Change the Brain; Relieve the Pain; Transform the Person
Section 7: Pleasure
Soothing and Stimulating
Defining happiness has been a more difficult task than defining pleasure. Well-being is a combination of pleasure and a sense of living life fully, but what is happiness? This question was posed to several authors who had written chapters in the definitive look at the neuroscience of pleasure, Pleasures of the Brain. While the authors could speak with authority about the neuroscience of pleasure, none of them could define happiness. It seems odd, since there is a robust and ongoing public discourse about being happy or unhappy. There is a clear understanding that there are happy experiences and happy people. Flow experiences produce great happiness. While pleasure is a temporary experience, happiness can be sustained over time.
Our own definition of happiness is that it is the state we achieve by establishing a balance between soothing and stimulating. This can be in the moment of an activity or lived over the course of one’s life. The key point is to experience all of life in this way. Regardless of the difficulty or pleasantness of an event, seek to balance soothing and stimulating while going through it.
The Pleasure of Your Company
The pleasures of social interaction are critical to the survival and evolution of our species. Our experience of life is nurtured and enriched by the relationships we have. Each person we meet has something to teach us, directly or indirectly. We become defined by those around us; where we fit; how we are perceived; how we act and interact. We develop values, morals, habits and customs based on where we live, our needs, the needs of the community, our ethnicity and heritage. Developing relationships and being connected to a group of individuals creates a sense of belonging. Our special talents become evident. We do what we are able to do within the group. We each have our roles. It is so important to have, build and nurture relationships because they connect us to the world and life. We give of ourselves and take others in. Pain draws people emotionally and physically into themselves. Relationships are another direct way into our own brains and those of others. Having meaningful relationships with others helps us wire away from pain.
Are you fully participating in your close relationships? Have you told anyone you love them today? Are you making an effort to help anyone else? Have you been hugged lately? Have you hugged anyone else? When did you last speak to your best friend? Think about who has had the most profound influence in your life and ask them for help now. Who do you consider close family? Give them a call.
Humor
The brain gets really excited about a good joke. The mood elevation aspect of humor is in the Ventral Medial Prefrontal cortex reward center, which also assesses the “funniness” of a joke. Puns activate left orbital frontal cortex and insula speech, sound, pain and pleasure processing areas. Jokes that rely upon semantics are processed in bilateral middle temporal lobe and left inferior temporal lobe global coherence areas. A string walks into the ventral medial prefrontal cortex and says give me scotch and soda with a twist. The VMP says that’s not funny and we don’t serve strings. The VMP throws the string out of the brain. The string dusts itself off, ties itself in the middle and pulls apart its end. This time it strolls into the insula, and says give me a scotch and soda with a twist. The insula says “Hey, get out of here. You’re the string the PFC just threw out.” The string says
Laughter releases endorphins. It stimulates the immune system. Laughter stimulates oxygen exchange. It releases GABA. It enhances blood and lymphatic circulation. Laughter makes us happy because it balances stimulating and soothing. It truly is the best medicine.
Laugh. Poke fun at yourself. Buy a joke book. Go to a comedy club. Use a whoopee cushion. Buy a crawling eyeball. Give someone a gag gift. Tell your favorite joke. Make a funny face. Wear Groucho glasses and mustache. Do something silly. Tape your nose up and go to Porky’s Palace for lunch. Do the Hokey Pokey. Look for the humor in everything. A little bit of humor goes a long way.
Anandamide
Look at the graphic on page 69. Close your eyes and picture anandamide being constructed in your brain’s synapses and being sent to inflammatory cells to shut off the inflammation. Anandamide serves many functions in the body, working on cannabinoid receptors. One of its main functions is to control local inflammatory responses started by nerve cells that are firing on their own, in a process known as Long Term Potentiation (LTP). Anandamide is quickly constructed in synaptic spaces and rapidly reduces the release of inflammatory cytokine molecules. This sets off a chain reaction and results in the shut down of long term potentiation. In this way, anandamide is a major modifier of persistent pain.
​If modifying pain this way was all that anandamide did, it would be a very valuable tool in our molecular toolbox, but it does so much more. It is known as an endocannabinoid and modifies everything from mood to appetite, sleep to wakefulness, pain to anti-inflammation. Remarkably short-lived, anandamide does its job and then quickly breaks down into its chemical components, waiting for it’s next call to duty.
