Understanding How the Brain Works and Addiction Recovery Programs

Addictions to drugs, alcohol and gambling have powerful systematic holds on the brain.  Luckily, the efficacy of recovery programs has increased over the years largely through trial and error.  The 20^th century saw the noticeable rise in recovery success using, among other things, step programs.  

Alcoholics Anonymous, founded by Bill Wilson and Bob Smith in 1935, is recognized for making step programs popular. Wilson may not have known it at the time but his plan was a multi-front attack on the brain of the addict that has some justification in modern science.

Addicts constantly repeat their behavior.  Repetition strengthens the myriad of connections in the brain that the behavior has created.  The strength of these connections is of supreme importance to the brain’s search engine algorithms.  They also reward the number of links.  As addicts link their behavior to other activities it becomes connected to new networks of connections.  Think of the football fanatic who can’t enjoy a game sober.  Soon this addiction has physically built an unimaginable number of links.

An examination of Wikipedia's overview of AA’s program brings to mind several possible scientific reasons for success.  The program employs powerful tools that are in the brain’s arsenal.  A quick look at AA’s tenants shows examples of emotional rewarding (spiritual belief and fellowship), game mechanics (rewards for length of sobriety), connection building (adding negative aspects to the addiction by confronting past sins), connection strengthening (building the power of the new structure with regular meetings and step repetition) and social bonding (mentoring). 

This simple list only scratches the surface of how these programs attempt to modify the brain.  While the long term success rate for participants in these programs is low, it is significantly higher than the rates achieved from the techniques that preceded it.   

But what happens when the wizard behind the curtain is exposed? Someday soon understandings of how the brain works will become common knowledge.  Will the belief in the magic of the step plans weaken?  Is the belief in the process an important component in making it effective?

While breaking the brain’s loyalty to fully packaged belief systems seems to be hard, it certainly happens.  Look at the effects of social upheaval during the French Revolution on religious beliefs in France.  At the same time, Lenin discovered that completely resetting a pre-revolutionary Russian mindset was impossible.  Large changes in cultural viewpoints, thanks to our pesky brain structure, tend to happen generationally. 

While a greater understanding of how the brain works may not undermine effectiveness for the current 12-step adherents, is it possible it will for future addicts?  If an addict knows how the brain responds to spiritual belief, game mechanics, public confession and repetitive behavior could that understanding make the process less effective?  Of course, we don’t know yet.  But many addiction experts preach that success only happens with complete mastery of a program.

Smith penned his 12-steps when the brain was a black box full of mystery.  The only way to understand how this box worked was to send in stimuli and then see what popped out.  The lid is starting to slip off the box and we are beginning understand how its components interact.  Scientific discoveries hopefully will bring more focused approaches to recovery. Possibly unused tools in the brain will be discovered that can join the battle.

I certainly would not want to discourage anyone who is suffering from addiction from taking advantage of what we have available today.  And I really have no position on the various viewpoints about the best approach to achieving recovery.  Most likely we will discover that it depends on the individual.  But at some point in the future we should be able to map the unique structure of the connections in an individual’s brain.  With a map we could possibly find ways to dissolve bonds that give life to addictions.  But those days are still very far away.

One thing is clear, brain science in the future will have an invaluably role in addiction recovery.

Note: I am in no way a scientist. In as such, I used highly inexact phrases like “brain connections” in place of scientific terminology (that I would most likely misuse anyway.)  I love reading books on science and there are many wonderful ones by those who practice it.  From time to time my readings will trigger thoughts about real world issues.   My purpose is to engage in discussions with the similarly curious.