11/05/2024
I frequently take notes for clients from important books that are often longer than they want to read. This set is 6-pages long but synthesizes key points in Gabor Mate's 400-plus page book, In the Realm of Hungry Ghosts. There are many important take aways, especially regarding the development of addiction, obesity, s*x and other compulsive-behavioral addictions.
These notes relate, initially, to infants' development of the opioid attachment reward system, dopamine-based incentive-motivation apparatus, self-regulation areas of the prefrontal cortex and the stress response system.
Happy, attuned emotional interactions w/ parents stimulate a release of natural opioids in an infant’s brain.
The endorphin surge promotes the attachment relationship and further development of the child’s opioid and dopamine circuitry.
Stress reduces the number of opioid and dopamine receptors.
Healthy growth of these crucial systems is “responsible for such essential drives as love, connection, pain relief, pleasure, incentive and motivation.” All depend on the quality of the attachment relationship.
When circumstances do not allow the infant or young child to experience consistently secure interactions, or worse expose him to many painfully stressful ones, maldevelopment often results.
Dopamine levels in a baby’s brain fluctuate depending on the presence or absence of the parent.
In 4-mo.-old monkeys, major alterations of dopamine and other neurotransmitter systems were found after only six days of separation from their mothers.
In these experiments, loss of an important attachment appears to lead to less of an important neurotransmitter in the brain.
Once these circuits stop functioning normally it becomes more difficult to activate the mind.
We know from animal studies that social-emotional stimulation is necessary for the growth of nerve endings that release dopamine and for the growth of receptors to which dopamine needs to bind in order to do its work.
Even rodents kept in long-term isolation will have a reduced number of dopamine receptors in the middle brain incentive circuits, and, notably, in the frontal areas implicated in addiction.
Rats separated from their mothers at an early stage display permanent disruption of the dopamine incentive-motivation system in their midbrains.
As we know, abnormalities in this system play a key role in the onset of addiction and craving.
Predictably, in adulthood, these maternally deprived animals exhibit a propensity to self-administer co***ne.
It doesn’t take extreme deprivation either: rat pups deprived of their mother’s presence for one hour a day during the first week of life grew up much more eager than their peers to take co***ne.
The presence of consistent parental contact in infancy is one factor in the normal development of the brain’s neurotransmitter systems.
The absence of it makes the child more vulnerable to “needing” drugs of abuse later to supplement what their own brain is lacking.
Parental attachment = more efficient brain circuitry for reducing anxiety. They also had more receptors on their nerve cells for benzodiazepines, which are natural tranquilizing chemicals in the brain.
Another effect of early maternal deprivation appears to be a permanent decrease in the production of oxytocin (the cuddle hormone), which…is one of our love chemicals. It is critical to our experience of loving attachments and even to maintain committed relationships. People who have difficulty forming intimate relationships are at a risk for addiction. They may turn to drugs as social lubricants.
Children who suffer disruptions in their attachment relationships will not have the same biochemical milieu in their brains as their well-attached and well-nurtured peers. As a result, their experiences and interpretations of their environments will be less flexible, less adaptive and less conducive to health and maturity.
Many people become hooked on street=pedaled benzodiazepines like Va**um and Xanax to calm jangled nervous systems.
The need for tranquilizers says much about their infancy and early childhood.
Studies of drug addicts repeatedly find extraordinarily high percentages of childhood trauma of various sorts, including physical, s*xual, and emotional abuse. One group of researchers was moved to remark that “our estimates…are of an order of magnitude rarely seen in epidemiology and public health.”
For each adverse childhood experience, the risk for early initiation of substance abuse increased two to four times. Subjects with five or more Adverse Childhood Experiences had seven to ten times greater risk for substance abuse.
Alcohol consumption has a similar pattern: those who had suffered s*xual abuse were three times more likely to begin drinking alcohol in adolescence. For each emotionally traumatic childhood circumstance, there is a two- to threefold increase in the likelihood of early alcohol abuse.
It’s just as many substance addicts say: they self-medicate to soothe their emotional pain; but more than that, their brain development was sabotaged by their traumatic experiences.
Parental nurturing determines the levels of other key brain chemicals too. Serotonin, the mood messenger, is enhanced by antidepressants like Prozac.
Maternal deprivation and other types of adversity during infancy and childhood result in chronically high levels of the stress hormone cortisol.
In addition to damaging the midbrain dopamine system, excess cortisol shrinks important brain centers such as the hippocampus – a structure important for memory and the processing of emotions – and disturbs normal brain development in many other ways, with lifelong repercussions.
Another major stress chemical that’s permanently overproduced after insufficient maternal contact is vasopressin, which is implicated in high blood pressure.
The brains of mistreated children have been shown to be smaller than normal by 7 or 8 percent, with below-average volumes in multiple brain areas, including the impulse-regulating prefrontal cortex.
Early trauma has consequences for how humans respond to stress all their lives and stress has everything to do with addiction.
In the corpus callosum, the bundle of white matter that connects and integrates the functioning of the two sides of the brain, and in several structures of the limbic or emotional apparatus, whose dysfunctions greatly increase vulnerability to addition.
In a study of depressed women who had been abused in childhood, the hippocampus (memory and emotional hub) was found to be 15 percent smaller than normal.
They key factor was abused, not depression, since the same brain area was unaffected in depressed women who had not been abused.
Milder disruptions in early childhood experience and brain development can and do occur and often result in “milder” forms of substance abuse or in nondrug behavioral addictions.
These children experience “an emptiness at one’s core; a striving to fill a void.”
There is a strong association between parental neglect and the later development of obesity.
Neglect does not need to be intentional or overt: parental stress and depression during the child’s early years will have the same effect, owing to the lack of attunement that follows.
