Is Addiction, Compulsion, Or OBSESSION a choice?

This podcast explains why it feels impossible to control any compulsion. If you have ever told yourself to stop, while still unable to put your compulsive habit down, you'll relate to this podcast. The information here is about the biochemistry you’re dealing with in any addiction. Knowing this will help you gain back power and control.

Citations
Gabor Maté - 'In The Realm Of Hungry Ghosts'
Nora Volkow - ​​Drug addiction: the neurobiology of behaviour gone awry: https://pubmed.ncbi.nlm.nih.gov/15550951/
Richard Rawson UCLA https://www.ncbi.nlm.nih.gov/sites/myncbi/richard.rawson.1/bibliography/44043452/public/?sort=date&direction=ascending

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Transcript

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0:00:02 - Speaker 1
Hi, this is Shelley Treacher from Underground Confidence. Today it's time for me to talk about what happens in your brain again with addiction and compulsion, because I've been reading this fascinating book by Gabon Mate. It's given me a slightly refreshed take on some things, so I want to share those with you. I will be talking about the chemistry of the brain. I have talked about that before, so you will find different information in the podcasts about habits and about a craving. But today I'm going to tell you a little bit more. 

Understanding compulsion and addiction is a complicated business, because we do have such complicated brains and lives. There's no doubt that biology, as well as our environment, makes a huge difference to us. Traditionally, doctors see addiction as a biological problem, but it can't really be separated from your environment, your upbringing, your history and your relationships. You can start to see the truth of this when you consider that not everybody gets addicted to the same substances and not everybody gets addicted to the same extent, and some people don't get hooked at all. But compulsions and addiction do have a biological element, and that's what I'm going to talk about today. Pretty much all of my other podcasts are about the human side of addiction and compulsion. As Gabor Maté says, if someone becomes an addict is because they were already at risk. Studies show that exposure to a substance doesn't predict addiction. Tobacco was the most addictive in one of the studies that he quotes, with 32% of people carrying on with it after they first tried. It is 15% for alcohol. That's pretty low, actually. So you've got to consider that there's a lot else going on. So, unlike traditional thinking, we really cannot say for certain that substances cause addiction. It's really more that they lend themselves to addiction or compulsion because of emotional issues or neurobiology and the psychology of emotions. To slightly recap, compulsion can be described as impaired control, as in not stopping despite the consequence, compulsion can be characterised by the persistence of it, irritation, relapse and craving. These are what Gabor Maté describes as the hallmarks of any addiction. 

So just to be really clear for those of you who are listening, who have more food than you think is good for you it's not the food that's making you addicted. I hear so many times that people say I've only ever been addicted to something that was hard to get hold of or that I didn't have to use three or four times a day to survive. I feel for you, because that does make it a challenge to resist all day long, but it's not the food that's making you addicted. There's some kind of precondition. Putting it in as simple language as possible stress seems to cause addiction. Stress and the substance those two things and a susceptible organism. 

Something I found really interesting one of the comments that Gabba or Maté makes is something that he made as a throwaway comment, but to me I was like wow, everybody knows this. So he said that everyone agrees that addiction is a different state of the brain. So whenever there is addiction, there's a different state going on in the brain and of course that makes sense. If you look at somebody who's addicted, they are in a different state and it's all about trying to get that fix. That's a certain state and I've talked about that so many times, but I didn't realise that everybody else knew that Anyway. So that clearly happens. Everybody agrees that that happens. 

But he said, what people disagree on is how this happens and this is where I start turning to the chemistry, because this is so interesting what actually happens in our brains. Apparently, when someone is addicted to a substance, we lose the white matter that we have in our brain. The white matter covers our brain looks after our brain, protects the brain, especially as we age. We lose that in addiction and he seems to be saying in any addiction, any compulsion, any substance, because of the state that our brain gets into. I will talk more about this, but what it means is that we get a loss of our learning capability. We have a diminished ability to adapt to new circumstances, to make new choices or to acquire new information. Isn't that astounding that a compulsion can lead to a degeneration of your brain? And as if that wasn't bad enough, he also says that the grey matter that's the stuff that the white matter is protecting is auto reduced. Our brains get smaller and we have fewer brain cells. This means a lack of rational decisions and regulating emotional impulses Isn't that interesting? And also a diminished energy utilisation. Basically, the brain just does less work. And one of the main chemicals responsible for all of this that makes us want to get into that state is dopamine. 

