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This is your brain on porn….

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Melissa Killeen

Pornography addiction and the reward pathway

Norman Doidge, author of the Brain that Changes Itself posits that deep inside your brain, there’s something called a “reward pathway.” We all have one, your cat has one, laboratory rats have one —all mammals have them, there is a reward pathway in all of us. The reward pathway’s job is to help keep you alive and happy by doing exactly what its name promises: it rewards you when you do something that promotes your life and well-being, like eating good food or cleaning up your apartment.

The reward pathway releases chemicals in your brain—mainly one that’s called dopamine, but others, as well, like serotonin and oxytocin. For example, when you eat something delicious, your brain releases dopamine, and it makes you feel good. Or if you hold hands with someone you care about, your brain releases a chemical called oxytocin, which helps you bond with people.

A neuron is a brain cell. A neuro chemical, is the chemical a neuron or brain cell releases to send a message to other cells. When a lot of brain cells get activated at the same time by something you see, taste, hear or smell, they release chemicals that help strengthen the connection between themselves and other brain cells (or neurons). Think of these brain cells being cemented together with neuro chemicals to build this reward pathway, in other words a reward superhighway. So, every time you went to visit your Grandma Martha she gave you a big hug, walked out on the porch, sat with you talking about what had changed for you since you last visited, while rocking with you on that big porch swing and she gave you a Reese’s Peanut Butter Cup to unwrap. You probably feel pretty great about Grandma Martha. Your brain has built a superhighway connecting thoughts of Grandma Martha with feeling happy, being loved and eating peanut butter cups. You have many of these of brain pathways for all sorts of things: talking to Grandma, riding a bike, eating lunch, walking the dog, and when a person looks at porn, their brain creates a new pathway for that, too.

Viewing porn stimulates the release of these pleasure chemicals. This rush of neuro chemicals happens over and over again, eventually creating a new reward pathway. Ultimately, constant porn use turns the reward pathway into a superhighway directing the viewer’s decision-making brain to want to view pornography for the quick rewards of the dopamine rush, rather than seeking healthy but less stimulating rewards, like eating a piece of chocolate or holding a girl’s hand. This changes the make-up of the viewer’s brain, and eventually results in an ever increasing appetite for porn.

Dopamine is sometimes referred to as the “pleasure chemical.” You may have heard that dopamine controls the “pleasure” systems of the brain, but these are not technically, accurate assumptions. Dopamine is all about wanting, seeking and searching for rewards, the anticipation of getting something.  Dopamine is  the motivation that drives us to pursue potential rewards or long-term goals. Although controversial, research suggests that driving “the want” best captures what dopamine does. The final reward, the feeling of satisfaction, arises from opioids, brain chemicals such as mu opioids and endocannabinoids, which are the brain’s natural versions of heroin and marijuana. As psychologist Susan Weinschenk explained in a 2009 article, dopamine does not cause people to experience pleasure, but drives a seeking behavior. “Dopamine causes us to want, desire, seek out, and search,” she wrote. It is the opioid system that causes one to feel pleasure and satisfaction. Yet, “the dopamine system is stronger than the opioid system,” she explained. We seek more after we are satisfied, we eat when we are not hungry.

Addiction may be thought of as wanting on overdrive. Just like other addictive substances, porn floods the brain with dopamine. The brain gets overwhelmed by the constant overload of neuro chemicals that comes with addictive porn use. It fights back by taking away some of its dopamine receptors, which is like closing the garage door on a neuron cell so that the truck carrying dopamine’s payload can’t come into the loading dock. With fewer receptors (fewer garage doors open), the user can’t feel dopamine’s full effect, even if the brain is producing all that it can. As a result, the pornography viewer isn’t as stimulated as they were before. So they go hunting for more porn, more novelty porn or more hardcore porn with the goal of receiving the same jolt of dopamine they received the day before. As the porn addict’s brain adjusts to these higher levels of dopamine flooding through it, regular activities that would normally set off a burst of dopamine to make the person feel happy, no longer work. Happy moments with their children, watching a football game with friends or a simple walk with their spouse leave the addict wanting a more stimulating jolt. So they return to porn, not more activities with their kids, nor more spousal contact. They go to view more porn because it delivers such a reliable and massive jolt. That’s one reason why pornography can be so addictive.

