RAT 4 Flashcards
Why might ‘People just need a space to be’?
To exist without judgment or harassment. Society often sees them as liabilities and blames them for social ills. Even professionals can be dismissive, and the system has abandoned them.
What are the results of proximal separation?
If a parent responds to a child’s emotional distress, it releases endorphins, helping the child feel soothed.
If the parent is emotionally absent and doesn’t respond, the child may develop poor coping mechanisms (e.g., thumb-sucking, rocking) to comfort themselves.
What is the Portland model, and why is it controversial?
It accepts people as they are, without forcing addiction treatment. Clean needles are provided, offering marginalized individuals safety and care.
How is addiction work like palliative care?
It aims not to cure but to lessen addiction’s harm and the legal/social punishments imposed on users.
What is behind the behaviors of people addicted to drugs?
Painful emotions
Without drugs, what do people who use drugs fear?
Users fear being trapped in emotional distress. They do not understand that the present moment will pass.
Why might people be motivated to work in addiction treatment?
Personal healing, a sense of duty, professional challenge, or even ego-driven motives.
What qualities keep workers in addiction treatment?
Authenticity and social responsibility
What do addicted clients seek from professionals?
Authenticity—professionals who are real, not hiding behind achievements or personas.
Why do people continue using drugs despite consequences?
To numb pain, seek thrills, or gain energy.
What role do negative consequences play in recovery?
They rarely convince people to quit. Addiction is about making the moment livable, not rational choices about consequences.
How is the medical model of addiction lacking?
It reduces addiction to brain chemistry, ignoring emotions and life experiences.
What is the link between addiction and emptiness/loneliness?
Drugs temporarily numb these feelings, but users return to them to avoid emotional pain, reinforcing addiction.
What is the function of emotions?
Emotions guide us, provide insight, and signal threats or growth opportunities.
Why should we encourage vulnerability in our clients?
Vulnerability deepens emotional awareness and healing.
Why might professionals dehumanize clients?
Jaded perspectives and biases can make clients seem like inconveniences rather than people.
What does ‘namaste’ mean in addiction work?
‘The divine in me salutes the divine in you.’ It reminds professionals to approach clients with humility and humanity.
How does the author define ‘divine’?
Not as a supernatural force, but as the essence of existence, love, and connection beyond religion.
How is grace present in drug-using culture?
Despite suffering, there is courage, connection, dignity, and moments of humanity.
What does the author see as the source of ADHD?
A response to deep discomfort with oneself, leading to an urge to escape.
What is addiction?
Addiction is a repeated behavior, whether related to substances or not, where a person feels compelled to continue despite negative effects on themselves and others.
What behaviors consist addiction?
Compulsive engagement and preoccupation with the behavior
Loss of control over the behavior
Ongoing behavior and relapse, even with harm
Cravings, irritability, or dissatisfaction when the behavior or object is unavailable
How is addiction different from obsessive compulsive disorder?
“The difference is that he has no craving for it and, unlike the addict, he gets no kick out of his compulsion.”
What is “one of the bedrock fables” of the War on Drugs?
“The misconception that drug taking by itself will lead to addiction—in other words, that the cause of addiction resides in the power of the drug over the human brain.”
How does the story of Rat Park relate to human lives?
Some environmental conditions are likely to induce addiction, compared to others
If given different environmental conditions, people addicted to drugs may change for the better
What three factors need to coincide for drug addiction to occur?
1) A susceptible organism
2) A drug with addictive potential
3) Stress
What three biological networks are involved in addiction and how are they involved?
1) Opioid apparatus, 2) Dopamine System, 3) self-regulation system
What is the Opioid Apparatus and what’s its purpose?
Acts as the “molecular gate” to opioid addiction
Purpose: Soothes physical/emotional pain, regulates ANS (e.g., heart rate, sleep, body temp)
Crucial for emotional bonding (mother-infant)
Influences immune system and helps with bonding in animals
What are endorphins and where are they produced?
brain’s “natural narcotics” and act as painkillers, similar to morphine,
Produced in the opioid apparatus
How do positive expectations affect the opioid apparatus?
