neuroplasticity

An Addicted Brain but a Recovering Mind

Posted on by alcoholicsguide

This blog used excerpts from

Do I still have an “Alcoholic Mind”!?

 

When I first came into recovery I used to get frightened by other abstinent  alcoholics proclaim that they were so glad they did not get the “wet tongue” when they saw alcohol or people drinking alcohol.

I used to feel ashamed as I did have an instantaneous “wet tongue” or mild salivation (Pavlovian response) and still do  years later when I see people drinking alcohol. Is this a “craving” for alcohol, do I still want to drink? Do I still have an “alcoholic mind?“. Did I do my steps properly?

It used to churn me up, these so-called alcoholics who had no physiological response to alcohol-related “cues”. By “cues” I mean the sight, sound and smell of alcohol and alcohol  related  stimuli, like wine gulping , glasses clinking, people having a good time, etc.

Part me also thought it was linked to addiction severity, how bad or chronic one’s alcoholism become, how far down the line or how low your rock bottom was? There may some validity in that observation.

It was partly because of mixed messages from alcoholics that I decided to take matters into my own hands and do some research into my alcoholic brain.

What I have discovered is that I have an “alcoholic brain” and not a “alcoholic mind” and there is a huge difference.

I found there is a difference between by addicted brain that has been altered by chronic abuse of alcohol and drugs and my recovering alcoholic mind, that  essence of me that is dedicated to recovery from alcoholism and addiction. These are very distinct – let me explain – on a daily basis I use my mind to help my brain recover.

For example, I meditate, I ignore the incessant chattering of my “illness”.

Both these are the function of my mind affecting the neuroplasticity of my brain.

In other words my mind is in control of my brain, the brain’s functions and structure can be shaped by my mind.    This is in effect, recovery.

For example, meditation can strengthen my control over emotional states, especially negative emotional states, by building yo the neural “muscles” of brain regions which regulate emotion.

Hence my mind and brain are distinct from each other, one effects the other.

So if there are people out there relatively new to recovery, listen up.

For chronic alcoholics there is an automatic physiological response when we see cues such as other people drinking. Mild salivation, quickening heart rate etc.

These are automatic, habitual, these responses happens to us rather than us wanting or willing it to happen. It happens unconsciously without our say so!

If you get a “wet tongue” i.e. you mildly salivate, then this is what happens when you have crossed the line into chronic alcoholism.

Loads of studies have shown there is this automatic response and have also shown there is also an attentional bias to alcohol cues. We notice alcohol cues in the environment before anything else. They have a heightened “noticeableness”.

Have you ever been in a new town and counted the number of drinking establishments automatically or had a heightened awareness of half drunken bottles of alcohol lying in the street? This is an attentional bias, we notice alcohol related stuff before anything else.

Some researchers in science call this a craving. I disagree.

I call this a physiological urge, distinct from craving.

I think a craving is more akin to a “mental obsession” about alcohol.

Alcohol has only had ‘luring’ effect on me while very emotional distressed or in the early days of recovery I was very scared that  I would drink but, looking back, I never had any desire to.

It is hugely important for recovering persons that we distinguish between urges and craving, in a clear manner that science seems to have been unable to do!

Lives can depend on this.

We are so vulnerable in early recover that we need sound direction on what is happening to us automatically and what we are encouraging to happen, consciously.

An urge for me is a physiological response to cues, external and internal (e.g. stress). A craving is different but interlinked.

Let me explain.

If I have an urge and it becomes accompanied by automatic intrusive thoughts such as a drink would be nice, and maybe a suggestion on where to get this drink, this does not mean I want a drink.

It is simply automatically prompted intrusive thoughts, the type of thought I used to get all the time and so became habitual, stored away in an automatized addiction schema or addiction action plan.

If I realize this and simply let these thoughts go, i.e. do not react to them, then they lessen and dissipate altogether.

This is not a craving. I have not consciously and emotionally engaged with these intrusive thoughts (although we often do in early recovery when they scare the life out of us!).

