Great Expectations

Joe Griffin goes back to basics to arrive at some powerful new insights into the givens of human nature.

HUMAN GIVENS is a living school of psychology and, as such, it has to continue evolving or it will become moribund. The day we think we have all the answers we become a cult, as some schools of psychology and psychotherapy have already done. So what follows are ideas in progress (because any piece of truth we may glean is always a fragment of a larger one).

All that any new science has in its infancy is the beginnings of an approach. It took hundreds of years for astronomers to focus their minds on the central fact of their work, which was to understand the physical universe. Prior to that, studying the planets and stars was mixed up with superstition — with astrology, occult practices and mythology. Our aim with the human givens approach is to bring that same clarity of focus to psychology and psychotherapy. To do that, we must draw out from the numerous approaches to studying psychology, and the hundreds of different ideological models for doing psychotherapy and counselling, the basic starting point — the one factor that all life forms have in common.

Every living thing, from banana tree to rare orchid, from insect to worm to jellyfish, and from mouse to orangutan to human being, all have in common that they come into the world with a set of expectations about the type of stimuli they will encounter in the environment and how to deal with them. Every living thing has an innate set of responses that matches to expected stimuli, such as food or light or danger. A baby instinctively knows to latch on to the nipple; a plant turns towards the sun; a rabbit freezes in the headlights. Expectations, therefore, are about the needs of living things and about the resources they anticipate using to help them meet those needs. This holds as true for the simplest unicellular creature, swimming about in a swamp, as it does for us.

Although plants have expectations they don't, of course, have brains. They don't need them. This is because they just react to environmental changes in preprogrammed ways, hour by hour, day by day, season by season. Movement is fundamental to the existence of brains, which developed primarily to control movement, remember the result of past movements and therefore predict the outcome of future movements. So, once creatures evolved to move, the range and complexity of their expectations became more elaborate. The part of the brain that controls movement is also the part of the brain that plans and calculates and assesses. So the more complex the creature, the greater its expectations and the greater the variety of ways it develops to meet its needs. For more complex creatures, emotions are linked into expectations (I shall come back to this more fully later). Emotions, derived from the Latin emovere, 'to move outwards, to stir up', are connected to our needs and survival. Any emotional arousal caused by an expectation — to eat, to have sex, to take defensive action — is discharged by satisfying the expectation.

Taking it as the starting point, then, that expectations are about the needs of all living things and the resources they anticipate using to help meet them, we can propose the following: any life form that meets its needs by using the resources with which nature has gifted it is a successful one. When a life form is not thriving — whether plant, animal or human being — the reason is that its needs are not being met. And because not every expectation is met, nature has had to evolve a mechanism to deactivate the unfulfilled emotional charges associated with those expectations — otherwise expectations unfulfilled today would continue to dominate consciousness tomorrow. That would soon jeopardise the integrity of our instinctive responses — any response is weakened if it continually goes unsatisfied. Nature's solution to unfulfilled emotionally arousing expectations, as I proposed and gave evidence for in The Origin of Dreams,[1] is to find a sensory match for them from memory stores (pattern matching) during REM (rapid eye movement) sleep and thus discharge them in metaphorical form in a dream — in effect, fulfilling them.

The new book Ivan Tyrrell and I have co-authored (Dreaming Reality: how dreaming keeps us sane or can drive us mad,[2]) reflects the changes and developments in the human givens approach as it relates to this core idea: the function of the REM state and dreaming and its importance to mental health. For much of our time, we're in a dream state. Not just at night-time, but for most of our lives. Indeed, the human species hasn't really woken up yet. The idea that 'Mankind is asleep', taught by mystics all over the world for thousands of years, is profoundly true, and modern science has confirmed it.

There is a tenet of science that I intuitively subscribe to: when a piece of truth is captured, it should simplify reality rather than complexify it. In the new book, Ivan and I again explain how emotionally arousing expectations that don't get pattern matched in the environment are deactivated in the REM state by finding a metaphorical pattern from memories to match to, which is the dream. But we wanted to find a succinct way to capture the essence of this theory. And the phrase that came to my mind was 'the expectation fulfilment theory' of dreaming. Once the theory was phrased in that way, it was easy to see how it contrasted with Freud's 'wish fulfilment theory' of dreaming. Freud's idea was not big enough to contain all the facts about dreaming. While wishes are indeed expectations, all expectations are not wishes.

