Understanding the Addiction Neuropathways
In my previous post, we talked briefly about addiction interaction and how addictions can co-occur in different ways. As we saw, it’s crucial to understand addiction interaction disorder because it can pose a danger to recovery as the possibility of one addiction replacing another is very real.
Moreover, addictions can interact with one another at the same time in highly complex ways. So while is always critical to get help for the most life-threatening addiction first, it’s important to be thoroughly honest with oneself while in recovery about all of the addictions present in one’s life.
THE AVENUES OF SELF-MEDICATION: ADDICTION NEUROPATHWAYS
You see, addiction is an insidious, patient beast. Addressing all of the addictions present in one’s life is the only way to starve the addiction and open up the possibility of making different choices. If the recovering addict does not “clean house,” the addict self will return in one form or another.
Understanding the neuropathways of addiction is a great way to help you consider how you might be seeking to alter how you feel via substances or compulsive behaviors. It’s also important to understand because it underscores the physical aspect of addiction and how important it is to maintain sobriety from mood-altering substances and behaviors in order to let your brain start to heal.
But hold on. How do neuropathways work?
“I’LL TAKE NEUROPATHWAYS FOR $800, ALEX.”
Whenever we do something pleasurable, for instance, drink alcohol, eat chocolate (or my favorite, ice cream!), or have sex, our brain releases dopamine. Some means of activating a dopamine release are faster than others; sexual activity provides a faster route to dopamine than drinking alcohol does. Yet while the means of activating dopamine release is varies, the end result is the same: You feel better.
As Patrick Carnes explains in the workbook on sex addiction recovery Facing the Shadow, “Exactly how you feel will vary depending on the neuropathway that you used to activate dopamine production in the first place” (p. 308). The specific pathway one chooses, i.e., one’s substance or compulsive behavior of choice, is determined by how a person wants to feel better, and THAT usually has everything to do with the painful feelings the addict wants to change.
Whew! That’s a mouthful. Let’s summarize:
Emotional pain —> substance or compulsive behavior —> corresponding neuropathway —> desired, altered emotional state (feeling better)
In other words, we often unconsciously choose a compulsive behavior or substance based on the emotional pain we want to alleviate. It would be worthwhile to devote an entire blog post of each of these, but for now, let’s see how this works by briefly looking at the four major neuropathways.
The arousal neuropathway is all about pleasure, excitement, stimulation, and intensity. The most common ways of activating arousal neuropathways are:
- high-risk relationships, high-risk sex, and high-risk activities
- compulsive shoplifting
- cocaine and amphetamines
This is the part of the brain that is always looking for something new and pleasurable. Many sex addicts, for example, report that they get bored with the pornography or sexual behaviors they engage in (i.e., their tolerance builds), so they seek out something new to get the next “high.” That’s how addiction can progress and escalate.
Arousal and the pleasure it induces is often a remedy to emotional pain. This is called the “opposite process of addiction” (idem, p. 309).
Satiation, or numbing, is aptly named because this pathway produces an analgesic effect: It calms, soothes, sedates, and relaxes. Alcohol and heroin are numbing drugs, but behaviors such as compulsive masturbation, certain forms of gambling (especially slot machines), shopping, and overeating can also anesthetize in the same way.
Satiation is an attempt to mitigate feelings of anxiety or high arousal. The goal of the satiation addictions is to keep anxiety at bay. That’s why arousal and satiation can often go together. Very often, an addict will engage in a satiation activity like compulsive masturbation after a high-arousal activity, like being with a prostitute. I’ve often heard sex addicts say, “I need to masturbate so I can go to sleep.”
In the fantasy neuropathway, escaping reality is the name of the game. The most frequent means of activating fantasy neuropathways are:
- Marijuana, LSD, and other psychedelic drugs
- Obsessing about the “big win” that will make everything okay when gambling
- Relationship or love addiction—finding the right person who will make everything better
- Watching pornography
The addict will literally inhabit some kind of altered reality in order to escape from his or her own reality, often entering into a trancelike state. Often, those who struggle with fantasy have learned to create and enter into another reality of their own making because their reality is unbearable, almost always because of trauma and abuse they’ve experienced.
This technique is called “compartmentalization”—the ability to create separate “compartments” in life into which painful and traumatic experiences, emotions, and states of being can be placed and ignored. Often, these compartments get shoved out of awareness entirely. (When it gets bad, we call it dissociative identity disorder, previously known as multiple personality disorder.)
This is why sex addicts can have a hard time remembering everything that they were doing while acting out when they start n recovery.
If arousal, satiation, and fantasy all involve means of acting out, deprivation is about acting in. Compulsive deprivation or abstinence is about control via going without: anorexia with food, spending, or sex.
Deprivation is usually a mechanism to control feelings of terror. Such terror may be unconsciously arising from the emotional conviction that something awful will happen if their needs were met, or that something will happen that they need to be constantly ready for.
Deprivation can also manifest when the addict feels guilty or ashamed because of excessive behavior associated with the previous three neuropathways. For instance, the sex addict who compulsively masturbates while watching pornography might abstain from all sexual activity for a week, a month, or more because of overwhelming shame. So, just like the binge eater who purges, deprivation becomes a way to balance out patterns of excess, creating a binge-purge cycle with sexual behaviors.