Posted on June 1, 2015 by Laura
By Frank Lawlis, Ph.D., A.B.P.P. and Barbara Peavey, Ph.D., M.S. PsyPharm, BCIAC
The new and additive approach to treatment of addiction has been termed psychoneuroplasicity, and the applications are many. However, given that it is a recent concept for addiction treatment, a huge hole of understanding in both name and approach needs explanation. The term comes from the relative use of neurological measurement technology, illustrating that how the brain is wired contributes to how the person functions and that the brain not only heals itself, but regenerates new connections within itself. Although we have known for years that people who suffer from strokes and trauma often regain functionality with rehabilitation, it is often conceived that they were strengthening muscles and finding new aspirations. What was found has been called, neuroplasticity, reflecting that new brain cells were being born and new backup brain patterns were being utilized to form the basis of functioning for these recovery abilities.
The question arose: If brain patterns governing muscles can be regenerated and reorganized to create adaptive functions, why couldn’t brain patterns managing behavior or emotions be susceptible to similar rehabilitation methods? The answer is that they can, in fact, be regenerated and reregulated with the same principles as physical neural rebirthing (neurogenesis) and retraining. Hence the term, psycho-neuroplasticity (PNP), was coined.
The next question to a traditional counselor with a clear understanding of the intervention would be: How would one recognize the differences in the initial therapeutic interventions between the PNP approach and a more conventional approach? First, the focus of therapeutic effort would be different. Empathy and genuineness are major ingredients in developing rapport and trust regardless of a PNP or a conventional therapeutic approach. The PNP approach is “brain-based” and develops an understanding of the patient through analysis of their thinking and cognitive patterns contributing to the perceptions of their world. It is also essential to understand the patient’s strengths, as these are the basis for change. Whereas in conventional therapy the therapist is focused on the understanding and insight about past events in an attempt to resolve their fixation, the PNP philosophy is based on the way the brain is “wired.” Thus, PNP identifies the strengths of the individual with a plan for future goal attainment through developing skills and retraining the brain.
For example, consider a male patient whose addiction grew out of using prescription drugs for increasing his attention. With the help of his therapist he would explain his problems with focus and concentration: how he needs his prescriptions to function and how he can’t succeed at his job or go to school without these substances. After listening, the therapist would point out with empathy the patient’s victimization by clarifying, “Do you think I fully understand your past experiences and current problems?” If the patient agrees, the therapist’s next response may be, “You can’t think this way because it is the thinking of an addict, and it won’t be long before you follow this logic with the action of addiction. We must not talk about the past this way, but learn to live without addictive substances.”
The PNP approach will be individualistic and specific to the person. The philosophy is broken down into three phases. The first phase focuses on healing the brain. Addiction is toxic and results in the depletion of critical vitamins and nutritional resources. Physical changes to the brain and body are due to poisonous aspects of the drug substances. Also, when there is a lack of restorative sleep, the build up of stress can create psychosis and irregular circadian rhythms. Long-term usage results in unrelenting stress that can lead to adrenal exhaustion and cortisol imbalances with damage to the neural system.
Improving the diet, rebalancing nutrients and metabolism, adding exercise (yoga type), and developing healing breathing patterns are the basic curriculum with alternative methods such as acupuncture, hyperbaric chambers, and massage to release toxins. Similar to the metaphor of an automobile, it is inappropriate to start a long trip if the motor is not running efficiently.
The second phase is strengthening and building brain patterns for healthy functioning. The negativity of the psychological perceptions is treated as a toxic leftover from the addiction. Change happens when the patient can focus on his or her strengths or on what is “right” about them, not by focusing on what is “wrong” with them. With the PNP approach, the patient is encouraged to develop a list of strengths they see in themselves. Much of the time therapy starts with reciting these major strengths in order to lay down new brain pathways for positive possibilities. The “negative coach” with negative self-messages, is replaced with a “positive coach” with positive affirmations: “I can do this!” Like any habitual pattern of thinking, new neuronal patterns are built on repetition and require discipline and accountability. The reinforcing element is that the impact of this phase is usually immediate and patient response is very rewarding.
Another principle of PNP is that brain change happens more quickly when it is associated with joy and positive sensory stimuli. Incorporating the senses of smell (olfactory) and sound (auditory) along with relaxation techniques are very powerful in this process. Consequently, it is possible to redirect the patient’s negative attitudes by associating them to these more subconscious avenues for positive possibilities. This process offers learning new ways of coping with stress, depression and anxiety by discovering a positive resolution to present stress-related events. Again, strength builds on strengths and self-confidence is gained.
For reference as to how the brain operates, in coaching there are three stages to teach a kid how to make basketball goals. The first stage is to create an image in your mind of what you want to accomplish. The more detail in movement and coordination the better. The tendency most people have when they don’t start making goals immediately is to become discouraged. They start self-criticizing and labelling themselves as losers. Therefore, the second stage is to not allow your brain to entertain any negative thoughts. Keep the winning image in mind at all times. The third step is practice and more practice, developing brain patterns in the right direction for success.
The third phase of PNP is transpersonal awareness. This is similar to the 12 Steps in that the patient practices being in the present and listening to a source of guidance for their lives. Accomplishing this process usually starts by letting go of fear and embracing love and spirituality. In this phase, the PNP principle of learning mindfulness in meditation and breathing (focusing on the present moment with breath) is incorporated to relieve the brain of the stress of the future and release it from the guilt and regret of the past. Providing the patient with a “safe space” for personal exploration often occurs when the patient experiences the results in a sensory deprivation chamber where space and time cease and the immortality of love can be realized.
These PNP phases are not linear in practice, but hopefully this initial explanation offers some logic and reasoning for considering fresh practices within the field of addiction treatment. There will be future blogs to focus on different aspects of this PNP process. This is the beginning of a new and optimistic approach. We look forward to sharing again!