The Table Video

Transcript

Thanks for checking out this video from the table conference on the topic Mind Your Heart. This video features William Struthers who’s a neuroscientist and he’s gonna be talking about addiction and the role of addictions in Christian spirituality, how we can understand abuse and misuse of substances and in addition what it means to actually be addicted and what can be done about that. So we hope you enjoy this video.

As mentioned earlier, I am a neuroscientist, I’m not practicing clinical psychologist, although I do spend an awful lot of time around them in my job teaching at Wheaton College. One of the areas that I have kind of really enjoyed as a researcher is that when I was a sophomore in college, I began doing work on the club drug ecstasy. And now people think, oh, that sounds really, really cool. Well, ecstasy actually is not what we would call classically an addictive drug, however, it is a drug that does some really interesting things to rats. Number one, it disrupts their sexual activity. And so back in 1990, I spent the majority of my time in a dark room under a red light watching rats mate after they have been pumped up with ecstasy. [audience laughs] So, I give that to you just as a taster of where I’m going [audience laughs] because I think that we use the language of addiction in a very interesting way in our culture.

Now what does rats and club drugs and ecstasy have to do with addiction? Well, earlier in the morning as I was milling around outside, I heard someone say, I have to get my coffee. I’m addicted to Starbucks. And, I thought, well, they’re going to hear me talking in another hour or so, so I’m not going to say anything. [crowd laughs] But we use addictions in a very sloppy way. For example, you are not an addict when it comes to your coffee. You do not sell your body on the street for your coffee. You do not rob from your neighbor for your coffee, but addiction has found its way into our culture in such a way that we have a very interesting way of thinking about it, and what I’d like to do, first off, is maybe sort of step back and say, let’s think about how we are defining addiction because we are kind of cavalier in the way that we do that.

Addiction comes out of a drug language and so we would say a person is addicted to heroin or addicted to cocaine, but if we step back a little bit further we would see that some drugs have what we would call appropriate uses. So, for example, if I were to take aspirin because I had a headache, that would be the appropriate use of a drug. Take the aspirin, its mechanism of action is that it gets into my bloodstream. It’s distributed to my brain. It influences the different sites of mechanisms of action that it causes, the reduction in my headache. Now, if I were to take aspirin and I took it over and over again because I was convinced that aspirin was going to give me a ripped set of abdominal muscles. [audience laughs] Can you tell? [audience laughs] No, that wouldn’t be using the drug inappropriately. That would actually be misusing the drug, wouldn’t it be? If I was taking aspirin to make my hair go back to its original color, no. That would be the misusing of a drug.

Now, you can misuse a drug without there really being any negative consequences to it. I can pop an aspirin in the attempt to get those ripped abdominal muscles, but it’s not going to work very well. So, what I might do is I might start taking more of it and in doing so now I’ve used from misuse to abuse. See, the thing that distinguishes abuse from misuse is that it causes damage to a system. Now, that system can be physiological or it could be psychological or it could be relational. I could take so much aspirin that I’m actually now beginning to do damage to my liver or to my kidneys in the process of trying to get that perfect ripped six-pack or getting my hair back to its original color. But not all abuse is addiction either. Addiction actually has kind of an interesting profile that’s associated with it in that you are usually repeatedly using the drug and whenever you repeatedly use the drug, as you can see there on the left there, you will, some drugs you develop a tolerance to. Your body just gets better at breaking it down and flushing it out of your system. So, you can have a tolerance to a drug, but not develop what is called a dependency.

Now, dependencies are when your body begins to rely on that drug in order to perform its normal functions. So, you can have a person who, let’s say, uses alcohol to enhance the taste of their red meat. They might misuse alcohol because they just can’t handle the stress and so they just put down four or five drinks to fall asleep to deal with it. They might abuse alcohol by binge drinking at the end of the week. Hey, let’s go out and get completely plastered. Class really was horrible this week. Let’s go binge drink and now we get alcohol poisoning, but that doesn’t make you an alcoholic. However, your body can develop if you are regularly consuming a drug over time a dependency on it. It could be physiological. Your body might need it, or it could be psychological, where you think you need it. If you have these dependencies you will develop withdrawal, and now this can be where we get into an interesting time where we step back and say, well, we’re talking for the most part about substance abuse, substance abuse, which really isn’t even addiction. But substance abuse, or substance addicts, are individuals that will experience withdrawal if they find themselves dependent on something. We hear an awful lot about behavioral addictions, and I’ll talk a little bit more about that in the breakout session.

