Neuroplastix

Change the Brain; Relieve the Pain; Transform the Person

Pleasure

Wiring New Connections


Nucleus Accumbens


The Nucleus Accumbens is a deep area of the brain that generates pleasure in other regions of the brain. It starts a circuit that moves from structures in the deep brain, below the level of consciousness, to the highest functioning areas of the brain. This allows pleasure to move from a purely sensory experience to the pleasure of thought, idea, concept, social interaction, altruism, creativity and spirituality.

Look at the graphic on page 70 of the Neuroplastic Transformation workbook. It shows one of the two Nucleus Accumbens located on both sides of the brain toward the midline. This is an area of the brain that does not process conscious thought. It sends nerve branches to several other areas of pleasure processing below the level of consciousness. These are called hedonic hotspots and are located all over the brain. These are small islands of nerve tissue in deep brain areas and include the Nucleus Accumbens, Ventral Pallidum, deep limbic structures and areas in the brain stem. Activating one area activates the others. Eliminating any one area does not eliminate the ability to experience pleasure. It is important that damage to any part of this pleasure network does not eliminate pleasure because avoiding pain and pursuing pleasure is such a basic necessity of survival.

The experience of pleasure and pain are on a continuum and are intertwined. The expectation of pain relief results in decreased pain. The relief itself is pleasurable and is generated in the Nucleus Accumbens. One of the distinctions between the pleasure of pain relief and appetitive pleasures, such as enjoying a beautiful walk or a great meal, is that pain relief activates the Nucleus Accumbens much more than the other pleasures.

Pleasure Circuit


The experience of pleasure usually starts below the level of consciousness, but may be stimulated by conscious processes. Reading a particularly poignant passage in a book evokes visual activity in the brain. It activates areas of the brain where conscious and unconscious experience take place. Depending on the nature of the passage, we may experience other sensory perceptions, all without glancing away from what we are reading. The brain generates images, sensations, thoughts, memories, emotions, movement and beliefs without any peripheral input. In fact, the brain may direct the heart rate to increase or decrease, dry the mouth, increase the acid base balance in the bloodstream, flush the skin on the face, or cause other changes in the body completely generated by input from the book. The eyes or other sensory organs are required to start this process, but once it begins the brain is capable of generating great pleasure without any further sensory input and alters the experience of the body.

The brain’s reward circuits are involved in the experience of pleasure. There are two separate, but related phenomena processed in these reward circuits. They are liking and wanting. There is a distinct difference between the two. Liking is associated with pleasure. We can like something and derive pleasure from it, even if we do not want it. This involves the pleasure centers of the brain and causes the release of the pleasure neurotransmitters. These are endorphins, oxytocin, anandamide and GABA. On the other hand, wanting is associated with acquiring something. We may or may not like it. When wanting becomes craving it may lead to addiction. Wanting involves release of the neurotransmitters dopamine and glutamate.

Gratitude List


Several studies demonstrate that people who are grateful for things in their lives experience high levels of well-being. These studies cut across socioeconomic status. It is easy to lose sight of the things that make a person grateful, secondary to life’s struggles and disappointments. Persistent pain is one of the most difficult of those struggles. Making a list of one’s gratitudes is an excellent way to start remembering the good things that have happened. In the brain this sets off pleasure circuitry. Pleasure reverberates between cell clusters deep in the brain to large networks in the thinking brain. Just as pain causes pain and calm leads to more calm, pleasure generates more pleasure. Starting with a gratitude list can be a helpful way to get back on track and build pathways in the brain that reinforce pleasure.

Pain I Want to Avoid; Pleasure I Want to Pursue


Turn to page 67 of the Neuroplastic Transformation workbook. There is a worksheet with two columns entitled, “Pain I Want to Avoid” and “Pleasure I want to Pursue.” Follow the instructions. You may add as many pages as you wish, but in the end the number in each column should be equal. At the end of the exercise review both columns one item at a time.

As people mature and enter adulthood, the pursuit of pleasure is often valued less than duty and responsibility. It is given a secondary role in life, reserved for vacation, a night out or some other special activity. People living with persistent pain have a very hard time feeling pleasure. The biology of these processes is such that pain is virtually excluded when pleasure is being experienced. Add to this the lower social value placed upon pleasure and it becomes an increasingly lost pursuit. The fact is that just as pleasure is hard to experience in the face of persistent pain, pain is hard to experience in the face of well being. Since, well-being is described as the experience of a sense of pleasure and of a life well lived, pursuing pleasure is an excellent strategy for undermining persistent pain.