Bizarre and complex theories

What made Freudian psychoanalysis so complex, arcane and twisted was that it had to try and explain why people would wish for nightmares. That is at the heart of the baffling complexity, the inane psychobabble, of psychodynamic therapy and all the strange notions about the subconscious mind, about symbols, about sex, and secret wishes to have one's penis cut off (or, if a woman, a penis transplant)! These bizarre complexities arose as Freud and his many followers tried to make sense of why people had painful dreams. They came to believe that our subconscious minds must, because we secretly wish it, get pleasure out of frightening the living daylights out of ourselves.

Another influential figure, Carl Jung, also grasped a bit of the truth — that dreaming is somehow connected to the knowledge of the species — but his idea was also not big enough to make coherent sense of it. Jung thought that, somehow, just by decoding their dreams, people could tap into an archetypal unconscious wisdom within the universe for free, without realising that all new knowledge has to be earned.[3] So Jungian thought also became complex, weird and damaging to people.

But once we can see that it is our expectations that are fulfilled in dreaming, all the complexity falls away. When we grasp this larger piece of truth, it lights up our understanding in all directions. And, indeed, scientific research that further supports this understanding has just very recently been carried out. Before I comment on it, however, I want to refer to the theory of dreaming which till now has had the most scientific acceptance. This is the idea, proposed by J Allan Hobson, professor of psychiatry at Harvard Medical School, that dreaming is fuelled by the REM state, when it is activated by the brainstem periodically throughout the night. Certain neurochemicals, particularly acetylcholines, are released from the brainstem and trigger off electrical waves called PGO waves, known also as the orientation response.

The orientation response, part of our evolutionary heritage, is what makes us react, when awake, to anything sudden, such as a novel noise, sight or movement. During sleep, these PGO waves cause the brain to fire off at random as it goes into repair and maintenance mode. Hobson suggests that this random firing is what causes the visual imagery we see while we are asleep, and that dreams are epiphenomena — of no significance in themselves. On the occasions when we remember them, our minds put together some sort of story to explain them, but essentially dreams are meaningless.[4] That is Hobson's big idea and it is the prevailing theory accepted within sleep research today. But it has recently met a very interesting challenge from the work of Mark Solms, professor of neuro-psychology at the University of Cape Town.

Solms's research is based on studies of people who have suffered strokes. He found that, when the nerve fibres connecting three brain structures (the amygdala, the ventral tegmentum and the anterior cingulate) to the frontal cortex were damaged, dreaming stopped but REM sleep persisted.[5] Hence his basic challenge to the most widely accepted theory at this time is that dreaming and the REM state are separate phenomena. This means that dreams cannot be meaningless epiphenomena resulting from random REM activation and that the firing of the REM state itself does not explain dreaming.

Any dreaming that occurs outside the REM state must further confirm that dreaming and the REM state are separate processes, says Solms. And, as sleep researchers have known for a long time, people report dreams in about 10 per cent of cases when they are woken from slow-wave (non-REM) sleep, compared with 80—90 per cent of cases, when woken during REM sleep.

The other half of the story

However, that is only half of the story. Four fifths of the 10 per cent of dreams recorded outside the REM state come from what is termed Stage 1 sleep, the stage when we drift off to sleep. But Stage 1 sleep has the same cortical organisation as the REM state, and any dreaming that occurs at that stage does not need to be stimulated by a signal from the brainstem because the brain is pattern matching to expectations that exist in working memory, to discharge them in a dream. Dreams are occasionally recorded from other stages of sleep, but these occur quite close to the REM state, when some of the typical REM state phenomena (such as paralysis of major muscles) also occur. Thus there is a partial activation of the REM state on those occasions.

So, while Professor Solms's work does represent a serious challenge to Hobson's theory, it actually supports the expectation fulfilment theory. If one of the effects, when particular bundles of neuronal fibres ascending to the cortex are knocked out by a stroke, is that dreaming stops, that focuses our attention on the fundamental question, "What are those fibres doing?" In his paper, Solms writes that this circuit is the dopamine circuit "which can be described as the seeking or wanting command system".[5] In other words, it is the brain's expectation system, just as the expectation theory of dreaming predicts. In the expectation theory of dreaming, those fibres should be involved in holding our expectations together and channelling them.

