Understanding the "Blind Spot" in Addiction
Written by Dr. Cory Reich, Ph.D., Posted on , in Section Editors Picks
We have all heard the statement “you don’t know what you don’t know.” While we all accept that we are not “all knowing,” the consequence of “not knowing or seeing” lessons of life can be significant and even devastating.
Similarly, one of the first educational points in driving, is the notorious “blind spot.” The blind spot represents that part of changing lanes, that after you have looked in both your rearview mirror and side mirrors and over your shoulder, you move to make a lane change--thinking it is clear. Feeling confident that all is clear, you begin to merge into another lane only to hear the sound of a horn as you crash into the car in your blind spot. When the ticket is issued, yes, you are at fault!
This point is taken further in the popular insurance add on T.V. where the primary talking point is based upon the statement, “What you don’t know can hurt you.” What a simple but powerful truth! So what is the implication of this “blind spot?” We use words like mindfulness, recognition, and awareness to emphasize the effort to create insight to overcome or manage this blind spot.
But herein lies the greatest challenge, the very fact that you “don’t know what you don’t know” implies that dependence on your self-knowledge is not enough. It is very hard for us, especially our pride and ego, to contend with the fact that “we” by ourselves, cannot overcome our blind spot. In fact, we are blind to their existence in the first place, making us equally “blind” to the effects on others and its impact on our lives.
It is in this “awareness” that we come to “recognize” that we are dependent upon others to assist us with our blind spots, as well as support us in our efforts to manage them--we need help! As a result, one of our greatest strengths is manifest in our openness, acceptance, and humility in looking to others to support us in managing our blind spots. This interdependence we have upon one another deeply impacts the quality of our lives.
One of the greatest manifestations of this blind spot occurs in the disease of addiction. Addiction itself is characterized by “continued use despite negative consequences.” The phrase itself seems to announce the fact that the blind spot becomes bigger than just a spot, but more like a wall. However, the bad behavior so often identifiable in the addict is not the result of a personality defect or that the person is “bad,” but can be explained by specific things that are happening in the brain.
The Neurological "Blind Spot" in Addiction
We all know that the brain is extremely important in sustaining life and performing life’s functions. The brain is characterized by specific areas that are dedicated to a specific functions in how we live--its called localization. What that means is that specific parts of the brain perform specific functions and communicate with other parts of the brain to make sure that everything works together to ensure survival and promotes the ability of living a meaningful and purposeful life.
When we think of who we are, who and what we value and attach to, our morality, being a nice law abiding person, even our spirituality, the part of the brain that regulates these functions is the frontal cortex. When you wake up in the morning and consider what is most important to you, how to live, make daily choices, live with purpose, it is this part of the brain that helps to make all that happen. This part of the brain occurs on the conscious level, we are aware and have insight to these areas of our life.
There is another real important part of the brain, called the mid-brain. This part of the brain performs the function to recognize those things that sustain and support life in the moment. This part of the brain accomplishes this function through what we call the “pleasure system.” The pleasure system is why we do anything twice, or why we will unlikely do somethings again.
This part of the brain communicates to the frontal cortex that whatever we did was helpful for survival and the pursuit of what is important, or, what was a threat and could possibly kill us--something to be avoided in the future. This area of the brain is the first domino in pleasure, learning, memory, and motivation. This area of the brain and its functions occur on a unconscious level, called pre-conscious. Information in this area eventually makes it to the frontal cortex, creating conscious awareness, but the mid-brain gets first crack at things.
So when you eat a food that supports survival or attach a food to a positive emotional event, take a walk in the mountains or on the beach, kiss your sweat heart, get a raise or promotion, work hard to study and pass a test, etc, the mid-brain actually releases a neuro-chemical that creates the feeling of pleasure or satisfaction, communicates to the frontal cortex so that you can remember where, when, and how to repeat pleasurable events or what to watch out for to avoid threatening ones.
Because survival and meaning fulfillment is critical, the mid-brain supports behavior and events that are successful in coping with stress and that create fulfillment to those things that you value on both a pre-conscious and conscious level. The brain marks or tags behaviors and substances with emotions and it triggers the learning and memory of that event to either repeat to ensure coping and survival in the future or to extinguish because it does not have value or even threatens the quality of life.
What happens with alcohol, drug use, even behaviors like sex, gambling, and gaming is that it tricks the brain to think that these things are the best forms of coping with stress and ensuring survival. In fact, not only survival, but the neural message is that you just hit the mother lode, the creme de la creme of pleasure. From a neuro-chemical perspective, drugs and specific behaviors cause the brain to think that all other normal pleasures and coping with challenges are subordinate to the alcohol, drug, or behavior.
