There seems to be none more insidious a mis-match in our 21st century than that of the interaction between our brains learning and reward centre and the modern environment we now contend with. I've recently finished reading The Hacking of the American Mind (by Robert Lustig - a highly recommended read) which has been incredibly timely to come across. This blog is in some ways a synthesis of Robert's book, coupled with observations and suggestions from my practice.

As humans, we are wired to learn and remember important experiences, which occurs through a complex and sophisticated motivational system that includes dopamine and endogenous opioids – powerfully rewarding neuro-chemicals. When we do something that feels good or is salient, our brain’s nerve cells send a rush of dopamine (a motivation and reward neurotransmitter) from the ventral tegmental area (VTA) of the brain through to another area called the nucleus accumbens (NA).  The nerve cells in the NA then release natural opiates, reinforcing the pathway, so we are likely to want to do the 'thing' again and to remember it - especially when cued or triggered by reminders of it in our environment. This reward pathway has historically been very useful for us as part of survival (e.g., to learn where good food sources were located and to be motivated to return for more supplies). These days it is most commonly associated with substance 'addiction', and when applied to other encounters (e.g., sex, sugar, shopping, IPhones, social media etc.) becomes a topic of scientific controversy. (Also, the reward pathway can also be utilised in remembering things that don't feel good - a topic for another blog!).

I wrote recently about "loss of zest" - a non-diagnostic term I’ve used with clients who are not necessarily substance dependent, but describe having lost the capacity to feel pleasure, motivation, and reward from their everyday life. This can occur through the chronic activation of stress hormones like cortisol but generally also involves the pursuit of behaviours that fire the reward pathway in an attempt to feel different/distracted/better, albeit fleetingly (e.g., coffee, alcohol, work, nicotine, social media, pornography). At an Attachment and Addiction conference I spoke at in 2011, Philip Flores (author of 'Addiction as an Attachment Disorder') said "addiction is in the user not the drug." By way of explanation, he meant that the quest for any particular 'thing' is individual and based on 1) the drive someone has to seek reward (relates to attachment style), and 2) the 'thing' that person perceives to be rewarding. I.e., what does it for one person may not for another - which is the concept of 'drug of choice'. Yes, certain drugs have predictable effects (like MDMA increasing the activity of dopamine, serotonin, and norepinephrine) that will impact on the user, however it is the user's unique experience that will determine whether they are driven to use it again. 

In terms of 'loss of zest', there are major effects that repeatedly doing things that stimulate the reward pathway will have on the human brain, and how it can sabotage our ability to feel content, happy, or satisfied. The content/happy pathway in the brain is seperate from the reward pathway, although these overlap and interact. Contentment is more closely associated with serotonin, another neurotransmitter. Serotonin is required throughout the brain, but most of your serotonin is used by other parts of your body before the brain gets its quota. Serotonin is in short supply for a variety of reasons including that the 'ingredients' needed to make serotonin are in competition with those needed to make dopamine.  This means if you are constantly doing things to drive a dopamine rush that you can sabotage serotonin production. While it has recently been revealed that most of your serotonin is made in the gut (95%), this can’t actually cross the blood-brain barrier to access the brain and instead has localised effects within the gut. More about what to do about this later.

Your reward system, when activated over and over again, can eventually start to erode the dopamine receptors (this is the phenomenon known as tolerance – when you require more and more of the rewarding 'thing' to get the desired effect). Specifically after drug abuse or dependence these can actually regenerate and re-grow if you catch the situation early enough – however there can be a point of no return, where your brain’s neuroplasticity to regenerate these has been so far compromised that you can’t fully return. Think aging Hollywood rock stars who have had the lifestyle to fund unusually extreme amounts of dopamine surging activities (sex, drugs and rock n roll).

The everyday experience of loss of zest for most human’s may not be to quite this extent, but involves this formula:

Repeated dopamine/opiate hits (e.g., pursuing the rewarding ‘thing’ = sugar, porn, device checking) + high stress environment (cortisol) + nutrient deficient diet (white and processed) + less relational connection = impaired brain serotonin.

