Thursday, March 22, 2012

Willpower – Is it useful for recovery from addictions?


It must be a hot topic, because I have come across three articles in the last month that have discussed the issue of “willpower” and how we can resist urges to do things that may not be good for us.

It turns out that there are new techniques, including functional MRIs, for studying the human brain. These functional MRIs (fMRIs) are starting to shed some light on how we make decisions, and particularly how we resist temptations. Of course we have known for quite a long time that there is a deep seated part of the brain that gives us strong urges, or strong drives to do things that feel good. This is sometimes called the primitive brain or the lizard brain. In medical terms it is called the Locus Ceruleus, the Nucleus Accumbens, or the Ventral Tegmental area. I just call it the Pleasure Center. Whatever you call it, this area of the brain works with Dopamine, which can be called the pleasure molecule. When this region of the brain is activated – and this can happen with pictures, memories, strong emotions and feelings, or food, sex and drugs – Dopamine is released. When Dopamine is released we feel euphoric and we may have cravings for more -depending on how much Dopamine is released and what the situation is.

Now, it is obvious that sometimes acting on these urges or cravings is not a good idea – think of having a large Chocolate milkshake if you are on a diet, or having a cigarette when you have been off cigarettes for 6 months. This is where the frontal lobes of the brain come into play. The frontal lobes contain the thinking parts of the brain. The frontal lobes can put the brakes on our urges. They can evaluate whether this really is a good idea or not. The frontal lobes are where willpower resides. Sometimes the frontal lobes lose out and the pleasure center wins, but some of this new research is helping to understand how this  works and what we can do about it.

I will highlight some of the findings of this new research:

1.     If you successfully resist something once – it is harder to resist the next tempting thing – even if the next temptation is something different. I have heard that exerting willpower to avoid a temptation is a little like holding a ball under water – the more you keep it down, the more it wants to come up. It is better to avoid the temptation in the first place. In a practical sense, this means not being around other people who are smoking, not going to places that sell chocolate milkshakes, etc.

2.     Low blood sugar seems to make willpower go down. It may be that the brain has to conserve it’s resources, so if brain energy is low it may be more tempting to get satisfactions (dopamine) in other ways.

3.     Alcohol and drugs clearly decrease willpower. Judgment gets altered and consequences don’t get clearly evaluated. Alcohol and drugs decrease willpower even for people who don’t have an addiction problem, so if you do have an addiction problem it is a double whammy – don’t drink or do drugs!

4.     Cravings trigger a fight or flight effect, which is usually an increase in adrenaline. Our bodies go into panic and fear mode which can make willpower less effective.

5.     There is often a “what the hell effect” on willpower. This means that if you have given in once it is very easy to throw it all away because the day is shot anyway. Not much frontal lobe thinking in that scenario, but many of us do fall into this trap. 

6.     The “halo effect” decreases willpower – this is when you have worked out at the gym and used up 400 calories – you have been so good that you may as well get that milkshake (500 calories) on the way home – tell that to your frontal lobes!

7.     Near misses – or almost getting what you want seems to decrease willpower. Gambling machines actually set their machines up to have a lot of near misses (seeing 4 cherries in a row on the line just below your line) so that compulsive gamblers will keep playing. Gamblers will actually believe that they were so close, that the next time they are much more likely to win. Logically this makes no sense but try telling that to a gambler.

8.     Environment makes a difference. Studies show that people who come from environments with high crime rates and low life expectancy are much more likely to not use willpower to avoid temptations that are risky – why should they?

9.     Thinking about the long term does improves willpower. If people see a computer generated picture of themselves - as they are going to look in twenty years - they are more likely to make good decisions, including putting away more retirement money. It seems that getting in touch with the reality of our “future self” allows us to make more rational decisions. 

10.  Meditation and mindfulness really do improve willpower.

11.  Good habits can make a big difference to willpower. One suggestion to make it a habit of going to exercise is to put your exercise gear where you will see it when you get home (the cue), then do the exercise (the action), then make sure you get something good (the reward) - like some chocolate. After a while, the exercise will become a habit and it will be its own reward.

It is fun to learn about willpower and how these amazing brains of ours work. Temptations are always going to be there, but clearly it is up to us to learn how to moderate and avoid them.

Whether you struggle with opiates, benzodiazepines, chronic pain, methadone or suboxone, the Coleman Institute is here to help you!  Please give us a call at 1.877.77.DETOX...you'll be glad you did.

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