There is another reason porn is addictive, we get bored with the same old, same old. Researchers tested this theory. They wired up some 45 guys, each one a healthy 25 to 36 years old. Each participant had sensors on their penises that were linked to a computer. Researchers played the same erotic film repeatedly for these dudes. They had to watch porn. The researchers had to watch them watching porn and monitor indications of arousal, yes, in these guys’ man parts. This went on for three days. Torture, right? Well, the reports revealed a progressive decrease in sexual arousal after the 15th viewing of the same tape. The “same old, same old” gets boring. Seeing the same pornographic video, or even having sex with the same partner using the same position, over and over again, reduces dopamine production, and eases the jolt. After 18 viewings of the same erotic video, test subjects were nodding off. So researchers introduced a different, more erotic video for the 19th and 20th viewings. Bingo! The subjects and their penises sprang to attention. And yes, this theory also worked on women, for whom research showed similar effects.

Internet porn is especially enticing to the reward circuitry because a new mate, an unusual scene, a strange sexual act, or—fill in the blank—is just a click away. Something different every click. With multiple windows open and clicking for hours, one can experience more sex partners in ten minutes than our hunter-gatherer ancestors experienced in a lifetime.

Research confirms anticipation of reward and the many varied sexual selections (called novelty by the researchers) can amplify and increase excitement, and begins to rewire the brain—in other words, paves the porn superhighway in the brain. Pornography and erotica have been around forever, yet today’s version of Internet pornography is a completely new animal. Thanks to the power of the Internet, porn now stimulates the most powerful natural dopamine releases through a never ending stimulus cocktail using these elements:

    • Endless novelty, shock, and surprise
    • Strong emotions: surprise, fear, disgust, anxiety
    • Seeking and searching: exploring territories, foods or mating opportunities
    • Anything that violates expectations: unexpected bonanzas or dangers

All of these situations have been scientifically proven to increase dopamine surge. And because Internet porn offers an endless stream of variety, users can flip to a new image every time their high starts to fade, keeping dopamine levels elevated for hours. Virginie Despentes is a French writer, novelist and filmmaker. Her most famous novel, and film of the same name is Baise-moi, a contemporary film with a graphic mix of crime, mystery, violence and very explicit sex scenes. The title translates to: F**k Me. She states:

“Consuming pornography does not lead to more sex, it leads to more porn. Much like eating McDonalds everyday will accustom you to food that (although enjoyable) is essentially not food, pornography conditions the consumer to being satisfied with an impression of extreme sex rather than the real.”

Next week’s post will continue with the consequences of prolonged pornography use.


Resources used in this article:

Doidge, Norman M.D., (2007), The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science, James H. Silberman Books, Penguin Books, New York, NY

Inna Schneiderman, Orna Zagoory-Sharon, James F. Leckman, Ruth Feldman (2014) Oxytocin during the initial stages of romantic attachment: Relations to couples’ interactive reciprocity, Pyschoneuroendocrinology, Aug, 20913 37(8) 1277-1285. Accessed from the National Institute of Health National Library of Medicine at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3936960/

Hilton DL, Watts C. Pornography addiction: A neuroscience perspective. Surgical Neurology Institute [serial online] 2011 [cited 2015 Jan 9]; 2:19 http://www.surgicalneurologyint.com/text.asp?2011/2/1/19/76977

Hilton DL , (2013) Pornography addiction – a supra-normal stimulus considered in the context of neuroplasticity, Socioaffective Neuroscience & Psychology, Vol 3 (2013) incl Supplements. Accessed at: Socioaffective Neuroscience & Psychology 2013, 3: 20767 – http://dx.doi.org/10.3402/snp.v3i0.20767

