May 27, 2012 Blog #13.

(Warning, this is a long one. The large central section is about our brain’s reward, motivation system and how it works in my/our addictions and various compulsive habits.
Feel free to skip to the last few paragraphs after the first couple)

Nothing to do, nowhere to go. (a buddhist saying)

Here in southern Crete, Having time in one place without a list of “to do”s or “to sees”‘ or must do or must see is novel for me. I have always tried to cram in as much activity and accomplish as many tasks as possible, throughout my life. I also always was motivated to avoid the pain of “missing anything”. “Doing” has been an addiction. “Efficiency” has been a major virtue… Whenever I had open time or space, my mind would immediately reach for an item on my “to do” list. If I was getting ready to go somewhere and leave the house, I would always try to do one more thing, if I was ready slightly early, in the name of “efficient use of time”. Similar process led to multitasking. If I had errands to run, If I could plan the route, the required time for travel, and doing the errands, so that if it “worked like clockwork”, I experienced marked “reward center” satisfaction. It became an expectation of myself; I could always experience a little inner sense of reward when I got one more thing done. I even tried to sleep efficiently, go to sleep as quickly as possible and sleep for the minimum requisite hours that I needed to feel and function well. Reviewing the list of accomplishments to check off my multiple lists could provide a feeling of esteem and inner satisfaction, “I’m OK. However, sometimes looking at all my lists could create an edge of anxiety, overwhelm, thinking of all that needed to be done. Diving in to do a task or five could always relieve, defend against almost any anxiety, mitigate almost any pain, loss, or sadness. Opportunities to do this are everywhere, and society tends to reinforce, admire, value doers, productivity beyond most other values. Doing for the sake of doing creates the productivity, runaway juggernaut of performance as a measure of value.

In psychiatry, when I studied brain chemistry and particularly the chemistry of addiction, I developed a bit of jargon that entered our family lore and vocabulary. My kids, David and Maureen, both knew what a “reward center poof” referred to. I would say getting that task done just gave me a ” reward center poof”. The kids would giggle, but they began to recognize this experience in themselves, when they were complimented by peers, made a basket, finished a project, or won a race. I was speaking about a primary survival network within my brain. There is a neuronal pathway that is mediated by the neuro hormone, Dopamine, in the core of our brain that mediates motivation. Bear with me, now. It begins deep in the midbrain associated with primitive survival specific wiring. For a rat, if it sees some cheese, it is motivated to run over and eat it. A group of cells that produce Dopamine are activated that stimulates an upward, spreading series of neurons in what is called the “median forebrain bundle”, that creates the experience of “ahhh, that feels good; I really like that. I want to do it again.”. It is the primary pathway of behavioral training through stimulus and reward. As a rat, when I see and when I eat the cheese, I experience a burst of Dopamine in my median forebrain bundle, my center of motivation and reward. Using modern functional imaging, we might say that area “lights up”.

Addictions and compulsive activity serve at least two primary purposes. First, participating in the addictive or compulsive activity numb outs, blocks, or defends against unpleasant feelings. If I am busy enough doing things and feeling good about it (dopamine bursts), I can avoid or deny almost any feeling, mood, or distress. Secondly, the addictive or compulsive action creates a short cut, an artificial dopamine burst of pleasure, as if some survival sustaining action had occurred.

In this way, a devoted mother can cook up meth in her house, poisoning her children, prostituting, leaving them alone for long periods or with untrustworthy, dangerous men in order to get her “fix” of meth. She may contract AIDS, Hepatitis C, lose her teeth, and lower her cognitive capacity, and make herself psychotic, all to get that methamphetamine explosion of dopamine in the median forebrain bundle. So also, in less severe ways, children, relationships, sleep, personal needs can all be ignored when on a working jag, feeling continuing rewards for ever increasing accomplishment. I once saw an article in a law magazine entitled, “Work: The Noblest Addiction”. These process addictions are powerful and insidious.

This repetition compulsion resulting from dopamine receptor stimulation is in common with almost all animals with brains. It supports survival, because I get that reward center poof whenever I do something like eat, find shelter, have sex, am positively recognized in a group, get a promotion, a raise in pay, a new house, etc. For humans, this system has become more differentiated, because we are social beings that from birth require love and care taking and adult human attention to survive. So, any action or even the anticipation of action that will assist us in making nurturing connections with other humans will trigger a burst of dopamine release in that pleasure center of good feeling. After a while, we become conditioned, it takes on a life of its own, separate from survival or the original reason it was rewarding, (imprinted especially in our family of origin, schools, peers, media, advertising, political and social propaganda) train our motivation center early, on a mostly unconscious reflexive level.

