The Science of Psychotherapy Academy

This lesson describes how adaptive and maladaptive habits become learned behaviors coded into our implicit memory systems. They affect our motivation often involving forming procedural and emotional implicit memory.  Procedural memory is facilitated by the striatum and nucleus accumbens so that they become automatically associated with pleasure and/or the relief of discomfort. 



Habits that become addictions can play a bidirectional causal relationship with anxiety and depression. From an integrative approach to addressing addictions, anxiety, and depression it is important that we do not conceptually separate them “diseases.”  The rigid categories dictated by the DSMs, psychotherapy books, and seminars generally stay clear of addressing chemical dependency, while addictions providers defer to mental health providers for people with “psychiatric” disorders. Integrated psychotherapy goes beyond the one-dimensional conceptual frames of “dual diagnosis” and “co-occurring disorders.”  Addictions, also including those that are not chemical in nature, such as to gambling and computer games, hijack the dopamine circuits, nucleus accumbens, and striatum neural networks. 



By understanding the neuroscience underlying habits, therapists can more effectively help clients boost motivation and overcome maladaptive habits.   For example, most addictions downregulate dopamine receptors, making the range of potential positive experiences narrow to the addictive behavior. And if a person had experienced multiple ACEs, he tends to have a reduced range of potentially positive experiences, which represents a set-up to develop addictive behaviors.  When stressed, they may engage in their go-to source of pleasure, their addiction. Expanding the range of positive behaviors, expands the number of medium spiny neurons in the nucleus accumbens, making this part of the brain better able to put the brakes on an automatic habit generated by the striatum.