How the brain functions

For new scientific discoveries to be right, they have to be compatible with existing knowledge. If they are not, then we cannot claim that a true scientific advance has taken place. So let us see how these new understandings accord with what is already known about brain functioning.

In the somewhat stylised brain in the diagram (page 15), the dark shaded area represents organs that are activated in REM sleep and the lighter shaded areas represent organs deactivated in REM sleep. The hippocampus can be seen as the storehouse of all our conscious memories. Note the pontine tegmentum in the brainstem, which fires off the PGO orientation response, the amygdala and the organ called the anterior cingulate.

Also note the dorsolateral prefrontal cortex, where what we term 'the observing self' operates. This is the region of the brain that American neuropsychiatrist John Ratey memorably termed 'the chief executive officer', [6] and that, on this side of the Atlantic, we might call 'the boss'. When we are fully conscious and awake, this organ is switched on. It is the part of our brain that coordinates all our awareness of the moment. It has a sense of who we are, what we are about and what our priorities are. But when it is switched off and we are operating 'on automatic', the anterior cingulate runs the show. The anterior cingulate was termed by Ratey 'the executive secretary' — we would say 'the boss's secretary'. I am going to use these metaphorical terms to create a picture of how the brain's expectation system works.

When we are awake, information comes in through the senses to the thalamus and is flashed to the amygdala (except smell, which goes directly to the amygdala) for a pattern match. (It is alerted by the orientation response, the mechanism in the brain that draws our attention to novel stimuli. The orientation response itself is an expectation; it says, in effect, "Something important is going to happen. Pay attention!" If the incoming information is deemed to constitute an immediate threat to survival and there is no time to go through the proper bureaucratic channels, the amygdala can act as a manager in its own right and take the emergency step of activating the fight or flight response — though nowadays, of course, we experience life-threatening moments relatively rarely.

More usually, after pattern matching the incoming information, the amygdala tags it with sufficient emotional charge (in the form of dopamine), to reflect how important for survival it deems it to be and sends it up to the boss's secretary. (An emotional tag is what we think of as a feeling: anger, sadness, fear, desire, awe, joy, greed, disgust and so on.) On the way up, the information passes through other neural assemblies, which perform more analysis on it, each one adding more subtle chemical messages to the package. It is now a unique file with its own special chemical signature, which includes dopamine to get attention but also many other neurotransmitters, to indicate more precisely what type of pleasant or unpleasant stimulus this is. This means that when the boss's secretary gets the package — the message from the amygdala — she also gets a briefing paper about where it belongs: the anger file, the sadness file, the disgust box, or whatever.

Emotions and expectation

Emotions, as I mentioned earlier, are about movement — the very reason that brains evolved in the first place. An emotion is a behavioural impulse attached to a piece of information that creates an urge to do something. Emotions are therefore always about expectation and they follow on from pattern matches made by the amygdala. This means that emotions and expectations are really the same phenomena and cannot be separated. They urge us to be happy and celebrate, to feel desire and pursue a goal, to be sad and withdraw, to be angry and attack, to feel disgusted and walk away, and so on. Our emotions are a set of expectations that represent a preliminary classification from the amygdala, telling the boss's secretary, "This is how I expect you to respond to this information".

The boss's secretary, the anterior cingulate, has dopamine (essentially a stimulant that works like cocaine) as her preferred modus operandi. She recognises anything sprinkled with dopamine as priority information. Dopamine doesn't itself define a message as bad or good — you can have a 'bad' or a 'good' trip on cocaine — so what the secretary does with the package from the amygdala depends on what other chemical signatures are attached to it. The dopamine is just there to get her interest. And the amount of dopamine determines how much attention she gives it. The more dopamine, the more attention.

A lot of things we do routinely happen automatically. For example, if we like pulling a cigarette out of a packet and lighting up, the amygdala enables that to happen mindlessly. It doesn't need permission from the boss's secretary. But if the boss's secretary sends a missive down to the amygdala saying, "No more cigarettes," the amygdala might be sufficiently intimidated to respond, "Oh, can we please have one?" So it sends back a message more heavily laced with dopamine, to urge her to let it fulfil the expectation of smoking.