I am conditioned to see myself as more valuable when I accomplish tasks. Being more valuable results in increased positive attention and nurture, being wanted by the group or important members of the group for my survival. It is so imprinted that even if nobody knows I did the task, I get a reward center poof, because I feel more valuable to my own inner social and interpersonal critic, self evaluator. I feel increased sense of well-being.

Helping other people, whether professionally or in daily life also creates a similar reward center poof for the same reasons. Being useful to others, to the group, means I will be included, wanted, able to make a living, which are critical parts of programming for human survival. Everyone’s motivation is mediated this way. And every addiction is mediated through this mechanism, the reward center gone wrong, misdirected. Whatever occurrence tickles our reward center, we will want to repeat. Now helping others is a good thing, but when it becomes a compulsion,not so much….

Of course, there is also a motivation network that trains us to avoid repeating a painful or anxiety producing experiences by triggering another neuro hormone, norepinephrine, substance P, in brain regions where we experience pain or anxiety etc. Obviously, pain avoidance is a core species protective pattern, which creates aversive or negative reinforcement, negative motivation to assist our survival . In fact, the absence of a certain amount of reward chemical, dopamine and also endorphins deficit creates pain in the relevant brain regions. So withdrawal from something that provides reward center poofs creates activation of psychic pain networks and craving for the object that rewarded us. This of course, is the negative reinforcement pathway in Behavior modification, also the distress of addictive withdrawal. Between these two basic, primitive, hard wired networks, survival is markedly enhanced, and addictions have remarkable power over us.

What this means is that not only substances, alcohol, cocaine, nicotine, opiates, meth etc are addictive and painful to withdraw from, but also behavioral patterns that create dopamine bursts want to be repeated and develop powerful repeated executive functions to support their repetition. In recent decades, this experience has been called “process addiction”. Video games, porn, internet surfing, exercise, eating, sex etc etc can all become “compulsive”, another word to describe the repetition compulsion motivated by the release of dopamine in the median forebrain bundle.

In humans, of course, these neuronal pathways continue up into the cortex, thinking part of the brain, where we can rationalize all sorts of pleasurable dopamine related activity. AA speaks of “stinkin’ thinkin’ that all addictions produce. It’s also why addictions are so much more powerful than our rational(?) mind. These brain systems are among the deepest, most hard wired networks that support species specific survival action. Unfortunately, humans have a great potential for this system to get “hijacked” by chemicals or behaviors that release the dopamine reward center poof.

Sorry for that lengthy aside, but I think it is fascinating and highly useful to understand, since we all are motivated this way. And compulsions of one sort of another are universal to each of us. What is your compulsion? Many such activities are positive, though become negative when over-developed. They are responsible for much of your daily autopilot, the routines that economically run our lives. These routines and compulsions support homeostasis and it is stressful to disturb homeostasis and seek a new normal pattern that may support you as well as me better now, at this time in my life.

Part of the first month of my sabbatical, I chose to leave home and work etc and travel and break with my routines. I realized that I could not make the change, truly rest and reflect, free of my compulsive doing, at home. There are too many triggers and reinforcers at home. (you don’t kick a cocaine habit by hanging around the old neighborhood) I had to withdraw from my usual routines that tend to “run”me. Not surprisingly, my first month was filled with content, learning, accumulating interesting experiences, reading myths and legends which trigger dopamine release for me. But, consciously, I tried to bridge this transition, this withdrawal period, by strengthening my cognitive rationale. Diving down, I tried to discern and keep remembering what the hell I am doing on this sabbatical and why. The process of change requires first awareness of the old behavior that I want to change. Then I reflect empathically with myself to develop compassionate motivation (a kind acceptance and appreciation for the value and the understandable reasons for my old pattern) for that change. This creates a new pattern of dopamine release when working on the change I seek. It involves disrupting the old patterns, and then seeking to practice new ones, trial and error.

The wisdom of AA, 12 step model begins with compassionate recognition that the dopamine system reward center controls me. I am out of control in this area. Standard efforts to change the habit have been prone to repeated failure? The old dopamine releasing behavior was valuable in the beginning and at some level it just continues to work too well. So, I am helpless, on my own, to behave in a new way that is so powerfully opposed by the reward center imprinting. A good question might be, why do I want to change this compulsive doing habit, if it works so well? One reason is that I want to regain my freedom to choose as opposed to being inwardly compelled. Also, life areas (fun, laughter, spiritual connection, more friendship and community) that call to me now are strongly hindered by compulsive doing. I don’t want efficiency to be my false god any more.