John D. Salamone, Mercè Correa The Mysterious Motivational Functions of Mesolimbic Dopamine (2012), Neuron – 8 November 2012 (Vol. 76, Issue 3, pp. 470-485)Accessed at: http://yourbrainonporn.com/mysterious-motivational-functions-mesolimbic-dopamine-2012

Your Brain on Porn.com web site, the video of Dr Robert Sapolsky describing anticipation and dopamine. Accessed at: http://www.yourbrainonporn.com/dopamine-more-about-anticipation-dr-robert-sapolsky

Your Brain on Porn.com web site featured: Is the Pleasure Molecule Dopamine? (2008), Accessed at: http://yourbrainonporn.com/is-the-pleasure-molecule-dopamine-2011

Susan Weinschenk, PhD. (2009)100 Things You Should Know About People: #8 Dopamine Makes You Addicted To Seeking Information, Team W Blog Accessed at: http://www.blog.theteamw.com/2009/11/07/100-things-you-should-know-about-people-8-dopamine-makes-us-addicted-to-seeking-information/

Kent C. Berridge and Terry E. Robinson, What is the role of dopamine in reward: hedonic impact, reward learning, or incentive salience?: Brain Research Reviews, 28, 1998. 309–369.

Terry E. Robinson and Kent C. Berridge (2008.) The review of the incentive sensitization theory of addiction: some current issues. Philosophical Translations of the Royal Society. B (2008) 363, 3137–3146 doi:10.1098/rstb.2008.0093. Published online 18 July 2008, Downloaded from http://rstb.royalsocietypublishing.org/ on January 9, 2015

Ingrid Meuwissen, Ray Oliver, Habituation and Dishabituation of Female Sexual Around (19 90) Behavior, Research and Theory, Vol 28, No 3, p 217-226 Access at: http://www.mendeley.com/catalog/habituation-dishabituation-female-sexual-arousal/#page-1

Gary Wilson, (2010) Intoxicating Behaviors: 300 Vaginas = A Lot of Dopamine, Your Brain on Porn.com web site featured: http://yourbrainonporn.com/intoxicating-behaviors-300-vaginas-a-lot-of-dopamine

Your Brain on Porn.com web site featured: Novelty increases the mesolimbic functional connectivity of the substantia nigra/ventral tegmental area (SN/VTA) during reward anticipation: Evidence from high-resolution fMRI (2011). Accessed at: http://yourbrainonporn.com/novelty-increases-mesolimbic-functional-connectivity-substantia-nigraventral-tegmental-area-snvta

http://www.Wikipedia.com http://www.yourbrainonporn.com http://compulsionsolutions.com http://fightthenewdrug.org/

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I can’t sleep — How can I get more sleep?

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Melissa Killeen

Sleep has a potent effect on the addicted brain

There are many tools available to a recovery coach. Information on the importance of sleep is one of them. Sleep is a necessity for everyone, including those in recovery from addiction. In fact, successful recovery and practicing healthy sleep habits are inseparable. Sleep has a potent effect on the addicted brain, proving to be one of the most influential factors in successful recovery.

Dr Ralph Carson, author of The Brain Fix, describes why proper sleep is crucial while recovering from addiction. He explains that for addicts in an inpatient treatment program, it’s paramount that individuals be prepared to accept new concepts, embrace a different lifestyle, and apply their creativity to this recovery challenge. The effectiveness of treatment is compromised if people aren’t getting quality sleep and thus don’t wake up feeling refreshed, responsive, positive, and committed to the hard work of recovery.

Of special interest to those in recovery, sleep impacts the pre-frontal cortex of the brain. Sleep removes neural toxins from the brain, which provides the brain the opportunity to re-organize the information that it has learned. Addiction negatively affects the pre-frontal cortex of the brain, leading to many problems, including compulsivity, impulsivity and most of all, impaired judgment. Strengthening this part of the brain is an essential part of the recovery process and strengthening the pre-frontal cortex involves getting enough sleep to clear out the neural toxins accumulated during the day.

