Substitutes for the ThumbSubstitutes for the Thumb

The thumb is our original coping The thumb is our original coping device- we use it to self-soothe.device- we use it to self-soothe.

The chemistry of contentmentThe chemistry of contentment

The goal of self-soothing is satiation.The goal of self-soothing is satiation.

All the ways a parent meets baby’s needs become All the ways a parent meets baby’s needs become associated with comfort, love, bliss.associated with comfort, love, bliss.

When all our basic needs are met, we experience When all our basic needs are met, we experience satiation.satiation.

Any behavior that alters mood in a positive way Any behavior that alters mood in a positive way will be repeated & intensified.will be repeated & intensified.

Desire for satiationDesire for satiation is ultimately a desire to return is ultimately a desire to return to the calm, comfort, & lack of responsibility of the to the calm, comfort, & lack of responsibility of the womb.womb.

Psychologically, satiation seekers reduce stress Psychologically, satiation seekers reduce stress by passive withdrawal from conflict.by passive withdrawal from conflict.

Chemistry of contentmentChemistry of contentment

HeroinHeroin is the ultimate is the ultimate satiation drug.satiation drug.

Other things:Other things:– SedativesSedatives– MusicMusic– FoodFood– MassageMassage– CigarettesCigarettes– TV or Internet use TV or Internet use

Psychoactive drugsPsychoactive drugs

Endorphins- the keys to paradiseEndorphins- the keys to paradise

Endorphins are opiates produced by the body Endorphins are opiates produced by the body to reduce pain & produce euphoria.to reduce pain & produce euphoria.– EndorphinsEndorphins are released by the satiation drugs, are released by the satiation drugs,

slowing mental activity- except in the slowing mental activity- except in the nucleus nucleus accumbensaccumbens (the brain’s reward center) in the limbic (the brain’s reward center) in the limbic system.system.

Op-mex Op-mex (opiate-mediated experience) are drugs (opiate-mediated experience) are drugs that produce pain relief and soothing.that produce pain relief and soothing.

Too much of these drugs can result in all systems Too much of these drugs can result in all systems of the body shutting down. It also results in of the body shutting down. It also results in cravings.cravings.

Homeostasis requires a delicate Homeostasis requires a delicate balance of excitation & inhibition of balance of excitation & inhibition of

neural firing.neural firing. Warm milk contains Warm milk contains

tryptophan which tryptophan which converts to serotonin & converts to serotonin & decreases excitatory decreases excitatory neurotransmission.neurotransmission.

Naloxone blocks Naloxone blocks endorphin effects, endorphin effects, resulting in decrease in resulting in decrease in eating behavior.eating behavior.

Why would alcohol be considered a Why would alcohol be considered a depressant?depressant?

When alcohol is ingested, the inhibitory When alcohol is ingested, the inhibitory synapses are first to be depressed- resulting synapses are first to be depressed- resulting in excitation, lack of inhibitions.in excitation, lack of inhibitions.

As drinking continues, the excitatory As drinking continues, the excitatory synapses are also depressed, resulting in synapses are also depressed, resulting in stupor & slowed reaction time.stupor & slowed reaction time.

Since the drinker no longer can make good Since the drinker no longer can make good decisions, he believes he can drive, but his decisions, he believes he can drive, but his ability to drive is severely impaired.ability to drive is severely impaired.

What is the genetic connection?What is the genetic connection?

50 – 60% of the risk for alcoholism is inherited50 – 60% of the risk for alcoholism is inherited Alcoholics metabolize alcohol differently from Alcoholics metabolize alcohol differently from

others- the enzymes needed to process alcohol others- the enzymes needed to process alcohol are less effectiveare less effective

Those who can drink more with less effects send Those who can drink more with less effects send more alcohol to the brain. They don’t experience more alcohol to the brain. They don’t experience nausea, which would slow them down.nausea, which would slow them down.

So the one who can drink you under the table is at So the one who can drink you under the table is at highest risk for alcoholism.highest risk for alcoholism.

DependenceDependence

As neuronal activity in the brain decreases As neuronal activity in the brain decreases in response to a drug, the user needs the in response to a drug, the user needs the drug simply to feel normal. drug simply to feel normal.

WithdrawalWithdrawal occurs if drug is discontinued. occurs if drug is discontinued. Users develop Users develop tolerancetolerance to a drug, which to a drug, which

allows them to use much more of the drug.allows them to use much more of the drug. Tolerance prevents the user from recreating Tolerance prevents the user from recreating

the original high.the original high.

Challenges to sobrietyChallenges to sobriety Conditioned desireConditioned desire

– Cravings erupt in situations of previous useCravings erupt in situations of previous use Conditioned withdrawalConditioned withdrawal

– Someone who is sober, feeling the shakes, cramps, anxiety Someone who is sober, feeling the shakes, cramps, anxiety when considering drinking again- similar to withdrawal from when considering drinking again- similar to withdrawal from the drugthe drug

Acamprosate can reduce effects of conditioned Acamprosate can reduce effects of conditioned withdrawal by reducing the excitability of glutamate withdrawal by reducing the excitability of glutamate receptors (an excitatory neurotransmitter)receptors (an excitatory neurotransmitter)

Naltrexone is another drug that reduces relapse by Naltrexone is another drug that reduces relapse by blocking receptors for endorphins & causing a bad taste blocking receptors for endorphins & causing a bad taste when drinking.when drinking.

Drug interventions aren’t enoughDrug interventions aren’t enough Other things the sober person needs to manage are:Other things the sober person needs to manage are:

– Staying away from high-risk situationsStaying away from high-risk situations– Replacing peers or friends who useReplacing peers or friends who use– Learning to control interpersonal conflictLearning to control interpersonal conflict– Developing higher self worth through skill-building, management Developing higher self worth through skill-building, management

of thoughtsof thoughts– Practicing other responses & thoughts (RET)Practicing other responses & thoughts (RET)

Rule violation effect-Rule violation effect- – the result of cognitive dissonance, self-attribution (I’m a failure for the result of cognitive dissonance, self-attribution (I’m a failure for

wanting to drink), positive perceived effects of the drug – it all wanting to drink), positive perceived effects of the drug – it all leads to self-justification of drinkingleads to self-justification of drinking

Most people trying to be sober will lapse when they feel Most people trying to be sober will lapse when they feel frustrated with no ready solutionfrustrated with no ready solution

Cognitive strategies for managing Cognitive strategies for managing cravingscravings

Can drinking be therapeutic?Can drinking be therapeutic?

Moderate alcohol intake (2 drinks/ day) is related Moderate alcohol intake (2 drinks/ day) is related to lowered CVD (20% lower risk of stroke or heart to lowered CVD (20% lower risk of stroke or heart attack than abstainers)attack than abstainers)– Alcohol increases good cholesterol- HDL & reduces Alcohol increases good cholesterol- HDL & reduces

clotting of the bloodclotting of the blood The downside is increased risk of cancerThe downside is increased risk of cancer

– Risk of colon cancer increases 15% if you drink more Risk of colon cancer increases 15% if you drink more than 1 drink a day- 4 drinks/ day and the risk is 40% than 1 drink a day- 4 drinks/ day and the risk is 40% higher (risk also increases for breast cancer)higher (risk also increases for breast cancer)

Alcohol is the 3Alcohol is the 3rdrd biggest cause of preventable biggest cause of preventable death after smoking & obesitydeath after smoking & obesity