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Addiction

The Pivot Point

Efforts to say No give way when "ego fatigue" sets in.

There is something terribly interesting about the moment of giving in. That moment when the teeter-totter crosses that invisible threshold, when the momentum shifts, when you know you're going to do it, despite the hours of telling yourself you won't. It's a very distinct feeling, says a recent reader. It's a lot different from thinking about getting high. It's not thinking at all, really. It's not imagining what it will be like. Rather, it's a feeling of free fall, a release from the incessant gravity of your own rule book. It's a massive change: from control to freedom, from responsibility to neglect, from wisdom to foolishness, from security to doom -- all at the same time.

We've just come through the holiday season, most of us intact, I hope. And yet many of us may have slipped in one way or another. If you're a recovering alcoholic, you may have buckled and started drinking. Maybe for a night, maybe for a week, or maybe you're still drinking. If you're a chipper (a sometimes addict), maybe you chipped at something a lot bigger and a lot more dangerous than you thought you would. If you live on the clean side of the line of self-indulgence for most of the days of your life, maybe you crossed the line -- for an hour, a night, or a week -- with a bottle, with your neighbour's spouse, with a reckless ride through the dark side of the internet... What I'm interested in is that moment when you actually cross the line. When it's no longer a choice that you continue to make or that you're always about to make, but a choice (if you still want to call it that) you've already made. That's when the free-fall starts...that pitch away from your centre of gravity to a new orbit, a new star, much brighter in that moment than the dull planet you've been calling home.

Sometimes the moment of giving in is barely conscious, and sometimes it comes long before there's a full recognition that you've already changed orbits, irrevocably, and the crash landing is coming next. Just the other night I read of the "fall" of a reader/fellow blogger whom I respect very much. She's a recovering alcoholic who gave in to a couple of drinks, and she wrote about it before, during, and after crossing the line. In one post she describes the moment when (I'd say) her intention shifted trajectories, though that moment was still embedded in the chatter of a familiar self-dialogue:

"Today I was at the market and managed to talk myself into buying wine - for taking to a friend's house for dinner tonight, of course, but the truth is we don't have to take wine. We're bringing other things, so wine is probably a bit too much. But I talked myself into buying it anyway, "just in case". Just in case WHAT, I now ask myself. I tell myself, you know. Who are you trying to kid, you know exactly just in case WHAT. What was I thinking? Ohhhh, I'm so far out on the limb I'm not sure I can get back."

Choice disappears at the tipping point.

Choice disappears at the tipping point.

At a certain point she warned herself, "One sip is too many...the dangers are huge...but the desire is chipping away at my resolve."

Once you've said that to yourself, it's pretty much game over.

In my years of addiction, I told myself many many times that my resolve was weakening. Like that terrible weekend, working as a psych intern in a small Ontario city in the summer of 1979. After two days of pressing constantly, desperately, on the brakes, it began to feel inevitable that I would steal drugs once again. I had lost the belief that I was capable of self-control. And I was so fed up with the whole process that I took absurd chances that night and managed, finally, to get caught in the act and carted off to jail. To say "my resolve is weakening" is code for "I can't stop myself anymore."

But luckily, this blogger -- someone I now consider a friend even though we've never met -- stopped herself, just an hour or two later. Check out her second post. It's a happy ending. Relapse is part of recovery, so they say.

Where am I going with this? I want to spend the next couple of posts thinking about loss of control - a major theme in the psychology and neuroscience of addiction. Psychologists have been studying a phenomenon known as "ego fatigue" for roughly ten years. That's when you've been trying to suppress or inhibit an impulse continuously, for an hour or more, and the result is a breakdown in the self-regulatory function -- which we think is housed in the anterior cingulate cortex (ACC: see my book for details). After excessive use (think of a car that's been going uphill in first gear for an hour), that part of the brain literally runs out of its fuel supply (glutamate and/or GABA), and like an over-used muscle it just caves in. Recovering addicts have the unfortunate mission of maintaining active, effortful -- sometimes tremendously effortful -- self-control. Not just for an hour but for a day, several days, a week, maybe a month or more. Our neural machinery wasn't made to take that kind of strain.

But that first pivotal moment of giving in doesn't just feel like a branch breaking under too much weight. There is also excitement, tingling anticipation, hope, freedom, relief - and something a lot like pride -- for some of us -- a sense of triumph, just for that brief window of time. Now you are no longer ensnared in a tug-of-war between two ideal selves. Now you are wholly and completely you. Or so it seems.

In my next post I'll get into some details, looking at people's experience of the loss of control and the brain processes behind those experiences. Stay tuned.

(This piece is cross-posted on my website, Memoirs of an Addicted Brain.)

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