If I consciously engage, emotionally react, to these thoughts either because I want a drink (elaboration of these thoughts as in embellishing a desire state) or the thought scares the life out of me (averse reaction) I can end up in a mental obsession.

If in recovery, we try to suppress these thoughts then they will come back stronger than before which will raise  already high stress levels and recruit a whole host of memories of why I should drink, with who, where, and how much I will enjoy it.

They will also activate an Alcoholic Self Schema (different to the recovery self schema still being formed in early recovery).

Then I have a memory Hydra effect where attempting to suppress this terrible flowering of desire based memories or to cut off the heads of these thoughts and memories leads to them increasing and increasing.

 

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Then there are lots of these memories driving you crazy and scaring the life out of you.  And this is in someone who does not want to drink but wants to remain in recovery!!?

The other guy who is embellishing these thoughts is kinda thinking about drinking or toying with the possibility, so but again he is reacting cognitively and consciously to these intrusive thoughts. He is elaborating on them. He is using a different more cognitive part of the brain and a different memory system to those activated when he was simply having unconscious, habitual, automatic intrusive thoughts. He is now involved in this process rather than it simply happening to him.

So what I am saying is that there is no simple urge state that automatically leads to drink. We have to cognitively and emotionally react to it.

In my time in recovery, I have rarely heard of or witnessed  someone lured siren-like by a cue to a drink and when I have it is because he wanted to drink really, was testing their alcoholism, or he was in huge emotional distress and went “to hell with it!”

As we will see in later blogs,  there has to be a  cognitive-emotional reaction which mediates between an urge and a relapse!

If you have urges of a “wet tongue” accept this fact, that it is because you are an alcoholic. Non alcoholics are bedeviled with these things, only alcoholics are.

Thank the heavens you have had this reminder of your alcoholism. I used to replace this urge states with gratitude, and thank God for giving me another insight into my condition.

 

The Neuroscience of Attachment (Part 2)

Posted on by alcoholicsguide

Part 2

Here we again borrow extensively from an excellent article by Linda Graham

“How relational learning works

John Bowlby, British psychoanalyst, founder of attachment theory, hypothesized that attachment is all about safety and protection and emotional regulation in times of perceived threat or danger. Attachment is part of a 3-part motivational system of fear–attachment-exploration. Fear triggers attachment behaviors. The safe haven of secure attachment soothes the fear of the amygdala, and opens exploration.

Exploration eventually bumps us into something that triggers fear again which shuts down exploration and triggers attachment behaviors again which soothe the fear again and open exploration cycle of safety-exploration again.

It has been amply demonstrated by Allan Schore that the need for emotional regulation is what drives attachment behaviors. Affect regulation is the engine of attachment and attachment is what drives the development of the pre-frontal cortex, the brain structures that do that. Dan Stern and Peter Fonagy have amply demonstrated that it is the need for empathy, the need to be seen, understood and reflected that drives the intersubjectivity that develops theory of mind. I know that you know what I know and I know that you can also know something different than what I know.

So how parents use empathy and bonding and reflection to regulate fear, anxiety and shame, and soothe the firing of the amygdala, and help the other discover who they are by seeing and accepting them first, this attunement and feedback are so very determinative of attachment patterns.

So, even before consciousness develops, the parent is regulating the emotions of the baby through their own pre-frontal cortex, brain to brain regulation. The baby is “borrowing” the PFC functioning of the parent to regulate their emotions. And the baby is introjecting the reflections of who they are from the parent to develop the internal working models of who they are in relation to the other. As the baby’s PFC develops from these experiences, they can begin to regulate their emotion on their own. They can begin to have self-awareness and self-reflection on their own.

The 9 functions of the pre-frontal cortex are:

regulation of body – SNS-PNS balance

attuned communication, felt sense of other’s experience

regulation of emotions

response flexibility – pause, options, evaluate options, appropriate decision

empathy

insight – self awareness

fear extinction – GABA fibers to amygdala

intuition – deep knowing without logic

morality – behaviors based on empathy.

