The Conditioning Power of Orgasm

Orgasm

The role of orgasm includes more than just procreation and partner bonding. Orgasm is also a powerful reinforcement of the behaviors and stimuli that elicit the response.

Classical conditioning theory can help explain this process. You’ve probably heard of Pavlov’s dog experiment, but just in case you haven’t: Pavlov rang a bell before feeding the dogs in this experiment. The food elicited a salivation response from the dogs, but after multiple trials, the ringing bell would cause the dogs to salivate. Therefore, the ringing bell became associated with food.

A similar process occurs with sexual stimuli and orgasm. Let’s take porn for example. John enjoys pornography that includes group sex, so he seeks out this type of stimulus when he masturbates. Every time he orgasms to stimuli (visual or fantasy) of group sex, John’s brain forms an association between the stimuli and orgasm. And the more he pairs his orgasm to group sex, the stronger the association. Now, this doesn’t mean that simply seeing or thinking about group sex will cause John to orgasm, but it will start the arousal process. And more importantly, John might find that it takes longer to become aroused or to achieve orgasm to other types of sexual stimuli. He may even have to fantasize about group sex when he’s being intimate with his partner in order to orgasm.

Understanding this process and the conditioning power of orgasm is crucial to cultivating healthy sexual behaviors. It is important to remain mindful of the stimuli one associates with orgasm and how frequently one orgasms to stimuli that aren’t accessible through  sexual relationships. The use of pornography is not necessarily unhealthy, but fantasizing during sex with a partner certainly can be. (The reason I am using vagueness here is because healthy sexual behavior has an idiosyncratic definition. What’s healthy for one may be self-destructive to another.) In John’s case, I would encourage him to include fantasy of his sexual partner and other types of pornography to his masturbatory practice. In some cases, stimulus switching is necessary for re-conditioning orgasm. The person is instructed to switch from the problematic stimulus to a healthier one right before orgasm. Over time, the person switches to the healthier stimulus earlier in the arousal process and eventually can become aroused by the healthier stimulus.

Photo credit mustardgreen

Put this in your shot glass and inhale it!

 vaportiniWatch out, America! The Vaportini is coming to a store near you. That’s right, why drink alcohol when you can INHALE it?

All jokes aside, this method of consuming alcohol can be extremely dangerous. Apparently researchers create alcohol addiction in rats by exposing them to the vapor (they don’t like the taste of alcohol). Not only are the addictive qualities of alcohol increased, but the risks are as well. Rats exposed to alcohol vapor demonstrate anxious behaviors and deficits in the reward center of the brain. In humans, reward center deficits can lead to anxiety, depression, and decreased motivation.

The dangers associated with alcohol intoxication also increase with this method of consumption. Inhaling alcohol bypasses the digestive system which means two things: 1. alcohol is absorbed quickly into the bloodstream through the vessels in your nose and lungs causing a rapid and more intense buzz, and 2. protective measures of the digestive system such as slower absorption rates and vomiting become obsolete and may increase the risk of alcohol poisoning.

This isn’t the first time alcohol inhalers hit the market. In 2004 AWOL (Alcohol Without Liquid) was introduced in the U.S. and quickly banned in 22 states. AWOL sold for $300 a unit, but at $35 a unit for the Vaportini, access is granted to many more people, especially college kids who are looking for a novel way to consume alcohol.

Circumcision of the brain?

opiate addiction

Photo by Domiriel

Physicians in China performed brain surgeries to treat opiate addiction by destroying the nucleus accumbens, the pleasure center of the brain. The procedure is called stereotactic ablation of the nucleus accumbens, which means brain tissue is burned away. Although the procedure was banned in 2004, surgeries continued in the name of research.

The hope was that by destroying the part of our brain responsible for pleasure associated with drug use (among other things) the desire for using drugs would diminish. Results published in World Neurosurgery last October showed that 5 years after the surgery, 53% of participants had relapsed and were addicted to opiates again. In addition, 21% of participants experienced memory deficits and 18% experienced loss of motivation. These side effects are permanent due to the irreversible nature of the treatment. Read more about this controversial surgery here.

