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MICHAEL SHARP, MD

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Being Who You Are

By Michael Sharp, MD

In my last column, I explored the nature of the uncomfortable feelings that many people with addictions are fleeing from in their search for comfort. In addition, I suggested that willpower is a poor strategy for dealing with the impulses to seek comfort by using our drugs of choice. Using willpower—in the parlance of those of us in recovery—is called white-knuckle sobriety.

Michael Sharp, MD

This is the strategy I used for several years. I was a miserable person to be around. I was clutching so tightly to right-thinking and right-behaving that I was making all sorts of decisions every day out of a world of obsessive-compulsive behaviors and thinking that weren’t natural or free-flowing or in harmony with anything outside of my inner world of tight controls. I remember those years with regret and some embarrassment. I alienated so many of my friends and loved ones because there was very little about me that was approachable, warm, or at ease.

In that last article I also discussed the search for comfort in what might be called the right places. These are the places where self-esteem lives—acts of kindness, service to others, and getting out of our own heads (where some crazy voices can live!). And this was where I made the claim that long-lasting sobriety was difficult to achieve by one’s own self.

Amygdala and Hippocampus

The uncomfortable feelings that virtually all of us try to escape and which lead some of us to addicting behaviors originate in the primitive reptilian brain called the amygdala. This is where fear lives and it is the control center of our autonomic nervous system, which accounts for the body sensations that go along with being scared: rapid heart rate, empty feelings in our guts, hyper-alert sensory organs. It is the origin of the fight-or-flight response, and it is hard-wired into all of us—the very powerful and automatic response that is triggered when we feel we are in danger. This reaction conferred a huge evolutionary advantage to the animals that possessed it. They survived when others did not.

The next step in our evolution was the development of the limbic system including the hippocampus. These parts of our brain allowed us to form memories and affiliate; we became tribal animals, and these behaviors turned out to be more powerful forces of survival than fight-or-flight. Tribes survived when individuals did not. Unfortunately, these internal parts of our brain operate at odds with one another. When the amygdala is active we tend to want to isolate and raise our defenses. An active amygdala tends to shut down the hippocampus. People who experience a prolonged state of fight-flight arousal often have difficulty with memory, because the hippocampus actually shrinks. This explains why many people who have had traumatic childhoods remember few if any details of their growing up.

The Power of Tribes

Instead of isolating and keeping secrets, the answer is to reach out, yet this is not our natural tendency when we are afraid (ashamed, embarrassed, feeling weak or out of control). The one thing that characterizes all people with addictions is their difficulty asking for help. And this may be the most important reason why it is so difficult for people to escape their addictions.

If you are timid and afraid it can be challenging to look for help by reaching out to others. And yet those of us who were able to cross that chasm and find a community of people dealing with the same issues often discover it is the ultimate and most powerful antidote of all. The answer to the isolation that comes from trying to find comfort in our escapes is the warmth and acceptance of each other despite our weaknesses. Most of us have not been able to be honest with ourselves (the power of denial can sometimes be shocking when seen through the rear-view mirror). But when we find honesty there is powerful comfort. We learn that avoiding secrets is a source of discomfort, that admitting them openly takes their power away, and that the thing we thought was a hole—the hole of inadequacy—can actually be an enormous gift, a gift of being OK just being who we are.

Oh, and by the way, as a Functional Medicine doctor I can tell you that allowing yourself to reach out to others as you honestly are is very good for your health. But that’s for another column. Stay tuned.

To your health.