Addiction and Neuroplasticity - Professor Marc Lewis

[Music] thank you I think you're most well known for your learning model of addiction um we've already touched on it a little bit but you know for someone hearing about it for the first time what what what is it and why is this important for mental health professionals particularly to understand I mean learning is just about everything that happens to us we come out of the womb pretty much unformed in so many respects and we first learn about relationships from obviously our interactions with our close their caregivers uh and so forth learning how to regulate emotions is about where is learning learning how to feel better but there's all kinds of steps along the way that are um jump off points for different kinds of learning for example when kids get theory of mind but the age of three and a half or four once they have once they can conceptualize that other people have a subjectivity have a mind my mom is looking at me with that look again so she's probably thinking that I did something bad and I'm gonna get in trouble if you start that at age four well then what are they going to do about it well I'm gonna say I'm sorry Mommy I won't do it again or they're gonna you know run and hide or they're going to beat up on their little brother or sister or whatever it is and that's a way to learn to regulate in a specific context given a particular developmental stage or Milestone well you take that on up the age span and there's different kinds of learning that go on it each step and especially in adolescence of course we know that the availability of substances and alcohol is a massive social uh you know contextual Factor so now it's like you probably are learning to use a lot a little every day or to shun it and avoid it um luckily my present generation of children my 17 year old boys uh go to the gym instead I wish I had at that age but I didn't that's learning you know it's all learning it's all learning and learning how to have social relationships how to be a good social participant and have friends and make friends and feel happy with other people that's learning too learning how to listen how to be polite and considerate and you know accommodating that's learning too and if you don't learn that well you're more likely to learn other ways to feel okay to feel to feel um safe from depression and those might involve alcohol and drugs so I just see it all as learning it's all learning the thing about learning is the end of the brain is uh is only one way to learn and that's to repeat something and when you repeat uh some addictive behavior when you when you repeat some regulatory Behavior some way of regulating your emotions and feeling better and it's reinforcing and you do it again and again and again and again you're building synaptic patterns what fires together wires together and you're building networks of associations that will make it more and more likely to go there again the next time around whether it's the next evening or the next week or the next weekend or what have you and I can see why this would be beneficial for both people struggling with addiction but also mental health professionals working with their um with clients um because you know if you're looking at as learning then you can learn new Behaviors new patterns and neural neuroplasticity happens and you can gradually you know change what's the wiring there um but if you thought if you thought much about about limitations here in the sense I interviewed a guy last week for this called uh Oliver Morgan are you familiar with Oliver's work no he's published a book recently on addiction and he looks at it from a like maybe a really broad context so he takes in the learning model he takes in uh or he thinks about it you know from the point of view of learning point of view of disease the point of view of social ecology and he says that there's great power in the learning model his contention is that it views addiction only within the individual and it doesn't take into account the social factors and the contextual factors and the societal factors that are that are at work here and I'm just curious to get your thoughts on that you know I know you've you've thought a lot about that so I'm just curious what what would you respond to that well there are powerful societal factors we know that racism poverty oppression sexism various ways of becoming marginalized or alienated having less power not being able to control your life our grounds to will increase the odds of addiction it's that simple because but you can always insert a mediating Factor because it makes you more miserable to not have a shitty job and not be able to you know direct your own life course the way you might think is valuable and exciting you're going to be more depressed and more bored and more anxious or whatever it is and then you're gonna do stuff that make you feel better so you can always translate those social forces into what's going on around the individual I guess I like to think of it I like Johann pari's uh um phrase the one he made famous that the opposite of addiction isn't sobriety it's connection and and we we know that a lot of societal factors will constrain the amount of connections people can have with people who with others who might be supportive and caring and um you know resourceful well so you might start off with a certain kind of isolation based on some of these societal factors you're at risk so to speak and then you start to use drugs or whatever it is or drink too much and people don't want to really be around you except maybe other people who use those substances or drink a lot so the social World becomes more and more contracts it has less and less opportunity for freedom and movement and you know excitement and while the social world is Contracting so you're getting less and less juice from that the uh the appeal of the substances becomes relatively more attractive and that is a feedback loop right there the more you use the less connection you're able to maintain unless shall we say creative or valuable connection you're able to maintain I see it kind of as a we haven't talked about the brain yet but certainly in learning the brain does a lot of very interesting things like pruning of synapses it's a very critical part of all learning the brain consolidates his networks by getting rid of connections that are no longer needed so the brain is becoming more and more um shall we say focused or contracted or constructed at the same time the social world is becoming more and more con contracted and constrained well that would be the case if you're learning the French horn you're more likely to fall into a small group people who also play in the orchestra that's fine right but if you're a heroin addict the same formulas is that does not uh suit does not some offer you Sunny Horizons right because the The Habit is forming and constraining and the social world is Contracting and you they're just feeding back and forth until you're really stuck that's very well said and I suppose it changed well with what we were speaking about earlier and that guy actually said addiction is a jealous relationship it cries out all of the most of the other relationships in your life too um no you have given several talks and uh written