It is clear that addiction has devastating effects, but how far are we willing to go to treat it? Is it fair to ask addicts to potentially sacrifice pleasure and motivation to kick their habit? Some of the participants of this study were as young as 19 years old and had been addicted to heroin for 3 years. Granted, this research was conducted in China, a place where the death penalty is considered a suitable intervention for addiction. Is it ethical to have moral standards influence scientific research? Where do we draw the line?

Drug Tolerance Explained

toleranceOur brain thrives on novelty and dopamine helps us store information about novel situations.  We know that dopamine is released when we receive a reward, but it is also involved in noting unexpected rewards. If you get more juice than you anticipated, your brain releases dopamine and sends it to the anterior cingulate in your frontal cortex, a brain region responsible for anticipating rewards and making decisions. Get less juice than you anticipated and, again, your brain will encode the information, but this time, by sending less dopamine to the anterior cingulate. If you get the same amount of juice you expected, no dopamine is released. This mechanism enables us to recognize patterns and learn which behaviors lead to risk versus reward.

How does this translate into drug and behavioral tolerance? When you use cocaine for the first time, your brain registers it as a pleasurable experience. After using it a few more times, you might notice that you don’t experience the same level of euphoria as before. That’s because the experience has lost novelty and your brain has learned to recognize the pattern. In other words, dopamine isn’t released since there isn’t anything novel about the experience. Tolerance is born. In order to achieve euphoria from cocaine, you must now use more.

The same process occurs with compulsive behaviors. The first few times you shoplift (and don’t get caught) you experience relief and pleasure, but with subsequent trials you notice a decrease in the euphoria you experience. So, you start shoplifting more frequently.

NoteThere are many neurobiological mechanisms at play in addiction and compulsive behaviors and the role of dopamine in addiction and tolerance is just one facet of a complex biopsychosocial phenomenon.

Substance Abuse Treatment Options: Getting Help

substance abuse treatmentCounseling? Rehab? Support groups? How does one know where to start when it comes to choosing a substance abuse treatment program?

First, you’ll want to get a formal assessment from a licensed professional to determine which treatment option is appropriate for you. Some substance abuse treatment options to consider are support groups, inpatient, and outpatient treatment.

AA, NA and other 12 Step programs

Support groups led by peers that focus on helping a person abstain from substances or behaviors.
Pros:  offer additional support and can be a good place to find additional resources and information, free, many locations, various meeting dates and times
Cons: Abstinence is the only treatment goal option, lack of clinically trained support staff, religious undertones, little to no treatment for underlying psychological issues

Inpatient substance abuse treatment

Patients are required to stay in a facility for a pre-determined amount of time varying from 15 to 90 days or more.
Pros: safe, contained environment, trained professional staff, 24/7 support, sometimes the facilities are relaxing and luxurious, intensive treatment, various modalities including individual therapy, group therapy, expressive arts
Cons: expensive (plus you’ll have to take time off work), limited contact with outside support system, intensive treatment, there may be limited availability in your area

Outpatient substance abuse treatment

Patients attend treatment once or several times per week and address underlying issues plus addiction.
Pros: individualized treatment,  local, clinically trained professionals, choice of abstinence or moderation, various modalities to choose from including individual therapy, group therapy, partial hospitalization or intensive outpatient
Cons: some treatment options may be expensive, may not be enough support or treatment for your needs, availability may be limited in your area

A partial hospitalization program involves daily treatment for 6 to 8 hours per day for one to two weeks. This is a good substance abuse treatment option for those who cannot afford inpatient treatment but would like intensive therapy or who live far away from an outpatient treatment program that specializes in the care they need. Intensive outpatient treatment (IOP) involves daily treatment for 1 to 2 hours per day and can last up to several months. This option works well for those who need substance abuse treatment more than once per week or who have time commitments that prohibit them from seeking more intensive treatment. IOP can even be done in the evening after work.

 

Some people will need to go through medical drug detoxification before starting substance abuse treatment and in some cases it may be a prerequisite for admittance into a program. If you are dependent on a substance, (especially alcohol, opiates or benzodiazepines) it is advisable to detox under medical supervision to avoid complications and discomfort from withdrawals.

Never stop using alcohol or benzodiazepines (Xanax, Klonopin, Valium, Ativan) cold turkey! The withdrawal effects can be severe and life threatening. It is necessary that you detox from these substances under medical care if you have been using them daily and at high dosages.

