On Drugs And Tranquilizers

(Originally published September 10, 2008)

The choice of tranquilizers or pain-killing drugs depends on very early life experience, even during womb-life. It is this fact that makes a cure so difficult to achieve; yet without delving down into the antipodes of the brain we cannot resolve the need for any kind of drugs, from cigarettes to alcohol to illicit drugs.

No one takes drugs chronically if there isn’t some lack in the physical system. An addiction, first of all, is not to alcohol or drugs; it is to need. (either trying to fulfill it or repressing it). We are addicted to fulfillment but because the critical period is past when need could have been fulfilled; we become addicted to substitutes. We are forced into seeking symbolic substitutes so long as the real need is heavily suppressed. And the urgency of the drug seeking is the same as that of the original need. The person is not only suppressing current pain but also the past pain which he or she may not be aware of. That is what makes addiction look like—addiction. The original need is sequestered and unreachable. 

Drug or alcohol taking is overt, something obvious, a behavior we can treat by redirecting behavior through, not so oddly, Behavior Therapy. It is something we can see and measure; so many months off booze and drugs equals a successful treatment, in their approach. The success is measured in terms of external behavior, not internal processes. Yet it is those internal processes that count the most in the use of drugs. Addiction most often results from very early painful imprints, even during womb-life. It is this fact that makes a cure so difficult to achieve; yet without delving down into the antipodes of the brain we cannot resolve the need for any kind of drugs, from cigarettes to alcohol to illicit drugs because, again, it is not the need for alcohol, it is THE NEED.

Since we needed love early on to stabilize the system, we must make up for its lack by taking something that does what early love would have done: with alcohol or drugs we feel warm, relaxed, untroubled and energetic. And, important, they are immediately available. All of these are temporary solutions; the only permanent solution is to have been loved very early on, or to feel the need and pain from that lack. That re-balances the system. Love in the present won’t do it, but feeling unloved in the past will. 

Our former speed (amphetamine) addicts cannot imagine taking speed when their systems are normal. Perhaps one may consider this a simplistic approach but behind these statements are many decades of experience and much new research that clarifies our position. For a bit more detailed explanation I am indebted to Myron Michael Goldenberg for his description of drug action.

("Pharmacology for the Psychotherapist."Accelerated Development Inc. 1990). 

We need to understand what addiction is and how it works. We need to know what we mean when we say that a drug binds to a receptor, which is how it may work to calm us.

For primal pain to be acknowledged it must arrive at conscious-awareness. If the message never arrives, if it is blocked by any one of the neuro-inhibitors we produce in our brains, we may feel a vague uneasiness, a tension or amorphous suffering, but we will not know what it is specifically. And we will go on suffering. The central aim of those inhibitors is to block too much information, too strong an emotional message from rising to conscious-awareness. When some of the message gets through there is active anxiety, symptoms and impulse-driven behavior. How does that happen? 

Receptors and Receptor Theory

Several theories exist on how drugs actually act in the brain and body. These are by (1) attaching to cells called receptors, (2) interacting with cellular enzyme systems, or (3) affecting the chemical properties of the outer cell membranes. (Goldenberg. Pages 36 & 37)

Many drugs are believed to combine with chemical groups within the cell or on the cell wall. These drugs combine with specific agents known as receptors. The theory is that these receptors actually attract the drug by having a molecular shape that fits with the drug. This is sometimes known as the "lock and key" theory. Think of the shape of a key that will only fit into a certain lock. When the correct shaped key and lock are matched up then the lock can be opened. The receptor theory is much the same. A certain shaped drug molecule is attracted by a receptor site on the cell wall. When the two shapes fit or line up together, the drug acts the same way as a natural body chemical does to set off a chain of events. The key here is that the drugs mimic what our body should have done if we were loved as infants or even before. What almost any drug does is somehow mimic what we should produce naturally. For example, the naturally occurring body chemical acetylcholine combines with receptors in the membranes of muscle and nerve cells that are chemically specialized to receive it. Certain synthetic drug agents can duplicate the action of acetylcholine by combining at the cell wall. These drugs are sometimes referred to as agonists. They boost the action of the cell. The antagonist, in this case atropine, competes for the receptor site which normally accepts acetylcholine. It says, “get out of the way. I will now take your place for the moment.” It will block or dislocate the normal physiological function. Why dislocate? Because the energy and its tendency still exist but must be diverted somewhere. It noses around finding another vulnerable place. The person acts out by overeating, is made calm by drugs, and then suffers from high blood pressure. Sometimes the attack site is not apparent until years later. 

There are drugs that can block the receptor site and interrupt its effect. If there is too much stimulation and we feel that we are about to jump out of our skin there are medications that can stop that stimulation. The pressure is so much from inside that we literally feel that we need to get out of our skin. It is the message lodged deep the nervous system that is doing it, mostly of not being loved or early trauma, a chronically depressed mother both while carrying and afterward, for example. Not being loved has always to do with not having needs fulfilled—from lack of oxygen at birth to lack of touch right after birth. There is a timetable of needs that form a critical window when they must be fulfilled. Once past that window needs can only be fulfilled symbolically. Feeling unloved cannot be eradicated in adulthood by more love. 

