Dr. Margaret Cary, who wrote the foreword to LOVE ADDICT: SEX, ROMANCE AND OTHER DANGEROUS DRUGS, often sends me articles she thinks I’ll find interesting. Research papers on the genetics of addiction, usually, or lactose intolerance.  This week, she sent a piece from THE WEEK about advances in epigenetics.

        Epigenetics — literally “on top of genetics” — is the recently discovered process by which our DNA blueprint will express, or not express, itself as a genetic command.  Our genes are malleable, not immutable; they adjust and alter throughout our lives, This explains why identical twins become less identical over time.  Science has lately confirmed what many have long suspected: our environment and our behavior can literally change us to the core.  It now appears that everything from childhood hugs to drinking from plastic bottles can turn our genes on and off.

        One simple example: Two siblings inherit a genetic predisposition to lung cancer.  The one who smokes… gets lung cancer.   How many times have we heard about the hardy old sod who smoked until she was 93, healthy as a horse until she got run over by a truck?  (Okay, maybe not that specifically….)  You need both the gene and the catalyst to activate it to get the outcome.

        So, how does that apply to love addiction?  When I was researching my book, I encountered two distinct and seemingly mutually exclusive schools of thought on the causes and conditions for sex and love addiction.  The neuroscientists say it’s all biology.  They point to brain scans and statistical studies that clearly demonstrate addicts are wired differently from non-addicts.  We have more white area in our gray matter.  We produce different quantities of different neurotransmitters.  We have specific, quantifiable genetic variations.

        The psychologists, on the other hand, tell me it’s all caused by childhood trauma.  You were sexually abused as a child?  You grow up to be a sex addict.  You were emotionally abandoned as a baby?  You grow up to be a love addict.  Addiction is the great psychic hole caused by parental abandonment, a hole the addict seeks to fill with food or love or alcohol or cigarette smoke… whatever you got, baby.

        Nature or nurture?  It’s hardly a new argument, but maybe there is a new solution.  The answer is C: All of the above.  For example, according to a 2009 study reported by the University of Utah, “Child abuse leaves an epigenetic mark on the brain. In a comparison of suicide victims who were abused or not, only the abused victims had an epigenetic tag on the GR [glucocorticoid receptor] gene. Interestingly, the GR gene receives a similar epigenetic tag in rat pups who receive low quality care from their mothers.”

        In other words, hit your kid or forget to feed your furry rat baby, and you leave permanent changes on its double helix.  Changes which may lead to self-destructive behavior. Changes which can be inherited by the next generation, by the way.

        So go ahead, blame childhood trauma if you want.  Or blame neurochemistry.  But epigenetics tells us that you need both the gasoline and the match to start the fire.  It’s a concept those crusty old alcoholics who started the 12-step programs came up with back in the 1930s: Addiction is an allergy of the body, an obsession of the mind, and a malady of the spirit.

In my experience, Alanon is a great help if you find yourself obsessing on your significant other’s poor driving habits. It doesn’t do as much if you find yourself obsessing on driving your car through your married lover’s living room window.

It’s quite common to suddenly find ourselves face-to-face with our Affection Deficit Disorder only after stripping away all the mind-altering substances we were using to cover up the existential pain of it all.  Amend that: Mind-altering substances and behaviors; overeating, gambling and smoking work perfectly well on that front, thank you.  

Sex and love addiction are codependency on crack. That’s why the S programs — SAA, SCA and SLAA — are currently the fastest growing of the 12-step programs. Adult Children of Alcoholics (ACA or ACOA) couldn’t hurt, and I’m glad it’s serving you, but I have always found that the deep identification of fellow sufferers that formed the basis of AA back in 1935 is the best route to healing. Hence, SLAA.

Here’s what the old farts who wrote the Big Book (I always think of them as old farts; they were, of course, quite young at the time) figured out, based on their own experience and observation: Addiction is an allergy of the body, an obsession of the mind, and a malady of the spirit. This has since confirmed by modern science. To heal, we need to treat mind, body and soul.

You can work the triangle with therapy, yoga and volunteerism. Or church, charity and medication. For me, the 12-step model of recovery, unity and service addresses all three damaged areas in one neat package. It’s available all over the planet, it’s open every day, and it’s free. 

For someone who is in between health insurers, that looks darn good to me.

There are a couple of things love addicts do that baffle observers.  Okay, there are a hundred things love addicts do that baffle observers, but this conversation is about two of them, a pair that seem to be diametrically opposed.  And yet, I believe, they stem from the same mental quirk.

