Book Review Hijacking the Brain

Hijacking The Brain, How Drug and Alcohol Addiction Hijacks our Brains – The Science Behind Twelve-Step Recovery

During my time-off, I read this amazing book called Hijacking The Brain, by Louis Teresi, M.D., a Harvard neuro-scientist and also a recovering alcoholic. This book, for me, was like a gift from heaven. As you could tell from previous posts, my analytical attorney brain has always asked the question, “How does the 12-step program of Alcoholics Anonymous really work”? Forget the blind faith and the answers from old-timers (“It just does..”). I needed evidence, data, and scientific proof. Well, this book answers the question and explains a lot more about the chemistry of addiction. Here are a few passages from the book:

Just as viruses hijack a cell’s RNA and DNA, drugs of abuse hijack the brain’s core reward pathway to promote continued use. Just as the cell’s survival is dependent on its core DNA and RNA, so is the survival of the organism dependent on an intact brain reward pathway. By hijacking the brain’s reward pathways, drugs of abuse—through changes in emotions, cognitive function, and behaviors—all too frequently lead to severely negative consequences for the host/user, including death.

This “hijacking of the brain” is the central theory of the book. It seems common sense to any alcoholic or drug addict, but to “normal” people, they don’t really understand how alcohol and drugs literally change the brain. It’s like brain damage. Well, not like it, it is brain damage.

Addiction is due to a dysfunctional, substance-dependent reward system, and is characterized by a stress state and cognitive impairment. Once an addict takes a drink or drug, the brain’s limbic reward centers are activated strongly while, concurrently, the stress-response is activated and decision-making centers in the frontal lobe shut down. The body is reacting to a foreign substance that disrupts the nervous system. There is elevation of the stress hormone, cortisol, and a generalized increase in the activity of the excitatory nervous system, particularly in withdrawal states and in reaction to life stress. There is associated cognitive decline characterized by poor decision-making and judgment.

Dr. Teresi talks quite a bit about addiction’s effect on the brain’s limbic reward system — our primitive reward center. As he concludes, “mood altering drugs hijack the brain’s reward centers, leading to compulsive thoughts and behaviors to acquire the mood-altering substance. Consequently, thoughts and behaviors needed to survive are displaced; all the addict or alcoholic wants to do is more of his or her drug of choice.” Any alcoholic can attest to the overwhelming and powerful forces of craving and obsession to drink, and how hard it is to “fight” those forces. Moreover, addition compromises the alcoholic’s cognitive/front lobe functionality — literally making you stupid and incapable of thinking clearly and rationally. Hence, the reason why very smart alcoholics (like myself) engage in incredibly stupid and self-destructive behaviors.

With exposure to drugs or alcohol the stress hormone, cortisol, is elevated throughout our bodies, which potentiates and perpetuates the addiction and further cause’s cognitive impairment and damages other organ systems.

Dr. Teresi also discusses the stress hormone, cortisol. I know stress is one, if not the biggest, reason why I drank. The irony is that drinking at first calms you, but then turns on you, flooding the body with nasty stress hormones, and perpetuating a vicious cycle of wanting to drink to relieve the symptoms of stress. I didn’t really understand this process before reading this book.

Chronic Low Grade Agitated Depression: addicted individual experiences a chronic state of low-grade agitated depression due to abnormally low release of brain reward chemicals. This state is dysphoric and generates an urge to find something—anything— that will relieve this state.

The Big Book famously describes an alcoholic’s state of being “irritable, restless and discontent.” This state of feeling “yucky” is actually chronic low grade agitated depression, and is completely normal and common in early recovery and beyond. Whew, and I thought I was going crazy feeling like crap all the time…

The positive, empathetic socializing experience of the Twelve-Step group makes the addict “feel good,” which is why it is essential for recovery. Several empirical studies support this hypothesis and indicate that social reward is processed in the same brain reward centers in the limbic system as non-social reward and drug addiction. Working the Twelve Steps involves surrendering to a Higher Power and “letting go” of fear, resentment, guilt, self-pity and self-loathing. These emotions are known to be associated with stress physiological states, as exemplified in high autonomic nervous system tone: high blood pressure, elevated respiratory rates, and elevated cortisol (stress hormone) levels. Twelve-Step programs emphasize living along the lines of spiritual principles of honesty, humility, tolerance, patience, acceptance and empathy.

Numerous lines of research have shown that the processes of empathetic social interactions and spiritual practices stimulate the brain’s limbic reward centers, normalize hormonal imbalances and, therefore, we can hypothesize that these “natural” rewards replace those of the addictive substance. With empathetic socialization and spiritual practices, stress is reduced, lowering the blood cortisol level, increasing parasympathetic tone and stimulating oxytocin release.

Here are the goods. Participating in a 12-Step program makes the alcoholic/addict feel good and feel better. It’s a simple as that. Also, the fellowship of AA and 12 Step programs reduces stress and increases the release of the “good” hormones. As any AA member knows, we often feel much better leaving a meeting than when coming in!

Brain imaging studies also show that spiritual experiences achieved through intense meditation and prayer decrease activity in the area of the brain that orients our bodies in space, encouraging a blurring of the normal sense of self. This brain activity can stimulate feelings of mystical unity, “oneness,” peace, and even the sensed presence of God or other invisible entities.

Dr. Teresi advocates for lots of meditation and prayer, citing numerous studies that it makes the alcoholic feel better and heal those damaged neuro-pathways. This is an area which I definitely need to work on. In the morning, I do some reading out of the Hazelden 24 hour book and have begun to pray now and then, but I would love to find a weekly meditation group or class.

Well, that’s all the time I have today. I highly recommend picking up the book!

One day at a time, Dick


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