Addiction, Relapse, and Mental Obsession: Cutting the Pleasure Cord [Guest Feature]

This entry was posted in Rehab Info on by .

Mental obsession may mean many different things to different people because the experience of mental obsession is different depending on what your point of reference is. For most of us without addiction problems, when we think about a mental obsession to do something, we think about a strong urge to do it. For an addict, a mental obsession feels more like a matter of life and death. They have to use or perform a certain action or they might die, so their brain tells them. This is literally how it feels to them and no reasoning or obstacle can stop them until they “satisfy that obsession.”

So what is going on in the brain to create such an intense sensation? Are there things we can do to help the addict change or diminish this sensation? How does this sensation relate to the overall recovery process? In this article we will answer these questions and more with the help of research uncovered by “Institute for Addiction Study.”

To understand what is occurring in the brain to create a “mental obsession” we have to first look at the pathway that creates pleasure and how it works in the normal human brain. In a normal (non-addict) human brain, the activities we do on a daily basis cause release of dopamine in varying amounts. Some activities will cause more or less release of dopamine in the brain depending on how much the brain wants to remember it.  When we say “want” we are referring to the survival benefit to the organism. For instance, the things that cause large amounts of dopamine to be released are the things that are closely tied in with our survival, like sexual reproduction and eating foods rich in fats and sugars.

When we eat a piece of pie or cake it tastes good to our taste bugs. We interpret it as a good taste because of the amount of dopamine being released. This release helps our brain remember where that substance came from, what it looked like, who gave it to use, etc. When we eat salad greens not much dopamine is released because it is not calorically dense and is not a good survival food.

This becomes even more clear when we take a step back in time 2,000 years or so. It’s not hard to understand how this was helpful to hunters and gatherers for survival, for example.  This system was very important to help us remember where to get food and what foods to choose. The better it tastes, the more dopamine released. The more dopamine, the more likely it is essential for survival. In this way, the brain is programed or hard-wired to remember the foods and things that are going to keep us alive. The brain does this by preferentially storing everything about the experience of “good food.” The sights, sounds, feelings, smells, tastes, etc. are pulled in and stored, creating a hyper-memory.  Next time we need food, the brain will subconsciously take us back to this place through accessing this hyper-memory. We may think we are going out hunting, but subconsciously, we are looking for certain things about the environment that will take us to where we are most likely to find the food. This is how we survived as hunter gathers. So what happens with memory formation when the thing we consume secretes such a high level of dopamine that the brain is overwhelmed with dopamine?

With drugs, alcohol, and other substances of abuse, the dopamine secreted in the pleasure center of the brain is far greater than what we get from the natural world. It is this hyper-secretion of dopamine in this center that overwhelms the brain, leading to:

  • Inability to feel pleasure without the substance or anhodynia
  • Mental obsessions to use the substance
  • Continuing to use even though they don’t want to
  • Prioritizing use of substance above anything else
  • Susceptible to relapse with stress

The above scenarios are interrelated and are common aspects of the addict’s life. With stressors, the addict looks to the only thing that takes them out of the stress: the substance. Along the same lines, ongoing depressed mood or lack of feeling pleasure, bored, etc. will lead them to the only thing that will give them pleasure: the substance. In both of these scenarios they may even be telling themselves they don’t want to use. Just as the subconscious brain took us to the good place to score a meal in primitive times, it will take the addict to the place most likely to score the drug, alcohol, etc. There is no decision to use because once the person finds themselves in front of the substance, they have to use. Like a hungry animal going after its prey, the addict has to use.

So most of the time, the decisions  to use drugs are not even conscious, and that is where mental obsession and behaviors similar to this come from. So what can you do to lessen the control the substances have on your subconscious mind? Are there things you can do to break the mental obsession, the inability to feel pleasure, etc.?

Yes there are. The basic idea is to build a new brain map for pleasure. While this is no small feat, it can be done with persistence. I will share with you a couple of options, but make no mistake: These will do nothing for you if you don’t stop using the substance.

So if you are going to build a new brain map for pleasure, you need to remove the things that insult the pleasure pathway. You need to limit (and completely eliminate substances of abuse) the things you use that insult this pathway. These would include caffeine, nicotine, sugar, video games, sex, etc. If you can’t eliminate these completely, use them consciously, as a reward after a hard week, day, etc.

A second way to build a new pleasure map is with a simple mediation exercise. This mediation activates and invigorates the senses to make a miracle out of the mundane. For this exercise, you sit quietly and try to see and take in as much as possible: smell the air, feel the breeze, listen for the smallest sounds, and so forth. When you do this over time, you will get a deep sense of calm and peace. In other words, you are getting pleasure from sitting and observing the world. The best thing is, you can access it anywhere and it take no time to achieve. ​

About: Dr.Terranella has helped over 1,000 patients with detox from alcohol and drugs of abuse. For over 5 years at a residential substance abuse treatment center in Arizona, he has used both conventional and holistic medicine to speed up the recovery process. 

He is formally trained as a naturopathic physician and an acupuncturist, and has spent much of his continuing education on understanding holistic and conventional methods of treating mental health conditions. The mechanics of the addict’s brain and how it impairs their ability to stay sober is of particular interest for him.  He enjoys finding new ways to teach about and interrupt the cycle of addiction. 

“Working with addiction in any form is a transformative process because it reminds us how venerable the mind and spirt can be. It also reminds us how regenerative they can be given the right nourishment.” Dr. Terranella, practices at Southwest integrative Medicine in Phoenix Arizona. You can visit his website at http://www.swintegrativemedicine.com.