In his 1977 film Annie Hall, Woody Allen’s character, Alvy Singer, says to the title character, played by Diane Keaton, “I’ve spent fifteen years in therapy. I’m gonna give him one more year, and then I’m going to Lourdes.” (The famous Roman Catholic healing site in France.)
It’s a subject Allen returns to often in his work, in ways that many who have turned to therapy to recover from whatever troubles them can relate to. Usually, he characterizes therapy, especially psychiatry, as something that promises rich rewards, but delivers very little, despite which his characters find it hard to give up. Nestled carefully in the jokes is the idea that therapy, or the effort to “get better,” can itself become a form of addiction if we’re not careful.
A lot of therapy clients have discovered that while talking out what’s bothering them may feel good in the short run, after they leave the session or even years of therapy their issues are still with them. They understand why they are the way they are and do the things they do, yet find that knowing about it and doing something about it are two different things.
And it isn’t just clients who find this to be true. Kimberley L. Berlin, an integrated addiction therapist who uses traditional western and eastern approaches in her practice, quotes Dr. Daniel Amen, the author of Unchain Your Brain, whose work has revolutionized how we view and treat the brain, as putting forth “one of the most compelling statements that I’ve heard”: Psychiatry is the only field in medicine that diagnoses an illness without looking at the organ it is treating.
Dr. Amen’s remark is almost a Woody Allen line itself. What he means is that although the brain as the center of memory and personality lies at the root of psychological disorders of any kind, until recently psychiatry tried to treat these issues without the benefit of scientific findings about the operation of the brain itself. This was, of course, mostly because science had not advanced enough to be able to examine the brain with the kind of microscopic detail required to make meaningful interpretations of how its inner workings translated into mental and emotional states. But that has begun to change.
Ms. Berlin is clearly not intending to put down therapy per se. She is a therapist herself, one who is, as her biography states, “grounded in the 12-step tradition and guides patients to a deeper understanding of what recovery can truly mean in their lives. Berlin holds advance degrees, licenses, and certificates in clinical social work, addiction counseling, mindfulness, interpersonal neurobiology, and clinical trauma. She is a published author and some of her most recent work on women and alcohol was featured in Social Work Today.”
Her purpose in her work is to provide traditional forms of therapy with the best, cutting-edge scientific information and tools regarding brain science and recovery. But she doesn’t limit her work there. As she said during a 2019 webinar on “The Science of Addiction and Spirituality,” “We want to gain basic knowledge of how neuroscience research supports spiritual approaches to traditional addiction treatment. And we want to understand how spirituality is defined and can be applied to secular persons in recovery. And then learn some techniques that could improve the quality and duration of recovery.”
These are ambitious goals, but the evidence Ms. Berlin presents suggests that they may well be attainable—some right now, and others in the not-too-distant future. While modern psychiatry and psychology originated in the late nineteenth century with the work of Sigmund Freud and others, and concentrated on talk therapy and dealt with the mind and personality alone, without much reference to the physical brain, and late twentieth century work began the process of mapping the brain and it’s neurological connections to issues like addiction and recovery, Berlin advocates for adding two additional factors to the mix, once again citing Dr. Amen’s work:
“One of the breakthroughs that Dr. Amen brings to the field is the four circles approach to healing. These are biological, psychological, social, and spiritual. Briefly, we cannot heal addiction without addressing the physical body and its return to health. Psychological attention to the underlying emotional causes is equally important. As is examining our social interactions, supports, and lifestyle. And, finally, the spiritual practices that we engage in to achieve connection.”
In other words, she stresses the value of a completely “ecological” approach to therapy in all forms, including how we treat addiction. In her work, she looks at the self, the body, the brain, the social environment of the client, and what kind of spiritual relationship they have to life as a whole.
Ms. Berlin quotes Thomas Hora, considered the founder of the discipline of metapsychiatry, an attempt to integrate principles from metaphysics, spirituality, and psychology, who remarked, “all problems are psychological, but all solutions are spiritual.” In saying this, he is agreeing with Albert Einstein, who famously remarked that problems are not solved at the level at which they are created, but from a “higher” vantage point from which a more complete perspective can be reached.
For Berlin, this is the integrated field that is catalyzed by the “bird’s-eye” view of the spiritual dimension. And it turns out, she claims, that there is a powerful link between the physical and neurological aspect and spirituality in the role of healing, including addiction recovery.
In the webinar, Berlin showed images of what occurs in the brain with substance use, whether long- or short-term. Using the methodology pioneered by Dr. Amen, the scans revealed the insufficient blood flow and regions of the brain where there was damage that looked like holes.
She then connects these findings to their basis in personal history—the psychological aspect—and the physical effects of both substance and process addictions.
We know that trauma is inevitably at the root of an individual seeking to self-soothe or self-medicate from traumatic events, whether childhood or adolescence, and even to adulthood. We also know how all the areas of the brain can be hijacked by substances such as alcohol and drugs, but also includes process addiction, such as gambling, sex, shopping, online video gaming, Internet, and social media.
Berlin also references the work of Rick Hanson, who I have mentioned here before, whose research concluded that because of human evolutionary history, negative or painful impacts make a stronger impression on the brain, something that was actually useful thousands of years ago, because remembering what had hurt or nearly killed you physically increased your chances of survival. But now, when we are less likely to get jumped by a tiger, the brain’s difficulty in distinguishing between physical and mental-emotional threats can put our bodies into fight or flight overdrive, as we continually rehash past hurts in our minds. Hanson calls this “negativity bias.” But he also found help for this process in the same studies. Says Ms. Berlin:
What Hanson proposes is that by activating the parasympathetic nervous system, the PNS, we can offset anxiety, depression, and many other conditions, including addiction.