Positive expectations can activate the endorphin system (e.g., pain relief)
Dopamine System
Key brain areas: Ventral Tegmental Area (VTA) and Nucleus Accumbens (NA)
VTA triggers dopamine release in NA (important for addiction)
Incentive Motivation: System responds to rewards and increases dopamine
Key functions: Reward-seeking, learning new behaviors
Self-Regulation System
Key brain areas: Cortex, prefrontal cortex, orbitofrontal cortex
Involved in decision-making and self-control
Why is the placebo effect not imaginary?
Even when a person takes an inactive substance (placebo), it can activate opioid receptors in the brain and endorphins are released, reducing pain.
What is the significance of “proximal separation?”
A child can feel emotional pain when a parent is physically present but emotionally unavailable (called “proximal separation”).
Adults also experience this when someone important is physically there but not emotionally present.
Why are cues or triggers so powerful from a biological perspective?
Cues linked to drug use (e.g., paraphernalia, people, places) trigger dopamine release, increasing the chance of repeated use or relapse.
The dopamine release in the nucleus accumbens creates a powerful incentive to use. Dopamine drives novelty-seeking, which can lead some people to engage in risky behaviors (e.g., street racing) for the excitement of dopamine release.
Where does the incentive to use come from and how can it motivate people to engage in risky behaviors?
External cues releases dopamine in the nucleus accumbens
Dopamine drives novelty-seeking, which can lead some people to engage in risky behaviors (e.g., street racing) for the excitement of dopamine release.
What does the emotional brain regulate for survival?
1) Attachment and 2) Aversion.
What causes an impaired emotional brain and what can it lead to?
Stress in society, it can lead to addiction
What is the cortex?
The cortex is the brain’s outer layer, like the bark of a tree, containing neuron cell bodies and specialized centers for essential functions.
What is the prefrontal cortex?
Involved in weighing alternatives, considering choices, and evaluating emotionally driven impulses.
What does damage in the prefrontal cortex lead to?
leads to impulsivity, aggression, and inappropriate behaviors.
Where are social behaviors learned?
Orbitofrontal Cortex
What is the obitofrontal cortex?
Receives sensory input and evaluates stimuli based on current and past information.
Decides the “emotional value” of situations and people.
Plays a key role in social and emotional behaviors, assessing relationships (“Who loves me?”).
Important for decision-making, inhibiting impulses, and balancing short-term and long-term consequences.
What issalience attribution?
“The assignment of great value to a false need and the depreciation of true ones. It occurs unconsciously and automatically.”
How does choice fit in with addiction?
Choice and responsibility are not absolute.
People make decisions within a context shaped by their brain’s functioning that was developed based on external conditions.
What is the addiction process on a neurobiological level?
On a neurobiological level, addictions activate the brain’s attachment-reward and incentive-motivation systems, which can bypass the brain’s impulse control and “thinking” areas (cortex).
What behaviors or characteristics do all addictions share?
Craving, shame, deception, manipulation, relapse
What is the unitary theory of addiction?
The unitary theory of addiction proposes that all forms of addiction, whether substance-related or behavioral, share common underlying mechanisms. These include the brain’s reward system, emotional dysregulation, and a person’s need to escape or numb emotional pain.
What is the relationship between addiction and emptiness?
Addiction is often linked to a sense of emptiness or an existential void in a person’s life. This feeling of emptiness can drive individuals to seek external sources, like substances or behaviors, to fill the void temporarily, leading to addictive patterns as a way to cope with deep internal distress.
What characterizes the addiction-prone personality?
Impulsivity, emotional dysregulation, a tendency to avoid negative emotions, a high need for stimulation, low self-esteem, and difficulty forming secure attachments. Seeking eternal validation
Definedifferentiationin the context of addiction?
“The ability to be in emotional contact with others yet still autonomous in one’s emotional functioning.”
What does psychological maturation have to do with addiction?
A well-differentiated person can interact with others while maintaining a strong sense of self, responding to emotions openly without suppressing or acting impulsively.
Why is psychological maturation important for proper development?