written I suppose the book the biology of biology desire I think the title was um so you know a lot about the Neuroscience going on here so I maybe want to transition briefly into this now and what um areas of the brain are implicated in The Addictive process so yeah the brain is obviously a very complex place but um I think identifying the main areas and what they're doing is a way to open up what learning actually means learning is not just like you know learning how how to where to park your car or learning you know the steps of the key of G when you're learning to play the piano it also has a very strong emotional element and anything that stays in mind long enough to be learned to be repeated is going to have some emotional impact so that means that the emotional parts of the brain are very involved and that includes for example uh the striatum which is a sort of big cluster of structures sometimes called the basal ganglia that are involved initially that means to say in our evolutionary history involved in movements this is the part of the brain is very old it's the movement brain it tells animals what to do and what you do when you're any kind of an animal as you go after resources to go after what you need whether it's food or sex or whatever it is or safety so that in human is that part of the brain still directs us towards what we need what we require what we value what we like and it develops shall we say emotional incentives or emotional uh uh urges to move toward those goals so the strident becomes the center of emotion-driven goals well when they talk about dopamine which they always do when they talk about brain and addiction what dopamine dopamine is a not to get technical but it's just it's a neurochemical that fuels the uh attractiveness of rewards makes things valuable makes you want them so you move towards them and you get a dopamine reward on the way there and once you get them especially if you get more than you expected you get a dopamine reward all that stuff is building synaptic structures in the striatum and that means you're learning what's valuable to you and what you what you want to go after and it isn't just pizza and it isn't just sex it's also you know uh crack cocaine or whatever it is and then you I mean it gets more complicated after that because the striatum itself has got a kind of impulsive section for impulsive behavior like you know yeah let's go get high that sounds great versus the compulsive behaviors which is more like I have to do it I always do it I need to do it it's like biting my nails I just do it those are different kinds of emotional learning so to speak motivated learning they're quite different and when we talk about addiction we often talk about compulsion because it seems as though it's it becomes automatic if it's bad enough it isn't really automatic but it seems to be and it becomes harder not to do it because the thrust is there before you even start thinking about it so there's all that stuff sorry making it's a long answer but so does that emotional brain so to speak but there's also the frontal good old prefrontal cortex that we value so much because that's where we make our decisions and that's where we say no that's bad ideal it's not to that that's got us in a lot of trouble last weekend and when we got home my wife gave me such so this I'm not gonna no I'm not going there so that's the other side of the uh of the algorithm that's no the part that says no it's very important for all everything we do and um I read in saying an addiction that the connection and the communication between the ventral straight and which responsible for motivation emotion Etc the communication between that and the prefrontal cortex gets broken down so there's less of it happening whenever there's a Strong Addiction at work I think that's that's a good way to put it yeah that's that's yeah that's pretty much what happens because the prefrontal cortex gets activated by making decisions making choices decision making value attribution and all the rest of it and um planning well but if you've if you just go after what what you know makes you feel great or makes you feel better than Time After Time day after day night after night that you're not really using this at all anymore you're not making choices there's no choices to be made I mean I know what I need I know what I like I'm just I'm nothing else in my Horizon so that part kind of shuts down or becomes less activated and there's actually studies that show that parts of the prefrontal cortex become um lose synaptic density uh over a period of time that addiction is taking place and that's with alcohol heroin or I think cocaine one of the other drugs norovolco the hedonitis and some of that work what happens with eating disorders too so it's not just substances but if you stop making decisions this this part of the brain just becomes shall we say under activated and maybe that results in a loss of synaptic connections and then the striatum and especially the the dorsal stride and that's in charge of compulsion it's got pretty much a free reign Wow that's scary so the longer you are involved in this process of addiction then the more gray matter your brain is essentially losing is that fair to say yeah I don't want to be too you know strict about that because but yes I think that's right right but we shouldn't think that that's because drugs are killing the brand that's just not true people can take heroin for 40 years and be absolutely fine and healthy and cognitively sharp it's amazing but it's true there's a lot of like some legendary Jazz musicians and so forth have taken heroin their entire careers same with math you could take meth for 20 years and be cognitively fine you can take too much and you can really screw yourself up but drugs don't kill brain cells rather drugs can be the focus of habits that utilize some sections and therefore uh some sense and over utilize some regions and underutilize other regions and the under utilization results in pruning pruning just like you prune the Hedge you know around the garden you cut off the excess branches that's the word they use for uh the reduction the the uh the ongoing developmental loss of of synapses neural connections if you're interested in seeing the full session and 34 others like it you might want to check out the holistic recovery Summit this is a revolutionary free online conference which brings together 35 word leading clinical psychologists researchers and practitioners we will share with you their best practices for mind body social and spiritual approaches to addiction treatment enabling you to be the Forefront of evidence-b's care with a lineup including Steven porges Janina Fisher Ed mcgilchrist pot Ogden Anna Lemke Stephen Hayes Richard Schwartz and 28 others this really is a once in a lifetime learning opportunity the best bit is it's 100 free to attend life and you can do so from the comfort of home you'll also be able to upgrade to your recordings and certification pass after registration although this is entirely optional for more information please check out the sign up link in the description [Music]

Channel: The Weekend University

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Id: iWE2nMcV7g8

Length: 16min 37sec (997 seconds)

Published: Mon Oct 02 2023