Psychologist Jack Edinger, Ph.D., of the VA Medical Center in Durham, North Carolina, and Professor of Psychiatry and Behavioral Sciences at Duke University, cautions that treating depression usually doesn’t resolve sleep difficulties. From his clinical experience, he has found that most patients with depression should be checked for insomnia and should be examined for specific behaviors and thoughts that may perpetuate the sleep problems. When people develop insomnia, they try to self-regulate or compensate by engaging in activities to help them get more sleep. Maybe they sleep later in the mornings or spend excessive times in bed or nap. These efforts usually appear as depression and are not helpful in resolving insomnia.

According to sleep researchers, a night’s sleep is divided into five continually shifting stages, defined by the types of brain waves that reflect either lighter or deeper sleep. Toward morning, there is an increase in rapid eye movement, or REM sleep, when the muscles are relaxed and dreaming occurs, and recent memories may be consolidated in the brain. Experts say that hitting a snooze alarm over and over again to wake up is not the best way to feel rested. “The restorative value of rest is diminished, especially when the increments are short,” says psychologist Edward Stepanski, Ph.D. who has studied sleep fragmentation at the Rush University Medical Center in Chicago. This on-and-off-again effect of dozing and waking causes shifts in the brain-wave patterns. Sleep-deprived snooze-button addicts are likely to shorten their quota of REM sleep, impairing their mental functioning during the day.

Cognitive behavioral therapy and sleeping

From his clinical Cognitive Behavioral Therapy (CBT) work and research on sleep, psychologist Charles M. Morin, Ph.D., a Professor in the Psychology Department and Director of the Sleep Disorders Center at University Laval in Quebec, Canada, says that ten percent of adults suffer from chronic insomnia. In a National Sleep Foundation study released in the recent issue of the Sleep Medicine Alert, Morin outlines how CBT helps people overcome insomnia. Clinicians use sleep diaries to get an accurate picture of someone’s sleep patterns. Bedtime, waking time, time to fall asleep, number and durations of awakening, actual sleep time and quality of sleep are documented by the person suffering from insomnia.

A person can develop poor sleep habits like using their smart phone, tablet or laptop in bed, watching Jimmy Fallon in order to go to sleep or eating too much before bedtime. Many times they may compensate by sleeping late the day after a bout of insomnia, or taking a long nap during the day to compensate for the lost sleep. Some develop a fear of not sleeping and a pattern of worrying about the consequences of not sleeping, which perpetuates the insomnia and can result in a dependence on sleep aids. Cognitive behavioral therapies are essential for patients attempting to alter the conditions that perpetuate insomnia.

CBT attempts to change a person’s dysfunctional beliefs and attitudes about sleep such as letting go of thoughts like, “I’ve got to sleep eight hours tonight” or “I’ve got to take medication to sleep” or “I just can’t function if I don’t sleep.” These thoughts focus too much on sleep, which can be similar to performance anxiety. Sleep has a way of creeping up on you when you are not actively seeking it. Banishing negative thoughts will allow sleep to arrive at your bedroom door.

According to a study published in the October 2004 issue of The Archives of Internal Medicine, cognitive behavior therapy is more effective and lasts longer than the sleeping pill, Ambien. The study involved 63 healthy people with insomnia who were randomly assigned to receive Ambien, cognitive behavior therapy, both or using a placebo. The patients in the therapy group received five 30-minute sessions over six weeks. They were given daily exercises to “recognize, challenge and change stress-inducing thoughts” and were taught techniques like delaying bedtime or getting up to read if they were unable to fall asleep after 20 minutes. The patients taking Ambien were on a full dose for a month and then were weaned off the drug. At three weeks, 44 percent of the patients receiving the therapy and those receiving the combination therapy and pills fell asleep faster compared to 29 percent of the patients taking only the sleeping pills. Two weeks after all the treatment was over, the patients receiving the therapy fell asleep in half the time it took prior to the study, and only 17 percent of the patients taking the sleeping pills fell asleep in half the time.