I talked about dopamine before in, as I said, the Habits Podcasts. Dopamine is a feel-good chemical. Putting it as simply as possible, the brain loves it and welcomes the intake of dopamine. All compulsion, all addictions, all contain fake dopamine. We get a dopamine hit, a fake dopamine hit. I say fake because it's not manufactured in the brain, it comes from outside of you. We get a fake elation and a fake stimulant, especially at the beginning of using a drug, and the brain learns to recognize that really quickly as something that it likes and would like to repeat. And here I have some more bad news for you. Basically, what happens here is your natural dopamine starts to reduce, so being able to produce your own natural sense of feeling that elation starts to be difficult as we rely on the fake supply. This means that we have less stamina and less motivation. Natural dopamine is responsible for getting us excited about life. You can see more here how addiction might form. Having a lack of motivation or energy. We might seek the fake version. We might seek a boost from the fake dopamine. And the more we get a fake hit of dopamine, the less receptors we have for the real stuff in our brains. The brain starts to offload them. 

Another thing that I've found so interesting in this book is that this explains tolerance. I've never really questioned what tolerance actually was and how it was produced in us. It seems to happen very quickly with most substances. In a nutshell, we have to use more and more of the substance to get the same effect because our dopamine receptors have decreased. This can also explain why withdrawal is so awful. Withdrawal from any substance can cause irritability, fatigue, depression, isolation, and it can take months to get your receptors and your natural dopamine up again. According to a study by Richard Rawson, UCLA, when we eat addictively, our dopamine levels go up by 50%. With nicotine or alcohol, or even sexual arousal, it goes up by 100%. With cocaine, it goes up three times that with crystal meth or speed 1,200%. This might be slightly good news amongst all these pieces of bad news for the people who come for it who are listening to this podcast, but it also might explain why we need to eat so much. Thankfully, though, withdrawal is less with food. The brain actually recovers much quicker and builds more natural dopamine quicker with a food addiction, as opposed to a stronger chemical. 

I really like learning about this stuff and I love it being the explanation, partly, of what's going on with addiction, because there's less blame. We can start to see that it is a chronic brain condition addiction. Remember I said that your ability to choose is impaired with addiction. This is what leads me to question whether addiction is a choice, and now a lot of people come to me saying that they don't feel like they have a choice, and this must be partly why it's just frustrating that our medical system doesn't seem to see it that way. Carrying on, having talked a little bit about dopamine, I'm now gonna talk about another apparatus in the brain, another part of the brain, another chemistry that happens. That certainly contributes to compulsion and addiction. This is the endorphins. This is known as the opioid apparatus. 

Endorphins are natural narcotics. They soothe us. They soothe physical and emotional pain. They regulate our autonomic nervous system. They affect our organs, our sleep, our breathing, our bowel movements, our immune system, our body temperature and they enable bonding with our mothers. When we expect relief from pain, physical or emotional, these parts of our brain light up. This explains the placebo effect. It's also where the imagination lives. Bringing together last week's podcast with this week's, this is where the attachment instinct lives. 

Drugs severely interfere with this area. If we haven't been cared for and soothed in our childhoods or in our lives, we are much more likely to seek soothing from a chemical Left on our own. We don't have ways to soothe ourselves as children. We have rocking, we have tuning out and we have thumb sucking. That's pretty inadequate. So it's easy to see how we might turn to something that makes us feel more of this soothing and feeling good. The endorphins are also responsible for life's pleasure and joy, euphoria and risk-taking and being loving. To put it really bluntly, the less happy we are, naturally the more likely we are to form happiness from a chemical. Dopamine raises that elation. Feeling so raises the endorphin area. Here we're tapping into a system that makes you re-trigger over and over again to get more and more of this drug, to the point of ignoring rest and any wellbeing. A question you could be asking yourself at this point is when do you get excited about using your drug? How does it switch from one biscuit to several? 

I know for me the second coffee is never a good idea. Thankfully I don't fall into this trap too often anymore, but recently I went dancing two days in a row first time in two years. I used to have a coffee before I went dancing, so I have that association in my brain. I can almost see the dopamine receptors lying in wait, waiting for me to go dancing so that we can repeat that pleasure. My brain tells me all kinds of things about how good the coffee would be how it would make me feel good, how it would keep me awake, how it would make my dancing superb. It really doesn't, and I even knew. I even knew that none of these things were true and I even was telling myself don't have it, shelly, don't have that second one. You know you shouldn't, you know you're going to suffer. 