Research has shown that 7 of the 9 functions of the PFC are outcomes of secure attachment.

The laterality of the two hemispheres of the cortex is important here. The right and left hemispheres of the brain develop at different rates and specialize in different functions, allowing a much greater complexity of functioning than if they were duplicating each other. The right hemisphere of the brain grows larger in volume and more rapidly than the left, from before birth through 18 months of age, which completely coincides with the developmental timetable of when attachment patterns are being stabilized in the brain. These patterns of attachment are stored in our memory in the mode of RH processing.

The right hemisphere processes experience differently from the left – non-verbally through body sensations, visual images, emotions, and holistically – it processes the gestalt of someone’s face or energy globally, all at once, rather than in a linear data bit by data bit mode. The right hemisphere is where we get our “gut” intuitive sense of things and the gestalt of things as a whole. The right hemisphere is the seat of the social and personal self. The right hemisphere regulates the sub-cortical limbic system and is dominant for social-emotional processing. Our attachment patterns are stored in this mode.

The left hemisphere is developing all along but goes through a growth spurt from 18 months to three years of age and becomes dominant after that, except for a period of re-organization during adolescence.

This adolescent period coincides with the need for attachment patterns to change, moving the focus from leaving parents to focusing on peers and forming one’s own family. The left hemisphere of the brain processes logically, linearly, linguistically, through symbols and words; it is dominant for cognitive processing.

Remember, both hemispheres do process experience consciously, it’s just that what comes to consciousness in the right hemisphere is images, sensations, emotions and what comes to consciousness in the left is words and symbols. The right hemisphere decodes our relationship experience; the left hemisphere describes it.

Because the right hemisphere develops early and the left hemisphere develops later, and because the right hemisphere is more neuronally connected to the limbic system than the left, it has a negative bias toward anxiety, shame, depression and withdrawal, which can impact our experience of attachment and make it harder to change those patterns. There is a corresponding bias in the left hemisphere toward positive emotions, humor and mania, and approach.

“An unfortunate artifact of the evolution of laterality may be that the right hemisphere, biased toward negative emotions and pessimism, develops first and serves as the core of self-awareness and self-identity. To be human may be to have vulnerability toward shame, guilt and depression. So although both sides of the brain are involved in emotion, the dominant role of the right hemisphere in defensive and negative emotions gives it executive “veto power” over the left. Just as the left can block emotional and visceral input from the right, the right can override conscious processing and emotional well-being in reaction to threat.” [Cozolino p. 78]

The corpus collosum, running right down the middle of the brain front to back, is what begins to integrate the information between the right hemisphere and the left hemisphere at about 12 months of age. What’s important about any of this brain functioning is integration. The brain is about teamwork; various parts of the brain firing together in synchrony.

There is bottom-up information from the limbic system about the emotional charge of any experience and top-down regulation of our reflexes and emotions; there is right left integration of feelings and thoughts, integration of positive and negative responses. The more integrated neural pathways, networks, structure are, the better the brain functions

How attachment shapes the brain and what patterns of attachment are embedded in the neural circuitry of the brain that shape our 3 R’s , relating, regulation of affect, and resilience, for the rest of our lives.

Dan Siegel has proposed a resonance circuit in the brain.

* Various structures cooperating with each other

* to support the processes of interpersonal resonance, attunement, and empathy * that activate neurons in the limbic regions and the middle pre-frontal cortex

* and stimulate neurons there to fire together, wire together

* and strengthen the synaptic connections for the circuits and pathways

* that become our internal working models, templates, schemas, mental representation of self and other in relationship.

his resonance circuit begins with sensory input – what we see, hear, smell, touch of another. Then mirror neurons, which were discovered in the cortex at the crossroads of visual, motor, emotional processing, communication, language, cohesion and empathy not even a decade ago, fire when I observe and comprehend an intentional behavior in you. The exact same neurons fire in my brain as are firing in your brain when I observe the intention of the behavior you are doing, or when I imagine myself doing it. If you make a random gesture of moving your hand toward your mouth, nothing much happens. If you pick up a glass of water and move it toward your mouth, the same neurons are firing in my brain as I perceive and comprehend your intention as are firing in your brain as you do that intentional behavior.