What works in many cases, is to give a person more control over their sleep. A person can keep a sleep diary for a couple of weeks so a clinician can monitor the amount of time spent in bed to the actual amount of time sleeping. Then the clinician can instruct the patient to either go to bed later or get up earlier or vice versa. A person can also establish more stimulus control over his or her bedroom environment, such as going to bed only when sleepy, getting out of bed when unable to sleep, removal of electronic devices from the bedroom and not smoking or drinking before bedtimes. The same wake-up times every morning (including weekends) and avoiding daytime naps are also good regimes to adopt in thwarting insomnia.

Finally, a person can incorporate relaxation techniques as part of his or her treatment. For example, a person can give herself or himself an extra hour before bed to relax and unwind and time to write down gratitude lists, meditate or use tapping (Emotional Freedom Techniques).

In CBT, said Morin, breaking the thought process and anxiety over sleep is the goal. “After identifying the dysfunctional thought patterns, a clinician can offer alternative interpretations of what is getting the person anxious so a person can think about his or her insomnia in a different way.” Morin offers some techniques to restructure a person’s cognitions. “Keep realistic expectations, don’t blame insomnia for all daytime impairments, do not feel that losing a night’s sleep will bring horrible consequences, do not give too much importance to sleep and finally develop some tolerance to the effects of lost sleep.”

How can I get more sleep?

According to leading sleep researchers, here are some techniques to get more sleep:

• Start a sleep diary to chart your progress
• Keep a regular sleep/wake schedule and develop a regular bedtime (go to bed at the same time on weekends as on weeknights)
• Try and wake up without an alarm clock—get rid of the snooze alarm
• Attempt to go to bed earlier every night for a certain period of time; this will ensure that you’re getting enough sleep
• Give yourself a 60-minute relaxation period before you sleep, meditate, chant, write a gratitude list, complete an eleventh step
• Don’t drink or eat caffeine four to six hours before bed and minimize daytime use
• Don’t smoke, especially near bedtime or if you awake in the night
• Avoid alcohol and heavy meals before sleep, curb night eating
• Get regular exercise
• Minimize noise, light and excessive hot and cold temperatures where you sleep
• Avoid daytime naps, especially after 3pm
• Reading is okay, however make it a non-stimulating choice, romance, murder mysteries and sci-fi thrillers are very stimulating and can inhibit the relaxation portion of your pre-sleep ritual
• Consider taking a hot shower at bedtime, instead of in the morning. Use aromatic soaps that promote sleep such as chamomile and lavender

Dr Ralph Carson writes about the additional impacts of having a pre-frontal cortex that is “shut down” due to poor sleep. He explains: “This can cause you to overreact to negative experiences. Instead of facing your problems like a well-reasoned adult, you’ll be more apt to act moody, inpatient, or irritable.” For those in recovery, these negative mood states can be extremely triggering, increasing the likelihood of relapse.

As previously stated, sleep deprivation inhibits the pre-frontal cortex’s ability to work efficiently, making it more difficult to focus on “what your big goals are.” Addicts who increase the duration of their sleep experience an improved ability to “resist relapse.” Increased sleep makes their brains cleaner and better fueled, helping them remember their goals to remain sober.

If you choose to try a few of these suggestions, please first speak to a medical professional about your lack of sleep or insomnia.


