by Charlotte Wincott
When I was a graduate student at NYU not all that long ago, I was interested in the facets of behavior that led to substance use disorders. I had already lost my mother to alcohol use disorder and a friend to an opioid overdose. So many of the most interesting people I knew were struggling with addiction and as a neuroscience student, I wanted to make more sense of the hold that substances had on their lives. It seemed that there was so much overlap in the traits that made these unique and remarkable people who they were and the traits that drove them into the labyrinths of their addictions.
The professor who guided my thesis studies was open to my delving more deeply into what caused the different behaviors that had become of interest to me. At the time, I was designing my thesis project and trying to figure out not only how to answer questions, but also how to ask them. To this end, I set out to visit a world famous behavior lab at Cambridge University in the UK that summer in the hopes that learning about accomplished scientists’ methodologies and experiments would flip the switch to a few of my own light bulbs. When I got there, I was inspired by the beautiful gothic architecture of the campus and the lovely River Cam where students rowed by in the stifling heat of the summer. I remember walking past a sign on one of the buildings that advised visitors that it was in that very spot at the Downing Site that Hodgkin and Huxley had developed their famous theory of action potentials in nerve cells.
The scientists in the Department of Physiology, Development, and Neuroscience at Cambridge kindly allowed me into their laboratories and excitedly showed me all of their ingenious contraptions. I was almost shocked at how generous and unpretentious they were. They genuinely enjoyed sharing their knowledge with an awkward American graduate student, and no question I asked was met with the same 📷kind of Ivy League snobbery I had been exposed to in some of the ivory towers of the United States.
They excitedly showed me all of the nifty machines that they had built to understand behaviors associated with all kinds of disorders, including addiction. iPad-like touchscreens were set up in boxes where mice and rats would poke with their noses on various parts of the screen to touch shapes and a type of reward would be released. I felt like I had walked into the future. They were able to see if the rodents were impulsive and pressed too quickly, or if they kept poking certain spots over and over. They would try different manipulations to see what made the behaviors better or worse. It was during that time around my visit to Cambridge University that I really started to think more deeply about all the complex traits that appeared to contribute to addiction.
To state the obvious, behavior is complicated. When we think about the people we know (or ourselves for that matter) who struggle with substance use disorders, we probably think of them as a gestalt of many different traits: some wonderful and some perhaps terrible. Maybe they take more risks than others, or seek out new sensations and thrills. Maybe they keep doing things over and over that could lead to disastrous consequences (or fantastic achievement, in best case scenarios). Some of the traits that may be harmful in one context can be beneficial in others, which is why those traits have likely persisted throughout evolution.
I became very interested in the neuroscience of impulsivity during graduate school since it seemed to play a role in both the initial experimentation with drugs as well as relapse to substance use disorders. Perhaps it was this very trait of impulsivity that allowed our ancestors to gain access to food sources and more frequent mating opportunities so that they could pass along their genes. This same trait, however, could also be responsible for more destructive behaviors and has been shown to be involved in the psychopathology of addictions as well as other disorders.1 I was also interested in risk-taking and sensation-seeking, two others traits that appeared to have both favorable and detrimental implications in real world settings. Studies have shown that preferences for new sensations and novel stimuli may lead to and perpetuate risk-taking behaviors.2,3 A 2001 study of undergraduates conducted by researchers at the University of South Carolina found that sensation-seeking was a significant predictor of substance abuse;4 however, related traits may also be involved in the generation of new ideas that play a role in innovation.5 Dr. Tanja Sophie Schweizer of Heidelberg University describes the Novelty Generation Model whereby the first layer of the process is navigated by novelty-seeking that then leads to creativity, and creativity paves the way to innovative performance.
