Physicians Explain How Stress, 12-Step Programs Change the Brain
When Bill W. and Dr. Bob created Alcoholics Anonymous 77 years ago, they borrowed principles learned from a Christian fellowship called the Oxford Group to create their 12-step recovery program.
“They knew that their spiritual program was effective where other ‘cures’ had failed, and over the years, there have been many theories as to why,” says Dr. Harry Haroutunian, physician director of the Betty Ford Center in Palm Springs, and collaborator with Dr. Louis Teresi on the book, Hijacking the Brain: How Drug and Alcohol Addiction Hijacks our Brains – The Science Behind Twelve-Step Recovery (www.HijackingTheBrain.com).
“Now we know that stress is the fuel that feeds addiction, and that stress and drug and alcohol use cause neurological and physiological changes,” Haroutunian says. “The changes are primarily in the deep brain reward centers, the limbic brain, responsible for decisions, memory and emotion. These centers are ‘hijacked’ by substance abuse, so that the addicted person wants the booze or drug over anything else. ”
As a scientist and physician applying the 12-step program to his own life, Teresi studied the physiological changes triggered by this seemingly non-scientific treatment.
“One response is that elements of 12-step programs reduce stress and increase feelings of comfort and reward through chemical changes in the brain and body. These changes allow for neuronogenesis – the birth of neurons in the brain,” Teresi says.
“As substances of abuse affect the limbic brain, so do 12-step recovery practices.”
Teresi says the 11th step in the program, which emphasizes spiritual practices such as prayer and meditation, works for the following reasons:
• Chilling out: Addiction is a cycle of bad habits. When something bad happens, an alcoholic drinks to feel better. When something good occurs, he drinks to celebrate. After years of this behavior, a person needs a way to step outside of himself to maintain sobriety. Regular prayer or meditation achieves that and becomes “that other habitual option” for responding to emotions, he says.
• “Mindfulness” meditation: While certain forms of prayer are effective, meditation may be a more direct way to achieve the kind of beneficial self-regulation that makes the 11th step so crucial, Teresi says. Mindfulness meditation incorporates active Focused Attention and the more passive Open Monitoring to raise a person’s awareness of his impulses, leading to better self-control.
• The three-fold manner: A successful 11th step tends to have the following benefits: First, stress is relieved in both cognitive and emotional reactivity, as evidenced by reduced cortisol (stress hormone) levels and other biological indicators. Second, some forms of meditation are shown to stimulate the brain’s reward centers, releasing dopamine – a mood elevator — while improving attention and memory. Third, an increased sense of connectivity and empathy to others is achieved, satisfying our natural need for social connection and reducing stress.
Sobriety is not so much about not drinking or drugging, Teresi says.
“It’s about developing an attitude and lifestyle that brings sufficient serenity and personal reward that drinking, or taking any mood-altering drug, is simply unnecessary.”