Authors: Omar Manejwala
15
. J. M. Bossert, A. L. Stern, F. R. Theberge, C. Cifani, E. Koya, B. T. Hope, and Y. Shaham, “Ventral Medial Prefrontal Cortex Neuronal Ensembles Mediate Context-Induced Relapse to Heroin,”
Nature Neuroscience
14 (2011): 420–22.
16
. Marika Tiggemann, Eva Kemps, and Jasmin Parnell, “The Selective Impact of Chocolate Craving on Visuospatial Working Memory,”
Appetite
55, no. 1 (2010): 44–48.
17
. R. Suñer-Soler, A. Grau, M. E. Gras, S. Font-Mayolas, Y. Silva, A. Dévalos, V. Cruz, J. Rodrigo, and J. Serena, “Smoking Cessation 1 Year Poststroke and Damage to the Insular Cortex,”
Stroke
43, no. 1 (2012): 131–36. Epub Nov. 3, 2011.
18
. S. A. McKee, R. Sinha, A. H. Weinberger, M. Sofuoglu, E. L. Harrison, M. Lavery, and J. Wanzer, “Stress Decreases the Ability to Resist Smoking and Potentiates Smoking Intensity and Reward,”
Journal of Psychopharmacology
25, no. 4 (2011): 490–502.
19
. H. C. Fox, K. A. Hong, and R. Sinha, “Difficulties in Emotion Regulation and Impulse Control in Recently Abstinent Alcoholics Compared with Social Drinkers,”
Addictive Behaviors
33, no. 2 (2008): 388–94.
20
. K. Grasing, D. Mathur, and C. Desouza, “Written Emotional Expression during Recovery from Cocaine Dependence: Group and Individual Differences in Craving Intensity,”
Substance Use and Misuse
45, no. 7–8 (2010): 1201–15.
21
. In fact, in 2007 Hilke Plassman and colleagues conducted fascinating experiments to determine how much hungry subjects were willing to pay for various foods. These ingenious experiments using brain imaging confirmed that activity in the subjects’ orbitofrontal cortex and dorsolateral prefrontal cortex (which are parts of the prefrontal cortex) is responsible for determining these subjects’ willingness to pay. In recovery, including in AA and other Twelve Step programs, willingness is emphasized as essential to taking the necessary actions that result in behavioral and spiritual transformation. It seems that the willingness to take actions that result in improvement in our lives is at least, in part, prefrontally driven.
22
. The etymology of the word “crave” suggests that it is derived from the Old English “crafian,” to demand. In most cases where cravings are concerning or problematic for my patients, they don’t describe them as requests, but rather as necessities; “demand” seems about right.
23
. AA World Services,
Alcoholics Anonymous,
4th ed. (New York: AA World Services, 1991), chapter 3.
24
. The largest study to address this question has been Project MATCH. This group concluded that more severe alcoholics (those, for example, who require inpatient treatment) fare better with Twelve Step approaches than cognitive-behavioral approaches. This suggests that the more severe the craving, the less likely you will be able to think your way out of it.
25
. In fact, AA is more widely used than any other method to address alcohol addiction; C. Weisner, T. Greenfiels, and R. Room, “Trends in the Treatment of Alcohol Problems in the U.S. General Population, 1979 through 1990,”
American Journal of Public Health
85, no. 1 (1995): 55–60.
26
. For a fascinating look at the ways you can trick yourself into believing you have achieved insight, see David McRaney,
You Are Not So Smart: Why You Have Too Many Friends on Facebook, Why Your Memory Is Mostly Fiction,
and
46 Other Ways You’re Deluding Yourself
(New York: Dutton, 2011). McRaney describes in simple language many of the ways your mind fools you into believing things that aren’t true and why it’s important that your mind does that.
27
. Akitoshi Ogawa, Yumiko Yamazaki, Kenichi Ueno, Kang Cheng, and Atsushi Iriki, “Neural Correlates of Species-Typical Illogical Cognitive Bias in Human Inference,”
Journal of Cognitive Neuroscience
22, no. 9 (2010): 2120–30.