When we are attuning to another’s behavior and expressions of intention – facial expressions, body gestures, tone of voice, mirror neurons fire in our brain. Information from these mirror neurons travels from the cortex of our brain through the insula – a structure buried deeply in our brain that is located at the interface of the cortex and the limbic regions. The insula carries information down from the cortex through the limbic regions to the neurons of interoception – how we sense what is happening internally in our bodies.

The information gathered through interoception, tension, tightness, tiredness, travels back up through the insula through the limbic regions where the sensations are given emotional meaning, back up to the structures of the middle pre-frontal cortex. The insula integrates somatic experience with conscious awareness. We feel pain when another feels pain. Cozolino notes that this insula, though a very small part of the brain, is an evolutionary masterpiece.

Remember one of the 9 functions of the pre-frontal cortex is attunement – we interpret our felt sense of the other’s experience. Another function of the PFC is empathy – to communicate that felt sense, nonverbally being even more important than verbally. This resonance circuit is essential to stimulating growth of all 9 functions of the PFC, including regulation of body, regulation of emotion, extinguishing fear, response flexibility, self awareness etc.

This resonance circuit operates in the brain of the parent attuning to his or her child; it’s what stimulates the developing brain of the infant to process and know its own experience; its experience metabolized and reflected back by the parent becomes encoded in the infant’s neural circuitry. Because you know what’s in my mind and heart, I can know it, too. These patterns do stabilize in the brain by 18months of age, rendering them as Cozolino says, of permanent psychological significance.”

This resonance circuit operates in us by attuning to others – this I believe is what occurs in group therapy and 12 step/recovery groups – as others and ourselves experience others  attuning to them as they share their experience are also receiving our unconditional acceptance of that experience which re-wires their sense of it and their sense of self.

I also believe that these therapeutic groups act as the external PFC mentioned above, especially to those in early recovery who are effectively limbic regions on legs, one constant emotional over reaction.

They help regulate emotional responding in those essential days of early recovery. It is this  exterior self soothing that is essential in keeping newcomers coming back. It tells them we can love you back to health, it proclaims through loving action that the thing you are really looking for is here, love, tolerance and acceptance.

The thing you have been looking for all your life!

It tells then clearly that you belong here!

We will refer back to this blog because the regions of the brain implicated in the so-called “resonance circuit” are seen by affective neuroscience as those regions which govern emotional processing and regulation. Hence why I consider addictive behaviours to be the result of an emotional disorder. 

Thus insecure attachment may cause the impairment that has been demonstrated in all areas of this emotional circuity such as the amgydala, orbitofrontal cortex, ventromedial cortex, insula, anterior cingulate cortex, hippocampus and so on.

These regions have all been demonstrated to be have altered neural connectivity in all addictive behaviours and also to have altered anatomical volumes.

In other words, these regions do not work properly, in regulating emotions .

This is why it is very useful combining affective neuroscience with more psycho analytic theories such as attachment theory.

It clearly shows how environment can shape regions  of the brain and how these anatomical impairments are perpetuated via emotional processing and regulation deficits which result in addictive behaviours.

Addictive behaviours are thus the manifestation of underlying emotional dysfunction often caused by insecure attachment and child maltreatment. Hence in treatment we have to mirror what was missing and replace what was abusive with what is healing such as being around people who accept us for who we are without conditions.

It is then that environment can alter the brain and behaviour. Helping others can reshape emotional regions of the brain  via neuroplasticity and help us recover. “What fires together, wires together” as this article states.

Love and tolerance is the code of many and it helps us as well as others which is the basic philosophy of treatment and 12 step groups. We are social animals after all.

Love rewires the brain literally.  Helping others is good for us too.

 

References

http://lindagraham-mft.net/resources/published-articles/the-neuroscience-of-attachment/

 

 

How meditation helps with “emotional sobriety”!

