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Posted by on in Alcoholism

 

In my previous blog blog we asked the question whether  neurobiological or “conditioning” or reinforcement models of craving predict relapse in abstinent alcoholics and addicts?

For us this is the most essential question. How do we explain relapse in those individuals motivated to remain abstinent, especially when they have followed some form of treatment, including 12 step groups?

We have seen that most relapse seems to be prompted by psychological stressors such as interpersonal relationships and the failure to cope with these.

This is very different to conditioning or reinforcement models that simply posit that people relapse because of the lure of alcohol or drug related stimuli, “cues”, or cues in the presence of stress or negative emotions, which we believe does have some affect.

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Posted by on in Alcoholism

A constant thread throughout my blogs so far has been an assertion that alcoholism and addiction are primarily emotional regulation and processing disorders.

So I was thus  very interested to find this article (1) which describes how I am not the first to view alcoholism and addiction this way.

Here I use this article to present a  brief history of research, dating back to the 1930s, that has viewed alcoholism and addiction in a similar way to I do now in 2014.

 “Life, as we find it, is too hard for us; it brings us too many pains, disappointments and impossible tasks. In order to bear it we cannot dispense with palliative measures. (…), intoxicating substances, which make us insensitive to it” (Freud, 1930, p. 75).

 Rado (1933) was the first to describe substance use as a way of coping with excessively difficult states of emotions (3).

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Posted by on in Alcoholism

 

I know personally that when I first came into recovery a number of years ago I did not have a clue about my emotions, they were the things that drove your to the pub as far as I was concerned.

I drank to get away from my emotions, to regulate them through alcohol.

I used to tell my wife that the chief reason I drank was “to get away from myself” which brought out a very quizzical expression on her face.

What does that mean?

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Posted by on in Other Addictions

In this blog, I start a series of blogs which will elucidate on why I believe addictive behaviours to be the consequence of an emotional dysfunction partly perpetuated by genetics and partly by the environmental influence of insecure attachment to primary care givers and also childhood maltreatment.

All these factors appear to alter or impair brain regions implicated in emotional processing and regulation. This emotional dysfunction appears to contribute to initial use, abuse and addiction cycle all addictive behaviours.

Here I will briefly explain what I mean by emotional dysregulation and by emotional processing deficit, while highlighting how it appears to be a pathomechanism in addictive disorders. 

 

Research suggests (1) suggest individuals with poorly regulated emotions often turn to alcohol to escape from or down-regulate their emotions, creating a risk for diagnosable problems in relation to alcohol  difficulties as this impairment in emotion regulation is associated with alcohol-related disorders  and substance-related disorders (2).

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Posted by on in Alcoholism

 

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We might as well start as we want to go on...Most of my "proof of concept" PhD and other research is attempting to demonstrate that there is more to alcoholism than alcohol, more to substance addiction than substances of abuse and more to behaviourial addictions than compulsive behaviours. 

My PhD is attempting, to show, that there is an inherent decision making deficit in a variety of addictions and that this is due to an emotional processing deficit which means the prefrontal cortical, rational areas of the brain are not recruited in relatively simple task in which there is some uncertainty about outcome and instead undifferentiated emotions act like a distress signal to prompt more subcortical, limbic or emotionally reactive responding. 

This results in a tendency to be impulsive/compulsive and to choose short term smaller gain over delayed, but longer term greater gain. In other words addicts of various types seem to react in order to relieve this distress, this unpleasant undifferentiated feeling state rather than after the reflective deliberation of the pros and cons, the cost benefit analysis of a set of possible  decisions. This may be linked also to an intolerance of uncertainty often seen in obsessive compulsive disorder. 

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