Addiction : adverse childhood experience,
Homeopathy, and neuroplasticity
What is
addiction?
Addiction can be defined as any behaviour that
is associated with craving and temporary relief, and with long-term negative
consequences, that a person is not able to give up despite their best
intentions. Addiction is normally associated with drug abuse, but the
definition can extend much wider than that. One can be addicted to shopping,
food, sex, gambling, work etc.
Although some addictions are definitely more
damaging than others, neurologically there is only one addiction process no
matter what the behaviour or substance a person is addicted to. All addictions
engage the same neural pathways, the same brain chemistry, and the same reward
system.
Why is it that the addict will continue to
persist in their addiction at the expense of their careers, family, finances,
psychological integrity, physical health, and even their life? How can a
substance or harmful behaviour have such a binding hold on a person?
A common belief is that addiction is a choice
that people make – a choice that they make freely, and a bad choice. Therefore
it is appropriate to punish drug addicts with extreme legal sanctions.
The modern medical approach to addiction is that
it is a brain disease caused by genetics that then impairs brain function. This
has some truth. However if it is just a bad choice then why call it a brain
disease, and if it is a brain disease caused by genetics then why punish
people? This does not make any sense.
Even if you are born with genes that supposedly
pre-dispose you to addiction, it is the environment which dictates whether or
not you will succumb or not – whether these genes become switched on or remain
off (epigenetics).
What the ‘choice’ and ‘genetics’ viewpoints have
in common is that they both take society off the hook. If we accept these
definitions then we don’t have to look at the deeper reasons for addiction.
These deeper reasons for addiction actually have very little to do with personal
choice or genetics, and are much more associated with early adverse childhood
experiences, stressed and overwhelmed parents, and a fragmented and unhappy
society.
Yet another view of addiction is that the
substances that are abused are in themselves addictive. But if that were true
then everyone who had a drink would be in danger of becoming an alcoholic. The
fact is that the majority of people can try even very strong drugs like crystal
meth or heroine and not become addicted to these substances. The question
should be why do some people become
addicts where others do not?
Adverse Childhood
Experiences:
There is now heaps of research studies showing
conclusive links between adverse childhood experiences (ACE’s) and addictive
behaviour. The major piece of research involved over 17,000 people and
indicated an overwhelming correlation between adverse childhood experiences and
addiction later in life. The higher one’s ACE score (i.e. one has
suffered more adverse childhood experiences) the more likely it is for one to
develop addictive behaviour later in life. In fact for each ACE a person’s
likelihood of addiction increases by about 200%.
The graph above shows how the likelihood of
being an alcoholic as an adult exponentially increases with having suffered
adverse childhood experiences. ACE’s are things like emotional or physical
abuse/neglect, sexual abuse, witnessing family violence, absent parent/no
parents…
Not everyone who is traumatised becomes an
addict but early trauma is proven to radically increase likelihood of
addiction.
Gabor Mate, a Canadian doctor who works in
Vancouver’s impoverished drug area, says that out of the thousands of female
drug users he has seen, every single one of them had been sexually abused as a
child. That is quite a revealing statistic. The fact is that almost all addicts
are really just damaged children trying to self-medicate.
Any addictive behaviour is actually an attempt
to self-medicate. Drug addicts will say, ‘the first time I took heroine it was
like being wrapped up in a warm soft hug’, ‘when I took cocaine it made me feel
normal for the first time in my life’. Addicts say that a drug takes away their
pain, soothes, gives a sense of control, makes them feel able to function,
de-stresses them… etc.
So maybe the real question should not be ‘why
the addiction?’, but ‘Why the pain?’
Building a brain:
So we know for sure that there is a strong link
between what happens (or doesn’t happen) in early childhood and addiction. But
why is this?
The key thing to really understand here is that
the human brain actually develops though interaction with the environment. This
is no longer theory – we know it for certain.
According to the research, the key factor that determines the
development of the infant brain is the relationship and connection with those
around esp. the primary care giver(s) – usually the mother. People
connection=neural connection.