Posted on by alcoholicsguide

In this blog we have considered two main and fundamental areas:-

1. that alcoholism appears to be an emotional regulation and processing disorder which implicates impaired functioning of brain regions and neural networks involved in regulation and processing emotion such as the insular cortex, anterior cingulate cortex and dorsolateral prefrontal cortex.

2. that in early and later recovery there appears to be increased functioning in these areas especially the dorsolateral prefrontal cortex (dlPFC) and anterior cingulate cortex (ACC) which is important not only in regulating emotions but also in abstinence success.

Our third point is that mediation, of various types, appears to strengthen the very areas implicated in emotional regulation and processing, which ultimately helps with “emotional sobriety” and long term recovery.

Various studies have shown that mindfulness mediation training in expert meditators, as well as novices,  influenced areas of the brain involved in attention, awareness and emotion (1,2).

 

Meditation-in-Brain-660

 

A key feature of mindfulness meditators may be the ability to recognise and accurately label emotions (3). Brain FMRI studies have shown more mindful people having increased ability to control emotional reactions in various areas associated with emotional regulation such as the amgydala, dlPFC, and ACC (4).

In a study (5) on the the effects of long term meditation on physical structure of the above brain regions, practitioners of mindful meditation who meditated 30-40 minutes a day, had increased thickness due to neuroplasticity of meditation in brain regions associated with attention and interoception (sensitivity to somatic or internal bodily stimuli) than the matched controls used in this study. Again the regions observed to have greater thickness via increased neural activity (neuroplasticity) were the PFC, right insula (interoception and this increased appreciation of bodily sensations and emotions) as well as the ACC in attention (and possible self awareness as ACC is also linked to consciousness) .

A structural MRI study (6) showed that experienced mindfulness meditators also had increased grey matter the right interior insula and PFC as well as, in unpublished data, in the hippocampus, which is implicated in memory but also in stress regulation. Thus mindfulness meditation and the fMRI and MRI studies show it is possible to train the mind to change brain morphology and functionality through the neuroplastic behaviour of meditating.

Brain regions consistently strengthen or which grow additonal “neural muscles” are those associated with emotional regulation and processing such as the dlPFC, ACC, insula and amgydala.   Thus if we want, as recovering individuals,  to shore up our early recovery, by strengthening the brain regions implicated in recovery success we meditate on a regular basis, daily, so that we can also improve those underlying difficulties in emotional regulation and processing.

By relieving emotional distress we greatly lessen the grip our condition has on us on a daily basis, We recover these functions.  We will discuss the role of meditation on reducing emotional distress in later blogs.

 

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References

1. Cahn, B. R., & Polich, J. (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological bulletin, 132(2), 180.

2,  Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in cognitive sciences, 12(4), 163-169.

3.  Analayo. (2003). Satipatthana: The Direct Path to Awakening. Birmingham, UK: Windhorse Publications.

4.  Creswell, J. D., Way, B. M., Eisenberger, N. I., & Lieberman, M. D. (2007). Neural correlates of dispositional mindfulness during affect labeling.Psychosomatic Medicine, 69(6), 560-565.

5.  Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T., … & Fischl, B. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport, 16(17), 1893.

6. Hölzel, B. K., Ott, U., Hempel, H., Hackl, A., Wolf, K., Stark, R., & Vaitl, D. (2007). Differential engagement of anterior cingulate and adjacent medial frontal cortex in adept meditators and non-meditators. Neuroscience letters, 421(1), 16-21.

 

see also  Hijacking the Brain

The Distress at the Heart of Addiction and Alcoholism

Posted on by alcoholicsguide

This blog is written for alcoholics and those who love and live with them, by alcoholics in recovery. For those who know what it is like to live with alcoholism but would also like to know why alcoholism affects the alcoholic and those around him in the way it does.

We write this blog to help us and you understand how the alcoholic brain works; why they do the things the do, why they act the way they do. Why is it everything is going great and suddenly the alcoholic in your life “flies off the handle’ and acts in an emotionally immature way, which can often cause hurt to others around them? What is the reason behind this “Jekyll and Hide” emotional responding?

