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Brain Development & Addiction with Gabor Mate - parte 2

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When you talk to addicts and ask them why they do drugs... what is it that drugs do for you? One of the things they'll say is: It helps me not be so stressed. Now... In other words, the addict doesn't know how not to be stressed. They get stressed very easily. The person who is addicted get stressed very easily. Or the person who get stressed easily is more likely to be an addict. Because they're more likely to use the drugs to suit their stress. Because drugs are stress relievers in the short-term. I mean, as you say... If you're upset right now and if I give you a shot of morphine... you'd be pretty happy pretty quickly. They relieve the stress. They're stress relievers. But, for the addict... They don't have enough... capacity to regulate their stress. So they have to go to these external chemicals. So that's the third circuit that doesn't work in the addiction. An the forth one is what is called impulse control. Now impulses are urges and... motivations to behave or to do something. I might have the urge to... In a store I might have the urge to grab an object and stick it into my pocket. That's an impulse. I might have the urge to go up to somebody attractive of the opposite sex... and say something totally inappropriate. I might have all of these impulses. But there's something in the brain that says: "You shouldn't do this. Not a good idea." You might have the urge to do an injection of heroine. Something up here is supposed to say: "Not a good idea." The part of my brain that... that is supposed to control my impulses is called the grey matter, or the cortex of the brain. And it's supposed to say no. It is OK for me to have all kinds of desires. It is OK for me to wanna kill all of you. That's perfectly OK. I might be hungry or xxxxxx traffic was really bad. I might feel like killing everybody. Nothing wrong with that. As long as there's something up here that says: "Not a good idea." "These are human beigns. No one's gonna get killed just because you're having a bad day". "Maybe they have their own problems, you know". In other words, I'm exaggerating, but impulse control... is what stops us from doing what we ought not to do. The addict doesn't have impulse control. When he or she sees the drug, sees the needle... When they're gambling, the addict is in a casino, or even thinks about the casino... When they're shopping, the addict thinks about the store... There's nothing there to stop it. People is always talking about free will. Humans beigns don't have nearly as much free will as we think they do. Because for the most part, we're controlled by mechanisms deep in our brains that we're not even conscious. We think we have free will. The real problem with addiction is not the free will. As somebody said, it's the "free won't". The addict is not able to say no. The part of the brain that is supposed to say no doesn't function in the brain of the addict. How do we know that? Again, we look at brain scans. There's no "free won't" up there. It should be saying no, but that part of the brain doesn't function. So, I'll just quickly summarize... Four essential brain circuits: the opiates... which is the love, connection, reward, pain relief. Dopamine, which is incentive, motivation, vitality, curiosity. The sense of beign alive. Impulse control and stress control. These are the circuits that don't work in the addict. And the people in whom these circuits don't work... they're the ones to become addicts. But why don't they work? Why don't they work in some people? When the American Army went to Vietnan... 20% of them came back... as heroine addicts. 20% of the GI's that came back from Vietnan were heroine addicts. A few years latter only 1% was. So 95% of them go over there with addiction. Which is unbelievable. I mean, if 5% of my patients in the Downtown Eastside are walking out their addiction... they would think I was a genius of some kind. And here 95% are walking out their addiction. In other words, the drugs by themselves can't cause the addiction... because if they did they all would have stayed addicts. Because they were addicts. Something else must be going on. So why some people are more prone? What's wrong with the circuits in their brains? And here is where we have to look at life experience. Most doctors and most experts who write about addiction... they say it's a gentic disorder, you inherit it. That's a nice explanation, first of all it's simple... Secondly, it makes sense... because in a lot of families if one parent is an alcoholic, chances are the kids will be too. It runs in family, so it looks like it's genetic, looks like we inherit it... genetically. Thirdly, the biggest advantage of that explanation though... even though there's no scientific basis... is that it explains everything without having to look at people's actual lives. See, if first nations people were addicted to alcohol... and these other drugs because of something genetic... Now we don't have to look at history. Now what happen in this country and what continues to happen in this country is irrelevant. It is just all in the genes. Too bad. It's nature's fault. But we can't help it. But what if it's not like that? What if it's actually... what happens in people's lives that make them addicted? Now that's a different story. Then you have to look at the whole society. How are we treating each other? What kind of system do we live in? How do we look after our children? And these are questions of course that are much more painful than simply saying... it's a matter of genetics. Well, I'm here to tell you... it's got little to do with genetics at all. Why? Because these are all have to do with the brain, and how does the brain develop? How does the human brain actually develop? Well it turns out --and this is not I'm telling anything new... I mean, you may have heard this or you may not have heard this... but I don't make it up. This is just brain science the way we know it to be an absolute fact. It's not even controversial anymore... That the way that the human brain develops is in interaction with the environment. It's shaped by the environment. That baby --how old is that baby there? Seven months. See, in the first year of life, the ties in that kid's life on every second... a million connections are being made. I mean, every second, a million connections are being made... at xxx in that kid's life. The human brain is the only one that continues to grow in the same rate... outside the uterus as it did inside the womb. Human beigns are born with very premature brains. We're all premature when we're born. Doesn't matter when we're born. At nine months we're still premature, compared to a horse. A horse can run on the first day of life, right? A human beign can't manage that neurological control... the balance, the visual acuity, the muscle strength... the coordination, for two years. So the horse is two years ahead of us in terms of brain development. So the horse developed in the mother's womb. Two years in advance than the human beign. And why is that? This is because as human beigns evolve... begin to have larger and larger heads. I mean begin to have larger and larger heads so that we can use the hands. So that they can tell the hand what to do because the hand is a very... I mean, compare the hand with the hoof of a horse... This is far more