In other words the neural pathways of the brain are set
early on by the mutual responsiveness of parent-child relationships. The more
present and responsive the care-giver is to the infant, the more neural connections
are made in that infant’s brain. The type
of attention will determine the type
of connections that grow.
In an infant’s life there are periods when every second millions of connections are being made. The human
brain is the only one that continues to grow outside the uterus at the same
rate as it does inside the womb. We are actually born premature compared to
other animals (i.e. compared to a horse that can run on the first day). This
means that most that most of our brain development happens after we are born. The
human brain is 80% mature within 3 years of life.
So the brain develops through this interaction with the environment in
first three years of life. The circuits that get stimulated will grow and the
ones that do not will atrophy or die.
As an extreme example, if a child is left in the dark the visual
circuitry will not develop and that child will be blind – forever – because the
visual circuitry needs to be stimulated by light in order to grow. Imagine In
an infant whose mother is suffering from post-natal depression. The mother will
lack a feeling of connection to her child, will be less available and less able
to sooth the child, will be less responsive to that child, and may even neglect
its basic needs (in severe cases). This will influence the infant’s developing
brain and which circuits develop or atrophy. This hard-wiring of the brain
occurs very early on in life and sets the patterns for behaviour, and stress
handling ability later in life.
In double blind experiments on mothers with post-natal depression with a
control group of non-depressed mothers they could tell by looking at the EEG of
the infants whose mothers were
depressed and whose was not depressed.
The neuro-chemicals of addiction:
The three main neuro-chemical circuits involved in addiction are
endorphins, dopamine, and cortisol. Understanding how these three circuits are
‘built’ during infancy through interaction with the environment, in particular
the primary care-giver, and how they operate, is the key to understanding
addiction in all its forms.
Endorphins and love:
One main class of drugs are the opiates (from
the opium poppy). These include morphine, codeine, and heroin. The opiate drugs
are extremely powerful pain relievers. Opiates sooth both physical and
emotional pain. Brain scans show that physical pain and emotional pain are felt
in the same area of the brain. When someone is hooked up to an EEG and
experiences physical pain or emotional pain, the same areas of their brains
light up. How is it that these chemicals derived from a poppy even work in our
brains? It is because our brains have receptors for opiates. Why do we have
receptors for opiates? We actually have receptors for our own endogenous
opiate-like substances called endorphins. One of the functions of endorphins is
to relieve pain. Imagine how life would be if we had no mechanism in place with
which to relieve pain?
Endorphins are also the neurochemical of
pleasure. People who have very low endorphin levels may feel depressed and take
no joy in life. Exercise releases endorphins which accounts for the high
experienced by long-distance runners. Imagine life without the ability to feel
pleasure?
Most importantly, endorphins are released during
the loving interaction of people, especially between mother and child. In
experiments with rats and monkeys, if endorphin receptors are blocked, the
mother will not bond with or take any interest in her offspring, and the
offspring will not thrive. In this way we can see that without endorphins life
would not be possible.
In infants whose mothers are not present,
loving, and connected, the endorphins will not be flowing and so this endorphin
fed pleasure/pain/bonding brain circuitry does not properly develop. One can
understand how this might leave the person more susceptible to addiction later
in life, as they will become dependent on getting the endorphin substitute they
need from an outside source.
Dopamine and
reward:
Dopamine is another important neurotransmitter
involved in the addiction process. Dopamine is the incentive or motivation
hormone and flows when you are seeking food or a sexual partner. It is the
brain chemical implicated in curiosity, interest, novelty, feelings of
alertness and aliveness. If your dopamine receptors are knocked out you take no
interest in anything - a zombie-like state. You won’t even feed yourself. The
more dopamine in your system, the more alive, engaged, and motivated you will
feel.
The more exciting something is perceived as
being, the more dopamine is released. The addict’s dopamine response is very
linked in to their addiction, meaning that even thinking about their addiction
will trigger dopamine which then drives them on to seeking out their substance
or behaviour even if another (wiser) part of themselves knows it is not a good
idea. This is why addicts have extremely poor impulse control and find it very
difficult to stop their addiction even though they may want to. If it were a
matter of ‘just saying no’ then there would not be so many addicted people!