Childhood abuse also created a risk of adult obesity.
The greater (a person’s weight), the greater the percentage of adults reporting being abused.
Disruptions in the parent-child relationship have significant impacts throughout the lifespan of the child.
It’s safe to say that any pursuit, natural or artificial, that induces a feeling of increased motivation and reward – shopping, driving, s*x, eating, watching TV, extreme sports, etc., -- will activate the same brain systems as drug addiction.
PET scanning revealed that playing video games raises dopamine levels in the incentive-motivation circuits.
For someone with a relative shortage of dopamine receptors, it’s whichever activity best releases extra quantities of dopamine – this euphoric and invigorating neurotransmitter that will become the object of addictive pursuit.
PET imagine studies in addictive eaters have, predictably, implicated the brain dopamine system. As with drug addicts, addictive eaters have diminished dopamine receptors. In one study, the more obese the subjects were, the fewer dopamine receptors they had. Recall that reduced numbers of dopamine receptors can be both a consequence of chronic drug use and a risk factor for addiction.
Junk foods and sugar are also chemically addictive because of their effect on the brain’s intrinsic “narcotics” the endorphins.
Sugar, for example, provides a quick fix of endorphins and also temporarily raises levels of the mood chemical serotonin.
It is becoming apparent that eating and drug disorders share a common neuroanatomic and neurochemical basis,” conclude two experts on addiction and related disorders.
Not only are the identical incentive-motivation and attachment reward circuits impaired in the brains of overeaters and drug addicts, but so are the impulse-regulating functions of the cortex.
“Some evidence suggests a decision-making impairment in obese patients, a recent JAMA article pointed out.
Compulsive shoppers experience the same mental and emotional processes when engaged in their addiction. The thinking parts of the brain go on furlough.
The electrical discharges of the brain circuits governing pleasure were found to be in overdrive during shopping, in contrast to the rationality circuits.
Neurologist Michael Deppe, the lead researcher, said, “the more expensive the product, the crazier the shoppers get. And when buying the really expensive products, the part of the brain dealing with rational thought has reduced its activity to almost zero. The stimulation of emotional centers show that shopping is a stress relief.”
5.5 percent of men and 6 percent of women appear to be addicted shoppers.
Addictions are often interchangeable – a fact that further buttresses the unitary theory that there’s a common addiction process.
“It has a lot to do with which experience brings relief from whatever pains us,” said Dr. Aviel Goodman, an authority of s*xual addictions.
When, owing to internal demons arising from their own childhoods or to external stressors in their lives, parents are unable to regulate – that is keep within a tolerable range – the emotional milieu of the infant, the child’s brain has to adapt: by tuning out, by emotional shutting down, and by learning to find ways to self-soothe through rocking, thumb-sucking, eating, sleeping, or constantly looking to external sources for comfort. This is the ever-agitated, ever-yawning emptiness that lies at the heart of addiction.
A child with a depressed mother feels constant deprivation and deep distress.
…Emotional deprivation will trigger a desire for oral stimulation or eating just as surely as hunger will. Children who continue to suck their thumbs past infancy are attempting to soothe themselves.
Except in rare cases of physical disease, the more obese a person is the more emotionally starved they have been at some crucial period in their life.
If children today are at greater risk for obesity than those of previous generations, it’s not simply because they are less physically active as a result of being absorbed in TV or computers. It’s primarily because under ordinary peacetime conditions there has never before been a generation so stressed and so starved of nurturing adult relationships.
The obesity epidemic demonstrates a psychological and spiritual emptiness at the core of consumer society. We feel powerless and isolated, so we become passive. We lead harried lives, so we long for escape. In Buddhist practice people are taught to chew slowly, being aware of every morsel, every taste. Eating becomes an exercise in awareness. In our culture, it’s just the opposite. Food is the universal soother and many are driven to eat themselves into psychological oblivion.
The roots of s*x addiction also reach back to childhood experience. S*x addiction authority Dr. Aviel Goodman points out that the vast majority of female s*x addicts were s*xually abused as children, as were up to 40 percent of men.
“Human beings are very adaptable. Being held and cuddled is so important to us that we’ll associate love with whatever gives us that warmth and contact. If a person feels wanted only s*xually, as an adult they may look to s*x to reaffirm they are loved and wanted.
S*x addicted who were not abused as children may have had more subtle forms of s*xuality projected onto them by a parent, or they may have felt so unloved or undesirable that they now look to s*xual contact as a quick source of comfort.”
The lack of an emotionally attuned and consistently available parenting figure is a major source of stress for a child. Such a lack can occur when the parent is physically present but emotionally distracted, a situation that has been called proximate separation.
Proximate separation happens when attuned contact between parent and child is interrupted due to stresses that draw the parent away from the interaction. The levels of psychological stress experienced by the child during proximate separation approach the levels experienced during physical separation.
The development of the brain’s neurotransmitter and self-regulating systems and, in particular, the stress-control circuits is then disrupted, and, once entrenched, these physiological dysfunctions increase the risk for addictions.
Addictive tendencies may already be seen in young children. …Human children lacking sufficient attuned parental contact may readily become addicted to television or to self-soothing behaviors such as eating.
At the core of every addiction is an emptiness based in abject fear. The addict dreads and abhors the present moment; they bend feverishly only toward the next time, the moment when their brain, infused with the drug of choice, will briefly experience itself as liberated from the burden of the past and fear of the future – the two elements that make the present intolerable.
So writes Eckhart Tolle: “Even our 24/7 self-exposure to noise, emails, cell phones, TV, Internet chats, media outlets, music downloads, video games, and nonstop internal and external chatter cannot succeed in drowning out the fearful voices within.”