Are there behaviors that a person can become addicted to? Gambling addiction or pornography sex addiction, comic book addictions, addictions to Breaking Bad, [audience laughs] addictions to shoes. We use that language in a sloppy fashion, but we hear it used because one of the hallmarks of addiction when we stop and look at it is that really it has this sort of inability to control the way in which you seek out pleasure. You are dysregulated because all of those things that you do when you take a drug and you get the high off of it. Addicts will move to a place where they keep chasing after that high. You find that oftentimes because of tolerance they have to take more and more of the drug in order to get the high. Well, when you have the tolerance and you develop the dependency, of course, now you enter into a season of withdrawal and what you see with many addicts is that they actually stop taking the drug to get high. They really tend to take it more just to try to function normally and avoid the withdrawal symptoms because one of, what we’ll see here in a second, one of the hallmarks of the neurobiological system is that that first high that you get off of that drug your body responds in such a way that you’re always chasing after that first high and you can never get it because the more you chase after it the more impossible it is to achieve. So, what you find is that people will get to a place where they have this withdrawal and it has all of these negative consequences and they want to stop and they try over and over again and they relapse and they try and they relapse, and they sometimes will go deeper.

And so, what we call this in psychology, at least in my branch of psychology, is we would say we’ve moved now to where that person has sort of lost their sense of agency where the drug now controls what they do rather than they control what they do. Now, this is, I think, historically very interesting because when you look at the way that we think about addiction, it’s not like this is new. It’s not like we haven’t had drugs of abuse before the 19th or 20th century, but we are now in a season where we have a couple of different models and depending on, as a psychologist, which are most interesting, you’ll adopt one of these models. The one that the contemporary culture goes with is sort of this disease model where we’re looking for genetic markers for addiction. We’re looking for neurological processes. We’re looking for the way that the chemicals act on the neurobiological system.

Another way of going about looking at it is the cognitive or behavioral approach where we’re looking for the maladapted behavioral patterns or the maladaptive thought processes that get the people into using drugs over and over again. There are some who will adopt what’s called a family systems approach where they look at how these things might be moving from generation to generation or how the disfunction within a family may cause people to retreat to these addictions in order to deal with the disfunction of the family. But if we really move back a little bit further in time, back into maybe the 18th century, the 17th century, and those centuries prior, what we find is a view of addiction that is much more rooted in what we would call a moral or a temperance perspective. That is, addiction is a sign of a moral failure. It’s viewed as sort of an ethical weakness, a vice that the person has. It’s part of who they are, their character. And, if we review even further back what we find is that, this is not necessarily the case just in Christianity, but in other parts of the world in other religions, that sometimes addiction is viewed as a form of demonic possession, like the demon alcohol gets into you and it holds onto you much in the same way it speaks to you internally.

So, these ways of thinking about addiction are very different, but what I’d like to do is propose a model that tries to incorporate all of these ways of thinking about it. This is a figure that’s taken from a social neuroscience article that was published last year. It’s wrong, I think, but I’ll kind of try to point out why I think that it’s wrong, but in psychology we use this language of bio-psycho-social models. We’ve got the biological aspect of the person, the psychological aspect of the person, the social aspect of the person. And in Christian communities we like to kind of tack on at the end there, there’s no spirito. There’s no bio-psycho-socio-spirito model. We just say the bio-psycho-social-spiritual model.

Now, the spiritual is not included in this figure because this is obviously a secular article, but you can see at the bottom there what we’ve got is, let’s see, do I have… Hey, I have a pointer, cool. All right, you can see here at the bottom that we’ve got a genetic component to it. Well, we know that genes influence the way that cellular systems work. Now, genes have DNA polymorphisms and RNA transcription, activation has to occur in order to get the proteins that will influence the cellular systems. We know also about epigenetic factors now where things that can influence me will alter me in a such a way that my children and my grandchildren will be affected in their DNA code. This is the field of epigenetics. Well, epigenetics, genetics influence our cellular systems, how the cells work. We know a lot about that. Cells influence circuits and neurological systems and immune systems, sort of a whole bodied integrated approach, and these influence behaviors and the psychological thought, motivational, emotional factors, and of course as psychological agents we operate in society and social cultures. Now, the reason why this link here is a link that should be removed in the model. I don’t know why they think that you all are sort of stressing me out to change my genes right now. I don’t know why that’s going on. If we think really hard let’s make sure there’s XX. Hmmm, he becomes a woman. No, nope, [audience laughs] it doesn’t work that way. This has to backflow down in this direction before you can have genetic factors. Society’s influence psychological factors. Psychological factors influence behavioral, neurological, cellular, and then genetics. So, this link here should actually be removed from this. Just a kind of geeky thing.