A child must become unique and independent, understanding their own thoughts and emotions without being overwhelmed by others.
What is psychological maturation?
the development of a sense of self, separate from inner experiences, which young children lack.
How do emotional processes rule an addict’s perspective?
Shut down defensively, cannot accept love, and cannot cope with emotional discomfort leading to irritability
Why do people turn to addictions to regulate moods and internal experiences?
They cannot accept love openly
What is an addict’s natural response to emotional loss?
Shut down defensively
What are behavioral addictions?
In individuals with addictive behaviors, the orbitofrontal cortex and related systems are influenced from childhood to prioritize false wants over real needs.
What does addiction have to do with love?
Addiction often stems from a lack of emotional nourishment or attachment. When a person feels unloved or emotionally deprived, they may turn to substances or behaviors to fill that void, seeking comfort or a sense of connection that they feel is missing in their lives.
How are emotional nourishment and eating connected?
When individuals lack emotional fulfillment, they may turn to food as a way to cope or soothe emotional pain, leading to emotional eating. This can become a form of self-medication or a way to fill the emotional void.
What is emotional nourishment?
Support, care, and validation we receive from relationships and ourselves.
How can an obese person be starving?
An obese person can be starving emotionally
Eating only calms the pain for a moment but the addiction of eating always comes back
Why is sex addiction not perversity?
Sex addiction is not pervisity (desire to behave unreasonable) because it can derive from associating sexual feelings with feeling loved, seen, etc.
Who is to blame for a person’s addiction?
The circumstances in which the parents were raised and the conditions during the addict’s childhood.
What isattunementand why might it matter for addiction?
An innate sense of being loved by a caregiver is crucial for a child’s development.
Even if love is shown verbally or physically, children can sense when a caregiver isn’t properly attuned to them, which may lead them to seek love in unhealthy ways, such as addiction.
Lack of attunement in infancy increases the risk of addiction later in life.
What is self-regulation in the context of addiction?
Self-regulation is not about “good behavior” but about the ability to maintain a stable internal emotional state.
Does addiction originate in abuse/neglect?
While trauma can have various origins, poor parent-child attunement is one possible cause that can lead to addiction later in life.
What is self-esteem?
“It’s the quality of self-respect manifested in his emotional life and behaviours.”
What might cause us to be critical of our clients?
When there’s an imbalance between your personal and spiritual life
What iscompassionate curiosityand why is it important to recovery?
Cultivating loving-kindness starts with being honest, loving, and compassionate toward ourselves.
Compassion curiosity helps us be kind towards ourselves instead of fostering self-denigration
COAL stands for:
Curious
Openness
Acceptance
Love
What isjustification?
Justification is a form of judgment as harmful as condemnation.
Justification excuses the self from responsibility, while understanding helps us take responsibility.
What is the difference between chronic anxiety and healthy anxiety?
Chronic Anxiety
Not rooted in the present; it comes before the moment and often manifests as cynicism.
Healthy Anxiety
A fear response focused on real dangers in the present.
How does an ecological perspective view the addiction process?
Addiction is seen as a changeable, evolving dynamic shaped by a person’s ongoing interaction with their social, emotional, and internal psychological environment.
How does an ecological perspective view recovery?
Recovery from addiction is not about curing a disease, but about creating new internal and external resources that support healthier ways of meeting genuine needs.
It also involves developing new brain circuits that promote more adaptive responses and behaviors.
What ismental force?
Conscious mental effort
It can physically rewire malfunctioning brain circuits and alter dysfunctional emotional and cerebral responses.
Changing external circumstances can also improve brain physiology.
Why is important mindful awarenessin the context of addiction?
In addiction, mindful awareness is crucial because it helps unlock automatic patterns that trap the addicted brain and mind.
What isimplicit memoryand how might it indicate its presence?
When people are influenced by past experiences without realizing it, they are unaware that something is shaping their behavior.
Why is implicit memory powerful?
The subtle, undetectable nature of implicit memory makes it powerful, as it can strongly affect our mental lives without our awareness.
What isbare attentionand why is it important to addiction and recovery?