All the stimulant drugs (amphetamines, cocaine,
coffee, tobacco) increase dopamine levels. A shot of cocaine increases dopamine
by 300% meth-amphetamine by 1200%.
The other thing that increases dopamine levels
is any risk taking activity; extreme sports, gambling, illicit or novel sex.
The greater the risk, the greater the dopamine kick. The problem is that the
addict’s dopamine circuits get wired to the addiction, whatever form it takes.
So, for the shopaholic, their dopamine circuit gets wired to their shopping
addiction. The addict will often say that their addiction is what makes them
feel most alive, most engaged, most motivated. When the addict is not engaged
in their addiction, their dopamine level is low and they feel withdrawn,
dis-interested, anxious etc. This begs
the question, is it the drug/behaviour that people get addicted to, or is it
their own dopamine?
Cortisol and
stress:
Cortisol is a stress hormone. It helps to maintain fluid balance, blood
pressure, blood sugar and a host of other things when we are experiencing undue
stress. It is similar to adrenalin although has a longer lasting action.
Adrenalin’s affect is more immediate and passes more quickly compared to
cortisol. Cortisol levels rise dramatically in the face of stress as a useful
and necessary response to deal with the immediate threat. Stress raises
cortisol levels which enable us to more effectively deal with a challenging or
dangerous situation by increasing our heart rate, blood oxygenation, glucose
levels, and a host of other things.
Experiences during infancy are known to affect the organism’s ability to
regulate cortisol levels. While stressful early experiences have been
associated with deregulated cortisol levels, positive early experiences, i.e.
high maternal caregiving quality, contribute to more optimal cortisol
regulation (http://www.ncbi.nlm.nih.gov/pubmed/23116166) . The
infant’s stress regulation response is undeveloped and is mediated by the
mother through soothing contact and attuned responsiveness. So, a well-bonded infant with a responsive
attuned mother will mean that the infant will develop healthy stress regulation
circuitry. However, an absent, tuned out, stressed out, or depressed mother
will mean that the infant will not develop healthy stress handing ability, and
so will remain chronically stressed with raised cortisol levels.
There is a clear link between a person’s ability to handle stress and the
likelihood of developing addictive behaviour. Addiction is about
self-soothing. Due to the stress
regulation patterns set up in early infancy, adult addicts not have learned how
to regulate their own stress response and so will experience more stress, and
longer lasting stress from a lesser stimulus. One can then understand that they
are more likely to fall into addictive patterns of self-soothing with drugs or
other forms of addictive behaviour.
As an aside, chronically raised cortisol levels are related to a whole
host of health problems including cardiovascular disease, diabetes, and
osteoporosis. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1993964/
These three circuits - for the opiate love chemistry, for the dopamine
reward system, and for cortisol stress regulation, are all set up during early
infancy mainly through mutual responsiveness between the infant and the mother.
If there is any major or ongoing disturbance or trauma in the infant’s early
environment, this will shape how these circuits function as the person goes
through life, and therefore how prone this person will be to self-soothing
addictive behaviour.
For the healthy development of the infant’s brain neural chemistry it
requires that the care-giver is not stressed, is present, relaxed, consistently
available and attuned to the infant.
This is not about blaming parents though.
Most parents are loving, attentive, and want the best for their children. Most
parents would never knowingly do things that will impact their child’s
well-being. However, it is not just about things that shouldn’t happen
happening, but about things that should happen not happening. D.W. Winnicott
[the late British child psychiatrist] said that there are two things that can
go wrong in childhood: things that happen that shouldn’t happen — that’s trauma
— and things that should happen that don’t happen. Children are equally hurt by
things that should happen and don’t as they are by things that shouldn’t happen
but do. If the parents aren’t emotionally available, [for example], no one will
define that as trauma, but it will be for the child. If a mother has post natal
depression, that’s not defined as trauma but it is likely to lead to emotional
neglect, consequently interfering with child brain development.
