in reducing shame and regaining self-respect.

 

    As a psychotherapist specializing in addiction, I facilitate a number of groups, including a Men’s Process Group for people who have just entered rehab, an Eating Disorders Process Group, and a Gambling Process Group that is part of the UCLA Gambling Program. One of the questions I ask the new men is: “How old were you when you began using drugs, and why do you think you got hooked?” When I hear the answers, I am continually shocked and saddened.  Many of these men began slamming heroin and snorting meth at the tender age of nine or ten years old.  As for the answer to WHY they got hooked, “I felt normal for the first time in my life”.

    Addiction specialist Dr. Vincent Felitti states, “Addiction is not the problem. It is the solution to the problem.”  In other words, people who are in pain (psychic or otherwise) are seeking relief from suffering. Initially, drugs numb the pain. Soon enough, addiction becomes an added and recalcitrant problem that may serve the individual, but eventually destroys the individual.

 

    I often pose the following question to the members of my groups: “If you felt loved, respected, attractive, witty…would you feel the need to numb yourself with these substances?” The answer is invariably a resounding “No”.

    Once the physiological mechanisms of addiction are understood, addicts and their families realize that this scourge is not an emotional failing or a moral lapse. At this juncture, addicts and their families can more readily begin the healing process of forgiveness.

 

Victoria Cooper, M.A., MBSR

June, 2011

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