But of course I had it. I wanted the taste, or so I told myself. And when I actually analysed it and I knew this at the time I couldn't see any good reason to have it at all. So I know it was that dopamine thing. It was the hit inside me saying God, just have it. We loved this once before, so we're going to have it right. I could not have resisted, but it did make me feel awful. My dancing was terrible, my connection with people was awful and I didn't feel good about that, because that's something I absolutely thrive on. I just felt really fuzzy-headed for the rest of the afternoon. But at least I've given myself a memory so that I don't do it again for a while. So ask yourself when do you get excited about your addiction? When do you feel like? You know that it's wrong, you know it's going to make you feel bad, but there may be some apparatus in the brain Taking away your choice. 

As I've been saying, research shows that repeated drug use leads to long-lasting changes in the brain that undermine voluntary control. This is a quote by Nora Volkow and co-written by the National Institute of Drug Abuse. So once an addiction or a compulsion develops, it damages decision-making parts of the brain and, as I've been saying about the opioids, the endorphins and dopamine, the self-regulation system is affected by drugs, which of course might make us afraid of giving up all the activities that we have around drug abuse or substance abuse. But emotions help us to survive. That's why they exist. They modulate attachment and aversion. So opioids and dopamine are essential parts of this process. When they're impaired under the stress of addiction or compulsion, this is a really big attraction than this is a problem. 

When we are being influenced by the fake dopamine hit trying to get us to have more of the dopamine, the part of us that is employed in our brain to make good choices for us is actually not available. So we have poor impulse control. In society we're seen as immature or bizarre. If we behave with poor impulse control, we do have diminished social capacity the parts of our brains. That's like the mission control of our emotional life. It's also in control of what we smell, taste, touch and evaluating that and preserving that. So if we have a smell associated with a positive experience, we will try and have that smell again and have that positive experience again. So it evaluates personal meaning for you. It also decides about people and situations and whether they're good for you or not. It assesses who loves you and who doesn't, and how much. You guessed it. 

Addiction also affects this part of the brain and the next one, I know you know it inhibits impulses that are inappropriate, like violence. This is also, incidentally, the part that is activated during craving. Just the thought of the drug lights this part of the brain up. So I'm hoping that you can see, with everything that I've said today, that it's really not a matter of willpower to overcome a food addiction or any other kind of compulsion To go along with what I've talked about a lot in this podcast. This is especially true. All of this that I've said today is especially true when emotionally triggered, and that, I believe, is where the solution lies, because it's not an easy choice to make to stop having these things that make you feel better. My work focuses almost entirely on helping yourself to feel better in another way, but it is important to understand what you're up against. So that's why I've told you all about the chemicals today. Today I've talked to you about the effect of dopamine and endorphins in our brain, both the natural effect but also the chemical effect. I've spoken about how, if you use a substance that increases the fake dopamine in your brain reduces your natural dopamine receptors and dopamine, and we've seen how the brain can overvalue these drugs and chemical triggers to the detriment of everything from food, sleep, health and to relationships. 

The next time I produce a podcast will actually be at the end of the month. I'm going to be talking about relationship, because that's the end of the month is a spotlight on relationships. So I'm going to continue from the last podcast, which was about avoidance. I'm going to be talking about how you can work with that and through it in relationship. The following podcast will be a continuation of today's podcast, where I'll talk much more about the attachment system and how the endorphins work and how addiction interferes with that. But for now I'll be taking a break for Easter. 

Sometime over the next few weeks I will be publishing my new community, so please get in touch with me if you're interested in finding other people who think exactly the same way as you and have a lot of difficulty with comfort eating that nobody really talks about. One of the things that I feel most touched by when I run my groups is how the people bond in the groups. So what usually happens is we start off quite nervous. I've got a group starting this week and I can guarantee that most people will be quite nervous to start with and reluctant to speak, which is fine but what usually happens is they end up wanting to speak because these people have the same thoughts. They all go through such similar experiences and have so much in common that it becomes liberating to talk to someone who finally understands. 

What often ends up happening is that they enjoy talking to each other so much more than they enjoy listening to me, which is fine. It's actually such a pleasure to see that. So if you're one of those people who might need someone else to identify with, please get in touch with me. Trust me, it's very well understood that this is quite scary. So, as always, your humanness is very welcome. Thank you so much for listening to me today. I hope you all have a lovely few weeks and a lovely Easter break. If that's what you're going to have, I'll see you on the last Wednesday of the month. This is Underground Confidence with Shelley Truecher.