28
. This is from the work of Jochen Musch from the University of Mannheim. “Personality Differences in Hindsight Bias,”
Memory
11, no. 4–5 (2003): 473–89.
29
. Wolfgang Hell, Gerd Gigerenzer, Siegfried Gauggel, Maria Mall, and Michael Muller, “Hindsight Bias: An Interaction of Automatic and Motivational Factors?”
Memory & Cognition
16, no. 6 (1988): 533–38.
30
. Britta Renner, “Hindsight Bias after Receiving Self-Relevant Health Risk Information: A Motivational Perspective,”
Memory
11, no. 4–5 (2003): 455–72.
31
. Emily Pronin, Justin Kruger, Kenneth Savitsky, and Lee Ross, “You Don’t Know Me, But I Know You: The Illusion of Asymmetric Insight,”
Journal of Personality and Social Psychology
81, no. 4 (2001): 639–56.
32
. Thomas Shelley Duval and Paul J. Silvia, “Self-Awareness, Probability of Improvement, and the Self-Serving Bias,”
Journal of Personality & Social Psychology
82, no. 1 (2002): 49–61.
33
. Joyce Ehrlinger, Thomas Gilovich, and Lee Ross, “Peering into the Bias Blind Spot: People’s Assessments of Bias in Themselves and Others,”
Personality & Social Psychology Bulletin
31, no. 5 (2005): 680–92.
34
. R. E. Meyer and S. M. Mirin,
The Heroin Stimulus: Implications for a Theory of Addiction
(New York: Plenum, 1979).
35
. Paul D. Cherulnik and Murray M. Citrin, “Individual Difference in Psychological Reactance: The Interaction Between Locus of Control and Mode of Elimination of Freedom,”
Journal of Personality and Social Psychology
29, no. 3 (1974): 398–404.
36
. AA World Services, “The Doctor’s Opinion,”
Alcoholics Anonymous,
xxv.
37
. John Bradshaw,
Healing the Shame That Binds You
(Deerfield Beach, FL: Health Communications Inc., 2005), 136.
38
. Thomas J. Scheff, UCSB website,
www.soc.ucsb.edu/faculty/scheff/main.php?id=2.html
.
39
. L. E. O’Connor and colleagues demonstrated this several years ago when they measured shame, detachment, and depression in recovering addicts, some of whom were still in residential treatment and some of whom were in active recovery in Twelve Step fellowships. Compared to nonaddicted people, recovering addicts were much more prone to shame (and less prone to guilt), and women were more likely to exhibit shame overtly whereas men were more likely to show signs of emotional detachment. L. E. O’Connor, J. W. Berry, D. Inaba, J. Weiss, and A. Morrison, “Shame, Guilt, and Depression in Men and Women in Recovery from Addiction,”
Journal of Substance Abuse Treatment
11, no. 6 (1994): 503–10.
40
. For an excellent review of shame and addiction from an academic perspective, see Shelly Wiechelt’s review “The Specter of Shame” in
Substance Use & Misuse
42, no. 2–3 (2007): 399–409.
41
. Marc Schuckit, “Genetics of the Risk for Alcoholism,”
American Journal on Addictions
9, no. 2 (2000): 103–12.
42
. L. J. Bierut, S. H. Dinwiddie, H. Begleiter, R. R. Crowe, V. Hesselbrock, J. I. Nurnberger Jr., B. Porjesz, M. A. Schuckit, and T. Reich, “Familial Transmission of Substance Dependence: Alcohol, Marijuana, Cocaine, and Habitual Smoking: A Report from the Collaborative Study on the Genetics of Alcoholism,”
Archives of General Psychiatry
55, no. 11 (1998): 982–88.
43
. AA World Services,
The AA Member—Medications and Other Drugs
(New York: AA World Services, 2011). Of note, this pamphlet was written by physicians in recovery from alcoholism.
44
. Michael A. Sayette, Christopher S. Martin, Joan M. Wertz, Michael A. Perrott, and Annie R. Peters, “The Effects of Alcohol on Cigarette Craving in Heavy Smokers and Tobacco Chippers,”
Psychology of Addictive Behaviors
19, no. 3 (2005): 263–70.
