Twelve-step groups such as Alcoholics Anonymous have been known to be effective with many alcohol and substance disorders. In this section, we will discuss factors that may help or hinder this therapeutic process. The processes of peer support interventions, 12-step groups, and mentors or sponsors require interactions that support learning. Specifically, what conditions enable or limit the brain’s functions in learning? What does research suggest with regard to this type of learning?
Some researchers have suggested that primitive biochemistry, neuroanatomy, and reflexes in human brain evolution work to enable the learning process in support groups such as Alcoholics Anonymous (A.A.)
Research suggests that learning and brain growth are best in the context of human relationships. This would include the relationships that are formed and maintained in 12-step groups such as A.A. *Secure relationships promote brain growth and learning.
Research suggests that learning is maximized in conditions of support (Peer Support, Sponsor in A.A. or a 12-step group) encouragement, and attachment to others enable learning and brain growth (plasticity). In contrast, tension, stress, and states of high arousal limit learning, acceptance, and neuroplasticity in the brain.
Research suggests that stress often occurs with alcoholism inhibits brain growth and learning.
Some research also suggests that when we are too anxious or afraid the brain triggers certain chemicals (norepinephrine and cortisol) that impede the process of learning and brain growth. It is safe to say that an interaction with peer support, beginning in a 12-step group or being admitted into a rehabilitation facility often produces some anxiety in the problem user. Peer Support specialists should be ready to address this anxiety. This can include staffing the case with Employee Assistance (EAP) or Clinical Director.
Research suggests that the appropriate use of humor can result in chemical brain changes, attachment (to caregivers), and reduced anxiety needed in the learning process. Getting a person into treatment involves learning and effective guidance (teaching and support). This is also the brain neuroscience of peer support!
Research also suggests that an optimal learning (and support) environment requires minimizing shame and emotional pain. In addition, the brain is quite resilient in healing shame and emotional pain through the growth of new neuropathways (neuroplasticity). This process can begin with peer support and supportive relationships (this is the essence of the peer support interaction).
Alcohol Disorders Research
There have been some advances in brain science and research on alcohol addiction in the last 15 years. Research and scientific investigation have yielded some new insights in the field of addiction. The following are excerpts from recent alcohol research.
One study suggests that dopamine (reward) systems are compromised in crucial phases of the addiction cycle. The decrease in dopamine function is hypothesized to increase the sensitivity of the drug (alcohol). Researchers theorize that the reward system is represented by the high or euphoria derived from the initial usage (e.g., heavy drinking). The compromise of the dopamine system eventually minimizes the reward.
The next phase leads to the motivation to drink and alleviates withdrawal symptoms Alcohol diagnostic criteria for withdrawal symptoms include; irritability, nausea, vomiting, tremors, anxiety, insomnia, hyperthermia, hyperventilation, tachycardia, convulsions, seizures, hallucinations, and delusions.
Research has suggested that 27 genes have been identified that were altered in alcoholics.
Research has also suggested that both neurobiological and environmental factors influence motivation to drink. Biological variables (including genetic) and environmental (including learning and drinking environment) factors along with social forces have a strong influence. These variables play a key role in expectations about the consequences of alcohol that shape decisions (regarding drinking behavior).
Research has supported solid evidence of the association between chronic alcohol usage and stress-related symptoms. These symptoms include; anxiety, negative emotions, sleep difficulty, changes in diet, and aggressive behaviors. Alterations in attention, concentration, memory, and desire/craving are noted. Neuro-imaging (e.g., functional MRI) has also supported that chronic alcohol usage stimulates the hypothalamic-pituitary-adrenal (HPA axis) that stimulates the stress response.
Studies report that many people initially drink primarily to experience stimulation (high) and accompanying positive effects. These people become dependent on alcohol when they switch to drinking primarily to experience reduced anxiety associated with sedation. A number of research reports suggest a strong association between alcohol misuse and impulsivity. This includes a number of behaviors including risk-taking and novelty-seeking behaviors.
Adapted from; Summer, W. H. & Spanagle edts. Behavioral Neurobiology of Alcohol Addiction 2013
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