Anandamide stimulates the brain in its pleasure centers and creates a state of bliss. In fact the person who discovered this molecule named it Anandamide, because in the ancient Sanskrit language Ananda means Bliss. There is a great overlap in pleasure and pain circuits. When pleasure molecules such as anandamide are released, they dominate pain chemistry. Consciously pursuing the experience of pleasure and happiness is a wonderful way to counteract pain.
Chocolate
One of the best ways to get Anandamide is by eating raw chocolate/cacao! Yes, it’s true. Raw chocolate really does have medicinal and therapeutic benefit. These include anti-inflammatory and pleasure effects. Have it raw for the anandamide, the flavonoids, the magnesium and watch it lift your mood and make you feel better. Rubbing on cocoa butter enhances the sensory pleasure of touch. Better yet, rubbing on raw cacao butter adds topical flavonoids and anandamide. Raw cacao nibs are quite bitter, but when mixed with the sweet chocolate flavor of a piece of dark chocolate, that bitterness transforms to a richer chocolate flavor than either component. This is a direct example of neuroplasticity. The brain cannot “taste” bitterness in the face of sweet. So eat it, rub it on, let it melt in your mouth!
GABA
GABA is discussed on page 56 and page 70 of the Neuroplastic Transformation workbook. Review these pages. It is also discussed as a soothing neurotransmitter on the website in the Workbook/Mood and Pain section. Go to that section and review it, taking time to look at the animation, as well.
GABA is highly involved in the pleasure chemistry of the brain, along with anandamide, endorphins and oxytocin. Unlike the other substances, GABA is present in abundant quantities in both the brain and the peripheral body. Although it is too large a molecule to be able to cross the Blood Brain Barrier, the brain can “read” changes in GABA levels in the bloodstream and adjust itself to them. When GABA is released in the Nucleus Accumbens it fires deep brain pleasure hotspots.
One of the more interesting aspects of the relationship of GABA and pleasure comes from studies in depression. In patients with anhedonia, the absence of pleasure, GABA levels were consistently reduced in the Anterior Cingulate Cortex, part of the mood and pain processing region of the brain. There is lower density of GABA producing neurons in the Ventral Medial Prefrontal Cortex in depressed patients. Additionally, the mechanism for making GABA is decreased in patients with major depressive disorder.
Pleasure vs. Addiction
Pleasure centers in the brain range from deep brain structures below the level of consciousness to the highest functioning thinking regions of the brain. They involve the brain’s resting state Default Mode Network, where we have a true sense of who we are. The pursuit of pleasure is a basic drive for survival. It is involved in well being and meaning and is the major motivation for social connections. Liking and wanting are psychological concepts involved in pleasurable pursuit. Pleasure and happiness are derived from finding the balance between liking and wanting. When wanting becomes the driving force pleasure is lost. What starts out as a pleasurable activity becomes an overwhelming need to attain that experience. It is a need that is so great that it is actually stressful, because nothing else matters than obtaining the object of desire. This leads to unhappiness and is the driving force of addictive disorders.
Happiness is finding a balance between soothing and stimulating. We have to prioritize our desires and understand what is most important to us. For those who have lost this balance, development of self-soothing strategies is of great importance. Although some addictions require abstinence as a strategy (substance abuse), this is not always possible (abuse of food). A strategy in all circumstances is to recognize that wanting something too much threatens pleasure. How do we create balance for the object of desire? Can balance become the object of desire? Can pleasure become the object of desire? Can well-being become the object of desire? Can free will become the object of desire? Can a quiet amygdala become the object of desire? Ultimately finding value in not being addicted is the key to restoring the balance between liking and wanting.