Chronic cortisol production actually drives us to return to habitual behaviour that involves the seeking of reward, making it hard for us to resist. And triggers to these habitual behaviours are all around us in the 21st century via advertising and the internet. Such as 24/7 access to porn, sugar, alcohol, shopping, working, social media, Netflix - which are designed to cue you to crave the next hit. You can see this is a vicious cycle that we simply weren’t exposed to at earlier times in history when things were simpler. 

Of course, not everyone has challenges with these things and this is not an anti-modern living blog. I use many modern technologies myself (obviously, as I am not inscribing this on a slate), however I think we need to be cautious about the possible insidious effects for some, and especially so when it comes to the next generation who are the first to be saturated from birth with social media exposure. Those who are vulnerable to the reinforcing effects of seeking the 'thing' are those who are relationally deprived - this is because oxytocin (a bonding hormone) offsets the stress response, among other factors. In other words, if you don't have deep and meaningful connection with others then you are at risk of seeking 'things' to meet the need of connecting. Those without sufficient stimulation in their lives are also at risk.

Signs that may indicate your reward system is in trouble

• Chronic boredom

• Feeling consistently unmotivated

• Difficulty concentrating and focusing

• Short-term memory changes

• Cravings/urges for foods, substances, or activities (sugar, junk food, coffee, alcohol, pornography, social media, spending money/shopping)

• More frequent/longer duration of using the 'thing' to get the desired effect

• Low impulse-control

• Mindlessness/aimlessness

• Feeling flat or low without the ‘thing’

• Sense of loss of control over your behaviour

• Thinking about doing the 'thing' a lot

How to reset your reward centre

When I'm working with people who are looking to change such behaviours, whether it's substance use, pornography use, digital-detox related, or dietary, there are multiple avenues to cover. While cutting down can be a helpful approach for some, I'm more of a fan of the period of abstinence method - as this gives your brain a complete reset, and opportunity to set up new pathways and let old ones fade. There are five steps:

1. Establish motivation to change

2. Get a period of abstinence

3. Manage withdrawal symptoms

4. Manage cravings/urges to use

5. Add in new behaviours

“We are distracted because we want to be. Because it’s fun and it obfuscates real life.”

~ Robert Lustig (MD) In: The Hacking of the American Mind.

1. Motivation

Anyone doing my line of work knows that motivation to change is the most crucial step – no one changes without wanting to, and it is up to you alone to decide if you want to change or even if you should change. Even then, motivation will ebb and flow depending on various factors, so making and maintaining change can be incredibly difficult. I find exploring values a helpful first step - this is the WHY. Why would you do something uncomfortable, stop things that feel good in the short-term, or change your behaviour unless there is something important to you out of it all? Often health or relationships are motivating values - when the behaviour is getting in the way of your wellbeing or your capacity for the kind of relationships you want. 

2. Abstinence 

To understand what kind of relationship you have with the 'thing' you first need to spend some time living without it. When is the last time you switched off your phone for a day? Didn't check Social Media all week? Had a month break from caffeine, porn, or alcohol? How easy do you think that would be? In order to have a period of abstinence, you need to set yourself up for success - as, contrary to popular belief, stopping is not all about will-power (motivation goes up and down depending on mood, cravings, urges). Make your environment one without easy access to the 'thing' (e.g., take those foods/drinks out of your kitchen, remove certain Apps from your phone, put your device out of sight or install helpful software like self-control). Have a plan for what you'll do when you find yourself around people, places, or things that make it likely you will be exposed to the 'thing.' Sometimes this means having a break from certain places, things, or people until you are through the worst of withdrawal and have some good strategies for dealing with cues, cravings, and urges in place.

3. Withdrawal

When trying to stop or cut down use of the 'thing,' there is generally a period of withdrawal, which involves feeling pretty crappy or like something is missing from your life for quite a while. This process is not unlike the feelings that occur in a breakup. People may feel low mood, tired, empty, stressed or anxious, have a lot of thoughts about using the 'thing', find it hard to focus on anything else, and be bombarded with cravings and urges. With stopping dependent use of alcohol of other substances there may be predictable syndromes of withdrawal that are physically unpleasant, such as tremors, insomnia, loss of appetite (and can be life threatening when severe enough - e.g, seizure risk in alcohol or benzodiazepine withdrawal). If there are psychological difficulties being medicated through using the substance (like trauma, anxiety, insomnia) then these may need addressing by seeing a professional. As withdrawal abates individuals usually experience a calmer state, the time frame for this can vary depending on what the 'thing' is and how much/how long you've been relying on it for a rush.