Why do they suddenly cut off their emotions so profoundly it leaves your emotions in limbo, confused and upset?

In this blog we seek to explain, as researchers,  in terms of the processes of the brain, why alcoholics, particularly  those in recovery, do the things the way they do, act the way they do.

We hope to explain this disease state, which alcoholics themselves call a “emotional disease’, a “cancer of the emotions’, a “parasite that feeds on the emotions” or quite simply  “a fear based illness”. It appears that alcoholics in recovery are aware to a large extent of what they suffer from. But why do they do what they do sometimes if they know what is going on? Why do they not seem to be able to help themselves from engaging in certain responses and behaviours?

Why do they endless engage in self defeating resentments,  taking “other peoples’ inventory” or criticizing, why do they project into future scenarios and then get emotionally paralyzed by doing so, why do they run through the list of cognitive distortions on a daily basis, why do they get self absorbed and engage in “me, me, me” behaviour!? Why do they indulge in self pity to the extent they end up in full blown depression?

More importantly, perhaps, how do various therapeutic strategies deal with these behaviours and seek to challenge and address them? And do these therapies, in time through practice and the neuroplasticity (neural reshaping of the brain via behaviour) change how they act, feel and live in this life. In short, how does recovery change the brains of alcoholics for the better?

As we are personally well aware, self knowledge does not bring recovery – only action does. But this action can be based solidly on a better understanding of what goes on in the brain of an alcoholic for example, why should I mediate? What beneficial, adaptive change will that bring, how will that “help me recover”? What is the point of doing the steps, how exactly do they effect change in one’s alcoholic brain? Is there a good healthy neurobiological reason for going to mutual aid group meetings like AA or  SMART?

We also believe that academic research definitions of alcoholism are inadequate – the latest DSM V  equates the emotional difficulties we highlight here as ‘co-morbidities’,  conditions that occur alongside the condition of alcoholism. We disagree, we suggest these ‘co-morbidities’ (co-occurring psychiatric disorders) are a main reason why we become alcoholics, they are what make us vulnerable, along with genes and environment to becoming alcoholic.

Most alcoholics feel they never fitted in, were emotionally hyper “sensitive”,  engaged in risky behaviours, got into trouble without intending to, and other impulsive behaviours which we believe are illustrative of an emotional dysregulation which makes certain individuals vulnerable to becoming alcoholic.

Science tells us there are many such vulnerabilities in children of alcoholics. The alcohol regulated, medicated these errant emotions which caused such distress, even at an early age. It is these emotional processing deficits and emotional dysregualtion (i.e. poor control of emotions, especially when distressed!) which lie at the heart of the this psychopathology or if you like  this psychiatric disorder called alcoholism.

It is a distress-based condition, day in day out, and we formally believe that various therapeutic regimes like the 12 steps, DBT, ACT or CBT, etc all treat this inherent distress state in some way. It is this distress state that activates this “fear-based illness”, that makes one hyper aware of cues, alcohol, it is this distress that provokes memories of drinking, alcohol use schemata, that trains one attention on people places and things from the past. Without this distress our illness barely gets activated! 

For example, does your loved alcoholic, “over do things”on a regular basis, do they engage in short term thinking, or “quick fix ” thinking. Do they resist your attempts at sensible long term , goal directed, “thought through thinking”?

Does your alcoholic work himself to a frazzle, do they easily become exhausted by overdoing it, whatever it is? Do they have a series of new addictions? Are they perfectionist doing too much, or nothing anything at all? Perfectionism is distress based.

Does your alcoholic fear the future, but continually project their thinking into the future? Do they have an intolerance of uncertainty, do they endless ruminate about things, do they react rather than act? Do the most simple decisions provoke a “fight or flight” response? Do they frequently come up with “I know how to do this, I have a great idea!” Only for it to be the opposite of a great idea! Do they give people “rent free room in their heads” because of resentments – replying the same old tape in their minds, over and over and over again? All distress based?

