By Matt Fox and Dr. Grant McFetridge
In this page we'll start by giving a historical perspective on treating addictions, current approaches in the addictions field, and the new and very different approach that Peak States therapists take to treating addictions.
Prior to the 1930’s treatment of alcoholism and addictions was nonexistent. The only effective approach was to confine the addict and limit his access to his drug of choice. Various mental health professionals attempted to treat alcoholism as a mental disorder, but met with failure. The existing paradigm of the time was that the addict was a ‘hopeless case.’ During the 1930’s, a new approach appeared that worked on the premise of alcoholics helping each other stay sober. Alcoholics Anonymous was founded by a lay person, Bill Wilson, and an MD, Dr. Bob Smith. AA was met with skepticism by many professionals, but during it’s almost seventy year history, it has proven to be the most effective treatment for the disease of alcoholism. The basic premise of AA is that alcoholism is a disease of the spirit, and that it requires a spiritual solution. Bill Wilson was not a mental health professional, and was outside the existing psychological paradigm. In fact, one of the traditions of AA is that the fellowship should always remain unprofessional. AA is a transpersonal approach that promotes increasing conscious contact with a Higher Power. The program has sound roots in the psychological theories of William James and Carl Jung. Bill Wilson was a sort of maverick, willing to try anything to help his fellow alcoholics recover. During the 1950’s he experimented with LSD-25 and advocated LSD therapy for the treatment of alcoholism. I believe that he would have been ‘all over’ the currently emerging trauma therapies. Readers who are interested in further information about the history of Alcoholics Anonymous are directed to a book published by AA, ‘ Pass It On: The Story of Bill Wilson and How the AA Message Reached the World’, published by the World Service Office of AA.
The state of addictions therapy today has backslid from the early days. Most professionals have gotten caught up in recent findings about the brain and see addiction as a biological disease. In so doing, they have adopted a reductionistic viewpoint that envisions a cure through medications, vaccinations, gene therapy, or other biological interventions. Although AA is seen as an effective adjunct to therapy, many professionals disregard its spiritual basis and attempt to fit it into current reductionistic theories. I find the basic premises of trauma therapies to be consistent with the philosophy of Alcoholics Anonymous. Unfortunately, addictions counseling has developed its own paradigm, and many addictions professionals reject trauma therapies out of hand, without examination. This is an unfortunate departure from an oft quoted AA maxim: ‘There is a principle which is a bar against all information, which is proof against all arguments, and which cannot fail to keep a man in everlasting ignorance - that principle is contempt prior to investigation.’ - Herbert Spencer.
Meridian Therapies and Addictions
In the late 1990s entirely new approaches for eliminating trauma (and the extreme example of trauma, post-traumatic stress disorder or PTSD) became available to therapists. One very popular, simple and effective sub-group of these new techniques is called 'meridian therapies'. The two most well known, Thought Field Therapy (TFT) and Emotional Freedom Technique (EFT), use classical Chinese acupuncture theory. It postulates a subtle system of energy pathways, or meridians, along which energy, (chi), flows in the body. Blockages in this system can result in physical or emotional illness. The energy system is also subject to ‘reversals’ as a result of toxins that have accumulated over time. The reversal results in self sabotaging behavior. In this approach, the client ‘tunes in to’ his problem, rates the discomfort caused by the problem on a scale of one to ten, then taps on specific points until the discomfort goes away. If the client is ‘reversed’ around the issue, there is little or no change. The therapist then treats the reversal and the next application is usually effective. This process has a demonstrated success rate of about 80%, (as reported in the Family Therapy Networker, July/August 1996). Readers who are unfamiliar with this approach are directed to the Emotional Freedom Techniques website, www.emofree.com.
Meridian therapies see addictions as ineffective attempts at stress reduction. According to this view, treatment of addictions can be complicated, due to the fact that the underlying traumas are ‘layered and interlaced.’ The sum total of the discomfort resulting from these traumas are experienced as cravings. Theoretically, if the client uses the intervention every time a craving arises, they will eventually clear the system of all the underlying blockages. Re-exposure to the substance can result in re-addiction. The effectiveness of the approach can depend on a variety of factors, one of which seems to be the addictive potential of the substance. I (Matt) have seen clients loose all desire for chocolate for months, but cravings for nicotine can return anywhere from five minutes to 24 hours.
