Addiction can be defined as “the continued and compulsive consumption&nbsp; of a substance or behavior (...) despite its harm to self and others”&nbsp; (Lembke, p. 16, 2021). There is a multitude of things and behaviors&nbsp; making people hooked to the cycle of addiction, be it alcohol, nicotine,&nbsp; amphetamine, heroin, sex, gaming, gambling, eating, porn, shopping,&nbsp; social media, bingeing on Netflix and so on. And, as technology keeps&nbsp; developing, the possibility of new things becoming addictive keeps&nbsp; extending. "The smartphone is the modern-day hypodermic needle,&nbsp; delivering digital dopamine 24/7 for a wired generation" (Lembke, p. 1,&nbsp; 2021). The “feel-good” chemical dopamine, made in the body, is both a hormone&nbsp; and a neurotransmitter involved in reward and movement, important in&nbsp; behavior and cognition. Movement, motivation, attention, dreaming, and&nbsp; learning are but a few of the mental processes in which dopamine plays an important role (Yenisetti, p. XI, 2018). The more dopamine an experience&nbsp; releases, the more we enjoy it, and the more we will want to repeat it.&nbsp; Various fields of research in the last 40 years have supported the thesis&nbsp; that dopamine is at the heart of addiction, at the base of every desire&nbsp; (Solinas et al, p. 481, 2019). We can probably all relate to being hooked on some kind of behavior or&nbsp; drug; not being able to go to bed watching the third season of your&nbsp; favorite series on Netflix or looking forward to the weekend and a glass, or&nbsp; ten, of wine, or endless hours in front of the computer gaming with friends, or checking Instagram again, even though you swore you wouldn’t. Maybe&nbsp; you also have experienced the pain of excessive drinking, illicit drugs,&nbsp; addiction to sex or shopping while increasing the credit card debt. Studies&nbsp; by Volkow have shown that the release of dopamine in the brain of addicts may lead to deregulation and decrease in the release of dopamine both for the drug of choice, as well as for other activities that normally would&nbsp; create joy (Volkow et al, 2004, p. 566). With prolonged use of drugs or&nbsp; behaviors that create flooding of dopamine to the brain, the feeling of joy,&nbsp; happiness, and contentment subsides, leaving the world a dull and gloomy place. Once the brain does not produce enough dopamine, nothing feels&nbsp; good anymore (Lembke, p. 57, 2021). Even though a person with an addictive behavior wants to quit, it is&nbsp; difficult, because the brain becomes adapted to dopamine through a&nbsp; process called neuroadaptation (Solinas, p. 487, 2018).&nbsp; This creates adrive to ease the painful low dopamine state in the brain, compelling the&nbsp; person to use again, making the path to relapse short in search of letting&nbsp; light into the darkness. Dr. Anna Lembke describes the positive feelings&nbsp; created from behaviors that release high amounts of dopamine in the&nbsp; brain, and the corresponding low release of dopamine as a pleasure-pain&nbsp; balance (p. 47, 2021). The more pleasure, the more pain will follow. If the&nbsp; individual continues to seek pleasure as an impulse to avoid pain, the path to addiction is completed. The path out In the journey through addiction, there exists not only a path leading in but also one leading out of the dopamine-deficient brain state, offering hope&nbsp; and recovery. According to Lembke, if we abstain from use, the brain will&nbsp; return to its baseline of dopamine, at least most of the time. By restricting&nbsp; use an extended period, around four weeks, it is possible to restore&nbsp; balance. Usually, it takes this long for the brain to reestablish balance (p.&nbsp; 78, 2021). In a study by Schuckit, men with an addiction to alcohol&nbsp; combined with depression, were admitted to a hospital for four weeks.&nbsp; After this period, 80 % of these men no longer met the criteria of clinical&nbsp; depression, without any specific treatment of the depression itself. This&nbsp; study implies that the depression, for the most part, was a result of the&nbsp; drinking itself (Lembke, p. 78, 2021). The first 14 days will probably be hard, but as the brain begins to readjust, the cravings and the intensity of the addiction gradually diminish. This&nbsp; period of withdrawal and readjustment can be a challenging part of the&nbsp; recovery process. Managing to abstain for a month is more likely if&nbsp; motivation is high. Motivation can be achieved through methods of&nbsp; conversation like Motivational Interviewing (MI). The purpose of this&nbsp; method is to strengthen a person's motivation for change by eliciting and&nbsp; exploring their own reasons for change (Miller &amp; Rollnick, p 3, 2023). This&nbsp; is described in more detail in the article Creating motivation to change. Therapeutic interventions, motivational conversations, support groups,&nbsp; and counseling can all play vital roles in helping individuals break free&nbsp; from the cycle of addiction. Engaging in regular exercise, practicing&nbsp; mindfulness and relaxation techniques, such as meditation or deep&nbsp; breathing exercises, can help regulate dopamine levels and reduce stress&nbsp; and anxiety, which are common triggers for addictive behaviors. Pursuing&nbsp; hobbies and interests and fostering positive social connections can all&nbsp; contribute to a fulfilling and balanced life without reliance on addictive&nbsp; substances or behaviors.Learning strategies to cope with triggers can also be valuable. These are&nbsp; learnable strategies, and will be described in more detail in the article...&nbsp; (hyperlink to article 2) Ultimately, understanding the role of dopamine in addiction can empower&nbsp; individuals to take control of their lives and seek the help they need to&nbsp; overcome addiction and reclaim their well-being.Literature - Lembke, A. 2021, Dopamine Nation, Headline Publishing Group, London,&nbsp; UK. - Miller, W. R., &amp; Rollnick, S. (2023). Motivational interviewing: Helping&nbsp; people change and grow (4th ed.) New York. Guilford Press - Sheffler ZM, et al, 2023. Physiology, Neurotransmitters. [Updated 2023&nbsp; May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539894/ - Solinas, M., Belujon, P., Fernagut, P.O. et al. Dopamine and addiction:&nbsp; what have we learned from 40 years of research. J Neural Transm 126,&nbsp; 481–516 (2019). https://doi-org.ezproxy.inn.no/10.1007/s00702-018-1957- &nbsp;

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The path into, and out of addiction.