Endorphins
Review the text on page 71 of the Neuroplastic Transformation workbook. It describes the way the brain uses endorphins on opioid receptors to reduce pain, fear and stress. They also regulate mood, motivation and reward. Endorphins enhance pleasure, exercise, sexual activity, excitement and love. Because of their ability to suppress pain and enhance pleasure, endorphins are highly involved in survival. They are located throughout the brain. Endorphins are short lived substances, breaking down relatively quickly after being produced, activated and released. The endorphin system is the reason we have opioid receptors. Opioid medications substitute for endorphins. They are much longer acting and they suppress the body’s endorphin system. One of the problems of this suppression is that it interferes with the important role of endorphins regulating the transition between pain and pleasure. It is by the very nature of endorphins being short lived substances, responding to increases and decreases of opioid receptors, that they regulate our experience of pain and pleasure. When they are replaced with opioid medications, the call and response of this system is lost. Instead the action of opioids involves more constant coverage of opioid receptors. While opioids reduce pain, they also reduce the availability and flexibility of a system that is involved in mood control, motivation and reward. The design of the body’s endorphin system exploits the temporary nature of endorphin activity, a design that is lost when opioids provide blanket coverage for extended periods of time.
Movement
Being able to move is one of life’s simple pleasures. It allows us to get out of the way of danger and gives us the ability to gather what we need and find what we seek. It gives us our independence, autonomy and control.
Bodies are meant to move. Movement enhances connectivity of brain and body and teaches us who we are, what we can withstand and how far we can go. It is the body that wires the brain and the brain that directs the body’s movements. From the time we are a tiny embryo, it is movement that creates and defines the various structures that make up the musculoskeletal and connective tissue systems. Cells differentiate into muscles, tendons and bones, supported and surrounded by the fascia. This connective tissue is within every system of the body. It allows us to move, and movement gives us flexibility, strength, coordination, power, balance and functionality. This equips us to respond to our environment, avoid danger and handle the stresses of life.
Our brain protects us by signaling us to reflexively withdraw from a painful stimulus. Acute injuries require immobilization and rest but once the acute phase is over, movement enhances healing. The very thought of moving an injured part of one’s body is unbearable at times but studies show connective tissue is preserved when early movement takes place. It helps to clear the area of inflammatory products, increases circulation, enhances oxygenation and forces the connective tissue elements to return to normal.
The brain loves movement and rewards us for it by releasing endorphins, GABA, anandamide and oxytocin into our pleasure hotspots. This turns on higher brain reward circuits and creates a feeling of well-being. Thus the pleasure of movement has the power to replace pain.
Oxytocin
Oxytocin connects people, soothes pain, reduces stress and enhances love. Review the text on page 71 of the Neuroplastic Transformation workbook. Oxytocin is responsible for social memory, recognition and bonding in and between both genders. Oxytocin quiets aggressive impulses in the amygdala and is involved in positive human sexual response. It reduces anxiety. Pain decreases Oxytocin levels throughout the brain and higher oxytocin levels reduce pain. Staying connected to loved ones, friends and colleagues is essential to maintaining healthy oxytocin levels.
Do we really need to care about our Oxytocin, endorphin, anandamide and GABA levels? These four pleasure chemicals paint life with a positive value. Why should this matter to anyone? The answer to these questions is that all human behavior and experience is really a manifestation of balance between complex biological systems. Persistent pain throws off this balance. Pain is reduced by pursuing pleasure, maintaining well-being and enjoying a well-lived life. The choice remains the same, regardless of an individual’s knowledge of neurochemistry. AVOID PAIN! PURSUE PLEASURE!
Happiness, Love and Altruism
It might be easy to distill all this down to a “feel good” experience but it is so much more. If you have reached this part of the program, you have done a tremendous body of work. You are moving from someone whose life has been wracked by persistent pain to someone who is forged in and strengthened by their pain. You have found ways out. You are free to experience pleasure and love. Hopefully, you are in a better place; a place that allows you to pat yourself on the back for a job well done. Realize it doesn’t stop here. You can now start to look outside yourself and see the world around you in a different way.
There is a big difference between controlling pain and living well. Pain relief is a reasonable goal on the path to well-being but it is not the ultimate goal. Like the phases of treatment, there are phases of life. We really are on this raft together. If a person is to heal, they have to forgive themselves, nurture themselves and love themselves. They have to give up on giving up and reach out for the help that is available. Then they have to turn around and extend that helping hand to others.
Being able to use your pain to help someone else, is the true transformational experience. Using what you have learned to alleviate the suffering of others is the gift of your own suffering. It gives meaning and it inspires. It embodies the generosity of the human spirit. It is how we are wired.
