"Compass of Pleasure": Sex, drugs and volunteer work

What happens in the brain during addiction? How could it be similar to doing yoga? Or learning? An expert explains

Published April 16, 2011 9:01PM (EDT)

In his epic ode to sex, "Don Juan," Lord Byron wrote: "Pleasure's a sin, and sometimes sin's a pleasure." Apparently, not much has changed since the early 19th century. No matter our era or nationality or creed, we humans like pleasure. The pleasure may take different forms. But whether it's chocolate cake or morning jogs, vodka or volunteering, we're all ultimately in search of the next hit.

Recent science has found that different kinds of pleasure are surprisingly similar in terms of brain chemistry and physiology. The buzz derived from a yoga class or a bump of cocaine look almost exactly the same on a neurological level. Perhaps unsurprisingly, our brains are also susceptible to liking pleasure a little bit too much, leading to behaviors we characterize as addiction.

In his new book "The Compass of Pleasure," David J. Linden, brain scientist and professor of neuroscience at Johns Hopkins University, unravels what's going on in our brains when we indulge in food, sex and drugs, or when we meditate or perform a good deed. As Linden describes brain circuitry through anecdotal evidence and lab-based research, he charts the evolution of pleasure from a primal instinct we pass on through our genes to the more complex co-opting of dopamine receptors through substances like drugs and alcohol.

After all, we've never had so much easy access to pleasure as we do now. What exactly is it doing to us? Why do some people become addicted to pleasure and others do not? Salon spoke with Linden to find out what a brain hooked on pleasure looks like.

What made you decide to write a book about pleasure?

Because what we do, we do for pleasure. Pleasure is our compass no matter the direction we seek. Social things, like exercise and generosity and learning for the sake of learning, give us a pleasure buzz that at the anatomical and chemical level is nearly indistinguishable from that we get from our vices.

The subtitle of your book, "how our brains make fatty foods, orgasm, exercise, marijuana, generosity, vodka, learning and gambling feel so good," speaks to this idea -- that our vices and virtues might have more in common than we realize.

The subtitle was designed to provoke, by juxtaposing things like orgasm, marijuana and vodka with things like exercise, generosity and learning. We have a distinct circuitry in our brains called the medial forebrain pleasure circuit that critically depends upon the neurotransmitter dopamine [neurotransmitters are chemicals that submit signals to the brain]. Portions of this circuit are activated in all of these behaviors, both the vices and the virtues. The pleasure that we get from doing good deeds or by learning is underpinned by the same series of electrical and biochemical steps behind the pleasure of fatty food or alcohol.

We tend to be a culture of excess. What do you think of someone like Charlie Sheen who seems to have become the poster boy for all kinds of pleasure? Is this part of a larger trend? Do you think we're addicted to dopamine?

Well, stepping back from Charlie Sheen for a moment, pleasure and reward are absolutely necessary in order for the species to be perpetuated. That's why there's a pleasure system in our brains, to make behaviors like eating and drinking and sex pleasurable. However, we've found artificial ways to short-circuit the pleasure center, like alcohol, nicotine and cocaine. But the circuit didn't evolve for things like alcohol, nicotine and cocaine. When you combine the ability to feel pleasure with our human ability to learn, to make associations between one event and another, then a miracle happens -- utterly arbitrary things can be rewarding to us. Take some extreme examples: If you hold a particular set of political or religious views, you can be just as rewarded by abstaining from sex as you can by having sex. You can be just as rewarded by fasting as by eating. This is what happens when learning and the pleasure circuitry interact.

What happens in the brain during addiction?

We have cultural ideas about addicts, for instance, that they derive more pleasure from a particular behavior than other people would. The truth actually seems to be the opposite. People who are at greatest risk for addiction seem to like these pleasurable stimuli less, but want them more. Liking and wanting are two sides of the pleasure coin.

We see remarkable similarities in addicts' stories. If you take the autobiographies of a sex addict and a heroin addict, for example, and remove all the words that make specific reference to sex or heroin so you're left with the most general descriptions of feelings and emotions and sensations, you find that people start out really liking their stimulus, but as the addiction develops, the liking goes away and is replaced entirely by wanting. In the later stages of addiction what people talk about is not, "I have to shoot heroin every night so that I feel really great because I love it so much." They instead say, "I have to have these things to feel normal, just to feel healthy."