Using Motivational Interviewing in Self-Motivating Behavior Change&nbsp;<h3>Introduction</h3>Motivation is often the key driver behind successful change. Whether you're aiming to break a habit, adopt a healthier lifestyle, or achieve a personal goal, maintaining motivation is essential. An effective method for bolstering motivation is through the practice of Motivational Interviewing (MI). Central to MI is the recognition of ambivalence, and the exploration of motivations for change. It is defined as “a particular way of talking to people about change and growth to strengthen their own motivation and commitment” (Miller and Rollnick, p. 3, 2023).&nbsp;<h3>A guided journey</h3>A conversation using Motivational Interviewing, is like a guided journey exploring why someone might want to keep doing a behavior. Or stop it. We dive into their feelings, thoughts, and attitudes about the behavior. Imagine it like a debate happening inside someone's mind: on one side, there are reasons to keep doing what they're doing, and on the other side, there are reasons to make a change. For any change, in any person, there are arguments both for and against – a kind of "inner panel" (Miller and Rollnick, p. 153, 2016) where on one side, there are various reasons for the person to continue as before, and on the other side there are arguments and reasons for change. These arguments are called "sustain talk" and "change talk." Sustain talk includes all the reasons someone might have for sticking with their current behavior, while change talk is all about why they might want to switch things up (Miller &amp; Rollnick, p. 153, 2016). Both types of arguments exist within a person, but when we focus on bringing out the change talk, it tends to boost their motivation to make a change.While the method was originally developed as a counseling technique, it can also be a valuable tool for self-help and personal development. By engaging in thoughtful conversations with yourself, you can use MI techniques to explore and increase your motivations, overcome resistance, and take meaningful steps towards positive change.<h3>Applying Motivational Interviewing to Yourself</h3>When applying Motivational Interviewing (MI) techniques to yourself, start by identifying the behavior or goal you want to address. This could be anything from cut back on the excessive time spent on Instagram and other social media to exercising more regularly or even pursuing a new career path. Once you've identified your target, you can begin the process of exploring your thoughts, feelings and values concerning the behavior.&nbsp;Begin engaging in a conversation with yourself, much like you would with a therapist or counselor, using MI. Reflect on your feelings, thoughts, and attitudes about the behavior or goal. Consider the reasons why you might want to continue with your current habits (sustain talk). Once you've explored the reasons and feelings related to continuing the habit, focus on amplifying the change talk. This involves highlighting the negative consequences of continuing, as well as the positive aspects of making a change and visualizing the benefits it could bring to your life. You might imagine yourself enjoying improved health, increased energy, and a sense of accomplishment from overcoming the habit.&nbsp;An easy rule of thumb; find three reasons arguing for sustaining the negative behavior, feel into the positive emotions the behavior gives you, and contemplate the good reasons you have for doing them. There is always an inner logic explaining why we do what we do. Have compassion for this part of yourself. Then find three arguments for negative consequences related to the behavior, as well as three arguments for the positive consequences of change.&nbsp;The number three is arbitrary and used solely as a mnemonic device. If you have less or more reasons, that is perfectly fine.Contemplating the reasons for change has to do with the why of change. When you have thoroughly explored the why in various shades, it is time to explore the how (Miller &amp; Rollnick, p. 114, 2023). How to change has to do with goals. Setting specific, achievable goals related to your desired behavior change, breaking them down into manageable steps will often aid in change. This incremental approach not only builds momentum but also reinforces your belief in your ability to change. One way to help making achievable goals is through setting SMART Goals. Break down your aspirations into specific, measurable, achievable, relevant, and time-bound goals. All though a structured plan does not suit us all, creating a clear action plan with manageable steps that you can take to progress towards your objectives might be of benefit (Miller &amp; Rollnick, p. 120, 2023).<h3>An example of the process</h3>In the following, I provide an example of this process from my own life. I was once drawn to watching Netflix series, and I had begun watching episodes until late at night. It was at a time in my life when the kids were small, and I had little time by myself. Watching took too much of my time, made me tired and out of energy, but I kept it going for months. Even though I told myself to stop, many evenings I retreated to one episode after another. The late nights took their toll, resulting in too little sleep. I was a bit addicted to the pleasurable feeling of zoning out in the quiet house. For more on addiction and ways to handle it, check out the article&nbsp;The Path Into, and Out of Addiction.