To help her decide what to do, the boss's secretary has a strategy. She says to herself, in effect, "Well, before I interrupt the boss about this, I'd better know a little bit more about what it's all about and what might be going to happen." So she sends a message down to the memory store, the hippocampus, saying, "Send me up details of something we've experienced that is similar to this circumstance, so I can see better what is going on here." In other words, she just doesn't take the amygdala's assessment on trust; she knows it's usually too black and white. So the hippocampus offers up memories to her that the emotionally tagged stimulus from the amygdala brings to the fore, through metaphorical association. If she is impressed enough to think the gathered information warrants the input of her boss, she adds her own sprinkling of 'cocaine' to the file, to get his attention, and sends it in to him saying, "Boss, sign this straight away!" And we all know who really runs the show. Most of the time, it's the boss's secretary.

So the common denominator for this entire neuronal pathway in the brain is expectation. It starts with the orientation response to the amygdala, which then puts on the first emotional tags to get the attention of the anterior cingulate, the boss's secretary, who then has to arrive at her own expectations, on the basis of the additional information she calls up and uses to decide whether or not to send the information on to her boss in the frontal lobe.

The dopamine pathway is the part of the brain that Professor Solms found to be damaged in stroke victims who stopped dreaming. In other words, in these patients, the communication lines for generating expectations had been damaged. So the secretary stops getting her mail from the amygdala and, as a result, she and the boss are left twiddling their thumbs, with nothing much to do. It is, then, expectations that fuel dreams, which is what the expectation fulfilment theory of dreaming predicts.

I would like to stress why it is important for human givens therapists to have a subtle and sophisticated understanding of what we mean when we talk about emotions and say it is important to calm people's emotions down. It doesn't mean that we are 'anti-emotion'. The human givens approach is about increasing the richness of human expectations — which are emotions — and refining them, so that our patients can take a wider perspective on reality and get their needs met more effectively. It is the crudeness of expectations that leads to the expression of crude emotions and behaviours, and that leads to crassness and cruelty in our culture and the inhumane way society is run.

Not so long ago, as a treatment for mental illness, so primitive were we that surgeons used to stick knives into the anterior cingulate and scramble up that part of the brain. This operation was known as a frontal lobotomy. In doing it, surgeons completely destroyed their victim's capacities for humanity, often reducing them to "the level of a household pet", an outcome not seen as undesirable.[7]

Today, there is a different barbarity in the mental health system and society at large: the excessive use of mind-influencing drugs. We should be aware that any artificial drug introduced into this amazing brain circuitry of ours is a totally crude instrument. Just as cocaine, alcohol, nicotine or chocolate target the dopamine expectation pathway to give good feelings, and yet do damage if overused, so do over-prescribed, mood-altering medicines. They are little different from alcohol or cocaine, which are just primitive, easy ways of creating pleasant trance states and avoiding the effort required to make the experience of life worthwhile, as nature intended.

Obviously, some drugs are stronger than others. Cigarettes, like cocaine, are stimulants but so mild (though highly addictive) that they don't disrupt the functioning of the observing self, so smokers don't become less capable of acting responsibly. The emotional tag attached to smoking is weak enough not to disrupt the functioning of consciousness, whereas we all know that too much alcohol can play havoc with consciousness, as does too much cannabis, heroin or cocaine.

Expectation and depression

Professor Mark Solms recently participated in a Radio 4 programme called In Our Time: science and dreaming.[8] Towards the end, another participant, Professor V S Ramachandran, a leading brain researcher at the University of California, San Diego, made a throwaway remark that there is a connection between long amounts of REM sleep and depression. Solms contradicted this, saying that people dream less when they're depressed and, presumably because this is not Ramachandran's field of expertise, he let that go unchallenged. This was a great pity because Solms's statement was misleading.

We have maintained for some years that there is a connection between dreaming and clinical depression. Indeed, this insight is at the core of why good human givens therapists are among the most effective at treating depression. When people get depressed, their sleep patterns become disrupted and they typically wake in the mornings still exhausted and unable to motivate themselves. This is described in Human Givens.[3] Depressed people enter REM sleep much earlier than non-depressed people. They continue in REM sleep for much longer. Normally, in a non-depressed person, 90 minutes pass before the first REM sleep period and it lasts for a maximum of 10 minutes, often less. In a depressed person, the first REM period occurs within about 50 minutes of falling asleep, in some cases 20 minutes, and can last for up to 50 minutes. So, in depressed patients, there is a massive increase in early onset of REM sleep and duration of initial REM periods. But it isn't the longevity of the REM periods that is critical but the intensity of the PGO waves and the amount that they are fired.