Of course it is impossible for a parent to be emotionally available and
non-stressed all of the time. For one thing, we live in a highly stressed
society. Often both parents have to work in jobs that they don’t like just in order
to pay the bills. Or the young mother is herself traumatised, isolated,
stressed, and has no support. Also, the nuclear family is not necessarily the
ideal model for healthy non-stressed child rearing. So the African proverb
states: ‘It takes a village to raise a child’. Now days most parents do not even
have extended family living nearby to help with raising the children. The
current way that we live so separate from each other is only a very recent
phenomenon (probably due to economic growth). The fact is that humans have
lived in small communities for tens of thousands of years, and it is only
relatively recently that we have moved to the nuclear family model.
So, in this context, addiction is a disease of our culture, and not of
the individual. It is our society that is sick, and this expresses itself in
the individual in a myriad of ways, one way being addiction. What if it is what
happens in peoples’ lives that makes them addicted? Then we have to look at our
society, the way we treat each-other, the way we bring up our children, the
mechanisation of childbirth, the split from nature and the wanton destruction
of the environment for the sake of economic growth.
As an example consider the first nations aboriginal people. Aboriginal
people used substances like peyote, alcohol, tobacco, psychotropic mushrooms
without any problems with addiction. These substances were always used in the
context of a sacred ceremony for the village. It was only much later after
these cultures had been violently crushed, raped, dispossessed of their lands,
their freedom, and their right to practice their religion that they developed
addiction problems. The current accepted ‘truth’ is that aboriginal people have
a genetic predisposition towards alcoholism and that’s why they became
addicted. Yet if it were just down to the genes then they would have been
alcoholics a long time ago because genes do not change in a population within a
few decades.
The road to recovery
So, if the tendency towards addictive behaviour is hard-wired into the
infant’s brain through painful early experiences, is there any hope of recovery
for the adult addict? The answer is a resounding ‘yes’. Fortunately the brain
is ‘plastic’,
meaning that it has the ability to re-wire itself and make new neural pathways,
and so the addict is able to change their behaviour. This can take a long time
though and certainly does not happen over-night. The little story below gives
an idea of how the brain builds new neural pathways:
As sheets of snow fell, two high
school buddies and I had a daring idea.
Hanging in the barn was the rusty
hood of a Volkswagen Beetle, and our thoughts went downhill from there,
literally. Its rounded shape, narrow in the front and wide in the back, made
the car hood the perfect giant sled. And the most dangerous slope we could
think of was a straight shot down an old logging road that descended what we
simply called “the mountain.” On the left side of this steep and rutted gravel
road a hill rose dramatically, but to the right a bank fell sharply to a wooded
valley.
Fresh, unpacked snow can make for
slow sledding. So to get the trail started we got a running start at the crest
and then all three of us recklessly leaped onto the curved hood. It bored down
the road, but soon careened over the right edge toward the valley where we
smashed into a tree. Bruised, aching, and laughing about it, we then devised a
plan to correct the failed track. We dragged the hood to the place where we
veered off the logging road, and then walked the hood the rest of the way down
the hill. By doing so, we created a groove in the fresh, deep snow, so that the
next time we rode down the hill we could avoid the original path that led to
the uncomfortable crash. At the top of the hill again, less reckless and more
intentional, we got another running start. The makeshift sled shot down the
road, and when we reached the exit to where we had crashed we leaned to the
left to stay on track. We flew past the danger point and gained such momentum
that the hood propelled the three of us across a creek at the bottom of the hill.
The new pathway that we took time to build had been the key to our success.
To break an addiction it is not enough to just stop or suppress the
addictive behaviour, but one needs to replace it with something new (and
healthy!). One needs to intentionally create a new brain patterning by changing
one’s thinking and behaviour to more healthy life-affirming pursuits.
Healing the original pain - How homeopathy can help people with addiction:
Consciously rewiring the brain by changing one’s behaviour will help with
addiction, but the addict will need to dig deeper if they are truly to overcome
their addictive nature. Because the susceptibility towards addiction begins
with traumatic brain-wiring experiences that occur early in childhood, it is
through healing of these past experiences that the foundation for addictive
behaviour is dissolved.
Homeopathic treatment can help a great deal with this, as it gives
self-insight into the nature and origins of one’s addictive patterning and has
the power to heal at a very deep level.
