Is Deep Change Possible?

An amazing thing is happening. Over the last 10-15 years scientists have shared their discoveries about how the brain functions.  New knowledge about how the brain functions provide incredible insights for both addiction treatment and relationships. But before I write about some of my recent research, we need a brief refresher course on the anatomy and function of the brain.

Thinking of the brain vertically

It is common to think about the brain either vertically, or horizontally. In the vertical model writers talk about the triune brain. This approach conceptualizes the major parts of the brain in three main sections: the brainstem, the limbic system and the cortex. Dan Siegel illustrates this beautifully in his video.

As Dr. Siegel notes, the brainstem and limbic system work together and monitor our basic biological systems as well as our emotions. This is why when we are frightened or anxious our heart rate increases. In response to a perceived threat, the limbic system kicks into action and we enter into the familiar “fight, flight, or freeze” responses. There are also implications for addiction. When we see something that triggers our addictive system (an attractive woman for a sex addict, a bottle of vodka for an alcoholic) our limbic system jumps into action and sends signals to rev up the engines because another opportunity to act out has presented itself.

The cortex is the outer layer of the brain and in the frontal areas, just behind the eyes, we find the region responsible for executive function and, more importantly, for emotional control. Now here’s the problem…the cortex and the prefrontal regions that provide control do not come online as quickly as the brainstem and limbic systems do. The limbic system can register a threat in as little as 20 to 30 milliseconds. Unfortunately the control center, the prefrontal cortex, does not respond until 300 to 400 milliseconds later. By that time, emotions are already revved up and moving in response to the perceived threat.

What’s a person to do? And, what does this have to do with addiction? Learning to recognize what is happening is essential. Dan Siegel talks about the need for “integration” of the brain systems in his book Mindsight. Through practice and training, we can in fact learn to slow the process of response down to give our prefrontal cortex time to become engaged in recognizing threat, or recognizing triggers in the case of addiction. (Check out Dr. Siegel’s webpage at: http://drdansiegel.com/ for more information.)

Thinking of the brain horizontally

Another common way to think about the anatomy of the brain is to think in terms of two hemispheres, each with different but interconnected functions. The left hemisphere is primarily geared to handle the logical, linear, language based functions of life. The right side is more concerned with emotions, imagery, and the relational side of life. Many of us are oriented to one side or the other. Some will “dwell” in the left hemisphere and they tend to approach everything logically, giving it a verbal description. Those more oriented to the right hemisphere are not only more emotional, but tend to think in images. Again, balance, or integration is important. Dan Siegel’s video on the two hemispheres is helpful here…especially as it relates to the importance of integration.

Two types of memory

Another component of brain function has captured my attention lately. Scientists tend to think in terms of explicit and implicit memory. Implicit memories are those memories that are stored deep with our sense of self. They are also more difficult to translate into words. For example, most of us at some point learned to ride a bicycle. The ability to maintain our balance, control our speed and direction, all while waving to our friends is implicit memory. Try putting into words all the things our brains do to remain upright on a bicycle…. Tough to do. However, if I ask you how to get to the public library, you can probably give me specific step-by-step instructions. Data, like directions to the library, is stored in what is called explicit memory.

As such, it is difficult to think about the brain as a single unit. We think in terms of regions, and while they are interconnected, they are also distinct. Here’s where it gets interesting. Dr. Allan Schore is part of the clinical faculty of ULCA Medical School. His research on the brain, and on emotional regulation, is fascinating. Dr. Schore suggests the idea of a single unitary “self” is misleading. We should instead think in terms of a conscious left-brain self-system and an unconscious right-brain self-system. He suggests that while we are more aware of the left-brain functions (through language and normal problem solving tasks of everyday life) it is really the right brain that is truly dominant in human existence. In short, emotions rule.

Implications:

Here’s what this means in every day life. In our interaction with others we “read” non-verbal signals at an amazingly fast pace (30 – 40 milliseconds) and those are continually being interpreted for possible threat. We form emotional responses to those non-verbal cues long before we verbally interpret the meaning of those cues. In some cases (many cases I’m afraid) we go through life basically oblivious to the non-verbal cues we are sending and receiving. Is it any wonder confused husbands ask in total bewilderment, “What did I do?” Too often they have made their living in the left-brain work-a-day world and communicating with their wives at an emotional level is like speaking a foreign language…literally.  Another important point here…the emotional side of life is often implicit. We learn (through our interaction with our primary caregiver(s) in infancy and childhood the meaning of attachment. In the context of relationship we learn, or fail to learn, feeling safe and secure in a relationship. That carries over into adult relationships.

There are implications for the addict as well. Without good integration, our addictive tendencies can be triggered and a brainstem/limbic system response can “take over” our normal restraint. Being triggered activates deep emotional responses. (See an earlier post on How Porn affects the Brain to learn about the role of dopamine and other neurotransmitters.) The result is what we sometimes call “bottom-up” living. That is, making decisions based on the activity of the lower portions of the brain as opposed to the prefrontal cortex. This is why addicts will tell themselves “I know I shouldn’t do this. I know this will lead to trouble,” and go right ahead and act out.

So, let’s sum this up. What does this mean for us in terms of deep change? Some of what follows is a summary of my reading of late. Some of the following bullet points are questions for all of us to ponder more deeply.

  • For deep change to occur, implicit memories must be addressed. These memories are those things we have absorbed so deeply into our being that we rarely question their appropriateness. For the addict, looking lustfully at another person is “just what men do.” For the trauma victim, “You can’t trust others.” While Cognitive Behavior Therapy approaches can help tremendously with coping and behavioral changes, deep healing requires addressing those core issues of how we see life at its deepest level.
  • Implicit memories can be changed. The 2005 Annual Meeting of the Research Society on Alcoholism in Santa Barbara, CA focused on how implicit cognitions can be changed and how changes will influence behavior. The consensus is that those with addiction have a bias toward responding to stimuli related to their drug of choice. (The alcoholic who sees a picture of a bottle of vodka wants a drink.) However, therapies can be designed to reduce those biases. People can learn to respond to triggers differently. So, when in sex addiction treatment I speak with addicts about the importance of bouncing their eyes as opposed to staring lustfully at another person or image, there are good reasons to believe that is effective.
  • And what about a faith dimension to this? What does it really mean when Jesus calls his followers to “love the Lord with all your heart, soul, mind and strength and your neighbor as yourself?” How do implicit memories play into my ability, or inability, to be consistent in my love of God and others? Dallas Willard writes about the role of the classic spiritual disciplines. He notes that the purpose of the disciplines (prayer, fasting, service, silence, etc.) is to train us to do those things naturally. In other words, we “pray always” until prayer becomes natural for us. We practice silence until we no longer feel the need to fill the air with words and can sit quietly until prompted to speak from the heart. To me, this sounds a lot like making the principles taught by the spiritual disciplines implicit in our lives.

Sounds like a life long process….

 

Tim Barber LPCC-S, CSAT-S, NCC

 

 

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