I (Matt) use these approaches often in dealing with traumas associated with addictions and have found them to be very effective. Unfortunately, my experience using meridian therapies to deal directly with addictions has been less than satisfactory. The intervention usually eliminates the craving, and it seems to work well in a controlled environment, where the addict has no access to substances. In an uncontrolled environment, however, I find that the addict usually chooses his drug of choice over the ‘tapping thing’. This occurs even when he knows the intervention will be effective. I have found treating the reversal in this situation only works for a short period of time. Often, even though the client reports that the urge to use is eliminated, at some level, the desire to use persists.
MacLean/Papez Triune Brain Theory and Addictions
The MacLean/Papez Triune Brain Theory is fairly well accepted by the addictions treatment community. In more familiar terms, this theory describes the biology behind our common experience of having a mind, heart and body. Many addiction professionals today accept reductionistic versions of this theory, but few have attempted to integrate it with a spiritually based approach. In this section, we'll describe this model and how addiction counselors understand its effects - that the drive behind the addiction is the brain stem, a key feature of the MacLean/Papez Brain Theory.
According to this theory, the brain is a product of evolution that has resulted in progressively complex components. The earliest and most primitive is the brain stem, or reptile brain. The brain stem is responsible for the most basic aspects of biology - breathing, heart beat, digestion, reproduction, etc. The brain stem does not reason and cannot look into the future. The next part of the brain to appear was the limbic system, or mammalian brain. This area appeared with the development of mammals and allowed attachment and emotions. If a reptile comes across it’s young after their birth, it may eat them. The limbic system allows parents to become attached to their young and helps ensure survival into adulthood. The last part of the brain to evolve was the neo-cortex, the primate brain, which deals with reason and judgment. This part of the brain thinks it is in charge of the entire system, an attitude that contributes to the development of addiction. The three brains live together in the same skull, but generally don’t cooperate very well. They each vie for control, and will manipulate and sabotage each other in order to achieve it. Each thinks it is the most important part.
Due to the triad nature of the brain, and the primary task of survival, a hierarchy of control exists with the structure. The brain stem is the most impactful part of the brain, due to its primary responsibility for the continued survival of the physical body. It has the ability to override the mammalian brain and the primate brain. In situations that involve survival, the reptile brain jumps in and reacts to the situation immediately. Left to its own devices, the primate brain would stand around thinking about it until it is too late. Likewise, the mammalian brain can override the primate brain. This why, when a person is in the throes of an intense emotion, they will say and do extremely irrational things. The primate brain can regain control though sustained effort or breathing exercises that provide oxygen to the three brains and sends a message that everything is okay, and control can be relinquished to the neo-cortex. (This can be hard to accomplish, however, since the neo-cortex is not in charge at the time of the problem.) Deep breathing exercises are often a component of contemporary addictions approaches.
Pleasure is basically a brain stem function. The use of drugs and alcohol stimulates the pleasure centers, and eventually the reptile brain puts the substance into the same category as oxygen and food. It believes it needs the drug to survive. In this manner, the brain stem hijacks the entire system. It will go to any lengths to obtain and use the substance, disregarding all logic, judgment and personal boundaries of the neo-cortex. The consequence can be prostitution, theft, physical violence and the other ills that go along with addiction. The brain stem can actually take control of the neo-cortex and reason in a very limited way - resulting in the defense mechanisms familiar to addictions counselors. These predictable responses can be easily recognized due to the fact that they tend to be short sighted, ultimately self defeating and designed to protect the relationship with the drug of choice. Common defense mechanisms include: ‘I can quit any time I want to, I just don’t want to right now’, ‘At least I don’t drink as much as that guy’, ‘If I ever [steal, lose my job, use a needle, prostitute, etc.], I’ll know I have a problem’, ‘You would use too, if you had my [boss, wife, kids]. Since the neo-cortex thinks it is the only part of the brain that exists, it assumes that the words coming out of its mouth are its own.