For society to progress, it is important to foster and nourish the traits that facilitate progress, but sometimes those traits can be a mixed bag. Dr. Judy Grisel, a professor who long ago became sober and went on to become a renowned neuroscientist, recently published a book detailing her own experiences living in and studying the world of addiction. A paragraph in Never Enough describes the phenomena of having this mixed bag of characteristics that, in the right context, can move society forward: “[I] think that some of the traits that facilitated my addiction have helped to make me a good scientist. Bottomless curiosity, a willingness to take risks, and perseverance that make a bulldog seem laid back have all contributed to the successes I’ve had as a neuroscientist.”6 The book goes on to describe what it is like to be shackled by substance use disorders and a seemingly unquenchable need for more and more drugs. She also shows us with her own experience how the traits that were maladaptive during her years of drug use were the same traits that allowed her to reach soaring heights in her career. Her story is a window into a best-case scenario of recovery. We need more of these.
When I learned that my mother had died, my devastation and grief were perpetuated by the sinking realization that she had never had the chance to realize her potential. She was funny, unique, and smart, but unfortunately she died before she had the opportunity to recover from her addictions.
Keeping people like my mother alive is Step 1 of Aim 1. How do we support those who are struggling at different stages of their substance use disorders so that they have the available resources to progress through their personal journey of recovery? Definitions of recovery vary significantly from person to person as well as over the courses of individuals’ lifetimes, but some of the markers include a restoration of relationships, employment, and physical health as well as the discovery of purpose and meaning.7Recovery is not, however, uncommon; Dr. Matt Field and colleagues hypothesize that recovery occurs when individuals collectively value activities that do not involve substances more than they value those that do. 8,9
Supporting those struggling with addiction as they consider taking that first step toward recovery is of utmost importance. As individuals get further and further away from substance use disorder and its accompanying environments, the more likely it becomes that they will prefer activities that are naturally rewarding, like helping others, engaging with their communities, and watching new ideas come to fruition. A nurturing backdrop makes it possible for those with substance use disorders to not only recover, but to use their own unique constellation of traits to move society forward.
1 Mitchell, M. R. & Potenza, M. N. Addictions and Personality Traits: Impulsivity and Related Constructs. Current behavioral neuroscience reports 1, 1-12, doi:10.1007/s40473-013-0001-y (2014).
2 Leeman, R. F., Hoff, R. A., Krishnan-Sarin, S., Patock-Peckham, J. A. & Potenza, M. N. Impulsivity, sensation-seeking, and part-time job status in relation to substance use and gambling in adolescents. J Adolesc Health 54, 460-466, doi:10.1016/j.jadohealth.2013.09.014 (2014).
3 Mitchell, S., Gao, J., Hallett, M. & Voon, V. The Role of Social Novelty in Risk Seeking and Exploratory Behavior: Implications for Addictions. PLoS One 11, e0158947, doi:10.1371/journal.pone.0158947 (2016).
4 Wagner, M. K. Behavioral characteristics related to substance abuse and risk-taking, sensation-seeking, anxiety sensitivity, and self-reinforcement. Addict Behav 26, 115-120, doi:10.1016/s0306-4603(00)00071-x (2001).
5 Schweizer, T. S. The Psychology of Novelty-Seeking, Creativity and Innovation: Neurocognitive Aspects Within a Work-Psychological Perspective. Creativity and Innovation Management 15, 164-172, doi:10.1111/j.1467-8691.2006.00383.x (2006).
6 Grisel, J. Never Enough. New York: Knopf Doubleday Publishing Group (2019).
7 Whitesock, D., Zhao, J., Goettsch, K. & Hanson, J. Validating a Survey for Addiction Wellness: The Recovery Capital Index. South Dakota medicine : the journal of the South Dakota State Medical Association 71, 202-212 (2018).
8 Heyman, G. M. Quitting drugs: quantitative and qualitative features. Annu Rev Clin Psychol 9, 29-59, doi:10.1146/annurev-clinpsy-032511-143041 (2013).
9 Field, M. et al. Recovery from addiction: Behavioral economics and value-based decision making. Psychol Addict Behav 34, 182-193, doi:10.1037/adb0000518 (2020).
Charlotte Wincott, PhD is an Associate Director at Pear Therapeutics. All opinions and views expressed in this article are her own and not necessarily those of Pear Therapeutics.