Unbroken Brain: A Revolutionary New Way of Understanding Addiction

by Maia Szalavitz

By itself, nothing is addictive; drugs can only be addictive in the context of set, setting, dose, dosing pattern, and numerous other personal, biological, and cultural variables.

Addiction isn’t just taking drugs. It is a pattern of learned behavior.

It only develops when vulnerable people interact with potentially addictive experiences at the wrong time, in the wrong places, and in the wrong pattern for them. It is a learning disorder because this combination of factors intersects to pr...

because hallucinogens prompt such revelations quite frequently, many believe they may be useful in therapy for addiction and quite a few studies now suggest that there is real promise in this idea.

psychedelics don’t produce compulsive behavior; they are too exhausting for most people to take daily and since they make bad moods worse, use rarely escalates over time.

Love will make you do things that you know is wrong. —BILLIE HOLLIDAY

an Egyptian love song inscribed on a 4,300-year-old tomb, containing the lyrics, “I love and admire your beauty / I am under it,”

nearly every behavior seen in addiction is also found in romantic love. There’s an obsession with the qualities and particulars of the beloved; there’s craving if the object of the addiction is unavailable; and, in some cases, people engage in extreme, uncharacteristic, and even immoral behavior to ensure access.

Importantly, like addiction, misguided love is a problem of learning. In love, people learn powerful associations between their lovers and nearly everything about them and around them; in addiction, these connections are made with the drug.

Soon, relevant cues like sights, sounds, and smells will spur relapses into obsessive behavior.

In both love and addiction, the stress relief system has become wired to the object of the addiction—you need the drug or the person to feel at ease, in the same way that young children need their parents.

In addition, both romantic obsession and addiction rarely appear before adolescence; both are shaped by life’s developmental stages.

The chemistry of love and addiction turn out to be startlingly similar—and both are intimately connected to learning and memory.

oxytocin is critical to the social lives of mammals. “It’s taking over parts of the nervous system and putting information into them about a sense of safety and trust,”

Without oxytocin, mice cannot tell friends or family from strangers—and mothers do not learn to nurture their young.

oxytocin and vasopressin receptors in the pleasure systems of prairie voles is what makes them monogamous. The specific geography of these receptors allows the memory of a special partner to be wired into a vole’s brain, making him or her “the one and only.” This happens during mating, linkin...

Later, when that partner is present, the stress system will be calmed and dopamine and opioid levels rise. In contrast, when the partner is absent, s...

The relevance of the oxytocin and vasopressin systems for human bonds can be seen in genetics: studies show that differences in genes for oxytocin and vasopressin receptors play a role in the way people handle relationships and in conditions that affect social skills, like autism.

In both men and women, oxytocin is copiously released at orgasm. It also spikes during childbirth and nursing, causing uterine contractions during labor and, later, the “letdown” of breast milk. At the same time, it helps bind parents to their particular babies. Consequently, oxytocin has become known as the “love hormone” or “cuddle chemical.”

(Vasopressin is far less well researched and understood, but it is critical to bonding in male mammals and also seems to spur aggression against competitors or intruders who might harm young or mate with females.)

Chemically, it seems to help wire the memories of our loved ones into the programming of our pleasure centers.

Unfortunately, oxytocin can apparently also do the same for the memory of drugs.

rather than associating a person with stress relief and pleasure, those connection...

Intriguingly, in fact, a few small studies suggest that oxytocin may relieve withdrawal symptoms in heroin and alcohol addictions—perhaps as a result of this wir...

oxytocin elevates trust and helps autistic people to more accurately detect other people’s emotions.

while oxytocin strengthens bonds and encourages altruism among “us,” it also elevates hostility toward “them,” with studies showing that it can increase racism or other types of discrimination

Oxytocin makes social signals stronger and more memorable, but it doesn’t necessa...

The happiness itself, however—and the comfort, relaxation, and warmth we feel in love and with our loved ones—comes at least in part from our endorphins and enkephalins.

the desire for and motivation to be with those we love is probably more dopamine driven: studies find that blocking certain dopamine receptors prevents prairie voles from forming partner preferences, for example.

“wanting” is more linked to dopamine, while opioids seem to be involved in b...

By linking the release of these substances to the presence of our loved ones, oxytocin makes us want and like them, ...

The way oxytocin wires social connections is highly context ...

the chemistry of romantic and parental bonds is quite similar. Preferences formed in childhood do affect romantic predilections in animals and humans as well.

having a highly affectionate and responsive mother turns on different suites of genes, compared to being raised indifferently.

neglect and trauma make social connection more difficult.

For instance, women with borderline personality disorder—a condition marked by extreme emotional reactivity and clinginess alternating with hatred or cold rejection—respond to oxytocin by becoming less trusting in experiments involving cooperation, and this is related to their levels of childhood neglect and sensitivity to rejection.

During infancy, oxytocin focuses your brain on remembering the characteristics of the people who raise you and linking these cues with stress relief, even if your caregivers are inconsistent or cruel.

if you grow up in a violent and/or neglectful home, this may skew your reaction to later romantic bonds.

In essence, oxytocin teaches you what to expect...

If your parents are warm and reliable, you learn to expect that in romantic relationships. On the other hand, if you learn that affection is barbed, you may find it hard to recognize love in a healthier context; in f...

If your bonding systems are miswired for any reason—genetic, environmental, or both—you also may not be able to feel the love other people actually do have for you and may also look for relief in drugs.

Indeed, because oxytocin wiring depends on both genes and the environment, it varies incredibly widely.

Since oxytocin wiring is basically designed to addict us to each other, it also plays a critical role in addictions. Like love, addiction is learned in light of a particular developmental context; your childhood affects your risk for addiction in part because of how it affects the way you experience love.

This means that each addiction is as individual and particular as each love, making the experience of addiction and the road to recovery immensely variable.

Moreover, to love, you typically have to persist despite negative consequences—as Shakespeare put it, the course of true love never did run smooth. It is a rare relationship that never requires compromise or perseverance. Love really...

foundered. I didn’t understand how to flirt, for example; I saw it almost as a form of lying because it didn’t reveal your true intentions. As I preferred to approach everything directly, I would instead throw myself at men I liked, with typically disastrous outcomes—hilarious only in retrospect.

Peele and Brodsky’s Love and Addiction, with its strong claim that love was a form of addiction, became a bestseller in 1975. The authors’ aim was to destigmatize addiction by comparing it to the most natural, healthy emotion of all: love. But given the cultural era in which it appeared, instead of making addiction seem less pathological, it wound up making love seem more so.

“It is a sad irony for us that our work contributed to labeling of yet more ‘diseases’ over which people are ‘powerless,’” Peele and Brodsky wrote in a 1991 preface to an edition of Love and Addiction, printed when codependency was all the rage. While they had wanted to show that normal love could go awry in a compulsive and life-contracting way—just as drug use can—instead, their work was interpreted to mean that all relationships were mere addictions and most love was delusional and self-centered.

ineluctably

baby, for example, literally needs to be held and cuddled for his stress system to be properly regulated; without repeated, loving care by the same few people, infants are at high risk for lifelong psychiatric and behavioral problems. Before this was widely known, in fact, one in three infants raised by rotating staff in orphanages died—essentially, from lack of individualized love.