Want a good mental work out to cure your bad habits? Try Cognitive Brain Training

 A promising new type of cognitive therapy called “brain training” has been demonstrated to be useful in treating drug addiction, according to an article recently published in the recent issue of Biological Psychiatry:

Warren K. Bickel, Richard Yi, Reid D. Landes, Paul F. Hill, Carole Baxter. Remember the Future: Working Memory Training Decreases Delay Discounting Among Stimulant Addicts. Biological Psychiatry, 2011; 69 (3).

 I use this type of therapy in my office to treat all types of problems ranging from depression, to AD/HD, to addictive problems. This new study adds significant weight to earlier preliminary results that brain training is highly useful for problematic substance abuse.

We have come to learn that drug addiction leads to changes in the actual structure and function of the brain. People with compulsive addictions, especially those that are substance in nature, tend to exhibit a trait called “delay discounting”, or the tendency to devalue rewards and punishments that occur in the future. People with addictions may at the same time have a predisposition towards what is called “reward myopia” which is the tendency towards the immediate gratification that drugs can provide with addictions.

Warren Bickel, Ph.D., a pioneer in Brain Training and his colleagues at the Center for Addiction Research in Little Rock, Arkansas borrowed a rehabilitation approach used successfully with patients suffering from stroke, or traumatic brain injury. The therapy approach involved stretching general memory capabilities. Subjects addicted to stimulants were given brain exercises that focused on strengthening the areas of the brain associated with storing and managing information reasoning to guide behavior. Dr. Bickel’s team found that by strengthening the brain circuitry, they also reduced the addicts devaluation of longer term rewards.

Dr. John Krystal, Editor of Biological Psychiatry comments on the article:“The legal punishments and medical damages associated with the consumption of drugs of abuse may be meaningless to the addict in the moment when they have to choose whether or not to take their drug. Their mind is filled with the imagination of the pleasure to follow. We now see evidence that this myopic view of immediate pleasures and delayed punishments is not a fixed feature of addiction. Perhaps cognitive training is one tool that clinicians may employ to end the hijacking of imagination by drugs of abuse.”

My experience with Brain Training has been equally exciting, in terms of seeing clients learn to develop competing thoughts and goals that not only challenge their maladaptive patterns (e.g., depression, anxiety, impulse delay with AD/HD or substance abuse), but replace those thoughts with real expectations of rewards in the future, if the client were to change his or her old pattern. This “old versus new” brain idea is explained to clients as offering a choice – either clients can revert to old “reptilian” responses that keep them locked in their psychic pain, or give a good mental workout to new neuroconnections that satisfy and encourage new thought and behavior patterns, and rewards! Putting it another way, if we envision in our minds new positive possibilities, we can not only get excited about those potential outcomes in our lives, but we can actually increase our brain’s likelihood that the brain “muscle” will train and grow in response to our cognitive strengthening exercises. How cool is that! So maximize your “brain
plasticity.” Cognitive Brain Training is an extremely useful addition to another great technique I use, Mindfulness Based Cognitive Therapy (MBCT), which will be the topic of my next blog. Stay tuned.

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