45
. American Psychiatric Association,
Diagnostic and Statistical Manual of Mental Disorders,
DSM-IV-TR, Fourth Edition (Text Revision) (New York: American Psychiatric Publishing, 2000).
46
. L. F. Fontenelle, S. Oostermeijer, B. J. Harrison, C. Pantelis, and M. Yücel, “Obsessive-Compulsive Disorder, Impulse Control Disorders and Drug Addiction Common Features and Potential Treatments,”
Drugs
71, no. 7 (2011): 827–40.
47
. For a very nice review of the similarities between these conditions and more detail on the imaging and neurochemical similarities between these conditions, see Leonardo Fontenelle’s paper cited above.
48
. J. E. Grant, “Family History and Psychiatric Comorbidity in Persons with Kleptomania,”
Comprehensive Psychiatry
44, no. 6 (2003): 437–41.
49
. Specifically, both kleptomania and cocaine addiction show decreased white matter microstructural integrity in the ventral-medial frontal brain regions compared to controls.
50
. Jon E. Grant, Brian L. Odlaug, and SuckWon Kim, “Kleptomania: Clinical Characteristics and Relationship to Substance Use Disorders,”
American Journal of Drug and Alcohol Abuse
36, no. 5 (2010): 291–95.
51
. Marc N. Potenza, “The Neurobiology of Pathological Gambling and Drug Addiction: An Overview and New Findings,”
Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
363 (2008): 3181–89.
52
. All of these findings are very well reviewed by Jon Grant from the University of Minnesota, in Jon E. Grant, Judson A. Brewer, and Marc N. Potenza, “The Neurobiology of Substance and Behavioral Addictions,” CNS Spectrums 11, no. 12 (2006): 924–30.
53
. J. Gunstad, R. H. Paul, R. A. Cohen, D. F. Tate, M. B. Spitznagel, and E. Gordon, “Elevated Body Mass Index Is Associated with Executive Dysfunction in Otherwise Healthy Adults,”
Comprehensive Psychiatry
48, no. 1 (2007): 57–61.
54
. Nora D. Volkow, Gene-Jack Wang, Frank Telang, Joanna S. Fowler, Rita Z. Goldstein, Nelly Alia-Klein, Jean Logan, Christopher Wong, Panayotis K. Thanos, Yemine Ma, and Kith Pradhan, “Inverse Association between BMI and Prefrontal Metabolic Activity in Healthy Adults,”
Obesity
17, no. 1 (2009): 60–65.
55
. Sakura Komatsu, “Rice and Sushi Cravings: A Preliminary Study of Food Craving among Japanese Females,”
Appetite
50, no. 2–3 (2008): 353–58.
56
. Mark Griffiths, professor at Nottingham Trent University, has published a very useful tool to help practitioners screen for these disorders by looking for precisely these symptoms. M. D. Griffiths, A. Szabo, and A. Terry, “The Exercise Addiction Inventory: A Quick and Easy Screening Tool for Health Practitioners,”
British Journal of Sports Medicine
39, no. 6 (2005): e30.
57
. These aspects of exercise dependence are well reviewed by Ian Cockerill and Megan Riddington, “Exercise Dependence and Associated Disorders: A Review,”
Counselling Psychology Quarterly
9, no. 2 (1996): 119–29.
58
. M. Varvel, “Exercise Addiction: An Examination of Associated Personality Characteristics” (unpublished dissertation, School of Sport and Exercise Sciences, University of Birmingham, 1992).
59
. Den’etsu Sutoo and Kayo Akiyama, “Regulation of Brain Function by Exercise,”
Neurobiology of Disease
13, no. 1 (2003): 1–14.
60
. A. Yates, C. Shisslak, M. Crago, and J. Allender, “Overcommitment to Sport: Is There a Relationship to the Eating Disorders?”
Clinical Journal of Sport Medicine
4, no. 1 (1994): 39–46.
61
. Michel Reynaud, Laurent Karila, Lisa Blecha, and Amine Benyamina, “Is Love Passion an Addictive Disorder?”
The American Journal of Drug and Alcohol Abuse
36, no. 5 (2010): 261–67.