The12 step folks use powerful reinforcers for change, social, affiliative support in the group, the opportunity to tell your story to non-judgmental people who empathize and admire your courage and honesty. But, perhaps most powerful of all, is reliance on a “higher power”. Recruiting, surrendering to, and affiliating with the pervasive presence and power of the universe is a potent survival action. One of the mysteries in recovery from addictions is the extra measure of “grace” and surrender, it seems to require for recovery. (Aside, I strongly recommend a wonderful book by Gerald May called “Addiction and Grace”, who was a psychiatrist, MD, and the Spiritual Director of the Shalem Instiute in Washington D.C. for many years.m he has written a number of other books, “Care of the Soul”, “Simply Sane”, and others.)

So, as I began my sabbatical, I visited sacred places, in Ireland, sacred also for their connection to my ancestors. I increased my spiritual practice of meditation, contemplation, and prayer. I spent a week at the sacred Isle of Iona, then 6 days at the monastery at Dighty, with loved and respected spiritual guides. Then, it was time to get on with it, go someplace (seaside beach and sun) remote from my old work, task oriented patterns and hunker down for a while. Do nothing? Gulp! Not travel around to cool historical or sacred sites, sleep more (not necessarily “efficient” sleep), not even race to the nearest snorkeling beach and fill my time? Not rent a car, but walk everywhere, watch the movement of the clouds, the colors of the day, the shifting shadows, not engage any outer thing, live by moment to moment sense of things?

Now, I return to the beginning of this edition, “nowhere to go, nothing to do”. For this day, this moment, It feels like a window opening, time and space unhurried, unfilled. So many old patterns attack and bark at my heels, trying to get me to run again. Inner voice, “Oh you are not having enough fun, all this time and opportunity to see and do things you might never get another chance to do and see. You don’t want to miss out!!!”

Aren’t I actually engaging in another old pattern of austerity, asceticism, and “virtuous” self denial by not doing fun and interesting things? I know I need and want to play more as part of this new behavior I am seeking.”. How do I know I am not just following another counter compulsion to doing, reactively not doing? My mind doesn’t know and it is playing all kinds of tricks on me to lure me into my familiar homeostatic processes.

I don’t know. So, for me, here is where grace comes in. Learning to listen, primarily through embodied contemplative practice to my soul and spirit as opposed to my mind, emotions, and patterns offers me a mysterious unknowing way forward. It is unknown, chaotic liminal, threshold space. Subtley, in the dark, trial and error, I rely on grace, something other than my own or anyone else’s resources to guide me out of no longer helpful, calcifying compulsions to do, accumulate experience, distract myself from the mission, to live a new way. I don’t really trust my self to choose well unless it comes out of that contemplative space.

I am tempting myself, risking the old patterns. Tomorrow, I will pick up a rental car. I do want to enjoy and have fun at the amazing variety of beautiful beaches that are not within walking distance. I suspect that I will visit a couple of cool, ancient monasteries and ruined Minoan and Roman cities and sites. I hope to keep awake my inner observer and in touch with gracious time and space, attuning as much as possible to divine wisdom as I seek a new balance of pleasure, fun, interest and learning with presence, free of my egoic compulsive doer. I welcome your thoughts and prayers and invite you to consider your own compulsions, however seemingly valuable….

Above all,
Trust in the Slow Work of God

Above all, trust in the slow work of God.
We are quite naturally impatient in everything
To reach the end without delay
We should like to skip the intermediate stages.
We are impatient of being on the way
To something new.
Yet, it is the law of all progress that is made
by passing through some stages of instability
And that may take a veery long time.

And so I think it is with you.
Your ideas mature gradually. Let them grow.
Let them shape themselves without undue haste.
Do not try to force them
as though you could be today what time
–that is to say, grace–
and circumstances
Acting on your own good willWill make you to orrow.
Only God could say what this new Spirit
Gradually forming in you will be.

Give our Lord the benefit of believing
that his hand is leading you,
and accept the anxiety of feeling yourself
In suspense and incomplete.
Above all, trust in the slow work of God,
Our loving vine dresser.

Amen

Pierre Teilhard de Chardin