Monday, October 20, 2014

Why Some People Just Can't Say No

The Brain Wants What the Brain Wants



You're sitting in a nice restaurant with your family. You've eaten your salad and your entrée, and you're absolutely stuffed. Then the pastry chef wheels out the dessert tray. Even though you're full, the cakes, pies and puddings cause your mouth to water. Unbelievably, you hear yourself ordering the triple-layer chocolate cake with ganache and raspberry filling. And when the waiter brings this six-inch-high slab to the table, you wolf down every last morsel (and you seriously consider licking the plate). Later you wonder, Why did I order and eat dessert when I wasn't even remotely hungry and I knew I'd need an extra hour (at least) of high-impact aerobics to work it off?



The answer to this question is actually quite simple. You did it because your brain is preprogrammed to respond to the anticipatory pleasure of dessert, even when you're not hungry. And it's not just sweets that precipitate this reaction. Alcohol, addictive drugs, salty foods, spending, gambling, romance and even sex can all cause the same anticipatory interest and excitement.



Neurochemistry and Intelligent Design



When an object of desire (like cake) or a potentially pleasurable activity (like sex) comes within reach of our five senses, our brains release a flood of mood-lifting and pain-avoiding neurochemicals -- primarily dopamine but also serotonin, epinephrine (adrenaline), endorphins, and a few others -- into the nucleus accumbens (colloquially referred to as the brain's "pleasure center"). It is this rapid alteration of brain chemistry, initiated by our five senses and heightened through memory and anticipatory fantasy, that causes us to feel excited and pushes us toward whatever it is that's triggered this neurochemical rush. In other words, we remember eating and savoring chocolate cake in the past, so when we see a similar offering in the present, we want it. We might even crave it, even though we know that we don't need it and if we say yes to it, we may regret it later.



This neurochemical reaction is actually a function of evolution. Certain substances and activities (food and sex, for instance) are necessary to survival of the individual and/or the species. Thus, our brains are preprogrammed to experience pleasure when we engage in these and similar life-affirming activities. Later, we remember the pleasure we've experienced, and we are internally encouraged to engage in the same or similar behaviors. This is intelligent design at its finest. Unfortunately, some individuals learn to use/abuse the brain's dopaminergic response as a means of coping with and/or dissociating from stress and emotional discomfort. For them, pleasure-inducing substances and behaviors are used not for enjoyment, but as a way to emotionally escape and therefore to control what they are feeling. Over time, these people typically develop an addiction.



Momentary Weakness vs. Addiction



Absolutely everyone is at times tempted by a highly pleasurable (and therefore potentially addictive) substance or behavior. But we each have different levels of self-control that help us decide in the moment if we're going to say yes or no to temptation. Most healthy people can pause and think before taking action, using experience as a guide. In other words, people with strong impulse control can objectively and intelligently decide if they want to have an extra scoop of ice cream, a cocktail, a bump of cocaine, a sexual fling, or whatever.



This ability to pause and consider potential risks and consequences before taking an impulsive action is a key measure of emotional and psychological health. Yet even a healthy person's ability to "just say no" can be compromised (either consciously or unconsciously) at times, depending on the relative strength of the triggering agent (the temptation) and the individual's current level of emotional and perhaps physical stress. When someone gets laid off from a job, for instance, he or she may decide to self-soothe with an extra martini, a cigarette (even though he or she quit many years ago), a bag of chips, a trip to the casino, sexual activity, or any number of other pleasurable substances or activities. And who can blame that person for consciously deciding to "escape reality" for a short while?



Even good things can throw us off a bit. A raise at work, the holidays, the birth of a child, and similarly joyful events may cause people to disregard their habitual cautions in celebration. (Who among us has not wildly overeaten at Thanksgiving, for instance?) But usually it's the downside of life that sets us off course. Typically, the more anxious, depressed, emotionally empty, lonely, angry, bored, or stressed-out we get, the less likely we are to make our usual good decisions.



This does not, of course, mean that everyone is an addict. In fact, people who occasionally overindulge with an addictive substance or behavior are usually not addicts. Most often, they are simply responding in a natural way to life circumstances and the anticipatory power of pleasurable experience. Conversely, individuals who repetitively and compulsively utilize an addictive substance or behavior as a way to cope with the vicissitudes of life are at great risk for addiction and the negative life-consequences that inevitably ensue.



Thus we see that healthy, non-addicted people under stress are likely, except in extreme circumstances, to take a deep breath, meditate, go for a walk, take a relaxing bath, watch TV, or talk to a friend as a way to cope and feel better. Conversely, those vulnerable to addiction (through genetics and/or life circumstances), when presented with similar stress, are much more likely to move toward the distraction brought about by neurochemical stimulation (via addictive substances and/or behaviors). Eventually, as they repeatedly "lose themselves" in this neurochemical fog of arousal and distraction, addiction rears its ugly head and they just plain lose their ability to say no.



Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. He has developed clinical programs for The Ranch outside Nashville, Tennessee, Promises Treatment Centers in Malibu, and The Sexual Recovery Institute in Los Angeles. He is author of Cruise Control: Understanding Sex Addiction in Gay Men and Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction, and co-author with Dr. Jennifer Schneider of both Untangling the Web: Sex, Porn, and Fantasy Obsession in the Internet Age and Closer Together, Further Apart: The Effect of Technology and the Internet on Parenting, Work, and Relationships. For more information you can visit his website, http://ift.tt/18N7Cgn.



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