“Fear based” is distress based.

A recent study showed that alcoholics have a part of the brain that helps process emotions but it doesn’t work properly so is overactive all the time; it is exhausting being on red alert, all the time , living on a state of emergency. Hence step 11 in the the 12 steps.

The problem with this hyperactive brain region, called the ventromedial prefrontal cortex, is that it  also cuts out , hypo-activates, when more or excessive stress is applied and another compulsive area of the brain, the basal ganglia, takes over. This part is automatic, habitualized, automatic, compulsive! It results in more more more, and is driven by distress not goal directed consideration. It simple does, does, does, without consideration of future consequence.    Sound familiar??

How did your loved alcoholic get to be this way? What happened to your own alcoholic brain? We believe there is a vulnerability to these aforementioned  emotional difficulties as certain brain areas which regulate emotion not working properly. This means they are smaller, impaired and do not function optimally or are not  connected properly.

Do you know an alcoholic who does not accurately know how he is feeling properly, does not know what emotion he is experiencing? Cannot label to emotion properly which makes processing of it difficult? Can’t rely on a neural feedback to tell himself when  he is tired, angry, hungry  and that he should HALT? This is the insular cortex not working properly.

Does your alcoholic see error everywhere (and worse still give a running commentary on it!?), always whinging about that not being right, or that being wrong. Why can’t they do things properly, be more perfect!! That is partly to do with impairment of the anterior cingulate cortex which monitors error in the environment.

This fear based stuff? That is a hyperactive amgydala, the “anxious amgydala”, and it also acts as a switch between memory systems, from explicit to implicit memory, and recruits the compulsive “go,go, go” area of the dorsal striatum from the always “on the go”, hyperactive, ventromedial cortex.

The amgydala is at the heart of alcoholism and addiction. It not only switches memory but also reward/motivation/ and emotional response so that distress provokes a habitualised “fight or flight response” in the dorsal striatum.

It is said that alcoholics are emotional thinkers, but this region is also an emotional “do” area which means emotional distress acts as a stimulus response. The brain responds to the stimulus of distress in other words. As addiction and alcoholism progress the ways addicts and alcoholics react  become limited in line with addiction severity. The further the alcoholic gets in alcoholism the more he will react out of distress, the more automatic his behaviours become, the more short term his decision making will be, the more he has to fight automatic urges and automatic drink-related thoughts, the more he has to contend with “fight or flight” thinking and feeling.

Add to this a brain that is out of balance, does not have homeostasis, natural neurochemical balance, but has a state called  allostasis, where the brain constantly attempts to finding stability via constant change, and the fact that the alcoholic brain has too much Glutamate,  an excitatory neurotransmitter, the “go neurochemical”, and not enough GABA,  an inhibitory  neurotransmitter, the brains’ natural brakes”, (and which is increased by drinking alcohol) the stop or slow down chemical and  that this also helps slow down an abnormal heart rate variability (HRV) found in alcoholics.

Alcoholics have a different heart rate variability meaning we have a heart rate more suited to being ready for the next (imagined) emergency.  The effects of alcohol are thus more profound on this group, and this HRV is also seen in children of alcoholics so represents a profound vulnerability to later alcoholism.

Add to that depleted levels of of  dopamine, which is very important in the addiction cycle. The problem with dopamine supplies is that our excessive levels of stress reduce our amount of dopamine,  that we are always on the look out for more dopamine. Add to this that stressful states increase our brain in “dopamine seeking” in an attempt at transient allostasis and you have a brain that is always trying to get a buzz out of something, especially when in distress states.

Then there is other deficits to the serotonin system, to the natural opioids  system, to oxytocin, all of which take a beating and are reduced by excessive stress systems. But all are increased via love and looking out for our fellow man, our families, loved ones and other’s in recovery. We can manipulate our brain chemistries, this is what happens in recovery in fact!

