Saturday, May 5, 2012
Addiction: It’s Not About the Brain, by Bruce Wilson (Science and Medical Writer)
Art and I were expressing our exasperation about two items that crossed our attention this week, both of them related to addiction.
The first was a WSJ article about a study looking at the adolescent brain: “Are Some Teenagers Wired for Addiction?” Using fMRI, the researchers identified a particular pattern of neural activity in teens who had a tendency to become addicted to drugs or alcohol. Specifically, these teens had lower activity in the orbitofrontal cortex (OFC), a region that mediates impulse control. The implication is that faulty brain activity causes poor impulse control which in turn causes kids to become easily addicted. A different pattern of faulty networks was found in kids with ADHD, also related to impulse control. In other words, the brain is the problem.
The second item was a segment on CBS’s 60 Minutes about the work of addiction researcher, Nora Volkow. In addition to being the director of the US National Institute on Drug Abuse, Volkow has the dubious distinction of being Leon Trotsky’s great granddaughter and actually grew up in the house where he was murdered. She describes addiction as a physical disease: “we know that drug addiction is a chronic disease; the drugs physically change the brain…those changes are very long lasting and persist for a long period of time after the person stops taking the drug.” The culprit? Dopamine! In Volkow’s view, addicts are conditioned by triggers that cause a dopamine rush, making them feel, “I want that!” And because of drug tolerance, “I want that!” becomes “I want more and more!” Hardened addicts are merely conditioned, like Pavlov’s dog, perhaps by a genetic disposition, the theory goes. But instead of salivating; they crave. Show them a photo of someone hitting up their favourite substance of abuse and the dopamine surges through their midbrain, reinforcing more brain dysfunction. Once again, the brain is the problem.
The problem with both of these reports is that the brain is not the problem; it’s what’s deep within the brain that’s the problem – the pain of unmet need. But why don’t these researchers see this?
The answer is that you have to feel it to see it, and they don’t feel it.
Over my twenty-year history working in the medical community, I’ve met precious few scientists who are able to see the full implications of what they are studying. Medical scientists are trained to analyze and to seek explanations for living processes in terms of the bits and pieces of life: molecules, biochemistry, pathways, and genes. This works well for genetic diseases such as cystic fibrosis or Huntington disease, but is utterly inadequate for mental conditions such as depression, schizophrenia, and…addiction.
As Iain McGilchrist points out in his brilliant work, The Master and His Emissary, analysis is a function of the left hemisphere whereas synthesis and intuition are functions of the right hemisphere. Whereas the left sees only the bits and pieces, the right sees the “big picture.” The best scientists use both processes when trying to explain phenomena but modern behavioral scientists seem to have forgotten that. The very term, “behavioral science” implies that people are stimulus-response units—turn on the stimulus switch and the response follows as behavior. The left brain scientist tries to explain that behavior in terms of brain mechanisms. As one cognitive scientist put it, the brain is nothing more than a “computer made of meat.”
Apparently, Volkow gets $1 billion a year to study the biological mechanisms of addiction, delving ever deeper into the neurons, synapses, receptors and cellular biochemisty, searching for the cure for this “brain disease.” The same is true at addiction research centres everywhere.
Meanwhile, the real cause of addiction is ignored, except for those who can see it because they feel it. Art Janov was writing about the primal causes of addiction as early as The Primal Scream. Gabor Maté, no stranger to addiction himself, works with hopelessly addicted patients in Vancouver’s Downtown Eastside, which he tells in his heart-wrenching book, In the Realm of Hungry Ghosts. Every one of Maté’s patients suffers from the pain of terrible childhood abuse, which is clearly the cause of their addictions. Neuroscientist, Jaak Panksepp, who has spent his career studying the neurology of animal feelings, sees addiction as an attempt to resolve the pain of unresolved separation distress, or in primal terms, a futile effort to get the love one didn’t get as a child. Addictive substances not only stimulate brain dopamine, they stimulate endogenous opioids as well – the body’s own pain killers.
No doubt, brain function is deeply altered by addiction; levels of neurotransmitters are altered; receptors are changed. But to conclude that these aberrations constitute a disease process that appears out of nowhere or is influenced by brain biology or genes is scientific reductionism at its worst. What about the personal history? The family history? What about the social determinants of addiction? What about poverty, stress, and the hopelessness of your life situation?
None of this counts in mainstream addiction research – the biological cause must be identified and a chemical cure must be found! So an army of left brain analytical scientists continues to spend more effort and more money to find what will never be found, the medical “cure” for addiction. Volkow—who goes for a seven-mile run each morning to get her own addictive hit of dopamine—envisions a vaccine that will banish addiction once and for all, as though it were a virus. But the real virus seems to be the one preventing scientists from recognizing addiction’s true cause and we already have a treatment for that – feeling.
Review of "Beyond Belief"
This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer
Quotes for "Life Before Birth"
“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine
Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University
Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University
In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System
A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University
"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH
His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.