Tell me if you relate to either of these behaviors: When approaching a new relationship (or, for that matter, applying for a job) we tell ourselves “Oh, it’s not that important.  I don’t really want it.  I don’t mind that much if it doesn’t happen.”  It’s a preemptive strike, an attempt to assuage our disappointment if/when the romance/job/tax refund/new puppy doesn’t materialize.  It doesn’t work, but that’s beside the point.

At the same time, however, love addicts are magnetically drawn to the least available partner in the vicinity.  You’re leaving the country?  I love you.  Married?  We can work with that.  The married Director of the CIA who is usually out of the country?  Perfect!  (I’m talking to you, Paula Broadwell…)

This second quirk, you would think, is a set-up for failure.  And anyone so afraid of failure that they will delude themselves they didn’t want whatever it was in the first place would, you would also think, avoid these set-ups.  And yet, these seemingly contradictory ideas coexist uncomfortably in the same heads.  Like mine.

Here’s what I think is going on in our addict brains.  We are managing our expectations — and addiction is all about expectation — in order to do what alcoholics call “control and enjoy” their drinking.  Bear with me while I try to connect some dots. 

Sex and love addicts — most addicts — live in the black and the white.  Highs and lows, peaks and valleys, ecstasy and despair.  This is all part of a brain reward system gone amok, the physiological component of addiction.  (There’s also a psychological and a metaphysical element.)  We love junkies, intoxicated by romance, thrive on anticipation and rarely feel satisfied.  The gap between high expectations and low results is despair.  The gap between low expectations and high results is ecstasy.

So if you prefer the ecstasy to the despair — and who doesn’t? — wouldn’t you rather have the rare and thrilling high of getting the ungettable than the frequent and thudding despair of losing anything else?  The flood of dopamine accompanying nailing that rock star makes up for a hundred lost jobs, especially when we tell ourselves the job wasn’t that desirable in the first place.  Managing our expectations.  If I expect little, I will be less disappointed if it doesn’t happen and way more appointed (is that a word?) if it does.

The downside of this system is that it’s insane addict thinking.  We are in fact every bit as disappointed when we don’t get the thing we pretended not to want in the first place.  And if we actually land the object of our obsession, that unfaithful/married/gay/felonious/foreign stranger, we rarely get to keep them because, after all, they were never a very suitable match.

Of course, we never really wanted them anyway….

And we’re back.  Still working my way through the pile of reader questions from JEZEBEL.  Hoping to have it completed before October, when I will be the Guest Expert of the Month at www.AddictionLand.com (“Easy to get in, but can you get out?”) and the floodgates will open once again.  

So far, the top contenders for my Dear Abby/Ann Landers’ Evil Other Twin name are: MISSED MANNERS, ANN BLUNDERS, DEAR ABBY-NORMAL and the one up there in the header, DOWNTOWN ABBY.  Feel free to add your own.

Minnesota 2012 asks:  Why do I continue to have sex with someone who doesn’t care about me? I know it’s a waste of time, I know I deserve so much better, blah, blah, blah - This doesn’t change that I still do it. Willingly. What is it about the sex act that makes a woman forego all logical self-respect?

It’s not the sex act; it’s the neurochemicals produced by the anticipation of sex (dopamine) and the cuddling afterwards (oxytocin) — not to mention the barrage of endorphins during the delightful bits in between.  And it’s not all women; it’s you.  Also me, and a bunch of us who are addicted to said feelgood brain chemicals.

So while the logical and rational front brain is saying “This guy doesn’t care about me, it’s a waste of time, I know I deserve better,” the lizard brain tucked way in the back is saying “Oh baby, oh baby. harder faster more.”  It’s a contest the lizard brain will always win… unless you stack the deck.  The process of  recovery is learning how to stack the deck: a supportive group, a counselor, contrary action, bottom lines/abstinence, blah blah blah.

You gain self-respect when you behave in a way that respects yourself.  I have to act myself into right thinking, because I can never think myself into right acting.  Stupid lizard brain always gets in the way.

Woman 23 asks: I would love to hear your thoughts on jealousy, open relationships, etc..

When I was in the throes of love addiction, I was pathologically jealous.  I was the kind of girl who would read his journals and freak out over women he was with before he ever met me.  When I was getting clean from cocaine, I gave up four months of sobriety because I saw the guy I liked dancing with another girl.  (I say “girl,” but I was 35 at the time and assume she was about the same.  This isn’t the junior prom we’re talking about, here.)  I never actually cut up anyone’s clothes or burned his car — I know women who have done both — but I have fantasized about it. 

