Addictions aren't just bad habits that compromise our health, destroy our relationships or land us in jail. They can have less dramatic — but still negative — impacts on our lives. The definition of addiction certainly includes substance abuse of drugs or alcohol, but according to Judson Brewer, M.D., Ph.D, who has studied the subject for two decades, it's also "continued use, despite adverse consequences." Continued use of what? Many things.
From his experience as a psychiatrist and scientist, Brewer knows addiction also includes problematic attachment to technology, love, distraction, thinking and even ourselves. That's because all of these things act on our brains in similar ways that are directly linked to how we evolved. "When we get hooked on the latest video game on our phone, or our favorite flavor of Ben & Jerry's ice cream, we are tapping into one of the most evolutionarily conserved learning processes currently known to science, one shared among countless species and dating back to the most basic nervous systems known to man," writes Brewer in his new book, "The Craving Mind: From Cigarettes to Smartphones to Love—Why We Get Hooked and How We Can Break Bad Habits."
Of course not all addictions are created equal: "The degree to which [an addiction] turned our lives and those around us upside-down helps determine the level of severity," Brewer writes. "In this way, we can view addictions along a spectrum calibrated as much on the degree to which our behaviors affect our lives as on the behaviors themselves."
The basics of bad habits
We learn both good and bad habits from experience, says Brewer, and understanding how they develop is key. Here's how it works: We do something, and it makes us feel good because of the substance itself (a sugar or nicotine rush) or because it makes us feel better about ourselves, such as reduced social anxiety. This establishes a positive feedback loop, and the next time we engage in the behavior, we reinforce the habit — whether it's healthy or not.
Humans developed feedback loops because, at their most basic level, they ensured survival — by helping us remember where to find food, for example. But as we evolved and became more complex animals, those loops sometimes had negative consequences. When a feedback loop turns into a behavior we'd rather stop or limit, but we can't, that's an addiction.
In this video, Brewer explains how any habit can become extreme, from running to eating to phone use:
As a scientific researcher who has had addictions of his own, Brewer says many of the ways we think about addiction are wrong.
"Avoidance doesn't work," Brewer told MNN, especially when it comes to things that we have to or want to do like eating or love. Take stress, for example. We try to avoid it, but "by trying to avoid it, we get stressed out over being stressed out. Then that lack of control is stressful." We have to take a different approach. "Because stress is unpleasant, our natural response is to run away from it. But here’s where we can learn to deal with something we have no control over," suggests Brewer. By facing our stress and deciding not to add to it, we can gain a small measure of control. Examining where the stress is coming from is a "critical starting point."
How mindfulness defeats addiction
Brewer suggests a radical new way of dealing with our addictions, whatever those addiction might be: Examine them using mindfulness, then ask questions about them. He says tapping into our curiosity is key.
If that sounds odd, you aren't the only one to think that; the cigarette-addicted people Brewer treated at the Veteran's Administration Hospital in West Haven, Connecticut, were surprised, too. By slowly and calmly talking through the feelings that craving and smoking cigarettes brought up, they came to understand how their thoughts and actions lined up. They learned they had been making assumptions about their own addictions that just weren't true upon closer inspection.
Case in point: One man, who came to Brewer stating that if he didn't have a cigarette his "head would explode," was asked to explain what that was really like. When forced to carefully detail the itch to smoke, he elaborated on each specific uncomfortable bit. He realized that when he got to the end of the list, his head never actually exploded, because that's when he smoked a cigarette; that was his cycle. But once he smoked, it started all over again.
Then Brewer asked what the man did when he was unable to smoke, when he was on a plane or bus, for example: "When necessary, he had made it [through the craving] without smoking, but hadn't realized it," Brewer writes. It's important to note that while we might "know" things (that our head won't actually explode, for instance), using this process to really examine our addictive cycles forces that knowing into a deep level.
Next came some mindfulness training: "I taught him to simply note to himself (silently or aloud) each body sensation that came along with a craving. We used the analogy of surfing: My patient's cravings were like waves, and he could use this 'noting practice' as a surfboard to help him get on the wave and ride it until it was gone."
That practice not only helped the patient quit, it also formed the basis of the further research Brewer did using mindfulness and curiosity when he founded the Yale Therapeutic Neuroscience Clinic, where he tested his ideas for quitting smoking against the "gold standard" treatment, the American Lung Association's Freedom from Smoking campaign. Twice as many people were able to quit smoking using his mindfulness program incorporating meditation, and a much greater percentage of his group stayed off cigarettes when compared to the those who followed the American Lung Association's approach.
The key is understanding the cycle
At some point we realize that "... we are holding our own hand over the fire," says Brewer. While that may seem frustrating, it's also empowering.
Here's the basis for Brewer's treatment of all types of addiction: Encourage the patient to understand their addiction-craving cycle, to turn toward (instead of away from) cravings and understand them, and to be aware of their true feelings. He's now collaborating on a study at University of California, San Francisco, that is showing promising results for those with food addiction.
It's a paradox, says Brewer. We think that if we can just get rid of a craving, we can reduce a behavior. But actually, it takes about three months to reduce a craving — by learning to be OK with it. By looking the craving in the face and not giving into it, the behavior changes and the cravings decrease. We've had it backwards all along.
Inset photo of Judson Brewer's book, "Craving Mind," courtesy of Yale University Press