&nbsp;One day, after a particularly short night, during a break at work, I decided to explore my theme through the lens of MI. I started by asking myself the reasons for my late-night behavior. I wrote down the answers on a piece of paper. Some of these were the good feeling of relaxing and engaging with exciting stories. It gave me a sense of peace, finding space to just be me for a while. The kids in bed, the house quiet, and the feeling of anticipation for the next moves on the screen. And, as soon as I started, it was difficult to quit. The stress of the day was gone, and I felt totally relaxed. All these arguments fit an inner logic that kept me watching. Exploring these arguments, I felt into, trying to experience the calm, peaceful feeling I get from staying up watching.&nbsp;The next step was looking for the negative consequences of my own action. A big one that came to mind immediately was tiredness; I could really feel how my brain worked on a lower gear. Teaching, it is important to access information quickly, and when I am tired, the words keep escaping me. I could feel how I was tired to the bone, with very little energy. I also thought of the need for energy being a mom, and how it was more difficult being level in my mood when I had too little sleep, not being able to enjoy hanging out with the kids as much as I wanted. This feeling really bothered me since it is so important for me being here for my children. Then I thought of the negative effect of too little sleep on the body. I know how my whole system needs enough sleep, and the detriments of sleep deprivation. It is associated with inflammation in the body and a reduction in the immune system.&nbsp;The last part of this was exploring the positive reasons to quit, both in the short and long run. What would I gain from not watching anymore? First, I would gain so much more time, to sleep, to read or listen to podcasts about topics that interest me. Sleeping, being restored in the morning would be such a nice feeling. Being the best version of myself with the children.&nbsp; When I am tired, there is not a big reservoir of patience, the one quality I feel I need the most in the challenges of daily life. When too tired, I do not have enough energy for working out, even though I really value and enjoy it, so sleeping more would surely make it easier. And, I really do not like feeling addicted to anything, and watching series had become some sort of addiction for me. Being free makes my life easier and more enjoyable.Summarizing my reasons: Looking through my own reasons to quit, I felt into them, trying to experience the feelings of freedom, of being restored from a good night’s sleep, from being the best version of myself. I could feel how I made a resolve inside; I would quit, and I would quit now.My motivation was so high, I just made the change without making a more specific plan than just abstaining. Change is even more likely to happen if we make a specific plan to which we commit, but my plan was just to stay away. And, it worked; 8 years later, I still stay away from binge-watching series. Finding the reasons that really are important to me, my values of being a good mother and making my life the way I want it to be, created enough motivation.&nbsp;The prosess in a nutshell<ul><li>Three reasons for doing the behavior, feel into each and explore implications.</li><li>Three negative consequences of the behavior, feel into each, explore how it affects your life, relationships, and other implications. Reflect on how it impacts your life, how it is more difficult to have the life you desire and the way it is out of sync with your values.</li><li>Three positive consequences of change, visualize the good feeling you will have when you have accomplished the change, how it positively will benefit your life and your relationships, and how it will enable you to live in harmony with your own values.</li></ul>Write down the answers, on a piece of paper or the computer. Writing helps create a distance to your thoughts and feelings, much like a therapist would in a conversation.Throughout this process, remember to be kind and compassionate with yourself. Change is rarely easy, and setbacks are a normal part of the process. However, by continuing to engage in thoughtful conversations and leveraging the principles of MI, you can cultivate the motivation and resilience needed to achieve your goals. If you are stuck, consider connecting with a therapist. Sometimes the terrain is complex, and a second pair of eyes and ears might be needed to guide you through.&nbsp;In conclusion, Motivational Interviewing is a powerful self-help tool for fostering motivation and driving positive change. This way of engaging in reflective dialogue with yourself about challenges and negative behaviors in your life might help you find motivation for change, creating a life you desire in harmony with your own goals and values. By exploring your motivations, understanding the reasons for doing the behavior, and amplifying change talk, you can overcome resistance and take meaningful steps towards achieving your goals. With patience, persistence, and a commitment to self-improvement, you can unlock your full potential and create the life you desire.&nbsp;&nbsp;References:- Miller, W. R., &amp; Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press.- Miller, W. R., &amp; Rollnick, S. (2016). Motiverende Samtale. Støtte til endring. Fagbokforlaget&nbsp;Written by Solveig Høegh-Krohn.&nbsp;About the author. Solveig Høegh-Krohn has been teaching Motivational Interviewing the past 17 years and gives lectures at the University College of Innlandet in Norway. She also works as a gestalt therapist and integrates MI into her therapy and coaching practices. She addresses a variety of issues including behavior change, anxiety, depression, grief, anger, burnout, and self-esteem problems. Her approach is characterized by empathy, presence, and a non-judgmental attitude, creating a safe and supportive environment for her clients and couples.&nbsp;

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