I’m not like that any more, thank God.  I wouldn’t be with a guy I didn’t trust, for one, and I also know that having a man’s attention 100% of the time is not the stairway to heaven.  That being said, open relationships are not for me.  I don’t poke sleeping dogs with sharp sticks, and love addiction is a very large, very dangerous dog.  I could pretend I had no problem with polyamory, either out of sheer denial or in vain hopes of converting the guy to monogamy, but for me that’s just a heartache looking for a place to happen.

And Precious Little of That asks: How do you convince a stubborn Baby Boomer to get into therapy when they don’t want to see a “head-shrinker?” I’m asking for…um…the child of a friend.

You’re singing my song, sister!  I tried to get my hypercontrolling, manic-depressive, gambling addict mother into therapy, into Gamblers Anonymous, into Alanon, into anything that might help her heal.  For probably 20 years.  Not only didn’t she go, but she resented that I judged and criticized her all the time and kept wanting her to change.

Kind of like I resented her all my life for judging and criticizing me, and forever wanting me to change.  Go figure. 

In the end, we can never change anything but our own actions and our own attitude.  The weird thing is, that changes everyone around us.

In your… um, friend’s case, I recommend being as happy as possible and, if asked, credit your tiny, shrunken head.

Erin Gloria asks:I once read that your romantic sophistication/development as a person ends when a long period of never being single begins — say, if a woman spent ages 20-3o hopping from boyfriend to boyfriend and suddenly finds herself single, when she tries to go out and date, she’ll approach it like a 20-year-old would.

What would your experience say to that? Do you believe that constant relationships impede personal development? Did it impede yours?

For most people, I credit this more to acculturation than personality development.  Dating  habits are formed when you were last dating, so you’ll revert to that until you learn new habits.  Other than creating some awkwardness that will make cute dinnertable chit-chat on your next internet date, I don’t see it as a big issue.

In the world of addicts (AdditionLand!  Easy to get in, but can you get out?), however, it’s a different story.  An addict’s personality development and life coping skills stop when they start using.  For most of us, this is smack dab in mid-adolescence because, after all,  there’s nothing to make you need a drink like puberty.  So we begin our “sober dating” life at 30 or 40 or 50… with all the romantic sophistication of a 15-year-old. 

This is past awkward to the point of potentially lethal, like underage driving.  We should all get learner’s permits. 

Informal interview with Los Angeles journalist Jason Stafford covers some FAQ bullet points re: sex and love addiction and recovery…

The old line “Anything an alcoholic has ever let go of has claw marks all over it” applies double for addicts. Especially love addicts. We not only won’t let go of the actual person, we won’t even let go of the fantasy of what the relationship should be, could be, or might have been.

Love addicts spend an inordinate amount of time rescripting the past, perseverating (I just learned that word. Cool word!) on things like ”If I hadn’t slept with him on the first date, things would have worked out. I should have done X, then he would have done Y, then I would have done X, and he would have fallen in love with me.” Or, “I should have turned down that expensive dessert at dinner. I could have said X, and he would have said Y, and I would have blushed X, and he would have said ‘Where have you been all my life?’” Or “I wish I had appreciated Johnny in high school. We would have gone to X, and I would have told him Y, and he would have said X, and we’d be married today.”

Love addicts also squander a lot of brainpower trying to read minds. “Does he think I’m too needy/too independent?” “Did I scare him away when I said I liked big families/hated children?” “Does he think my ass is too fat?” The most common one, the one women ask me all the time — as if I’m somehow a better mindreader than they are — is simple: “Why doesn’t he call?”

I say “he” because a woman will call you to tell you why she’s not calling    ;-)

“Why doesn’t he call?” I’ve asked it myself. Some guy will go to heroic lengths to get my phone number… and then not use it. Another will barrage me with IM’s and, as soon as I agree to a cup of coffee, disappear from the face of Facebook. Why do they do that?

If it makes you feel better, my studies have revealed two possible reasons why they do that. One is anthropological, the other neurological. I would love to include the experiential and hear from some men on the topic but, A, half the time they don’t know the answer themselves and, B, who knows any men who will call and tell you anything?

Anthropologically, men are conditioned to hunt and conquer. Much of this still lingers in mating behavior. Getting the phone number is itself a victory; they don’t need to follow up on it with an actual call or, riskier still, an actual date. Quit while you’re ahead, Oh Great Warrior. Getting the consent for an encounter is as satisfying as the encounter itself.