Resources using in compiling this blog:

National Sleep Foundation
http://www.sleepfoundation.org/

American Academy of Sleep Medicine
http://www.aasmnet.org/

American Insomnia Association
http://www.americaninsomniaassociation.org/

Sleep Research Society
http://www.sleepresearchsociety.org/

NIH National Center for Sleep Disorders Research
http://www.nhlbi.nih.gov/sleep

The MayoClinic.com Sleep Center
MayoClinic.com

Ralph Carson (2012) The Brain Fix, Health Communications, Deerfield Beach, Florida, p 214
http://ralphcarson.com/

National Institute of Health (2013) How Sleep Clears the Brain,
http://www.nih.gov/researchmatters/october2013/10282013clear.htm

National Institute of Health (2013), New Brain Cleaning System Discovered:
http://www.nih.gov/researchmatters/september2012/09172012brain.htm

Martica Heaner (2004), Snooze Alarm Takes Its Toll on a Nation, Health Section, New York Times.com, http://www.nytimes.com/2004/10/12/health/12snoo.html

American Psychological Association (2014 ) Why Sleep is so important and what happens when you don’t get enough, http://www.apa.org/topics/sleep/why.aspx

John O’Neil (October 5, 2004) Treatment: Think before You Sleep, New York Times.com, Vital Signs Section, http://www.nytimes.com/2004/10/05/health/05trea.html

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What is the difference between a recovery coach, a sponsor or a therapist?

(The following is the first in a series of excerpts taken from Melissa Killeen’s new book, RECOVERY COACHING — A Guide to Coaching People in Recovery from Addictions. This text is from Chapter 5, How Does a Recovery Coach Guide a Client Through Recovery?)

A recovery coach is not a sponsor, therapist, physician or priest. Even though there is a strong spiritual component in the recovery coach’s repertoire, the recovery coach is not a clergy member promoting a specific religion or church. As a coach, I follow both the International Coaching Federation’s Code of Ethics and the Core Competencies drafted by Recovery Coaches International (a professional association of recovery coaches) emphasizing the differences in a therapist, doctor, a 12-step program sponsor and a recovery coach:

1. Therapy is for those clients seeking relief from emotional or psychological pain. Therapy focuses on the past and how past unresolved issues are impacting the present. Coaching focuses on the present and what can be done, today, to move the client forward. Ethical guidelines require coaches to refer clients to a therapist or doctor if emotional or physical pain is evident. Recovery Coaching is often used in conjunction with therapy but not as a replacement for it.

2. Coaching separates itself from other professional healthcare relationships and roles such as a physician or a nurse, because a coaching-client relationship is a partnership. Whereas in a professional relationship, the physician or nurse has expert knowledge and they impart this knowledge as a form of advice, diagnosis or offering solutions. Coaches do not diagnose or impart solutions. Coaches encourage their clients to come up with self-powered solutions.

3. Sponsors from a 12-step program are different from coaches, as they are not paid professionals and they encourage abstinence from addictions by advocating use of a 12-step program. A recovery coach is not limited to using the twelve steps and traditions as a pathway to recovery. A recovery coach can suggest using SMART Recovery, Kundalini yoga, or the Buddhist path to freedom from alcoholism and addiction in order to help their client in recovery. Recovery coaching is not affiliated with any 12-step program or mutual aid group and does not promote a particular path of recovery; a recovery coach encourages the client to select their path and works with their client along that particular selection. (Susskind, 2006, Recovery Coaches International.org, 2006, Loveland & Boyle 2005).

A recovery coach has to establish certain ethical standards in order to help a recovering client. Simple emotional characteristics such as compassion and empathy go a long way, but do not help the coach in a crisis with their client. Educated with the knowledge of ethical standards, the core competencies and their experience, a knowledgeable and strong recovery coach can emerge. The ICF Code of Ethics and Core Competencies are recommended as a reference for recovery coaches. Visit Wikipedia to learn more about recovery coaching by clicking here: http://en.wikipedia.org/wiki/Recovery_coaching.


RECOVERY COACHING — A Guide to Coaching People in Recovery from Addictions gives readers something that “hasn’t been done before: a thorough explanation of recovery coaching” states Omar Manejwala, M.D. author and former Medical Director of the Hazelden Treatment Centers, “this [book] will be an indispensable resource for both the coach just starting out or the veteran.”

If you are interested in purchasing Melissa Killeen’s new book, click below.

Recovery Coaching
A Guide to Coaching People in Recovery from Addictions

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