Frontal Lobe Damage
As a feedback of sorts, the frontal lobes also atrophy, or shrink. Think of it as a “wearing out of the brake pads.” This physical and functional decline in the judgment center of the brain causes the person to become impaired in his ability to process the consequences of acting out in addiction. Addiction scientists have called this condition hypofrontality, and have noted a similarity in the behavior of addicted persons to the behavior of patients with frontal brain damage.
Neurosurgeons frequently treat people with frontal lobe damage. In a car crash, for instance, the driver’s brain will often decelerate into the back of his forehead inside his skull, bruising the frontal lobes. Patients with frontal lobe damage exhibit a constellation of behaviors we call frontal lobe syndrome. First, these patients are impulsive, in that they thoughtlessly engage in activities with little regard to the consequences. Second, they are compulsive; they become fixated or focused on certain objects or behaviors, and have to have them, no matter what. Third, they become emotionally labile, and have sudden and unpredictable mood swings. Fourth, they exhibit impaired judgment.
So cortical hypofrontality, or shrinkage of the frontal lobes, causes these four behaviors, and they can result from a car wreck or from addiction.
A study on cocaine addiction published in 2002 shows volume loss, or shrinkage, in several areas of the brain, particularly the frontal control areas. A study from 2004 shows very similar results for methamphetamine. But we expect drugs to damage the brain, so these studies don’t really surprise us.
Consider, though, a natural addiction, such as overeating leading to obesity. You might be surprised to learn that a study published in 2006 showed shrinkage in the frontal lobes in obesity very similar to that found in the cocaine and methamphetamine studies. And a study published in 2007 of persons exhibiting severe sexual addiction produced almost identical results to the cocaine, methamphetamine, and obesity studies. (Encouragingly, two studies, one on drug addiction [methamphetamine] and one on natural addiction [obesity] also show a return to more normal frontal lobe volumes with time in recovery.)
So we have four studies, two drug and two natural addiction studies, all done in different academic institutions by different research teams, and published over a five-year period in four different peer-reviewed scientific journals. And all four studies show that addictions physically affect the frontal lobes of the brain.
Addiction Is Addiction
I mentioned that the dopamine systems don’t work well in addiction, that they become damaged. This damage, as well as frontal lobe damage, can be shown with brain scans, such as functional MRI, PET, and SPECT scans. Recent brain scan studies have not only shown abnormalities in cases of cocaine addiction, but also in cases of pathologic gambling and overeating leading to obesity.
So non-biased science is telling us that addiction is present when there is continued destructive behavior in spite of adverse consequences. As stated in the journal Science, “as far as the brain is concerned, a reward’s a reward, regardless of whether it comes from a chemical or an experience.”
What about pornography and sexual addiction? Dr. Eric Nestler, head of neuroscience research at Mount Cedar Sinai in New York and one of the most respected addiction scientists in the world, published a paper in the journal Nature Neuroscience in 2005 titled “Is there a common pathway for addiction?” In this paper he said that the dopamine reward systems mediate not only drug addiction, but also “natural addictions (that is, compulsive consumption of natural rewards) such as pathological overeating, pathological gambling, and sexual addictions.”
The prestigious Royal Society of London, founded in the 1660s, publishes the longest-running scientific journal in the world, Philosophical Transactions of the Royal Society. A recent issue devoted 17 articles to the current understanding of addiction. Interestingly, two of the articles were specifically concerned with natural addiction, pathologic gambling and overeating.
Drs. Robert Malenka and Julie Kauer, in a landmark paper in Nature in 2007 on mechanisms of the physical and chemical changes that occur in the brain cells of addicted individuals, said, “Addiction represents a pathological, yet powerful form of learning and memory.” We now call these changes in brain cells “long term potentiation” and “long term depression,” and speak of the brain as being plastic, or subject to change and re-wiring.
Dr. Norman Doidge, a neurologist at Columbia, in his book The Brain That Changes Itself, describes how pornography causes re-wiring of the neural circuits. He notes that in a study of men viewing internet pornography, the men looked “uncannily” like rats pushing the lever to receive cocaine in the experimental Skinner boxes. Like the addicted rats, the men were desperately seeking the next fix, clicking the mouse just as the rats pushed the lever.
Pornography addiction is frantic learning, and perhaps this is why many who have struggled with multiple addictions report that it was the hardest for them to overcome. Drug addictions, while powerful, are more passive in a “thinking” kind of way, whereas pornography viewing, especially on the internet, is a much more active process neurologically. The constant searching for and evaluating of each image or video clip for its potency and effect is an exercise in neuronal learning, limited only by the progressively rewired brain. Curiosities are thus fused into compulsions, and the need for a larger dopamine fix can drive the person from soft-core to hard-core to child pornography—and worse. A paper published in the Journal of Family Violence in 2009 revealed that 85 percent of men arrested for child pornography had also physically abused children.