There’s hard evidence that the latter is physiologically true, as well. Recent brain studies on gamblers showed that, particularly among compulsive gamblers, almost getting a slot machine jackpot lit up the dopamine receptors every bit as much as actually getting a jackpot. (Dopamine is part of the brain’s reward system; addicts never have enough of it.) So if the gentleman caller you’re concerned with has some addict tendencies — and, knowing you, he probably does — just knowing that he can call you is as satisfying as making the call.

More study needed, and I really would like to hear from some men on the topic. But right now, I’m playing with the concept of wanting a cigarette after fantasizing about sex….

            Here’s an old AA story for you: A man falls in a well (I told you it was old; who gets water from a well any more?). He’s trapped down there in the cold and dark.  He calls out for help.  A priest passes by, hears his cries, leans over into the well and asks, “What’s the matter, son?”  Imagine a dramatic boomy echo on the dialog. “I’m stuck in this damn well!” yells the man.  “That’s no call for bad language,” says the priest, “but I’ll pray for you.”  And off he goes. The guy is getting steamed.

            Next, a social worker passes by.  “What’s the matter, friend?” “What does it look like?  I’m at the bottom of this well.”  “Aha!  I’ve got just what you need,” says the social worker.  She tosses a blanket and a length of rope down the well, and walks off with a smile.  The guy is really pissed off now.

            Along comes a doctor.  “Do you have a problem, sir?”  “Fucking A I have a problem!  I’m stuck in a well.”  “Are you anxious? Worried? Can’t relax?”  ”Whadda you think?”  “This should fix you up,” says the doc, and tosses a prescription for tranquilizers into the hole.

            It’s getting darker.  It’s getting colder.  The man considers hanging himself with the stupid rope, but there’s nothing to attach it to.  Finally, a new face appears at the rim of the well.  It’s a sober member of Alcoholics Anonymous.  “Looks like you’re stuck in a well,”  he calls down to the man.  “Brilliant deduction,” says the trapped man, now thoroughly disillusioned and angry at the world.  Unexpectedly, the AA member jumps down into the well.

            “Are you insane?  Now we’re both at the bottom of a goddam well!” shouts the man.  “Maybe so,” says the sober alcoholic.  “But I’ve been down this well before.  And I know the way out.”

            The point of the story — and I’m sure you’re a step ahead of me on this — is that no one can help you the way someone can who’s been where you’ve been.  Professionalism and expertise are great, but there’s nothing that compares to the deep identification you feel with someone’s who’s struggled your struggle.  It’s so easy not to take advice from someone, even good advice, when you can get up in their grill yelling “You don’t know what it’s like!”… and be correct.  

            This is one reason 12-steps programs have no leaders, no facilitators, no administrators, and millions of success stories.  It’s why Weight Watchers counselors have lost a lot of weight, and why the best treatment centers are started by former addicts and alcoholics, even if they do have lousy credit. 

            Which brings me to Broken Heart RX, from whom I recently received a press release.  According to the publicist, “Broken Heart RX is the first ever break-up, love addiction and emotional trauma support system that includes a proprietary blend nutraceutical supplement, a 30-day email support program and a referral network of experts created to help guide people to recovery. No one wants to feel crippled by a broken heart and now they don’t have to.”

            Indeed, in shades of the Schick-Schadel weekend recovery program for alcoholics, Broken Heart RX will, for the low low price of $34.95, provide you with a 30-day supply of their vitamin supplement, a month of “inspirational emails,” a 10-mninute phone consultation and a referral to a local therapist “if desired.”

            Ten minutes?  Have you ever talked anyone out of their fetal position on the floor in ten minutes?

            To be fair, 35 bucks isn’t going to break anyone’s piggy-bank and the nutritional supplement — full of St. John’s Wort, magnesium and amino acids — won’t hurt you and might even help stabilize your mood.  But the only way a 10-minute phone call is going to anything towards curing love addiction is using the time to recommend my book, Susan Peabody’s Addiction to Love bulletin board, and few years in 12-step meetings.

            I say this as someone who has tried every prayer, every prescription, every rope and blanket.  There’s no shortcut out of the well.

A new study at the University of California at San Francisco uses PET scan technology to prove what pretty much everyone has known forever: Drinking feels better to heavy drinkers than to casual drinkers.  Since the study was done at the I-kid-you-not Ernest Gallo Clinic, no mention was made of alcoholism, just “heavy drinking.”  In a clinic funded by a winery, the a-word is spoken in hushed tones, if at all. 