In an experiment on a cat, for example, PGO waves were artificially and continually triggered off in the brainstem, and the cat responded as though there were hallucinated creatures around it, just as a psychotic patient might. But eventually the cat's brain had no energy left to fire the response and the cat collapsed as if dead.[9]

This experiment indicates that the PGO waves, or orientation response, tap into an attention energy store, and that, once the energy in it is used up, the animal will collapse exhausted. To recap, then, the critical factor is not the number of dreams recorded but the intensity and amount of firing of the PGO waves (which in humans is demonstrated in rapid eye movements and muscular twitching). So, in depressed people, it is the intensity of the REM state and the upsetting of the balance between REM sleep and slow-wave sleep (slow-wave sleep is the state in which the brain normally repairs tissues, boosts the immune system and re-energises itself) that determine if the brain will become dysfunctional or not.

It follows from the expectation fulfilment theory of dreaming that depressed people should have depressed dream content. Nobody has found other-wise. And, if content is related to mood, that is another indication that dreams are not random epiphenomena.

Expectations can be both positive and negative. We can have happy dreams that make us feel fulfilled, joyous or content, and we can have sad, distressing dreams. If depressed people dreamed happy dreams, Freud might be right, and expectation fulfilment theory would be wrong. But they do not have happy dreams. In their dreams, they act out their depressive expectations of life going wrong. We know that, in an emotionally disturbed person, the expectation circuitry in the brain has been selectively activated and is continually firing off strong negative emotional messages. We know this from studies of the physiology of the brain and now we can explain it psychologically. It is negative catastrophic expectations that disturb people and induce panic attacks, anger, anxiety, depression, etc. When people can't fulfil their natural expectations, or their expectations are unrealistic or harmful, they develop mental illnesses.

Expectations of pain

In depressed people we see that their ability to have positive expectations of getting their needs met has collapsed and they are left only with expectations of pain. They expect terrible things to happen and feel powerless to stop them happening. This lopsided use of imagination explains why humans are so prone to depression. Animals only get depressed when their fundamental physical needs are not met, because they have no imaginations to get them worried.

A young man once came to me with a vomiting phobia, arising from feeling sick whenever he ate in public. When he was at secondary school he thought that, once he got to university, the fear would go away. But it didn't, and he worried about it so much that he became depressed and suicidal.

However, in just one session of counselling, I helped him to see that this was not a big problem at all and that it affected less than one per cent of his life. He could still play soccer. He could still do his exams. He could still have a laugh with his mates. Once he had consciously stepped out of the emotional frame of mind where his expectation was that his entire life was ruined, he could see that the problem was insignificant. He was comfortable and could live with it. When he came back to see me the second time he felt totally different. His depression had lifted and he was enjoying life at university and hardly ever thought about vomiting. Yet all I had done was change his expectation — his emotionally charged view of what he thought was going to happen.

It is always emotionally charged patterns like this that keep people locked in various forms of emotional distress. We depress ourselves by mis-using our imaginations and conjuring up in our minds emotionally arousing expectations of disaster (instead of solving our problems and getting our innate needs met). That's what worrying does to us. And worrying, when it doesn't lead to solving a problem, leads to excessive, intense dreaming and all the symptoms of exhaustion and loss of motivation.

Nonetheless, some people will say that, when they were prescribed Prozac and came out of their depression, they started to dream more. Non-depressed people do most of their dreaming in the last 30 minutes before waking up, and these are the dreams we most often remember. But, in depression, the intense dreaming occurs much earlier in the night (as the reliable sleep laboratory measurement of amounts and intensity of PGO waves fired off in depressed people has confirmed). So dreams aren't remembered, unless waking from a nightmare. As people come out of depression, the balance between REM sleep and non-REM sleep corrects itself and most dreaming again occurs just before waking in the morning. So, although people can recall more dreams when they're coming out of depression, it doesn't necessarily mean that they are dreaming more dreams. That is a misunderstanding.

Expectation and addiction

Now I want to concentrate on the connection between expectation and addiction. Two distinct neurochemical systems mediate motivation and reward: the opiate system, which is the heroin system; and the dopamine system, which is the cocaine system. The dopamine system generates motivation; it creates an appetite — you want to do something when you've got cocaine in you. The opiate system rewards us for satisfying biological urges, such as eating food or having sex. It is always triggered off when satisfying a biological urge.