Too much stress on the brain spreads like a forest fire throughout the brain, lowering levels of  essential neurotransmitters,  impairing memory and turning one from a goal directed action to a compulsive reaction type of guy. The alcoholic brain is always primed to go off!!

Chronic stress also impairs the prefrontal cortex, the cognitive, conscious “top down” controller of the brain’s emotions and urges, instincts and so on. It doesn’t help that it doesn’t work too well in alcoholics. The brain of an alcoholic is a “spillover” brain, it is a brain that spills over into various types of disinhibition,  impulsivity and compulsivity . It often acts before considering, speaks before thinking. decides this is a great idea with out consulting, reacts without sufficient reason or cause.

It needs help, this alcoholic brain. From another brain, from someone other than himself.

Recovering alcoholics need an external prefrontal cortex to help with the top down cognitive control of the subcortical emotional and motivational states. The problem with emotions are they, in the alcoholic brain, have become entwined with reward. We feel a certain way, negative for example, and fix this negative feeling, with something rewarding, makes us feel better, more positive, less self reflective,  and it seems this has been the case with certain alcoholics since childhood. Dealing with emotions by the granting of treats.

Feeling better by consuming. Fixing feelings via external substances. Sub contracting our emotional regulation.  Finding different feelings in a bottle, or a pill, or a syringe or snorting them up one’s nose. Alcoholics need a spiritual awakening,  a psychic change, a change in consciousness, in self schema;  this sudden change in how we feel about the world (including memories of our past life) because the old feeling about the world will lead to the sane old behaviours. Plus alcohol and drugs were  crude approximates of this change in consciousness, this  spirit awakenings, they dramatically and very instantaneously helped change our feelings, thoughts, perceptions about the world around us. They helped us fit in.

This is the purpose of a spiritual awakening too, a sudden change of consciousness. We believe the best and most sudden way to achieve this is to let go of the thing that causes all the suffering in the first place, the self. It appears we can live without the “self” . It also appears helping others brings a bigger buzz than even helping ourselves.

Helping others reduces our distress. and many many other therapeutic benefits to brain chemistry. This brain also needs some one outside of self, outside the self regulation network in the brain which is so impaired and cannot be relied on because at times it is maladaptive. Can’t be counted on the make the right decision because it favours  short term over the long term, is based on “fight or flight “thinking and rational, hence is distorted by fear.

If we have been thinking in this maladaptive way all our lives it  is no wonder we ended up where we have. We used alcohol to deal with our errant and quite frightening emotions. I positively ran away from my own emotions.

I used to say to my wife, the main reason for my drinking is “to get away from my self”. Now we have to find a solution to living with oneself, these sometimes torturous alien state of emotional sobriety.

I remember being asked by a counsellor to sit with my emotions for half on a hour. I felt I was being possessed by some poltergeist,  the feelings associated with emotional regulation were so alien to me, so frightening. I didn’t know what they were even. I had to have by wife label them for me and help me process them.

I believe steps 4 and  of 12 step programs help one emotional regulation hundreds  and hundreds of unresolved, unprocessed emotions from the past otherwise they will continue to be in there, haunting us like “neural ghosts” from the past, adding emotional distress to our conscious daily experience and encouraging relapse.  This is the case for many newly recovering alcoholics.  Being haunted by a million thoughts produced by  rampant emotional dysregulation.

Resentments swirling around the mind and driving the newcomer back to relapse. What the newcomer finds is that the drink stops working, and the emotional difficulties remain, in fact much worsened by years and years of sticking a neurotoxin down our throats and in into our brains. Havoc is then further reaped on an already not fully functioning  brain.

In AA they often they say that they are stuck at the emotional age of when they started drinking which is usually around the early teens when the cognitive part of the brain that controls emotions is still developing.  But we act much more immaturely than that, we act like the terrible twos or children. Our emotional brains never really grew up. This emotional dysregulation apparent as teens then shaped all our future decisions and eventually our alcoholism. That is what they mean in AA, when they say all your best thinking got you here. So there you have it . Sound familiar? Recognize anyone here?