According to the report here, the researchers used positron emission tomography to observe the immediate effects of alcohol in the brains of 13 heavy drinkers and 12 control subjects who were not heavy drinkers. In all of the subjects, alcohol intake led to a release of opiate-like endorphins. And, in all of the subjects, the more endorphins released in the nucleus accumbens, the greater the feelings of pleasure reported by each drinker.

In addition, the more endorphins released in the orbitofrontal cortex, the greater the feelings of intoxication in the heavy drinkers, but not in the control subjects.

“This indicates that the brains of heavy or problem drinkers are changed in a way that makes them more likely to find alcohol pleasant, and may be a clue to how problem drinking develops in the first place,” said lead researcher Dr. Jennifer Mitchell. “That greater feeling of reward might cause them to drink too much.”

The alcoholic community responds with a resounding “Duh.”  But here’s the greater problem brewing in the labs of the Center for the Study of the Blindingly Obvious: The researchers are excited about these finding because they pinpoint specific endorphin receptors active in the heavy drinkers.  This mean they can now develop drugs to block those receptors, the way suboxone and other opiate blockers are supposed to reduce heroin dependence by making heroin not work so well.  “If it doesn’t feel good, why do it?” is the theory.

The problem with that theory is that it doesn’t go far enough.  The actual addict continues “…I’ll just do something else.”  The basic need, after all, is to feel okay.  If the alcohol doesn’t make me feel good any more, I’ll find something that does.  What fills basic needs?  Food (overeating, self-starvation), money (gambling, shopping, hoarding), love (sex, relationship, romance, fantasy.)

Now, I am pleased as punch — rum punch, if you’re asking, but not today — that the American Society of Addiction Medicine has officially declared that addiction is “a chronic brain disorder.”  It’s less judgmental than “lack of willpower,” “moral failing” or “demonic possession.”  But you can’t cure addiction by attacking the substance; any more than you can heal a wounded soldier by treating the bayonet that stabbed him.

That, too, was once considered good medicine

.

A friend and colleague of mine is what we addict types call a “normie,” or “civilian,”  She doesn’t have an obsessive-compulsive bone in her body — or, if she does, she manages to keep it well hidden.  There’s a lot of that going around.

Anyway, she doesn’t know if she should feel sorry for addicts and alcoholics, or if she should be jealous.  Drugs and alcohol (or gambling, or shopping, or sex, or overeating, or whatever is it that turns your particular crank) obviously do something for the people who get addicted to them, or we wouldn’t get addicted to them.  Something spectacular.   Something they don’t do for my friend.  Can it be that, rather than having dodged a bullet, she’s actually missing something wonderful?

Now, I’m not going to tell her that the intoxication of infatuation — my personal drug of choice — isn’t spectacular.  It has been.  Often.  Too often.  I will tell her that, scientifically speaking, she’s the enviable one.  It isn’t so much that sex and love addicts get a bigger bang (pun semi-intended) out of sex and love than anyone else.  It’s that the rest of life is all a little… little, until something jabs you in the ass with a cattle prod.  Something like a line of cocaine, or a dozen roses from a secret admirer.

What I jokingly call affection deficit disorder, some serious researchers call “reward deficiency syndrome.”  The addict brain is stubbornly resistant to the neurotransmitters that activate what’s known as the reward cascade, a fireworks display of brain cells high-fiving one another in a joyful exchange of dopamine, serotonin, and a handful of other jolly juices.  For us, it takes a mega-dose of sex, drugs and rock’n’roll to get the party started.  My friend can pull it off with some nice French bread dipped in quality olive oil.

So it isn’t that mind-altering substances and behaviors feel so damn good to us.  It’s that we can feel them at all.  As Dr. Reef Karim says in my new book (insert a plug for the Sept. 1 book release here; you know the drill), “What happens if you’re an addict and you’re not getting enough dopamine is, you feel like ‘Eh, life’s a blah.’  Then you snort coke or have a drink or have sex and all of a sudden…..  How many times have I heard ‘Hey, Doc, for the first time in my life I felt normal!’” 

 And then, of course, we spend the next 20 years desperately chasing that feeling — which, by the way, can never be recreated because the more dopamine that surges through our brains, the more resistant we become to the stuff.  Oh, the irony.

You see, dear normie civilian, it isn’t that we get to feel so much better than you when we get high.  It’s that we finally get to feel like you.  We aren’t going from zero to 60, even if it looks like that from the outside.  We’re going from minus 60 to zero.