1. The Effects of Addiction
on Brain Function
& Effects of Brain Function on Addiction
Lynda Steele, LCSW
Partner, The Center for Transpersonal Therapy
Clinical Director, Project Recovery
lynda.steele@projectrecovery.com

2. Use, Abuse, Dependence, or Addiction
Use = Coping Strategy
Abuse = Psychopathology, defined as the over
use or misuse of a coping strategy
Dependence
Physical = Tissue Tolerance
Psychological Dependence/ Classical Conditioning
Addiction = A Bio/Psycho/Social Disorder

3. JELLINEK
SYPTOMATIC USE OF CHEMICALS
Initial Stage of Disease (PRODROMAL PHASE)
Increase of Tolerance Bio
Temporary Loss of Memory Bio
Sneaking Chemical Psycho
Preoccupation with chemical use Bio/ Psycho
Hurried ingestion of chemicals Bio
Avoidance of reference to Psycho/ Social
personal chemical use
Loss of memory becomes more frequent Bio

5. JELLINEK
Initial Stage of Disease
(PRODROMAL PHASE)
Homeostasis Creates Tissue Tolerance
Hippocampus Memory Deterioration
(Short Term & Sequential Memory)
Procedural Memory/ Unconscious Memory
Strengthens

6. JELLINEK
Middle Stage of Disease (CRUCIAL or BASIC PHASE)
Loss of control Bio
Alibis and excuses Psycho
Reproof by significant others Social
Extravagance (money, time, advice) Bio/ Psycho
Aggression Bio
Persistent remorse Psycho/ Social
Periodic abstinence Psycho
Change in chemical usage pattern Bio/ Psycho/ Social
Loss of friendships Bio/ Psycho/ Social
Loss of position or clients Bio/ Psycho/ Social
Significant others change habits Bio/ Psycho/ Social
(wife, etc.)
First Treatment Bio/ Psycho/ Social
Resentments – (unreasonable) Bio/ Psycho/ Social
Escape (geographical, psychological, Bio/ Psycho
social)
Protecting supply Bio
Morning usage of chemical Bio

8. JELLINEK
Middle Stage of Disease
(CRUCIAL or BASIC PHASE)
Hippocampus – Memory
Amygdala – Emotion
Septum – Pleasure
Cingulate Cortex – Pain

9. JELLINEK
Final/Late Stage of Disease – (CHRONIC PHASE)
More or less continuous use of Bio
chemicals beyond an 18 hour period
Ethical deterioration Bio
Inconsistent inappropriate thinking (lying) Bio
Decrease of tolerance Bio
Indefinable fears Bio
Tremors Bio
Psycho-motor inhibitions Bio
Recognition Psycho/ Social

11. JELLINEK
Final/Late Stage of Disease
(CHRONIC PHASE)
Includes distortion in all Midbrain
function & thus distortion in
communications with Prefrontal
Cortex

12. Prefrontal Cortex
prefrontal cortex n. The frontmost portion of the frontal
lobe, in front of the primary and secondary motor cortex,
uniquely large in the human brain, involved in anxiety and also
in brain functions such as working memory, abstract thinking,
social behavior, and executive functions such as decision making
and strategic planning, any or all of which are affected by lesions
in this area. The right prefrontal cortex is involved in monitoring
behavior, resisting distractions, and providing an awareness of
self and of time.
See also attention-deficit/hyperactivity disorder, delayed-
response task, dorsolateral prefrontal cortex, object
permanence, orbitofrontal cortex, ventromedial cortex.
PFC abbrev.
Midbrain communicates directly with Prefrontal
Cortex; Prefrontal Cortex places meaning.

13. Limbic System
limbic system n. A ring of cortical and subcortical structures folded
into the inner surface of the temporal lobe surrounding the brainstem
and bordering on the corpus callosum, including the
amygdala, cingulate
gyrus, fornix, hippocampus, parahippocampal gyrus, and septum
pellucidum, implicated in basic emotions, hunger, sex, and memory.
See also Papez circuit, pleasure centre. [From Latin limbicus
bordering, from limbus a border]
“Capable of dishing out pleasurable as well as frightening
emotions.”
“Purpose of a reward system in a primitive brain is to ensure
adaptation.”
“Connects key parts of the midbrain with the higher thought/
cerebral cortex.”
“Emotional thermostat, it tags emotions as hot or cold. Hot is to
remembered & cold is to be forgotten.” (Ronald Kotulak, Inside the Brain)
STOP & GO switches; set into motion cravings & pursuit of
alcohol & drugs