Now, when the addict gets stressed and has the need to manage that stress, or even pursue something that is meaningful in life, the brain remembers and believes that nothing works better than the alcohol, drug, or behavior. So instead of coping with the stress through exercise, taking a walk, talking to a friend or advisor, the addicted brain drives the person to the drug of choice. Rather than pursue your education, go skiing, surfing, or concentrate and focus on the project that needs to be completed to pursue the career dream, spend time with the family, the brain drives the person to the drug.
The localization function formerly enjoyed in the healthy brain changes. In a craving state, the frontal cortex is being shut down by the mid-brain. This is when the blind spot becomes the iron curtain. The addict, in a craving state, cannot make assessments of their circumstance and make decisions that come to bear upon those things formerly accessible in the frontal cortex. In other words, the personal “will to exercise choice” based upon morality, attachments, and spirituality are compromised. Is it any wonder that the founders of Alcohol Anonymous refer to alcoholism as a spiritual disease.
The brain and the messaging system has been “tricked” or “hijacked,” creating a lethal blind spot. Insight and clarity is difficult to sustain, especially at times of stress. As a result, the first step in overcoming the blind spot in addiction is to recognize “I am powerless over my addiction and my life has become unmanageable.” As indicated earlier, this humility, the openness and need to be supported by others to help is critical. We all require the support of others, the person suffering with addiction, like any disease, requires support to help with the inability to “see” things clearly and employ the necessary behaviors to manage the disease, especially in the acute use and post acute withdrawal phase.
Blindside Help & Recovery
No doubt by now you've either heard the story or seen the movie, "The Blind Side." It's the story of Michael Oher, current Baltimore Ravens offensive tackle, who was born to a crack-addicted mother, bounced around foster care for several years before finally being adopted by the Tuohy family of Memphis.
The Tuohy's helped to guide and support Michael's life in a completely different direction, one culminating with a Super Bowl victory over the 49ers. At a critical moment in the movie, the turning point for Michael in finding the insight and motivation to be aggressive enough to play football, was achieved by educating Michael about his role of covering the blind side in order to protect the quarterback.
Because of his life experiences, Michael possessed a powerful desire to protect and defend those he loves. His critical moment of change occurred when it was explained that, as the quarterback pulls and turns, the pulling guard (Michael) must protect his vulnerability, the quarterbacks blindside. Without his help, the quarterback could get tackled and even hurt. This insight tapped into something that ran deep in Michael. With this new found insight, now, Michael found the clarity and value of his role, the insight needed to excel.
Like the quarterback, we are all “dependent” and need “help” with our blind side. As indicated, this is especially relevant in addiction, due to the neurological changes and “blindness” of the addicted mind in regulating stress and placing proper value and importance in meaningful pursuits in life.
The First Step
As the insurance commercial indicates that “what we do not know can hurt us,” when we come to recognize we have blind spots, we can make choices to manage our blind spots, with the support of others--“we can better plan for our future.” The first step in learning to overcome the “blind spot” requires the insight or awareness that the current way of living life is not working. Remember, you don’t know what you don’t know! Self knowledge will not provide you with the insight that a problem even exist. Especially, if the brain has been hijacked by the drug or behavior of choice.
Blind spots or those behaviors that are causing life challenges, are not recognized only in those things that are wrong, but even more evident in those things that are not right. As is self evident, the essential attributes in this process are being honest, open, and willing. The following questions and there respective answers assist in the honest, open and willingness assessment about how things are going...or how much support is needed in managing the “blind spot.”
1. Are important relationships going well? Is there trust, hope and closeness in important relationships? Or, have you isolated
yourself, even terminated most of your relationships?
2. Are career or educational paths going well?
3. How is your health, are your eating habits, sleeping patterns, and exercise practices going well?
4. Do you have life goals that you have defined and feel excited about daily decisions that you are employing that are moving you in the desired direction?
5. When life stressors hit, do you identify and face the
challenges, asking for specific help and support from others?
6. Do you focus on addressing challenges or spend more time
avoiding them and managing your emotions?
7. Do you make commitments in your work relationships and keep
8. Do you ask for the feedback of others in both work and social circles about how they feel about their relationship with you? Are they satisfied? Do they feel you are trustworthy? Do they feel
emotionally, physically, and financially safe?
The answers to these life questions provide wonderful guidance to assist with the “blind spot.” Not unlike the new cars, whose side mirrors flash and the seat rumbles when a car enters the blind spot in the lanes to your right or left--what a wonderful feature. If new directions require seeking professional support to recover from a substance or behavior addiction, seek the necessary support. Life can become manageable again, hope restored, and dreams fulfilled.