Hello my blog name is Paul. I am blogging from the UK, hence the strange spelling at times!
Thank you to Addictionland for having me as an "expert" blogger for the month of December which is a special month for me as it was in this month, a number of years ago, that I found recovery in the rooms of AA.
I had not even heard of 12 step programs before my first meeting and believe that I had some form of psychic change at the meeting, for two main reasons - I had giving up completely or surrendered and the identification I had with those assembled in that room was enormous.
I felt listening to their "shares" that these people where just like me, that I had strangely come home, looking back. I had finally found the club or society of people that I belonged in. No longer felt isolated or alone. I had been accepted fully for what I was. As someone who has had an, at times, abusive upbringing and an insecure attachment to my primary care giver, it was a beginning of a journey home, the beginning of an earned attachment, the start of my adoption into a surrogate home and family in fellowship.
This is my recovery, 12 step recovery, although I am not blinkered to other forms and have researched many other therapies too. The ideas in some are very insightful and if it works, work it.
I am also not simply a recovered alcoholic, but also have a number of other addictive behaviours such as sex and substance addictions. I believe that various addictive behaviours have underlying commonalities and I have been surprised to find in recovery that I can become addicted to the most, at times, bizarre things. This has led me to conclude I have an addicted brain but mercifully a recovering mind.
As we will see in my forthcoming blogs, this distinction is crucial, for me, in recovery. A recovering mind can lead to adaptive, healthy behaviours which can actually change the neural machinery of the brain so that the brain itself also recovers. This is called neural plasticity, the ability of the brain to form new neural networks via behavioural change.
A classic neural plasticity in recovery is the positive changes brought about by meditation which alters the actual neural networks of the brain, particularly two regions of the brain called the anterior cingulate and prefrontal (particularly dorsolateral) cortices. These areas, among having other functions, help in the "top down" cortical control of emotional reactivity, particularly to negative emotions. They keep the "anxious amgydala", in the limbic, subcortical areas of the brain under control. I believe this control, this regulation of emotions is critical to long term recovery.
Sorry for the science, or neuroscience, but I will be mentioning areas like this in the hope of shining some light on how we recover in terms of neuro physiology and psychology. Little is written generally about recovery or the neuroscience of recovery and I will hope to redress this to an extent here.
Anyway back to my first meeting. At my first meeting I had little interest in what the fellow AAs were saying about alcohol or other substances but was fascinated by what they were describing in terms of what they called their "emotional disease" or "spiritual malady" or "fear based disease" - I found this intriguing as it seemed to sum me up perfectly, as if they were describing me. I was close to death at this point and in alcoholic psychosis so it seemed that the meeting was almost a heavenly waiting room and judgement day, prior to dying, like a Michael Powell movie where you are told what you were really like while on this earth even if you hadn't realised fully or were completely oblivious in fact, like me. It was like a final summing up, by perfect strangers. But they were not talking about me directly, they were describing themselves. I couldn't work out how they knew so much about me? I was, however, implicated indirectly as I was and am like them.
But the world was not about to end, quite the contrary my life was just about to begin. I was about to reborn whole. A personal journey of discovery so profound was just about to occur. I hadn't been living for many years, merely existing. Now I was about to propelled into another realm of living, a fourth dimension. I have become a new me, completely unlike the drinking and using me. This is why it is important to talk recovery - I am not just dry, clean, abstaining or stark raving sober, I have been reborn. I have experienced catharsis.
I appeared to respond to the world in the same manner as these people, my fellow recovering alcoholics. It was an eureka moment which has sparked sustained fervent research ever since.
How could these people be so similar to me? They would have to be suffering from what I suffer?
And I am not simply talking about alcohol of substance or behavioural addiction - those symptoms of this underlying disorder. They seemed to be describing a psychiatric disorder involving difficulties with emotions.
They were describing what I now believe to be, after several years of research, an emotional disease, what neuroscience would call an emotional processing, recognition and regulation deficits. It does not slide off the tongue like an emotional disease but there you have it.
I thought this was bad enough until I realised that these deficits appear to be implicated in children of alcoholics too, way before they ever start drinking. The emotional processing deficits, which is sometimes called alexithymia, is also present in up to 67% of alcoholics, according to one study.
Dysregulation of emotion has also been demonstrated in the majority of alcoholics, addicts, those with sex and gambling addiction and those with eating disorders etc.
External recognition of emotions is blunted too in alcoholics, especially the impaired ability to read emotional expressions and so on. Or to accurately hear and decode emotional tones of voice. When it comes to emotions we are universally alexithymic or have emotional hearing and seeing difficulties.
I noticed this profoundly in the first months or recovery, how I could not recognise, identify or label emotions. It was startling. It was only in verbalising these emotions that I learnt to process them and understand what they were.
Emotions used to be that an unpleasant, distressing and scary feeling state that drove me to use alcohol, drugs, sex etc. Even as a child emotions frightened me, they were to be avoided at all costs.
Emotions were not freely expressed in my home. Apart from anger. The problem with this emotional dysregulation is that it creates some many other problems. It makes us choose short term over long, makes us very impulsive, reactive, means we like substances and behaviours more than others, find them more rewarding, makes us poor decision makers, choosing risky over evaluated, makes us difficult to live with and also makes us have numerous obsessive thoughts about everything, in short our emotional dysregulation makes us obsessive compulsive and our intrusive thoughts can drive us crazy.
Even in very young children of alcoholics a decision making profile based on using sub-cortical emotional parts of the brain rather than prefrontal cortical areas of the brain has often been observed. Emotions when processed properly recruit this prefrontal area and if not they tend to act as distress signal in the brain to impulsively/compulsively react to decision making.
Unchecked emotions are at the heart of addictive behaviours it would appear.
We use substances and behaviours to regulate these troublesome emotions and after time these substances and behaviours become completely in charge of our emotional lives. In other words, our increasingly negative emotions compel us to use addictive behaviours, to fix our feelings, our addictions eventually taking over our self regulation, our emotional networks, our memory networks, our attention networks and our reward/motivation. Addiction has effectively become a parasite that feeds on our negative emotions, motivating us to use to fix these distressing feelings. Neuroscience is beginning to demonstrate what treatment centres have observed for decades.
So these are my research themes of interest, my recovery necessities - managing this emotional disease. Managing my emotional sobriety. When I am calm, serene, meditating, praying or helping others my disorder is soothed and fairly dormant. When I am distressed it can rage in spiraling negative emotion and deluded thoughts. Even today, some years into recovery.
I will be blogging about this emotional disease over the next month. I believe treatment, intervention and prevention can benefit from a greater insight into the pathomechanism of this disorder. If we can help those regulate emotions and foster in them a learnt or earned secure attachment I believe we can help many in recovery.
It has taken me a number of years to finally find out what is impaired in me. In addressing the neural mechanisms of this "emotional disease" here, I am grateful to have the opportunity to share some research and experiential insights with you.