A Buddhist perspective provides a powerful, reliable roadmap for addiction recovery.
Looking back, I realize that abuse transformed a good little kid into a mentally troubled alcoholic. After living that way for 20 years, I joined AA on the off chance a sober life might be possible. One year into my recovery I met my Buddhist teacher and began to meditate and practice the Buddhist philosophy of mind—the most profound and useful psychology I had ever encountered. Three years later came a wholly unexpected emergence from the misery of addiction. I could breathe freely, and with that came a sense of enduring peace and the certainty I would never drink again. The experience of my own recovery permitted me to evolve in my subsequent professional practice a completely new understanding of the relationship between the brain and mind.
What I have come to understand is that my personal journey connects all the necessary dots about how addiction arises and how it can be cured. In most instances, adult addiction starts with childhood abuse, which damages the brain and creates the functional abnormalities of mood and thinking that drive most addiction and mental illness in adults. When I began my medical practice, Western science believed that by young adulthood the brain had lost its earlier capacity for radical change, so a brain-damaged in childhood was no longer curable in adults. This view left no hope that abused kids could ever be fully delivered from their suffering.
Then, about 15 years ago, new science revealed that the brain maintains the capacity for radical change at any age. The mechanisms for this ongoing change are neurogenesis, the ability to create new neurons, and epigenetics, the mechanism by which genes can be switched on and off in response to current life experience. I have also come to the realization that the best way to take control of the brain’s natural growth processes—the way to consciously reshape our brains and how we see the world—is through Buddhist meditation practices that are 2,500 years old.
My marital and professional partner, Sharon, and I became Buddhists, as well as professionals in the field of addiction and mental health. To study more closely how the Buddhist philosophy of mind could be integrated into treatment of these disorders, we left the United States a few years ago for the Tibetan nation in exile in north India. Over the next year and a half, we translated a Tibetan text on human psychology from a Buddhist perspective, and studied the material in detail with scholars respected for their mastery of the material. From this work, we feel we have uncovered a reliable roadmap for successful recovery from addiction and many other mental health problems.
This is Your Brain on Abuse
Brain imaging studies of maltreated children reveal a chilling picture. They show profound structural abnormalities in many critically important brain regions as well as an overall reduction in brain size of up to 10 percent. Since the functions of the various brain regions affected by maltreatment have become generally understood, it is possible to predict the kinds of moods and behaviors likely to develop once these damaged kids become adults. These studies made it difficult to see how these kids could ever be able to lead happy, healthy, sober lives. But in 1998, with the publication of the Adverse Childhood Experiences (ACE) study, exactly what these kids would face as adults became clear for the first time.
The ACE study was a groundbreaking epidemiologic study that did two important things. First, the study encompassed virtually all forms of adversity including:
- Verbal, physical, and sexual abuse
- Witnessing the mother being maltreated
- Being raised by an addicted, mentally ill, or criminal parent
Secondly, complete medical and psychiatric records were available on a sufficiently large number of study subjects that the ACE study accurately represented the experience of the U.S. adult population.
What ACE revealed is that childhood adversity is an experience that most of us share. Fully two-thirds of the participants reported experiencing at least one type of adversity in childhood; 40 percent experienced two types, and 13 percent endured four or more.
The ACE study also revealed that each additional form of adversity experienced in childhood increases the likelihood of becoming addicted to drugs as an adult by two to four times. Fully two-thirds of adult injection drug use is directly caused by maltreatment in childhood. Furthermore, those who experienced six or more forms of abuse as kids were 4,600 percent more likely to inject drugs as adults compared to those who experienced no adversity. Correlations of this magnitude are unprecedented in the history of epidemiologic studies.
Of course, adult drug addiction is not the only result of childhood abuse. Among those brain regions damaged by childhood abuse, maltreated kids may have a hippocampus that is 15 percent smaller than normal. Because the hippocampus is a brain region involved in regulating emotions, a small hippocampus predicts not only adult depression but suicide. The ACE study revealed that 65 percent of all suicides in the adult US population are directly attributable to childhood abuse.
A Flash of Green
The reality of widespread childhood maltreatment and the resulting addiction, depression, and suicide revealed by the ACE study was made even worse by science’s belief that the adult brain was incapable of healing itself. As a health care professional trying to help good people overwhelmed by this suffering, I was looking for a sign for the way out.
But about that time, there was flash of green: The bright green lights of newborn neurons on a photomicrograph of the hippocampus. Neurogenesis! If there is one place in the brain where new neurons can do the most good for someone suffering from addiction or depression, it would be in the hippocampus, the Grand Central Station of the brain’s capacity for new learning and memory. It turned out that enough new neurons are born each day to easily restore a hippocampus shriveled by childhood maltreatment back to normal.