Healing is not about just fixing the symptoms, or, in the case of addiction, rewiring the brain. Healing is about treating the whole person; understanding the dis-ease within the context of the person's life history, taking into account all aspects of their nature, inherited predisposition and susceptibility. This approach fits perfectly within the remit of homeopathy in which every aspect of the individual is considered - physical, psycho/emotional, spiritual.
The homeopathic approach always views addiction (or any illness) as an expression of dis-harmony within the whole person. It recognizes that all symptoms are part of the whole and nothing stands in isolation; the person's neural wiring is not a separate entity in its own right. This of course is an absurd idea, but it does tend to be the view that conventional medicine takes regarding disease. This is why there is a different specialist for every part of your body, and they often don't talk to each other!
Healing is not about just fixing the symptoms, or, in the case of addiction, rewiring the brain. Healing is about treating the whole person; understanding the dis-ease within the context of the person's life history, taking into account all aspects of their nature, inherited predisposition and susceptibility. This approach fits perfectly within the remit of homeopathy in which every aspect of the individual is considered - physical, psycho/emotional, spiritual.
The homeopathic approach always views addiction (or any illness) as an expression of dis-harmony within the whole person. It recognizes that all symptoms are part of the whole and nothing stands in isolation; the person's neural wiring is not a separate entity in its own right. This of course is an absurd idea, but it does tend to be the view that conventional medicine takes regarding disease. This is why there is a different specialist for every part of your body, and they often don't talk to each other!
The addict can be viewed as being ‘stuck’ at a particular stage in their
life when the painful experiences occurred. Basically, something happened to
them (usually at a very young age), and they have never recovered. This is why
post-traumatic stress disorder (PTSD) and addiction are so intertwined. The
neural pathways (and therefore behaviour patterns) are set in response to these
early experiences, and so the person becomes stuck at this place in time,
behaving and responding in the present time as if these painful experiences
were still occurring. This phenomenon is known as implicit memory.
True health is not only about being free from physical pain and
suffering. In true health we are also free from our past pain and conditioning
so that we can respond appropriately to the present circumstances whatever they
may be. The key word here is ‘appropriately’. As an example, a baby who
experiences maternal abandonment will, as an adult, tend to re-experience or
interpret abandonment even when this is not actually happening. They will be so
keyed into this brain groove that they will interpret and perceive abandonment
in situations where they are not actually being abandoned. Also, if this person
experiences (or perceives) abandonment as an adult (and we all do at some point
in our lives) they will re-experience very intensely all the associated
feelings they experienced as an abandoned infant – terror, anxiety,
worthlessness…
In this way we can see how dis-ease is an inappropriate response – a
stuck ingrained pattern that has its roots in our early conditioning.
True health does not mean that we are pain free, but that the pain is in
proportion to the current situation. For example your partner criticizes you
for not doing the washing up properly, and you experience crushing rejection,
humiliation, and rage... This is an out of proportion reaction and we need to
realize that this reaction must be being fed from an earlier stuck and
unresolved experience of rejection and humiliation.
Homeopathic treatment can help to heal the pain and undo this past
conditioning so that we are unencumbered by our early negative programing, and
so able to respond in a more wholesome way, leading to healthier relationships,
peace of mind, and a far greater sense of well-being. This is the way to really
heal addiction; to remove the susceptibility towards it, so that it has nothing
to attach to.
In the homeopathic pharmacopeia we have over 3000 remedies of which many
can be used to heal this early emotional patterning. Each homeopathic remedy
has its own unique highly developed ‘picture’. The homeopath’s task is to find
the remedy whose picture most closely resembles the case history of the
patient. When the correct remedy is given, it triggers a healing response in
the person, often revealing and resolving deep emotional issues, as well as
physical ailments and predispositions towards disease.
The first step for the addict though is the realization that they have a
problem and then the willingness to address it. It should now be clear that ‘just
saying no’ is not enough, that detoxing by itself is not enough. Remember that
addiction is about self-medicating for pain, distress, depression… It is these
deeper issues that need to be addressed in order to fully heal.