15. Amygdala (emotions)
“long-term memory associated with emotionally
arousing events”
“fear conditioning; aversive learning mediated
by“
“anxiety disorders”
“intact inhibitory system is essential”
“selective blocking of inhibition produces an
uncontrolled anxiety-like state.” (Sanders &
Shekhar, 1995)

16. Hippocampus (memory acquisition)
“memory enhanced for emotional events.”
“emotional memory = amygdala & hippocampus, both are
recruited during aversion & anticipation of aversive
events”
“Vorel et al. reported that stimulation of the hippocampus at theta
frequency caused reinstatement of drug-taking behavior. It is suggested
that the hippocampal stimulation may cause a “read-out of an encoded
association between the context of the cocaine experience” and the
cocaine. In an accompanying news article, the lead author was quoted
as claiming to have “anatomically located the relapse circuits in the
brain.”
“It has long been established that the hippocampus has an important
role in inhibiting previously acquired and now irrelevant responses,
among other functions in organizing memories
hippocampal stimulation may have reinstated drug-taking behavior by
disrupting the hippocampus's role in inhibiting the newly irrelevant
behavior”

17. Hippocampus
(memory acquisition)
IN SUMMARY,
drug taking disrupts the process of the
inhibitory function of the hippocampus
rendering everything as relevant.

18. Septum (pleasure, reproduction)
septum pellucidum n. part of the limbic system and one of the
most important of the pleasure centers of the brain
electrical stimulation of this area producing intensely agreeable
sensations of well-being in humans.
Experimental rats with access to levers to control the output of
electrodes implanted semi-permanently in their septal areas
self-stimulate themselves for long periods
“Pleasure Circuit”
NUCLEUS ACCUMBENS (NA)
VENTRAL TEGMENTAL AREA (VTA)
Reward & Reinforcement
Attention
This is what research indicates getting “hijacked” as a result of
drug dependence.

20. Cingulate cortex
(pain & visceral responses)
“the brain’s error detection and correction device.”
“decreased activity leads to compulsive drug administration
and the lack of control over drug intake in the drug-addicted
individual.”
“elevated activity leads to tics, obsessive-compulsive
behaviors, & aberrant social behavior. “
“reduced activity can also lead to diminished self-
awareness & depression, motor neglect & impaired motor
initiation, reduced responses to pain, & aberrant social
behavior.”
“Overall plays a crucial role in initiation, motivation, & goal-
directed behaviors.”

21. Thalamus
thalamus n. (pl. thalami) relay stations for all
the sensory messages other than smell.
“conscious awareness of messages as
sensations – temperature, pain, touch begins
here”
“relays sensory information to the cerebral
cortex & is also concerned with the translation
of impulses into conscious sensations.”

22. CLASSICAL CONDITIONING
Procedural Memory – Unconscious
Occurs in Hippocampus of
the Limbic System
The strongest form of classical conditioning
is intermittent positive/ negative
reinforcement.
Example – Trauma/ Addiction

23. VERNON JOHNSON’S CYCLE OF SHAME
SHAME: Feeling/ Thinking Badly About Who I Am
GUILT: Feeling/ Thinking Badly About What I Do

24. Threat/ Arousal/ Endorphins
(Pleasure) Cycle
Mammals conditioned with learned
helplessness will always return to the original
scene of the shock rather than pursue effective
escape.
Endorphinergic Reward Systems in the Brain
Unconscious Reward Stimulus
Traumatic Reenactment
“Addiction to Trauma”
- van der Kolk (1989)

25. Capacity
vs.
Ability?

26. Long-Term Recovery =
Managing Chronic Disease
Physical
Healthy/ Safe/ Secure “Animal”
Nutrition
Exercise
Sleep/ Rest
Medication

27. Psychological
Individuate through Self Awareness
Acceptance
Symptoms of Disease
Losses
Wisdom Learned
Surrender
Self
Life on Life’s Terms

28. Social/ Spiritual
Develop A Healthy, Supportive, Social Community
Develop A Spiritual Practice That Includes
Principles:
Admission
Acceptance
Surrender
Asking for Help
Service to Others
Bringing The Gift Home

29. Supporting Leaps of Faith