The idea that addiction is a disease and not a personal failing isn't particularly new. What's changed in our understanding about the way addiction works?

What's new is our understanding of the biology behind it. About 40-60 percent of the variation in addiction -- not just drugs, but food, gambling, etc. -- is accounted for by genes. Repeated drug use produces a long-lasting physical and chemical rewiring of the brain that appears to drive tolerance and cravings. Stress causes release of hormones that bind specific receptors in the pleasure circuit and this is likely to cause cravings.

So, what does this mean for someone in recovery?

Many addicts will tell you that relapse is almost always triggered by stress. This means if you're a former addict trying to stay clean, one of the best things you can do is engage in behaviors that reduce your stress level -- things like exercise, meditation, prayer or interacting with pets. We know that when you undergo stress, your adrenal gland secretes stress hormones, which bind to receptors within your pleasure circuitry and produce a set of alterations that make you crave your drug or behavior of choice. In the future, helping addicts stay clean may involve pharmacological intervention to reduce stress hormones.

As of now, though, there's no magic pill to cure addiction. Aside from the development of drugs that interfere with stress hormones, what other implications does pleasure research have for recovery? AA uses community service as part of its treatment program. Is it possible to rewire the pleasure circuitry again in the brain of an addict? Can you replace the buzz one gets from alcohol with an exercise buzz, or a volunteer work buzz? Does this actually work?

We really don't know if pro-social pleasures like exercise or meditation or prayer produce lasting changes in the pleasure circuit that can counteract the changes produced by drugs or gambling or other vices. What we do know is that they reduce stress, which reduces relapse. Also, in some cases it's really not so bad to replace a destructive addiction, like alcoholism, with a constructive one, like running or learning.

On a societal level, here in the United States our moral code and laws are based on puritanical values. Pleasure can make us uneasy. How do we regulate pleasure as a culture?

When you think about it, a lot of our laws are dopamine laws. Our jails and legal system are full of people who have broken certain laws related to pleasure. Societies love to regulate pleasure because it is transgressive; it is anti-authoritarian. We have these ideas, "pleasure is best in moderation," "pleasure must be earned," "if you deny pleasure it can lead to spiritual growth," that are not just Western or American. But we also have these incredible mixed messages. We have a hyper-sexualized media, for instance.

And we have access to so much.

Right. We have access to so much, and it's so inexpensive. If you want to have a snort of crystal meth or a dose of ecstasy, that's not going to cost more than a large cappuccino at Starbucks. We simultaneously are telling people that you have to be very careful about pleasure, that you should not overindulge, and yet our media celebrates overindulgence, whether it is sexual or alcoholic or nicotine or what have you. There are enormous corporate interests involved in the dopamine world.

How should pleasure research inform the way we think about addicts?

In spite of the oft-stated idea that "addiction is a disease" we don't treat it as such. We lock folks up for simple possession and usually fail to offer them medical treatment. The biological basis of pleasure tells us that we must be compassionate towards addicts. Given the right situation, genes, stress, life experiences, anyone -- and I do mean anyone -- can become an addict. We humans are very invested in the idea that we have absolute free will in all things, and it's very threatening to us to imagine that there are these strong subconscious forces compelling our behavior, but there are. This is scary in a deep and profound way.

In your chapter on sex, you write, "The first thing to say about orgasms may be obvious, but it bears repeating: orgasms occur in the brain, not the crotch." I don't think that necessarily is obvious, especially where men are concerned. What is happening in the brain when an orgasm occurs?

Male and female brains during orgasm are extremely similar -- you see a very strong activation of the pleasure circuitry. Not very surprising. In that way, orgasm is not unlike having a hit of heroin. When the band Roxy Music sang, "Love is the drug," they knew what was going on. Orgasm and heroin really do have a lot in common. During orgasm, while you're having a strong activation of the pleasure circuitry, you're also turning down activity in the parts of the brain having to do with cognition, social reasoning, evaluation of outcomes, executive function and rational choice. Also not very surprising when you think what an orgasm feels like. You're pretty much in the moment.

By Adele Melander-Dayton

Adele Melander-Dayton is an editorial fellow at Salon.

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