Over the years I have read articles and case files of clients that suggest there is an abundance of anxiety and anxiety related disorders with people who experience alcohol and drug addiction. One of the chief components that produce anxiety is stress and according to Volkow and Li (2005) stress increases vulnerability to drug use and relapse in those addicted. They both argue that there is evidence that, “corticotropin-releasing factor (CRF) might play a linking role through its effects on the mesocorticolimbic dopamine system and the hypothalamic-pituitary–adrenal axis15-16” (Volkow, Li, 2005, p 1429). In simpler terms, stress produces CRF which affects the limbic system and the adrenals which in turn increases the stress response cycle.

In thinking about stress I stumbled across another article in the same issue of Nature and Neuroscience that talked about stress like responses, abet in a somewhat indirect manner. The article, by Antoine Bechara (2005) talks about the amygdala being out of balance. Bechara argues that addicted people become unable to make drug-use choices on the basis of long-term outcome because of hyperactivity within the amygdala (Bechara, 2005, p.1458). The amygdala which signals pain or pleasure of immediate prospects, overpowers the reflective prefrontal cortex system for signaling pain or pleasure of future prospects thus altering the decision making process. Bachara goes on to say that substance use can trigger involuntary signals originating from the amygdala that modulate, bias or even hijack the goal-driven cognitive resources that are needed for the normal operation of the reflective system and for exercising the willpower to resist drugs (Bechara, 2005, p.1458).

Knowing the basics that there is a relationship between the amygdala, drug use and stress I am willing to hypothesize that there is a circular connection here. Stress (and drug use) changes the composition of the chemicals that move through the body, this changed composition changes us more by altering the functions in the amygdala, which leads to changes in the decision making process. This combination of factors (stress-chemical composition-amygdala- and temperament) could be an over whelming force.

In fact, as long as I am going out on a limb and possibly completely limbless, I hypothesize that this stress amygdala cycle maybe related to the high/low reactive response Kagan noticed behaviorally in infants some thirty plus years ago at Harvard.

From Kagan’s perspective, temperament is an emotional/behavioral bias, independent of cognitive abilities, that affects receptivity to certain moods and emotions (Mitchell, 2006). Temperament has an effect on the neural chemistry of the brain and thus the sensitivity of certain receptors. Kagan theorized this is based on inherited factors that control the amygdala and thus the production of chemicals in the brain (Mitchell, 2006). This sensitivity, Kagan believes, is the basis of the behavioral/temperamental aspect of an individual.

In Kagan’s theory the chemical production of the amygdala alters receptor connections forming what he describes as high and low reactive (Mitchell, 2006). A high reactive is a high level of arousal to stimuli (crying), versus a low reactive which has a more relaxed reaction to stimuli. Highs have a more active amygdala, and tend to need to be in more control (control their responses and avoid the high reactive reactions).

Thus Bechara theory that drugs stimulate the amygdala maybe the same responses/reactions that Kagan saw in high reactive individuals. If one is a high reactive addict and you are surrounded by stimuli your inherent reaction is to want to control your high response because it creates tension within. The addict wants to quiet the tension, and the brain remembers that using fills that immediate need for control by quieting the reactions. But the drug use only temporally gives control as it also creates a hyperactive response in the amygdala which also reinforces that experience/feeling/thought that it’s more important to use now and not worry about later.

This hypothetical situation might manifest itself somatically by the addict contracting in response to memories of the original or current stressor stimuli for example. This contraction may have become neurologically and psychologically habituated as, “the body movements we develop when we are young are the modus operandi of dissociating” (Caldwell, 1996, p. 28). This contraction would possibly be followed by the person moving to remedy the situation by desensitization through a known movement pattern of perhaps contraction and release. This contraction/release could be a strain/release pattern, followed by a stop/go hesitation pattern as the person struggles with the need to control/quiet the self and the amygdala sends signals/memories of use that overrule the reflective prefrontal cortex. The person uses and goes into a running/drifting rhythm followed by even flow as the effects of the usage wears off.

Despite some 40 plus years of working with folks using movement and therapy I am still learning about movement and its relationship to addictions and disorders (disharmony) in general. I feel like I am also in the beginning stages of learning about neuroscience and the body with its behaviors. I get a wee bit excited when I think about the journals and articles that I have had only a chance to skim or read once and the connections with addictions as well as Kagan, Bachara, Volkow, Li, and others theories of addiction and personality. I never would have thought I would spend so much time looking at addictions but I see in adults with addictions many issues; adolescence, child hood trauma, dysfunctional families, depression, anxiety, low self esteem, disassociation from the body and from feelings. One population with many pathologies, just like every other population (humans) I suppose.

References

AHD, American Heritage Dictionary of the English Language, Fourth Edition. (2000) Houghton Mifflin Company. Retrieved February 28 2008 from Yahoo Education and Reference Dictionary at http://education.yahoo.com/reference/dictionary/entry/addiction

Ballas,C. MD. (2008). Medical Encyclopedia: Addiction. Retrieved February 27 2008 from National Institutes of Health at http://www.nlm.nih.gov/medlineplus/ency/article/001522.htm

Bechara, A. (2005). Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature Neuroscience. Vol 8, no. 11 Novemenber 2005.

Cadlwell, C. (1996). Getting our bodies back. Boston: Shambahala.

Capello, P,P. (2008). Dance/Movement Therapy with Children Throughout the World. American Journal Dance Therapy. (2008) Vol. 30. pg: 24–36

Fisher, B. MA, DTR. (1990). Dance/Movement Therapy:Its use in a 28 day substance abuse program. The Arts in Psychotherapy. Vol 17, pp.325-331

Fraser, J. S., & Solovey, A. D. (2007). Substance Abuse and Dependency. Second-order change in psychotherapy: The golden thread that unifies effective treatments., 223-244.  

Lewis, P. (2003) Marian Chace Foundation Annual Lecture: Dancing with the Movement of the River. American Journal of Dance Therapy Vol. 25, No. 1, Spring/Summer 2003

Milliken, R. (1990). Dance/movement therapy with the substance abuser. The Arts in Psychotherapy, The creative arts therapies in the treatment of substance abuse, 17(4), 309-317.

Mitchell, N. (2006, August 26). All in the mind: Jerome Kagan, the father of temperament. Australia Broadcast Corporation, Radio National. Retrieved August 26, 2006, from http://abc.net.au/rn/aim/

TIPS, National Library of Medicine. (2008). Groups and substance abuse treatment: From Treatment Improvement Protocol Series. Retrieved February 25 2008 from Health Services Technology/Assessment Texts http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.section.78466

NIDA, National Institutes of Health (NIH), National Institute on Drug Abuse (NIDA). (2008). NIDA Info-Facts: Nationwide Trends. Retrieved February 22 2008 from U.S. Department of Health and Human Services. http://www.nida.nih.gov/Infofacts/nationtrends.html

Volkow,N. Li, Ting-Kai. (2005). The neuroscience of addiction. Nature Neuroscience. Vol 8, no. 11 Novemenber 2005 .

Rose,S. (1995). Movement as metaphor in treating chemical addiction. In F.J. Levy (Ed.), Dance and other expressive art therapies. New York: Routledge.