sophisticated, this is far more complex. The brain has developed a lot of circuits and connections and systems to make this work. I mean, if you try to develop a computer to make the hoof work... and if you try to make a computer to make this thing work... Imagine the circuitry has to be much more complex, much larger. And that's why you have these large brains. So large brains, and at the same time we begin to walk on two legs... so we can use the hands as hands. So walk on two legs. Now the pelvis has to narrow. So now we have a narrow pelvis... Large head. Narrow pelvis, large head. Large head, narrow pelvis. You can't wait any longer inside otherwise you'll never get born. If that kid waited another couple of months, he'd be inside forever. You know, unless there was a caesarean sections or something. Because the head is already the largest part of the body, so we have to be born prematurely. To allow our brains to develop outside the uterus, and that means that... most of our brain development occurs following birth and not before. And most of that in the first three years of life. By the end of first three years of life, the human brain is 80% adult size... and the human is only 19% adult size. It's totally disproportionate. And that means that most of our brain development occurs in the first three years. Onto the impact of the environment. And the circuits in the brain that get the appropriate input... They get the right stimulation, they develop, otherwise they don't. They even die. xxxx wont't develop very well. And that's not so difficult to understand. If you took... a plant, a seed, and you stuck it in the floor here... would you expect it to grow? Of course you wouldn't. Why? Because the conditions aren't here. There's no irrigation, there's no sunlight, there's no nutrition here. Why would it go? It's the same with the human brain. It needs the right conditions. Now what are the right conditions? Well, depends on which circuit we're talking about. The visual circuits, that allow us to see... There's about 30 different circuits making up the visual system... That needs light. If this child was in dark for the first five years of live, he'd be blind directly for the rest of his life. Because there's no light, the brain says "I don't need visual circuitry, there's no light here". "I might put this energy into hearing or something else." So, for the development of seeing, you need light waves. Now, the circuits of the opiate: love chemistry... The dopamine: incentive, motivation system... The impulse regulation and the stress control system... Also needs the right environment. Just like the visual circuitry needs light. And what is the right conditon for these important brain circuits? And this is where we're letting our kids down. I'm talking about as a whole society. The necessary condition for the development of these circuits... Is the presence of a non stressed, emotionally available... constantly available parenting caregiver. Without the presence of a non stressed, emotionally present... constantly available parenting caregiver, these circuits don't develop. If you take monkeys, and you separate them from their mothers... And you measure the dopamine levels... they're down within a couple of days. The endorphine and the dopamine level in the child's brain depend on the presence... of a nurturing parent. Of a non stressed nurturing parent. Why do I say non stressed? I'll explain that in a moment. I could give you all the science behind that... There's a... let me give you an example... At the University of McGill in Montreux, they experiment with rats... and rats are easy to work with because they... they've a short gestation time, so they're not pregnant that long... and they grow up very quickly, so you can study them between birth and death very quickly. So rat mothers, when the babies born, when the rat pup... is expelled from the mother's womb, the mother immediately starts licking the rats. Licking them means xxxxx And that's how they groom them, that's how they connect with them. That's their version of bringing the baby to the breast. First they lick them. Now, some rats do better than other rats. Some mother rats lick their babies with more... care and nurturing than other mother rats. If you look at the babies that are well nurtured by their mothers... in the first few hours of life... and if you look at these babies as adults... they're less anxious, they're smarter... and if you look at their brains, they have more natural... tranquilizing chemicals in their brains. There's a class of drugs called benzodiazepins... benzos are drugs like valium and librium and ativan and so on. We have our own natural benzos in our brains. These rats that are well-licked by their mothers... they've more of their natural stuff in their brains... than the rest that were not well-licked. But it's not genetic, because if you take the rats... whose mothers don't lick them very well and you put them... those baby rats with mothers who do, they grow up to be just fine. So the presence... the proper brain chemistry of the infant... depends on the presence of the mother, and the capacity of the mother... to nurture the baby. In a group of monkeys... they're divided into three groups... They created different conditions for food-finding for these mothers. These mothers had small babies they have to look after... and they find food for them. One group they made it difficult. It was always difficult for them to find food. Predictably difficult. The mothers... knew that it would always be hard to find food... They'd had to xxx hard for Another group they made it easy for them, the food was just right there. The middle group... they made it sometimes difficult to find the food, and sometimes easy to find the food. So it was uncertainty. Now... guess which group of mothers... was it that their infants, when they grew up, were more insecure... they do cocaine and alcohol... The uncertain group, yeah. The mothers who always find difficult, they're adjusted to it. The mothers who always find it easy, no problem. The ones who were stressed... because they never knew... and uncertainty is a big cause of stress... they're the ones whose infants grew up to do cocaine and alcohol. And there's so many experiments like that. Now the same thing is xxxx human beigns. Because when the mother of an infant, and when I say mother it could be the father, it could be the grandfather, it doesn't matter... When the nurturing parent is looking into the child's eyes... and the child is looking into the mother's eyes, the parent's eyes... that's when them both have endophines happening in their brains. And that promotes the development of the child's circuitry. But what happens to people like Serena, whose story I read to you... ...and like all my other patients in the Downtown Eastside who never had that? Those circuit don't develop. So when they do heroine, guess what? It's like for the first time... they fell love and connection. For the first time they fell human.

Video Details

Duration: 16 minutes and 2 seconds
Country: United States
Language: English
Views: 127
Posted by: renan.ferreira on Jul 23, 2012

Gabor Maté is a Hungarian-born, Canadian physician who specializes in the study and treatment of addiction and is also widely recognized for his unique perspective on Attention Deficit Disorder and his firmly held belief in the connection between mind and body health.

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