And she concludes, citing many studies as well as her own work, the PNS can be activated through active spirituality and spiritual practices.
Through the phenomenon of neuroplasticity, the brain is able to heal. And by engaging in spiritual practices, we can train the mind, reshape the brain, affect levels of noradrenaline, and promotes new neural growth.
Neuroplasticity is the term for the fairly recent scientific discovery that, contrary to earlier beliefs that the brain’s condition is locked into shape by adulthood and cannot change or regrow tissue, it is much more dynamic than thought and does, in fact, respond to changes in response to experience, and can change both structure and function.
This is why, Berlin relates, the brain can be affected positively by spiritual practices. And while the physical, neurological basis for this was not understood in past ages, the effects of such practices clearly were, as in this quote from the Buddhist monk, poet, philosopher and scholar, Shantideva illustrates, writing in 685 C.E.:
Penetrative insight joined with calm abiding utterly eradicates afflicted states.
That is, the kind of stable physical, emotional, and mental states generated in meditation, prayer, yoga, and other forms of spiritual practice enable the mind to become calm and therefore focus clearly, so that insight into its own operations can be gained.
As a result of these discoveries, Hanson and others conducted brain scans of subjects who were engaging spiritual practices from a variety of traditions and backgrounds. What they found was strong evidence that these practices produced significant changes in the brain.
These included an increase in sensory awareness in the parietal lobe, and a reduction in activity in the anterior singular cortex (ACC), which is involved in emotion and decision-making. As Berlin notes, “when we reduce the activity in the ACC, we’re associating with reduced activity of negativity bias.”
Spiritual practices as varied as mindfulness, the repetition of a mantra, deep prayer, and the whirling dances of Sufi dervishes have all been shown to result in effects such as decreased stress and negative emotion, and, perhaps most importantly for those in recovery, the ability to teach the brain to self-regulate, as Shantideva implied 1300 years ago.
One of the places where ancient spiritual practices and modern science meet is neurofeedback. The child of the earlier process of biofeedback, Berlin relates that neurofeedback is used today using computers. And that process is used by the military, it’s used privately. It trains the brain to be able to self-regulate. The most recent discovery in biofeedback and neurofeedback science are gamma waves. And researchers found that long-time practitioners with meditation generated high-frequency gamma. So the discovery of gamma supports the science of meditation and self-regulation.
She also points out that “gamma-wave activity is also associated with distraction-free learning and cognition. So meditation really is the science of consciousness, attention, and knowing the self.” In summing up these findings, Ms. Berlin states
But the common elements here that are important to remember are that all of the types of meditation, no matter which one or which path you choose include: Attention, focus, awareness, holding, which is also known as witnessing, attending, paying attention, and then ultimately gaining insight from the practice.
The good news is that there have now been more than 60,000 research studies on meditation confirming the validity of these claims. Ms. Berlin says that this “now forms a therapeutic foundation for alcohol and substance-use disorder treatment, and I would say across-the-board.”
As meditators and yogis have known for a very long time, and as modern ones are discovering in ever-greater numbers, one of the most notable connections between body, mind, and spirit, and one of the easiest to find and apply, is through the breath, the basis of life itself. Neurofeedback, meditative and other spiritual practices meet in the breath. Ms. Berlin:
by understanding that our thinking can change the rate of our breath, the new work and research in breath and meditation suggests that breathing, focused breathing can impact our mental function….when we focus our breathing and pay attention to the regulation of our breath, we directly affect the levels of noradrenaline, which is this natural brain chemical messenger. It gets released into the bloodstream when you’re curious, focused, or emotionally aroused. And it enhances your attention to detail. Noradrenaline improves overall brain health by promoting the growth of new neural connections.
She points out that there is also exciting evidence that additionally connecting the breath to deliberate, focused physical movements, such as the hand gestures called mudras in Sanskrit, or the complex forms in yoga or tai chi, and undoubtedly in something like ballet, these kinds of benefits are enhanced even further. In the webinar, she discusses a kundalini-related practice that can be linked to the breathing:
…this particular mantra, “Sa-Ta-Na-Ma” was used in the image of the baseline scan and prayer scan, that colored slide with the frontal temporal lobe activity….What’s interesting about this, this uses the hands. So you’re going to take your thumb and forefinger and put them together. And then you move to your middle finger, your ring finger, and your pinky. So we start again with forefinger and thumb. Sa, Ta-Na-Ma. Sa-Ta-Na-Ma.
And this is repeated over and over. It activates neural senses through the finger pads, but it also activates the hippocampus, and it increases limbic activities. So memory, calm, and intensity of experience. Present moment-ness.
She concludes by saying, “There are many, many paths to recovery. And I think that the treatment field can recognize that introducing a comprehensive approach using evidence-based spiritual practices will enhance the journey of healing.”
For those in recovery, the potential exists to apply these discoveries by creating a coordinated practice for oneself that allows you to shift from “battling addiction” to “creating the life you want,” by altering the very processes of body and mind that manifest as addiction in the first place. And you don’t have to be religious, or believe anything that can’t be demonstrated, to do it.