Of course, the new discovery meant neurons are being born all the time and always have been. We just didn’t realize it. Nor did we understand epigenetics, the molecular machine that has the capacity to turn genes off and on in response to new learning experiences. In other words, what is happening in our daily life gives these new green neurons their marching orders: telling them where to migrate and how to plug into the preexisting neural circuits of the hippocampus.
As scientists, we had been stuck in the wrong story. Ironically, one key to the new story is the revolutionary power of new learning. New learning does not mean the acquisition of just simple data like 1+1=2; instead, it involves critical new insights like, “Hey, maybe I am a good person after all!” Such new truths immediately begin to compete with the lies of past maltreatment, which typically leaves kids with the overriding message “you are bad and unwanted.” With ongoing learning and experience, the “good person” message can overwrite and dominate the “bad kid” message as the brain literally reshapes itself.
The Wave of Becoming
Modern science has permitted a deeper understanding that who we are at any moment can be seen as a wave of becoming, continuously modified by unfolding experience. For most of us, however, the moving wave of who we become from moment to moment unfolds from accidental and unguided experience and results in changes that are random and incomplete. So if we were damaged as children, our ongoing experiences will tend to manifest as adult addiction and depression. Yet this progression is not inevitable. It happens because we don’t understand the process and we don’t pay close attention. We don’t realize that we can change not just what we think, but how we think, how we experience ourselves, and what sort of person we will become. Ironically, the best tools for doing this sort of conscious brain shaping are meditation practices developed 2,500 years ago by the Buddha—who understood even then that “What we think, we become.”
When we meditate, we consciously use our mind to command specific brain regions to operate and become strong. If this seems difficult, keep in mind that we do this in other ways all the time. For example, when the mind wills the little finger to move, the brain figures out which area of the motor cortex to activate, finds the right nerve paths to the finger in question, and the finger wiggles. While this movement now feels innate, it took lots of practice as infants to learn how to do it.
From brain scans we know that positive mental states result from the cooperative effort of many brain regions working together in a connected neural circuit. The areas responsible for these positive emotions are precisely the ones that are most weakened by childhood maltreatment. As we learn to focus and sustain the operation of these brain regions during meditation, they are strengthened and repaired. It really is not so different from learning as a child to move your little finger. But in this case, we are repairing the damages of childhood.
The Buddha and his followers developed their powerful psychology over lifetimes of intense inner work, yet we now know that the process of change can be quite rapid. Recent research reveals that activity in the brain regions responsible for focused attention is strengthened after only four hours of meditation practice. Only eleven hours of practice is required for new tissue to grow.
The insights of mind training from Buddhist psychology, practiced with the focused attention acquired from simple meditation techniques, empower us to stay in the “now moment” at the very edge of the wave of emergent becoming. As we do this, we are, intentionally, not accidentally, engaging and directing the power of neurogenesis and epigenetics to heal the wounds of the past, and to restore to us our right to be whatever we choose. For me, the first moment of normal brain functioning was the epiphany of sobriety in recovery.
3 fundamentals of virtue
Nonattachment: a mental state that correctly sees an object the way it is without falsifying its nature, and realizes that it cannot act as a source of our happiness.
Nonanger: a mental state that not only wishes to do no harm to an object, but sees the suffering nature of the object and wishes to relieve the object’s suffering.
Nonconfusion: A mental state that requires wisdom to see the true nature of the object free from the falsifying fabrication of deluded mental events.
Ultimate Virtue: To unmistakably see the self and all objects the way they truly exist. This is a mental state that requires wisdom, the highest spiritual attainment, and a view into the ultimate nature of reality that frees us from any possibility of attachment, anger, or confusion.
4 steps to recovery
- Recovering from addiction begins by practicing simple meditation techniques that strengthen the brain regions responsible for mental focus. Once we can focus our attention on any object we choose, we turn this tool inward like a lens to observe our thoughts and feelings as they arise in our mind.
- The second step is a lesson from Buddhist psychology, which provides a relatively short list of functions that are possible for the mind to perform. The list allows us to begin to identify and name the thoughts and feelings that arise in our mind. By sorting our inner world in this way, we bring a sense of order to what is often a mass of confusion.
- The third step is to assign these mental functions a moral value: either harmful or beneficial. This simple division allows us to begin to observe how our mental states cause behaviors that have good and bad consequences in our lives. This in turn makes it possible for us to see for the first time how the activity of our own mind creates the suffering or happiness we experience. We come to see that suffering is not our fate.
- Ultimately, we need to go beyond merely understanding how the functions of our own mind cause the misery or happiness we experience. We need to consciously modulate our mental states so that, eventually, only positive mental functions are permitted to act as the motivating force behind our actions. These practices are the core of Buddhist psychology.
David Hendricks, MD, recently gave a Traverse City, Michigan, TEDx Talk on this subject and is currently working on a book.