So, well, what about the spiritual? Where does it fit? It doesn’t fit in this model because I’d like to argue that the spiritual actually infuses all of these dimensions in different ways. It comes as an outside factor, that is, the spiritual can influence as a culture the way we think about things such as racism or sexism or the way that we worship together. The spiritual can influence me individually at the psychological level. The spiritual can also be not modifying the way that I behave and that I move, but it’s all done within this vast interconnected system. It’s not a layer and too often we think of these things as layers that sort of go on top and the spiritual kind of goes on the top. Does it go above the social? Does it go below the social and above the psychological? And I think it sort of comes in from the outside rather than being from the inside out. It is not a closed system. It’s an open system. Now, as someone who works with people who are addicts what do we do with this?

I like to just talk about this model to try to think about how do we renew our focusing and seeing that spirituality is not some sort of ghost in the machine outside influence coming in through some sort of magic. It changes your very embodied nature. When we think abut abstinence or moderation or these different approaches to dealing with addictions, they change you neurologically and that freaks people out when you tell them that what they do changes their brain. I’m changing your brain right now by talking to you. Ahhhhhh… [audience laughs] we’re shocked, but that’s way the brain works. It’s a plastic organ. It’s a beautiful organ. So, when we think about how we structure recovery programs we need to stop back and think how do we go about this process of bio-psycho-social repair? Or, in the event where there’s actually trauma to the system, bio-psycho-social-spiritual compensation. Thinking about abstinence is not just something that’s affecting me at a psychological level, but at a genetic level, at a spiritual level. That we are actually in the process of recovery, rebooting ourselves for what we are truly intended to be doing. When we think about how does this play with other co-existing disorders like depression or anxiety or some of the things you heard about last night or we’ll hear about today.

How do we deal with relapse? It’s better done I think when put within the context of a spiritual journey, not just a treatment failure, but a spiritual journey that people are on. So, when we think about how do we contextualize this, addictions, you have to understand your embodied nature. You have to understand that the spiritual is not just something that fractures off and leaves the ghost in the machine to go to heaven when you die, but it’s infused within you. We need to focus on an embodied emphasis of recovery and appreciation that the things that you do, the things that you put in your body matter, that there are multiple levels in the way that we think about what it means to be human and that we build into our diets, our exercise, our psychological patterns, our social patterns, our spiritual patterns, a sort of scaffolding to help us flourish, not just survive, but to flourish.

So, what I’d like to kind of end with is an understanding of the root of addictions. Why even have them at all? Well, you have them because they’re built into you. Not addictions aren’t built into you, but needs are built into you neurologically. We are created and to be created is to be constantly needy. [knocking on wood] This lectern doesn’t need anything to continue to exist. I do. I need water. I need glucose. I need a number of things in order to continue sustaining life within me, and we are built in to chase those, it’s built into us to chase those things down. And addictions are bound to these needs. They’re bound to the neurological systems. Aspirin is not a drug that you become addicted to, but cocaine is because cocaine hijacks this system that is tied to our needs, our needs to eat, our needs to drink, our need to connect. Those are basic human needs and what might be interesting I think for you as you kind of hear the rest of this conference is that in many ways the spiritual disciplines, these disciplines that we’re practicing back thousands of years ago before we even knew what the cortex was, before we even knew what DNA was, before we even know what metabotropic receptors were. Some of you may not know what that is. Before any of this was known it was still there and people were chasing after these things. These spiritual disciplines are tied into these needs. When we include them in our lives our needs are better met, so when we bring spirituality in the process of recovery we know that it influences us because of the reciprocal aspect of our embodied nature. I’d like to leave you with this thought. In many ways addictions are like M&Ms. You eat an M&M, and oh, it tastes good. It tastes good because it’s processed to activate those glucose receptors. Your body, yeah, it needs glucose, but it needs a lot of other things. But if I keep eating M&Ms, ooh, the hit’s good, and I keep eating them and I keep swallowing them and what happens? That six-pack now becomes a keg. [audience laughs] And I keep eating them, and you know what? I keep wanting more of them, but they don’t really satisfy me. They actually make me more unhealthy. The thing that would satisfy me would be an apple, but after all of the eating of the M&Ms the apple just doesn’t taste very good. That is, unless you stop eating M&Ms, and then after a while that apple tastes really good.

The key to all addictions whether they are substance addictions or behavioral addictions is what is the need that this thing is medicating in my life and that sometimes takes the help of people outside of us, that sometimes takes, we need the space to kind of search and spiritually open up to what are those spiritual needs perhaps. Maybe we’re getting all the food we need, all the exercise we need, but spiritually what are the needs that we have been deprived of and how are these things substituting for these deeper needs. There’s a link there at the bottom, bit.ly/myh-addiction. You can find this presentation online. It’s made public so you can go ahead and access it, but thank you very much.

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