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Metapsychology Online Reviews - Theory of Addiction

Metapsychology Online Reviews - Theory of Addiction

Here is the question: Why do some addicts relapse even when they sincerely claim that they do not like the substance to which they are addicted? Here is the Berridge and Robinson answer. Liking something is a hedonic process and is associated with its own neural substrate. Liking may explain why addicts initially take and persist in taking drugs (for the pleasure this produces, and to avoid the displeasure of withdrawal). Addicts, however, may re-take drugs after a period of refraining, long after the displeasures associated with withdrawal are past, and for no anticipated pleasure. This is because the neural systems that are sensitized to drug taking are connected with wanting or desiring. These are dopamine systems and they are not the same substrates as those for liking. Addicts may want drugs or be motivated to take them even if they rightly believe that they don't like them, and therein are both unawares of wanting them and unprepared to inhibit the impulse to seek them.

One clinical lesson of the distinction is that persons should continue to exercise watchful restraint over stimuli for addictive behavior even if, or perhaps just because, they feel no need to restrain themselves since the drug is no longer liked. So says the theory. That's a potentially potent idea, I believe, for, if sound, it applies to a lot of human behavior that is imprudent and disordered even if not specifically addictive. Consider, for example, obsessive-compulsive behavior, whose subject may claim that they receive no relief at all from washing their hands, and dislike the chore, but persist in the behavior and become anxious when stymied. West utilizes the idea in PRIME. Cigarette smoking may feel so disliked that an individual feels inhibited from lighting up. But beware. The impulse to smoke and motivation to renew one's engagement with cigarettes may abide.

In addition to his own theory of addiction and assessments of other theories, there is a lot of just plain useful information about addiction that West shares in this book. Did you know that it is rare for efforts to overcome addiction to be successful the first time? Did you know that adults who engage in one type of addictive behavior often (albeit not universally) engage in others?

This is from a book review. I am intrigued by the difference between liking and wanting, with dopamine controlling the "wanting" part. So you could like something, but if dopamine is lacking, you don't have the drive to seek it out. Addicts have the reverse problem, where dopamine has entrained itself to seek the addiction object, despite the dislike the subject ma feel. I wonder what causes the liking part? Serotonin perhaps? Or perhaps Dopamine, but in a different area of the brain?

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