Pleasure Packs

People tend to surround themselves with objects that give them pleasure. Examples include fine art, electronic gadgetry, sports memorabilia and collectables. The person with persistent pain should gather five small items and place them in a small pouch that they can carry anywhere. The objects in the pouch should be selected because they are pleasurable. The items can range from a smooth stone to stimulate touch receptors and soothe stress to a bottle of peppermint or lavender essential oil to stimulate scent and reduce pain. Take these objects out during the day and look at them or use them. Rotating the five objects with new items can continue to stimulate pleasure circuits in novel ways that the brain ranks high in order of importance. Having and using a pleasure pack reminds people to rank pleasurable pursuits high on their order of priorities. In turn, this helps lay down circuitry in the brain to stimulate these activities.

Pleasure Hunts


Pleasure is most accessible when we are so involved in an activity that we lose awareness of anything other than the activity itself. In a sense, during these times, we merge with the activity. We lose the distinction between our sense of self and our sense of what we are doing. This has been termed “Flow” by researchers and if we step back and consider how we feel during these Flow experiences, we acknowledge them as the most pleasurable activities of our lives.

There is a competition for conscious experience of sensory input. It follows a hierarchy of the strongest sensation taking priority. We survive by avoiding pain and pursuing pleasure. This system of filtering sensory input allows us to experience life in an orderly fashion. Deep brain structures sift through sensory input from the body. The most compelling sensations are combined with emotional responses and are passed from instinctual areas of the brain to higher centers where we become conscious of them. Once conscious, they are determined to be pleasurable or painful. Conversely, we can seek a pleasurable activity, enjoy it and consciously direct this back to deep brain pleasure hotspots. There it reverberates around pleasure circuits and, if given a high pleasure priority, is returned to consciousness. Thus we can decide to go see a lovely sunset at the beach, experience it as pleasurable and enhance our sense of well-being.

People with persistent pain have difficulty experiencing pleasure. Dedicate one day a week to go on a pleasure hunt. Seek and find new ways to enjoy life. Be resolved to pursue pleasure and have the intention of using it to counter-stimulate brain pain circuits. Best of all, see if you can use some of this time to share your pleasure with others.

Music to My Ears


Our sense of hearing is another way to soothe and wire away from persistent pain signals. Sound as music can be soothing and stimulating. The type of music that soothes will be unique to the individual but in it’s broadest sense, music is one of the most pleasurable aspects of life. It moves us and makes us want to move our bodies. Music can make us happy or sad. It speaks to our soul. It calms us and stimulates us. It ties into the times of our lives and keeps time in our lives. We remember certain special events or eras based on the songs or popular music of the day. It associates sound and melodies with autobiographical memory. We can remember the theme song of a prom or our wedding song.

Sounds of many types provide sensory pleasurable and soothing experiences. Perhaps it’s the sound of your mother’s voice, a child’s laughter, the sound of a train rumbling down tracks, the sound of the ocean, the hum of background noise. Even the absence of sound stimulates auditory circuits. Sound is linked to our experience and our sense of self.

Make playlists of your favorite and most soothing music. Set them up for pure pleasure or for soothing and comforting during difficult times. Music is one of the best ways to get into the flow. Play an instrument or sing a song. Bang a drum. Go to a concert. Listen to something you haven’t listened to in years. Get lost in the music and see where it takes you. When you return, leave your pain behind. Find your rhythm.

Brain Music


Read the text on page 58 of the Neuroplastic Transformation workbook. It explains the use of slow rhythms to capture spontaneous firing of nerves in the process of Long Term Potentiation (LTP). Neuroscientists have recently discovered another rhythm of the brain that is slower yet, found in Resting State Networks. These networks create the foundational slow wave electrical activity of the brain that all of the other faster rhythms are built upon. Two of these networks, the Frontoinsular Network and the Default Mode Network are intricately involved in generating persistent pain. These networks are normally in a rhythm of firing with each other one time every ten seconds. This shifts to once every 4.5 to 5 seconds in persistent pain states. When this happens the pain generates more pain and takes over a person’s life.

Brain music sound files have been created to capture and reset the brain’s natural rhythms. These sounds are pleasing and soothing. They can help with stress, sleep difficulties and pain.

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.

Look at the graphic on page 55 of the Neuroplastic Transformation Workbook. It shows GABA being released from the Insula to the Amygdala resulting in reduced pain. GABA is also used in regulating mood with this same circuit. GABA calms the extremes of emotions, and stimulates pleasure centers in the Amygdala.

GABA is truly the unsung hero of the brain and body. It is involved in calming, soothing, pleasure, mood regulation and pain control. It is literally everywhere, but remains hidden in plain sight. We can invoke its release by self-soothing and pleasurable activities.

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.