These two pathways work beautifully together, and I've been testing out the implications of this on myself over recent months. I wanted to do this because anything I have learned about psychology over the last 25 years has come from studying the bits of my life that are not working, rather than the bits that are. So it is because I haven't been able to fully understand my own proneness to addiction that I've been fascinated by addiction all my life. As a young Irishman living and working within the Irish building community in London during the 60s, I belonged to a tribe that had a highly alcoholic culture. In those days, I would have met most of the criteria for alcoholic drinking. The two things that saved me from full-blown alcoholism were that I wanted to do something with my life, and I married an English woman who had little tolerance for so much drinking.

So addiction fascinates me. Here I am, 56 years of age, hopefully approaching the foothills of maturity, yet, although I can drink a half a bottle of wine two or three times a week and enjoy it, every so often I can still get caught up in a heavy drinking session. Moreover, these occasions are entirely predictable: weddings, funerals, a dinner party with some heavy-drinking friends. In that kind of ambience, despite my good intentions not to drink too much, I would sometimes end up with a hangover that would leave me out of sorts for days. Granted, this binge-drinking didn't stop me from doing my work, but it irritated the hell out of me. Why couldn't I understand it or deal with it more effectively?

Then, one day, I came across a description of alcohol-drinking behaviour in research rats, and found a clear connection between theirs and my own. Research findings show that the standard drinking behaviour in reasonably contented laboratory rats is as follows. They often have an alcoholic drink before dinner; they also take a drink when it's freely available to them before they retire to bed at night; and, every few weeks, they get together with their mates at the drinking fountain, and have a binge-drinking party. So, all the time that I had been reading sophisticated psychological explanations in textbooks as to why I end up inebriated after a wedding party, my behaviour was, in fact, no different from a rodent's!

It wasn't until I started thinking about expectations travelling up the dopamine pathway that I could see how the process worked. I soon found, once I got my mind around this insight, that it was actually easy to stop an addictive behaviour. And I believe that may be proved true for anyone whose brain is not too damaged. The only difficult part in overcoming an addiction is creating enough space inside oneself to receive the insight and give it emotional commitment — a strong expectation — because addiction hijacks the expectation circuitry, so it has to be captured back again using a different expectation. That's all it takes.

On the face of it, the fact that our brains encourage us to increase our intake of the very substance that's poisoning us, by giving us withdrawal symptoms if we don't, seems like a major design flaw. But the expectation circuitry has to work in this way, to keep our behaviour flexible. This is the mechanism by which we learn. Whenever we are motivated to master something new, the dopamine circuit is activated, and we experience pleasure. But when that new way of doing something is mastered and the new learning becomes unconscious, automatic (like riding a bike or driving a car), the pleasure dial has to be turned down so that the pleasure reward system can be kept ready to encourage us to make new efforts to challenge ourselves, or meet challenges, and keep our behaviour flexible. Without it, we would be stuck with a limited, fixed range of responses to the environment, which would keep us inappropriately locked into ineffective ways of dealing with life and unable to adapt in the face of changing circumstances.

Carrot and stick

In addiction, however, this mechanism is hijacked. It can be understood in terms of the carrot and the stick. A person who is not succeeding in getting needs met finds an artificial way to activate the dopamine motivation circuit (carrot) in the brain. When the hypothalamus and the amygdala send, in the form of withdrawal symptoms (stick), a signal to the anterior cingulate that more of the addictive substance or behaviour is expected, the person quickly becomes trapped in the delusion that that is what is needed. This is because the anterior cingulate has called up relevant past memories to try and make an evaluation of how important the signal is.

Because the most immediate memories concern past indulgence in the behaviour, the anterior cingulate uses its own supply of dopamine to add to the strength of these memories before they even reach consciousness. So addictive behaviour repeats with little or no conscious interference. Even if the anterior cingulate does involve consciousness, by passing on the signal to the frontal lobes, the signal has been given additional emotional saliency (by the adding of dopamine), thus reducing the choices available for the conscious mind to make.

