Understanding Addiction & the Road to Recovery

What is addiction and how do we heal? If you have experienced addiction, you are probably familiar with the feeling of being trapped and unable to stop. Addictions can feel like you are stuck in prison, in an abusive relationship, or are enslaved to something. If you hate it, why is it hard to stop? You may have heard it is because there is a chemical imbalance in the brain or that drugs/alcohol are chemically addictive, but could there be more to the story?

Dopamine & Addiction

The chemical component is certainly part of the story. With advancements in neuroimaging, we have learned a lot about the reward pathways and dopamine system in the brain. In short, the brain communicates through chemical signals called neurotransmitters. Dopamine is one type of neurotransmitter that reinforces or ‘rewards’ behaviours that are important for survival and is part of addiction. 

For example, you eat a sandwich and then your brain releases a small amount of dopamine. On a chemical level, it is like our brain gives us a little gold star, saying, “good job, keep doing that!”. Dopamine is also released when someone smiles at us, we are given something, we have sex, and countless other behaviours. 

However, addictions, particularly substances like alcohol, opiates, cocaine, and other drugs (but also process addictions like pornography, gambling, shoping, sex, etc.), override our normal dopamine system. Rather than giving a gold star, something like heroin will trigger a supernova in our brains. Even though other behaviours like eating lunch or spending time with family are still rewarding, they pale in comparison, at least on a neurobiological level. This is partly why addictions can rip apart our lives- the gravity of the addiction is so strong that it pulls us away from all the other things that we care about. 

Dopamine is more about ‘wanting’ than it is about ‘liking’. We may ‘want’ or ‘need’ the thing that we are addicted to on a chemical level, but emotionally hate it.

So if we can re-regulate the dopamine pathways, can we solve the addiction? It is not quite that simple, unfortunately. There is more to the story than just dopamine. 

Understanding our hardwiring is important when we try to understand addiction. The dopamine system is only one of many relevant neurobiological systems, and looking at neurobiology is only one part of the picture. Many systems are implicated in addiction (like the pain system), and other facets like spirituality, the social environment we live in, and even the economic-political environment. However, we will focus on just two systems in this post: the social attachment system and the survival-stress system. 

The Stress System & Addiction 

The stress system is online from our earliest moments. It helps us sense safety/ danger and act to keep us alive (think the fight-flight-collapse response). So when the stress system is activated, our body on a neurobiological level responds like we are in danger or could die. Anything that helps reduce the activation of the survival stress response then becomes associated with safety and survival and on a neurological level is reinforcing.

To illustrate with a theoretical example, Carrie is very anxious about experiencing rejection in social settings. Anxiety is an activation of the survival stress response, in which the body mobilizes energy to fight or flee. So, on a neurological level, Carrie’s nervous system has associated rejection with danger and will elicit a stress response when it anticipates rejection. However, when Carrie drinks alcohol, it helps her to feel calm and to dampen the stress response (since it depresses the central nervous system). This restores balance to the nervous system. 

However, Carrie has become reliant on alcohol to regulate her stress response. Although she used to only drink in social scenarios, alcohol became the primary way that Carrie has learned to manage her anxiety and feelings of overwhelm. 

In this example, alcohol is chemically reinforcing- dopamine is released when she drinks. Since Carrie drinks a large amount of alcohol daily, if she were to stop drinking she would also experience withdrawal and need medical detox.

Additionally, part of the journey to recovery for Carrie is learning how to identify what triggers her to drink, such as feelings of anxiety or fear of rejection. She will need to learn new ways of managing and regulating these feelings without alcohol. Often we are not taught how to engage with, feel and regulate our emotions. In counselling, there are practical tools we can learn to engage with emotions in a healthy way. We also work to heal and transform the painful beliefs and memories that are at the root of the addiction. 

The Social Attachment System

What is our social attachment system? It is our inborn and innate need for people. It is woven into every part of our being. We are hardwired through our social attachment system to need connection and belonging. Even before we are born and are in utero, the attachment system is already developing. From the earliest moments of life, our survival is dependent on others - without our caregivers, we would die. In the absence of connection and belonging, we experience suffering. 

Experiencing safety and connection early in life shapes our stress and attachment systems to make flourishing likely. However, when we experience chronic stress and disconnection, and we lack safety/ soothing then these systems become wired for survival instead. In either case, the outcome is not permanent or unchangeable, but these experiences set us on a trajectory that can make us more vulnerable or resilient to addiction.

This partly happens through how we learn to engage with our emotions. We are not born with the ability to manage our emotions. Experiencing co-regulation (soothing and comfort through another person) is the first step to self-regulate our emotions. As children, we are dependent on our caregivers to soothe our stress system, to provide comfort and safety, and a sense of stability and predictability. If we do not have a caregiver who can provide this then we adapt through our attachment style (closing off to others, or feeling very anxious to be connected to another person). However, addictions can function like an attachment substitute. 

Addictions provide comfort when we experience the pain of isolation or disconnection and relief from emotional distress. Through the attachment system, we are designed to find comfort and safety in the context of safe and loving relationships. However, when we are isolated, have dysfunctional relationships, or learn early in life that we can’t trust other people, we experience the pain of disconnection and are still left with the inborn need for connection. 

When we lack quality relationships in which we are meant to find comfort and safety, we must look elsewhere for security and a way to fend off the pain. This is one way that addictions form. Addictions can function like an attachment substitute. They provide safety and comfort and help us to regulate our distress.

We also find a sense of meaning and purpose in the context of relationships. God designed us to be in community- to both give and receive in relationships. Addiction is a natural response to a lack of connection to people, place, and purpose.

The Road to Recovery

In counselling, we consider the role and purpose that the addiction holds in your life. Does it help you to manage anxiety and stress, to feel ‘alive’, or to keep painful memories at bay? We also look at the ‘ecosystem’ of your life. What might facilitate addiction or contribute to building a life so fulfilling that there is no space for addiction? We also will explore some of the underlying causes of addiction. 

There is no one-size-fits-all model for recovery and the road to healing is unique for everyone. However, freedom, healing, and recovery are available to everyone. If you or someone you love needs support with addiction, please reach out to us for help. 

References

Alexander, B. K. (2008). The globalization of addiction: A study in poverty of the spirit. Oxford University Press.  

Best, D. (2019). Pathways to recovery and desistance: The role of the social contagion of hope. Policy Press.  

Bracha, H. S. (2004). Freeze, flight, fight, fright, faint: Adaptationist perspectives on the acute stress response spectrum. CNS Spectrums, 9(9), 679–685. https://doi.org/10.1017/s1092852900001954 

Corrigan, F., Fisher, J., & Nutt, D. (2010). Autonomic dysregulation and the window of tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology, 25(1), 17–25. https://doi.org/10.1177/0269881109354930 

Fisher, J. (2017a). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge. 

Morgan, O. (2019). Addiction, attachment, trauma and recovery: The power of connection. W W Norton & Co. 
Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1–2), 201–269.https://doi.org/10.1002/1097-0355(200101/04)22:1<201::AID-IMHJ8>3.0.CO;2-9