Definition: Bare attention is the conscious focus on what occurs in the mind as it processes physical or emotional stimuli from both within and outside the body. It involves attending to the facts of a perception without reacting to them.
Importance: Bare attention helps individuals recognize that moods and feelings only have the meaning and power they assign to them. Over time, they realize there’s nothing to escape from internally, even though situations might need to be changed. This reduces the need to dull or stimulate the mind to avoid discomfort.
How does the past affect our present moment and how can we ‘change the past’?
Our present misery is not caused by past events themselves, but by how we allow those events to define how we see and experience ourselves now.
We can overcome trauma (e.g., abuse or neglect) by changing the narrative of the past and reshaping how it influences our view of the present.
What are the five steps the author proposes to address behavioral addictions?
Re-label: label the addictive thought or urge exactly for what it is, not mistaking it for reality
Re-attribute: you learn to place the blame squarely on your brain
Re-focus: “buying yourself time” to let the urge pass because it will not last forever; find something else to do
Re-value: in this step, “you will remind yourself why you’ve gone to all this trouble. The more clearly you see how things are, the more liberated you will be.”
Re-create: “It is time to re-create: to choose a different life.”
What iscounterwilland what’s its role in addiction?
Counterwill is an ingrained opposition to any sense of being forced, present in all humans.
It is triggered when a person feels controlled or pressured by others, and can even arise when we pressure ourselves.
Why can talk therapy be useful for people who use drugs?
“Talking it out prevents acting it out” means that verbalizing thoughts and feelings helps prevent impulsive actions.
Talking supports mental awareness and encourages responsible behavior.
In what ways is stress “salient in the ecology of addiction?
Stressors are external triggers that activate a physiological stress reaction, involving hormonal and nervous system changes throughout the body.
Stress increases the need for external dopamine sources, raising the risk of addiction.
Stress is a major trigger for substance abuse, addictive behaviors, and relapse.
Stress hormones themselves can become addictive.
What are the most potent stressors that may make an individual more at risk for addictive behaviors?
Loss of control, uncertainty in key life areas, or emotional isolation
Where must motivation for recovery come from?
“Motivation must come from within, not from techniques. It comes from their deciding they are ready to take responsibility for managing themselves.”
What is the family’s role in addiction and recovery?
Dysfunctional family dynamics can contribute to addiction, while supportive families help provide emotional stability and encouragement during recovery.
Why might working with “hard-core addicts” be challenging?
“Hard-core addicts” may have deeply ingrained addiction patterns, resistance to change, trauma, and co-occurring mental health issues, making it difficult to engage them in treatment and recovery.
Why do you need to deal with your own stuff?
Therapists need to address their own unresolved issues to avoid hindering the therapeutic process, prevent countertransference, and maintain clear boundaries, empathy, and effectiveness in helping clients.
What is ourdivine natureand why does it matter in addiction work?
Our divine nature refers to our inherent worth and potential. Recognizing this in addiction work fosters self-esteem and empowerment, helping individuals feel worthy of recovery and healing.
Where ismeaningfound?
Meaning is found in relationships, personal values, and a sense of purpose.
Why does meaning matter in addiction work?
In addiction recovery, meaning motivates change, offers direction, and prevents relapse by giving individuals a sense of hope and belonging.
What is the “existential vacuum?”
The existential vacuum is a sense of emptiness or purposelessness. In addiction, it can lead to seeking escape through substances. Finding meaning helps fill this void and supports recovery.
Why might people be resistant to the higher power concept?
Resistance to the higher power concept can stem from personal beliefs, negative past experiences, or a desire for control. Some may fear vulnerability or struggle with religious or spiritual ideas.
What is the “ego’s tragic flaw?”
The ego’s tragic flaw is its self-centeredness, pride, and need for control. In addiction, the ego can deny problems, blame others, and avoid responsibility, hindering growth and healing.
What is meant by “spiritual awakening?”
A spiritual awakening is a shift in consciousness where individuals experience a deeper understanding of themselves and a connection to a higher power. It marks a new way of living based on values, compassion, and spiritual growth in recovery.