Examining assumptions

If we want to stop an addiction (or make any other changes in our behaviour), we have to examine our assumptions first and realise that there is always a broader set of parameters that our subconscious circuitry is not allowing us to access. That requires discipline and a deliberate calming down of the emotional responses. In a calmed state, people in withdrawal from cigarettes, for example, can inhibit the additional emotional charges (of the pleasant memories and associations of smoking) put on by the anterior cingulate, and can choose to let all the other relevant data (the carcinogenic, body polluting, accelerated ageing, smelly facts about smoking) come to mind. They can also remind themselves that they can enjoy life much more when they are in control, rather than the poisonous, addictive drug they used to smoke. It is then easy to give up the smoking habit.

Dopamine, the motivational hormone, motivates behaviour to bring about something that is expected. Those who smoke expect to experience satisfaction, but it is temporary — and is more often a brief assuaging of the discomfort caused by expecting to smoke, rather than pleasurable in itself. Those who take illegal drugs feel motivated to take more of the stuff because they are not doing anything more rewarding with their lives at the time. But all the time they are being led by an illusion that something wonderful will happen, a state of frenzied expectation that never actually completes itself. When people have glass of wine after glass of wine at a social occasion, it is because one, two or any number of glasses of wine is never actually satisfying and so they continue until they reach their personal tolerance levels and the toxic side effects of the alcohol make them ill enough to stop. That is the huge illusion built into addiction: something wonderful or satisfying is about to happen! But the expectation is never fulfilled.

The reason we are blinded by this con trick is that, when the anterior cingulate calls up previous memories connected to the addiction, the further dose of 'cocaine' (dopamine) it adds to them means we are not recalling the feelings and experiences accurately but, rather, distorting, 'cocaine-soaked' memories. The psychological name for this is 'euphoric recall'. Heroin users call it 'chasing the dragon' — chasing something that never existed.

Any behaviour that gives pleasure has the potential to get out of control and become harmful. Shopping occasionally can be fun, but consumerism can turn people into mindless shopaholics, spending money they can't afford, buying things they don't need. The task of a psychotherapist or counsellor working with anxious, depressed, angry, greedy or addicted people is to help them calm down and replace their current expectations with more useful new ones that will address their needs more successfully. Cognitive therapists try to do this but focus too much on thinking: they do not get to the part of the brain where the action is — where emotionally charged anticipations narrow down options.

Referring to the diagram of the brain again, when the amygdala is highly active, as when we dream, the dorsolateral prefrontal cortex — the observing self — is switched off. When we are wide awake and conscious, the amygdala switches off and the observing self is switched on. There is an inverse relationship. The amygdala has the power to switch off objective intelligence and trigger the process of emotional arousal, but, unless it is an instant, life or death matter, it doesn't have the emotional intelligence to instigate strong emotional signals by itself. That is done, as we saw, by the boss's secretary, the anterior cingulate. So here is the important point: with its partner in crime, the hypothalamus, which is parked alongside, the amygdala stores the associations about any addictive behaviour.

"We want our fix"

The hypothalamus is the vital little organ that maintains homoeostasis in all the major systems of the body and brain. It monitors appetites and works hand in glove with the amygdala. In a smoker, if the hypothalamus signals to the amygdala that nicotine levels have gone down, the amygdala exerts its influence by sending up a little signal to the boss's secretary, saying, "Get to work, we want nicotine". It does exactly the same, whether it wants a substance, such as food, water, sex, cocaine or alcohol or an action, for instance, getting angry. But at this stage the signal is weak because the amygdala can't make things happen on its own. All it can do is produce a small physiological withdrawal symptom, a teeny-weeny bit of arousal if giving up smoking, or an alcohol-withdrawal signal if trying to turn down a drink someone is offering. At this point the signal is unbelievably mild.

I know this because I decided to look at how these patterns operate in myself. I was shortly to be a guest at my nephew's wedding and, in Ireland, it is often expected that one will drink to excess at such an occasion. I thought to myself, "Now, Joe, before you go on this binge, which will upset you for days, let's take a look at it. If I'm right about the amygdala, the withdrawal symptoms must be very mild, and it's only the boss's secretary, drawing up memories of past Irish weddings and boozing — sprinkling them with big doses of 'cocaine' and urging your observing self to let go and get drunk."