One way to rid of the feeling of being so anxious and agitated is to slow down or stop the transmission of messages between neurons (nerve cells) so that the message of pain (which stimulates) does not reach higher levels. We then feel calm even though a grand tumult is going on in lower brain centers. We never change the pain, only the appreciation of it. That is why we can take tranquilizers and pain-killers and feel good, but damage is still going on. No matter what we think or what we think we feel, it is an unreal state. In cognitive/insight therapy they change the way patients think they feel, not the way they really feel. To change the way they really feel means pain. If there is no pain there is no addiction or need for a drug that is calming.

The aim of therapy must be to establish fluid lines of communication among the levels of consciousness. This communication is a given when we have positive experiences from conception on. But when noxious stimuli--pain--intrudes, gating intercedes and blocks information between the levels. Communication is halted or misdirected, and one level doesn't know what's going on in the other levels. The true meaning of "holistic" is when all levels speak a common language and contribute their share to a single feeling. To make a patient whole is a desired goal so long as we know what that means in the brain. This is, grosso modo, the overall scheme, the goal of our efforts.

To be human means to be feeling. Inordinate, noxious input very early on provokes repression and blocks an aspect of feeling. Fully feeling beings are not blocked off from any aspect of themselves, that is, there is no massive gating that has sealed away major portions of brain function from access. Thus, each level of consciousness is able to contribute its share to an experience. This means being able to feel great joy as well as sadness. It means to sympathize and empathize. When a depressive tells us that he is not getting anything out of life, no interests, no joy, we know that he is carrying a load of repression and that repression is the underpinning of depression.

So what’s wrong with taking tranquilizers and pain-killers? Their primary job is to gate emotional pain. It keeps feelings unconscious. The result is that the cortex cannot signal emergency; thus keeping reactivity within bounds. The key here is that with pain-killers reactivity is blunted in order to save the system from massive over-reactivity (or occasionally, under-reacitivty). That reactivity, when enormous, can threaten one's life. This is what we see in our therapy when defenses are dismantled. Vital signs mounting to the danger area. Feelings are responding realistically to some unknown hidden force. If we do not acknowledge that force we are helpless before it. If we measure lower brain activity we will understand immediately; there is tumult going on below decks that we never dreamed existed. The ship is sinking; there is water below decks and we carry on as if nothing were happening. 

Quelling the deeper centers with drugs eases the so-called "thought" disorders. As our patients ease their defenses in a session, and great pain begins its march to prefrontal areas thinking centers, their cortex will ruminate about this danger or that until they actually lock into the feeling. In short, there is an anxiety attack as the system tries to stave off the approaching pain. Great terror pressing against cortical centers creates paroxysms of obsessive thoughts: "There's no space for me." "I am stuck and no one is helping." These often are birth statements. But because the actual feeling is so well buried, the person is left only with a vague anxiety. She will manufacture things to be afraid of but it is all a rationale. 

In the hierarchy of the nervous system the comparative force of imprints on the different levels diminishes as we move up the scale of evolution. Thus, something that happens at two months can alter the brain structure permanently, whereas if that same trauma, lack of touch, happens at age ten it will not produce serious brain impairment. There is clearly a timetable of imprints depending on the critical period; what characterizes the critical period is its irreversibility. Once the cortex is diminished it is not going to flower in adulthood. And the brainscans bear this out. There is less activity in the prefrontal area in certain impulse states. 

In our Attention Deficit Disorder research, hyperactive patients we have seen had elevated cortisol or stress hormone levels. (Our research in salivary cortisol, St. Bartholomew's Hospital, London) After reliving very early trauma, including the birth trauma, there is a normalization of cortisol levels. So dampening of pain is no longer necessary because the pain is gone—shorn of its original power it is now but a memory. 

Based on our own research, we can find no other explanation for chronically high cortisol levels other than the imprint. There is also a normalized brain system with a better balanced right and left hemispheres. 

We are all of one piece; part of an organic whole. Thus, we cannot isolate one factor, serotonin, or another factor, time off drugs, to make definitive statements about addiction. No can we attack only one aspect, lack of serotonin level, to achieve our goals. We need to attack the central organizing principle, and then the rest will take care of itself. The brain can no longer be considered an isolated organ encased in the cranium but must be considered part of an entire physiologic system. Thus, when the body is in distress, that distress can be found not only in the brain but in hormones and in the blood system.

It is our hypothesis that drug addiction is made up largely of early pain, i.e., lack of love, and that pain sets in motion its countervailing forces, namely repression. When repression is in place but faulty or failing, when the serotonin-endorphin systems are inadequate to the task, there is suffering and the need for outside help in the form of drugs to dampen that suffering.

Often the outside drugs utilized mimic the exact biochemicals we should produce internally, and that is what makes it so addicting; drugs are normalizing the system. We need them. We will go to any lengths to get them, even risking jail. The strength of internal imprinted pain can often be measured by its opposing forces--the repressive system. It is the dialectic again. Pain provokes its opposite and turns feelings into numbness. Then the person feels like she is in a bubble and cannot reach out of real life. It is all grey and dull. That is the price we pay for tranquilizers. Feeling no pain equals no life.