Using conventional techniques, recovery requires a period of sobriety that allows the brain stem to ‘forget about’ the substance. Ideally, the addict becomes involved with 12 step programs or some other spiritual pursuit that replaces the addiction. From the perspective of brain biology, addiction actually strengthens the neural connections between the brain stem and the pleasure centers. A prolonged period of abstinence allows these connections to become dormant. Spiritual pursuits strengthen the neural pathways between the neo-cortex and the pleasure centers. This reasserts control by the neo-cortex and reduces the chance of relapse. Although the brainstem/pleasure center connections are dormant, they continue to exist, and the brain stem lays in wait for an opportunity to regain control. Thus, an addict can be in recovery from addiction for years and suddenly return to use. A common example is a smoker who quits for twenty years, has one cigarette, and suddenly returns to smoking to a pack a day. A common quote from Alcoholics Anonymous is that alcoholism is ‘cunning, baffling, and patient.’ This describes the ‘reptile brain’ perfectly.
The limbic system and the neo-cortex can also contribute to relapse. An important task for persons in early recovery is to learn to appropriately express their emotions. They can be subject to wide mood swings as the brain attempts to regain a balance of neuro-transmitters. If the limbic system overcomes the neo-cortex during one of these times, it creates an opportunity for the brainstem to re-exert control and return to use. Another scenario involves the neo-cortex returning to the delusion that it is all-powerful, and can use again in a controlled fashion. The reintroduction of the substance reawakens the addiction, resulting in relapse.
A Breakthrough in Understanding and Treating Cravings and Withdrawal
In 2001, I (Grant) was asked by a First Nations friend who was an addiction counsellor to solve this problem so he could help his people. Matt Fox, an addiction counsellor in Florida, soon came on board to work on this project with me. When we started our research on addiction, we knew the models that were covered above, and Matt had been using trauma therapies on this problem for quite a while. But from our perspective, there really was no effective techniques for eliminating addictions, in spite of the assumptions one would make from the plethora of addiction centers, court mandated treatments, and so on.
For the first 10 years, we worked on finding a solution to addictions. Eventually, we verified that most cravings (including withdrawal symptoms) were caused by problems in the body (brain stem). However, these problems were not simple biographical trauma issues, as most therapists had assumed. Instead, we found that the body forms its own particular kind of trauma - what we now call 'body associations'. These are the illogical associations that, for example, that Pavlov's dogs made when they associate the sound of a bell to the taste of food. These associations are formed at moments of trauma, often prenatally. The addictive substance would be associated with survival - and this would drive the craving and cause the addictive behavior. Their bodies 'knew' that they had to have the substance or they would die. Hence, approaches like 'just say no' were relatively useless, since to the body, it was use or die. By 2007 or so, Matt and I came up with a way to dissolve those associations, which allowed Matt to test our theory on quite a number of addicts. However, it wasn't until 2012 that we came up with a better technique that was fast, simple and easy to use.
Thus, we'd figured out how to eliminate the cravings and withdrawal symptoms on most addictive drugs. And many addicts were just finished at this point, with no inclination to continue to use. However, some addicts would continue to use without having any cravings left whatsoever. And although our process worked for all drugs we saw in typical clients (crack, amphetamines, etc.), it rarely worked on smoking addictions. So, what was going on? It took another five years before we were to get a handle on these problems. Surprisingly, it turned out that smoking had a completely different biology than other addictive substances. And the need to continue using even without craving had several causes, some we'd found solutions for years ago, and one that we'd never even suspected that again was linked to survival.
If you are interested in tour treatment techniques, we're now writing a textbook on how to eliminate addictions, which hopefully will be done by the fall or early winter of 2018.
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1.1 March 24, 2018: Slight revisions to Matt Fox's 2002 text.
1.0 Jan 6, 2010: First draft of this webpage.