Setting up expectations

So I simply said to myself, 'Well, if I want not to have a drink at this wedding party, I need to have an expectation within myself that not drinking will actually be more enjoyable than drinking." I reminded myself of what drinking does for me in that situation. I get an easy way to forget worries, in expectation that the drink will make something wonderful and significant happen — but that never does actually happen. That expectation is an illusion that is always just one more drink away. And that's the positive part of the drinking! When we drink to excess, we also get a progressive deactivation of our intelligence system: we reverse several millions of years of evolution if we let the amygdala's message through! Indeed, with the addictive impulse totally in control, we are reduced to having no more discriminatory power than a maggot, and wake up with a painful hangover that we bitterly resent.

So this was the negative expectation I set up of what would be likely to come from drinking. Not very desirable. But then I needed positive expectations of how wonderful it could be to be at that party and not take a drink. What a powerful sense of control I would have, to be there at the party and know that I am not going to allow the amygdala to switch on the compulsion to drink alcohol; to know that I can be totally in command of my senses; to know that I can choose what to focus on; to know that I can discriminate between conversations that are worth listening to or not; to know that I can choose to give somebody my attention or not. I thought about children at their birthday parties. Do they need cocaine or alcohol to enjoy themselves? Of course not! The human brain, the most intelligent, refined organ in the universe, so far as we know, doesn't need puny, crude manmade drugs to make it happy. It doesn't need this sledgehammer to overcome a little shyness and enjoy itself.

So, the answer to addiction is the same as for depression: revise expectations, understand how the mind-body system works and realise there is choice and volition. As I revised my expectations in this way, I realised this was something that would have been inconceivable to me half an hour earlier. This party, after all, was one of the big events of my extended family's history and not to join in the ritualised, alcoholic indulgence that accompanied such occasions was unusual, to say the least. But when I said to myself, "Joe, that's it! You are not going to take a drink today," one of the most fascinating things I've ever experienced occurred. My amygdala started acting up. It made my mouth go dry, my lips go thin. I realised it was giving me the symptoms of withdrawal — and the party hadn't even started yet.

"Wow!" I thought. "You clever little devil!"

And because I was looking at the situation from my observing self, I immediately thought, "If that's all you can do, you're pathetic." And then it went away in embarrassment. At that moment, I realised that there is no greater human happiness than to have volition. It is liberating to have the free will to choose how to respond in a situation, rather than to act mechanically from mindless, primitive conditioned patterns in our brain, no different from those of a rat or a maggot. A maggot has only eight dopamine-producing cells and, when four of them are knocked out, researchers have found that it will crawl right past a pile of its favourite, staple food of bacteria as if it didn't exist.

What I am talking about is something very different from willpower. Will power involves desiring something and desiring not to have it, both at the same time. Suppression of desire eventually leads to relapse. But if, every time an urge for a drink or a cigarette or even a positive thought about an addiction arises, we remind ourselves that one won't be enough and it is just a never to be fulfilled expectation that leads us to take the next one and to end up with a headache or be sick, the file that the boss’s secretary calls up will eventually contain that information, instead of expectations of pleasure. Then she will bin it straight away and not even send it to the boss. In other words, a desire no longer reaches consciousness at all.

Separating fact from fantasy

When we increase our ability to choose, we gain spare capacity. That is the essence of what it is to be human. We can, of course, do nothing without emotions. They fuel our every act. But we need to be in control of them, not dragged about in all directions by them. However, this does place a huge responsibility on us because, to liberate ourselves, we have to operate from the observing self. We need our conscious awareness to be in the driving seat, so that we can take a cool look at the fantasies that the boss's secretary generates from the information she receives from the hippocampus, liberally sprinkled with 'cocaine' to try and focus our attention on them.

This is the key insight: to realise that, moment by moment, we are being driven by a drug and, to be free, we must step back into the observing self and say, "No, I am not going to respond to this particular 'cocaine-driven' fantasy". For the human species to wake up from its 'cocaine-drive' fantasies, it must increase its volition.

Of course, this doesn't happen automatically. It takes discipline to draw out from the hippocampus more realistic expectations of how we want to be, and the things we want to do, and bring that process under our volition. But it is within our power to have our emotions serve us rather than dominate us. We can make good things happen when we choose to refine our expectations — our emotional responses — and thereby stop reacting to primitive emotions conditioned into us. And it is a lot easier than our conditioned, illusory expectations want us to realise.

This article first appeared in "Human Givens Journal" Volume 11 - No. 1: 2004

References

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8. This programme, presented by Melvin Bragg, was broadcast on 4 March 2004
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