A note about harm reduction and abstinence: Harm reduction is at the core of all substance abuse treatment programs – abstinence based and moderation management. Harm is reduced by abstaining from the problematic behavior or through reducing negative consequences associated with it.

This is your brain on dopamine

Dopamine_PathwaysDopamine is a neurotransmitter responsible for movement, pleasure, motivation, and cognitive processes, such as learning. For the purposes of understanding its role in addiction, let’s concentrate on pleasure and motivation.

Whenever we do something that propagates the advancement of our species, dopamine is released in order to motivate repetition of the action. When we sleep, eat, and have sex dopamine is released in our brain and the message is, “That was great, do it again!” We also release dopamine whenever we find something pleasurable. Be it 18th century poetry, heroin, or Radiohead, our brain will release dopamine to encode the stimulus as something that brings us pleasure.

Dopamine not only serves to categorize the good things we encounter in life, it also programs our pre-frontal cortex (the part of the brain involved in judgement and decision making) to alert us when the pleasurable stimulus is available. If your brain cells could talk, it might sound something like, “OMG! There’s a flyer on that lamppost for a Radiohead concert. Go look at it!” In other words, we become hyperaware of opportunities for engaging in behaviors that bring us pleasure. In fact, a study on people with alcoholism found they were more likely to spot alcoholic beverages in a busy photograph than people who don’t have problems with alcohol.

When we consume substances, it makes us feel good because our brains release dopamine, but drugs elicit a higher amount of dopamine release than is necessary. This is part of what causes experiences of euphoria and feeling high. Sometimes the amount of dopamine released is so great, the chemicals in our brain become unbalanced and we may experience hangover or withdrawal. In time, our brain regains chemical equilibrium. However, if one abuses substances, the brain may develop a tolerance (meaning the person needs to use greater amounts to get high) or dependence on the substance as a source of dopamine. If one becomes dependent on a drug, it may take some time for the brain to regain equilibrium and the person may experience extreme physical discomfort and emotional distress when they aren’t using. The period of re-calibration depends on the amount, type, and frequency of the drug used. It’s always a good idea to be under medical supervision and receive support from friends, family, and a mental health professional if you’re dependent on a drug and want to stop or decrease your use.

The mechanism of tolerance is also evident in impulse control disorders, such as sex addiction, kleptomania, and compulsive gambling. Although it doesn’t appear that persons with an impulse control disorder undergo the same intensity of withdrawal that persons addicted to substances experience, there can certainly be a period of re-calibration of dopamine receptors during which a person feels irritable and agitated after stopping a behavior.

Based on the information presented here, it appears that we are all hard-wired to become addicts and you may be asking yourself, “If this is true, why do some people become addicted and others don’t?” This is a really good question and the answer is “We don’t really know.” We can predict the likelihood of someone becoming an addict based on factors such as first age of substance use and family history of addiction, and we know that a lack of social support and coping strategies (especially when coupled with mental illness) can also lead to addiction, but there is no conclusive answer to date.

The best ways to prevent addiction are to educate yourself about the substances you use (or to abstain from substance use altogether) and to be mindful about the choices you make. If you have a mental illness, ensuring that you are getting appropriate treatment and maintaining social support are good preventative measures.

The Truth About Addiction

addiction

Addiction is not a character flaw and it most definitely is not a choice.

Addiction is a biopsychosocial phenomenon that results in negative consequences and feelings of shame and guilt. Biological, psychological, and social factors culminate into a dependent relationship to a substance or compulsive behavior as a means of coping with distressing emotional, psychological, and environmental states.

More specifically, addiction is characterized by several criteria:

  1. the inability to resist an urge to consume a substance or engage in a behavior that is harmful
  2. an increase in tension or arousal before the act, followed by gratification and relief
  3. a noticeable  increase in amount and frequency of the act in order to achieve the desired effect (e.g. pleasure or escape)
  4. over-investment of resources, such as time and money, to engage in the act
The  emotions associated with addiction are one of the most notable elements. Shame, guilt and powerlessness are hallmarks of addiction and often lead to feelings of self-loathing and isolation. Individuals suffering from addiction are often misunderstood by their families and loved ones, causing them to lie and keep secrets.

This website offers information about addiction, drugs, and compulsive behaviors, including the latest news and research. Resources for people with an addiction and their loved ones can also be found here.

 

Informing yourself can be the first step in gaining power over your addiction.