Motivation, Kindness, Substances, and the Human Brain

"We are motivated to do things that have been associated with dopamine in our experience. So we are motivated to go camping if dopamine flowed the last time we went or, if you have never been, perhaps when you looked at pictures of a beauti­ful camping spot. As we look forward to the trip, we summon the drive it takes to pack up backpacks, organize maps, plan meals, and forgo our comfy bed for a week. When we’re there, we take in the sounds, smells, and adventure of the experience and dopamine flows and we feel good. In the end, the decision to do all the work associated with a camping trip is motivated by the anticipation and actual reward of smelling pine needles, hearing babbling brooks, and eating s’mores.

Motivation works in the same way with the decision to use a substance. Substance use increases dopamine in the brain (or the substance itself acts like dopamine). If someone who is struggling with depression uses cocaine and feels more alert, engaged, and less tired, they may be moti­vated to use cocaine to “feel better” again, even though going on a camping trip would also make the person feel better. Camping is a lot more work. According to what we’ll call the zero-to-sixty rule, the quicker a substance (or experience) affects the brain, the more powerfully the brain is moti­vated to use it. And it’s relative: if the brain’s reward system has learned to release dopamine in response to a drug, it might not get excited by nature, the smell of a campfire, s’mores, and so on. In other words, the benefits of camping will pale in comparison to those of using the drug. For someone using substances, cocaine is rocket fuel, while camping is a can of Sterno."

The above is an excerpt from Beyond Addiction, How Science and Kindness Help People Change. When I read this book, (devoured it as well as the 20 minute guide workbook,) I learned something striking and new. While we are, in truth, powerless over people's thoughts and actions, being supportive and kind can actually affect their brains in terms of dopamine production, much like drugs do. In acknowledging the truth and logic of this new kind of thinking, I found hope. And it spoke to a place inside of me that I knew existed all along.

Individuals with substance use disorder cannot kick drugs in a vacuum. These people need their family's love, support, engagement, and trust. While throwing loved ones "out" and getting out of their way so they can hit bottom may work for some....for others, engaged conversation, perseverance, an endless flow of love also speak volumes. When the addict feels seen and heard, it's my (unscientific) opinion that dopamine shoots into their brains and they will want more of this engagement. Over time, trust in the process develops and maybe, just maybe begin to feel better (instead of worse) around family.

This makes sense.

"The brain and the world in which it operates are inextricably intertwined; we literally take in sub­stances, people, and other stimuli, and they affect the very structure and functioning of our brains. Our brains in turn affect our behavior toward substances, people, and other stimuli in the world. Understanding the interactive nature of motivation, you can see the value in staying engaged. Your loved one is affecting his brain chemistry with substances; you can affect his brain chemistry with the way you interact.

When it comes to substance problems, however, it’s easy to lose objec­tive distance and let the problem taint our view of the whole person. The more unacceptable, frightening, or disturbing a person’s behavior seems to us, the more it pulls us to make judgments about the whole person(“loser,” “freak,” “bum,” “addict”). Such labels imply that the motivation behind the behavior is based on innate characteristics (weakness, weirdness, lazi­ness). The reality is that the motivation to use a substance rather than engage in some other behavior is based on how the outcome of that choice feels to the person—smoking pot feels relaxing, for example, and doing a crossword feels boring. By understanding the different motivations behind each choice your loved one makes, you will be better equipped to look at the problem clearly without judging, writing off, or hating the person for it."

This new form of interacting (including evidence based treatments for addiction such as Motivational Interviewing) may turn out to be the next great wave in terms of successful addiction treatment. Learning to listen better to our loved one, acknowledging him and his struggles, offering kindness and outside the box attention, holding him in love and providing a motivation to help him make healthy choices (within boundaries and while keeping ourselves healthy) may be a new key to unlock more hope for recovery from addiction.