John M
Isla Vista, CA
Abstract
We have noticed that different methods that are used to promote recovery from addictions all produce a rebalance of the Autonomic Nervous System. The practicing addict has a dominant Sympathetic Nervous System (ego, anger, fear, fight, flight). The recovered addicted person has a more active Parasympathetic Nervous System (PSNS) (serene: calm lack of fear, connects and cares for others). We conclude that the underlying feature of all methods of recovery from addictions are ways to increase the activity of the PSNS.
Proposal
We propose that different methods that are used to promote recovery from addictions all produce a rebalance of the Autonomic Nervous System. The practicing addict has a dominant Sympathetic Nervous System (ego, anger, fear, fight, flight). The recovered addicted person has a more active Parasympathetic Nervous System (PSNS) (serene: calm lack of fear, connects and cares for others). We conclude that the underlying feature of all methods of recovery from addictions are ways to increase the activity of the PSNS and give examples of four different recovery methods that change the Autonomic Nervous System
Examples of Addiction Recovery Methods that activate the Parasympathetic Nervous System
Alcoholics Anonymous
Mudie (in prep) proposes that recovery in AA (Anonymous 2001) occurs because of members with active Alcohol Use Disorder (AUD), (American Psychiatric Association, 2013) taking the humbling actions suggested by the program of AA. These actions change the balance of the Autonomic Nervous from an active Sympathetic Nervous System (ego state, self-centered, anger, fear, fight) to a more active Parasympathetic Nervous System (serene, calm, less fear, more connection with others). See Mudie (2021) for more details on this approach.
Cognitive Behavioral Therapy (CBT)
Buckman et al (2019) treated 92 women for AUD using CBT and observed it to “reduce sympathetic and/or enhance parasympathetic activity”
Felt Sense Polyvagal Model.
Winhall (2021a, b) has supported recovery from process and chemical addictions of abused women by extending this understanding to the Polyvagal Theory of Porges (2011), Porges and Dana (2018) and Dana (2021). Winhall achieves this by educating her clients about the Polyvagal Theory and supporting them in activating herself and her clients to access the various states of the ANS including the Flock , Play and Stillness states which all involve the Vagal Branch of the PSNS during a counseling session. She primarily uses body focusing and slow deep breathing techniques, supported by various other methods of felt sensing.
Meditation.
Witkiewitz et al (2005 p.223) discuss the effectiveness of meditation on recovery. They conclude that they “. .believe that the synthesis of relapse prevention and mindfulness meditation techniques will provide a more robust and durable treatment’
Niijar et al (2014 p558) studying Mindfulness Based Stress Reduction (MBSR) had found that “Compared to controlled respiration alone, meditation improved autonomic balance with reduced sympathetic and increased parasympathetic influence”
Discussion
It appears that several commonly used addiction recovery techniques ALL result in a change in balance of activity of the ANS from an active SNS to a more active PSNS as the addicted person recovers. When the addicted person is using, they have an active SNS (caused by the addiction) and when an undesirable event occurs, they trigger and feel anger and fear, want to fight or flee. They have learned that if they used/drank/snorted/gambled they could reduce the intensity of these undesirable emotions and so they “use” again with of course very undesirable long-term consequences.
But if they have experienced successful treatment for their addiction, they are far more likely to have an active PSNS. In this state they are less likely to feel fear when an undesired event occurs. They will become more accepting that an unwanted event has occurred (no fighting) and remain calm and peaceful. They therefore have less need to suppress unwanted emotions and are less likely to act out.
The implications of this understanding, that recovery happens when the addicted person’s ANS moves from an active SNS state to more active PSNS are profound. Any approach that shifts ANS activity should support recovery. For example, AA recommends meditation as well as taking the humbling actions involved in taking the steps. Slow deep breathing invokes the phenomenon of Respiratory Sinus Arrythmia, is very effective in shifting ANS activity towards the PSNS (Russo et al, 2017) and therefore is likely to support recovery from addictions.
Acknowledgements.
I thank Dr Lissa Rankin whose book “Mind over Medicine” introduced me to the importance of our Autonomic Nervous Systems and to Bill Wilson and Dr Robert (Bob) Smith for carrying the message of the possibility of recovery from an addiction to alcohol
References
Buckman, J. F., Vaschillo, B., Vaschillo, E. G., Epstein, E. E., Ngguyen-Louie, T. T., Lesnewich, L. L., . . . Bates, M. E. (2019, Dec 18). Improvement in women’s cardiovascular functioning during cognitive-behavioral therapy for alcohol use disorder. Psychol Addict Behav, 33(8), 659-668. doi:10.1037/adb0000524
Dana, D. (2018). The Polyvagal Theory in Therapy 320 pp. New York: Norton,.
Dana, D. (2021). Anchored. Boulder, CO, USA: Sounds True.
Mudie, J. D. (2021, 11 24). AA and the Autonomic Nervous System: a preview. Retrieved from peaceeaseuse.com: http://www.peaceeaseuse.com/aa-and-the-autonomic-nervous-systema-preview/
Nijja, P. S., Puppala, V. K., Dickinson, O., Duval, S., Duprez, D., Kreitzer, M. J., & Benditt, D. G. (2014). Modulation of the autonomic nervous system assessed through heart rate variability by a mindfulness based stress reduction program☆. International Journal of Cardiology, 557-559. doi:10.1016/j.ijcard.2014.08.116
Porges, S. (2011). The Polyvagal Theory. New York: W.W. Norton.
Winhall, J. (2021 a, July 15). Addiction from the Bottom Up: A Felt Sense Polyvagal Model of Addiction. Retrieved from janwinhall.com: https://janwinhall.com/media/addiction-from-the-bottom-up-a-felt-sense-polyvagal-model-of-addiction/
Winhall, J. (2021 b). Treating Trauma and Addiction with the Felt Sense Polyvagal Model. New York, NY, USA: Routledge.
Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness Based Relapse Prevention for Alcohol and Substance Use Disorders. Journal of Cognitive Psychotherapy, 19(3), 211-227.
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