4. Cravings/Urges

After stopping the 'thing,' there are also often mental, physical and emotional experiences of wanting it again.  Cravings involve strong intense feelings of need for the 'thing' based on positive memories of having it in the past. Urges include physically overpowering desire to act on the cravings. I use the analogy of feeding stray cats when it comes to cravings and urges. If you feed them (through using/doing the 'thing'), then they keep coming back - if you don't they will eventually settle down. However, because of how cues and triggers work, your brain will always have the potential to be cued to think about the 'thing' under circumstances that remind you of it. There are great techniques for managing cravings and urges such as urge surfing.

5. Add New Behaviours

If you are going to take the 'thing' out of your life, then what will you add in instead that is life-enhancing? This involves being able to satisfy your contentment and enjoyment needs (i.e., serotonin) as well as supporting your physiology through diet, exercise, mindfulness, pleasure, and connection.

Diet: It is recommended that you take a break from dopamine-firing foods. I generally encourage people to take a month off, but in many cases, you may want longer or even to maintain abstinence. The foods that help to have a break from include coffee, sugar, and processed foods (all foods that you are more likely to have cravings for). 

Instead, add in the opposite – nutrition that provide the 'ingredients' needed to improve contentment pathway functioning, especially those containing the amino acid tryptophan (which is the main ingredient needed for serotonin production). Foods high in this include eggs, seafood, chicken, and nuts. More broadly, eating a real food diet of animal products, fruits and vegetables, nuts and seeds and keeping well hydrated will support your body while you make changes.

I have observed that those who have experienced addiction tend to be deficient in B vitamins and Zinc (which get chewed up under chronic stress) - it is worth checking these out and supplementing if this is the case.

Exercise: For neurogenesis – or helping the brain to repair hippocampus damage (your memory centre) from chronic cortisol production, and to improve dopamine functioning and receptors. I recommend doing what you most enjoy doing for movement. If there has been chronic stress then starting intensive cardio exercise can continue to tell your body it is under stress and may be counterintuitive. A transition period of lighter cardio, strength training, and engaging some yin exercise (like yoga) may serve you better. Getting your exercise out under the sun, in nature, or as part of a group offers additional benefits, so why not maximise these.

Mindfulness: Seeking rewards or looking for the next hit of the 'thing' takes you far away from the present moment. Given that your brain has learnt to have these associations and to produce urges and cravings, you'll need to build your ability to engage in the present moment. Overtime these experiences will settle down if you don't act on them, although are likely to pop up again if cued from something in your environment (e.g., a sunny day leading to cravings for a cold beer). There are many ways to learn mindfulness ranging from professional assistance, local groups, through to self-directed learning or App's like Headspace or Calm.

Pleasure: Rather than the heady rush of the 'thing,' pleasure is about what you do that nurtures your spirit and vitality. Where you get a sense of mastery and intrinsic reward from - such as from doing things for others, gaining mastery from things you are good at, or being grateful for aspects of your life. It's how you engage with this process that matters rather than what you engage with, and finding ways to be present and fully experience whatever the activity is. There is nothing inherently wrong with enjoying food, having thrills and novelty, and engaging with modern technologies. As I quoted earlier, "it is in the user not the drug ('thing')." It is how you use it and the relationship you have with it versus the important things in your life. 

Connection: We are wired for connection. If you connect to the world and others in a meaningful way then you'll be less susceptible to the reinforcing effects of 'things' or substances to get an artificial boost. If you haven't had good early relationship experiences then it can be more difficult to engage and connect - I encourage you to learn about attachment theory and do some work here to improve things going forward if this applies to you, as these difficulties don't necessarily have to be carried forward. Building up real-time relationships in person with people you really click with helps to offset a chronically stressful world, and the tendency we have to numb out from it. 

Note: If you are regularly using illicit substances, alcohol, or certain medications (sedatives, opiates, etc.) and have formed dependence, then you may benefit from working with someone trained to help you to withdraw safely.  It can be dangerous to just stop using if you are a regular and heavy user, and so do check it out with your doctor if in doubt.