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Role of Dopamine in Addiction Causation


Theory of Addiction - Hypoism Hypothesis


Why drug use is unconscious and against one's willfulness - not volitional


Misuse of the word choice in addictions


THE INESCAPABLE LOGIC OF ANY VALID ADDICTION ETIOLOGICAL PARADIGM


WHAT OTHER DISEASE....?


What Am I Angry About? - Don't Ask Me This Again


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HYPOISM IN A NUT SHELL


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The History of the Proof of Hypoism in the Wake of the P/R Paradigm page 1.


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AIMING AT AN UNDERSTANDING OF ADDICTIONS


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What's Hypoism? What's an Addiction?


WHY WE DON'T NEED HYPOISM.


Why We Need Hypoism: A Comparison of the Principles and Consequences between the two Paradigms


Entitled to Your Opinion? Not Anymore.


HYPOICMAN: A non-recovering, unimpressed Hypoic


The Field of Addictionology: A Golfing Analogy


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Gateway theory finally disproven


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EMBRYONIC HYPOISM CIRCA 1968


#1 Hatred, #2 The Words: Opinion, Belief, and Knowledge, #3 Hate Addiction


#4 The Drug War War, #5 Evolution vs. Creationism Revisited for Addictions


#6 American Society for Addiction Medicine Statement for Recovering Physicians


#7 Issues Peculiar to the Disease of Addictions


#8 Critique of Alan Lechner's (NIH), "The Hijacked Brain Hypothesis."


#8a. Update!! Dr. Leshner recently makes a change


#9 MY STORY - The Doctor Drug War - Wrong and Wasteful p.1, 1/6/00


The Doctor Drug War p.2


Doctor Drug War p.3


Doctor Drug War p.4


Doctor Drug War p.5


Affidavit for judicial review of NYS Dept. of Ed.


#10 The Superstition Instinct 3/1/00


#11-Conflict of Interest in Addiction Research


#12 - Controlled Drinking Lands On Its Ass


#13 - The Kennedy Curse or Kennedy Hypoism?


#14 - The Lord's Prayer for Hypoics


#15 - Replacing Alan Leshner is the only way to end the Drug War


#16 - The Brain Addiction Mechanism and the COGA Study


#17 - Letter to the director of the National Academy of Medicine's Board on Neurobiology and Behavior Health on Addictions


#18 - Is Addiction Voluntary, A Choice, as Leshner and NIDA Insist?


#19 - Bush's Alcoholism and Lies


#20 - A P/R Paradigm Addict - "Cured?"


#21 - Congress Misled and Lied to by NIAAA


#22 - Special Letter to the Times on Addiction Genetics


#23 - JAMA Editor Publishes According to His Beliefs, Not Science


#24 - Smoking as Gateway Drug. I Don't Think So!


#24B - IS COCAINE ADDICTION CAUSED BY COCAINE?


#25 - One Less Heroin Addict. But At What Cost?


#26 - An Open Letter to the Judge who Sentences Robert Downey, Jr.


#27 - Letter To Schools About The Pride Program Against Drugs


#28 - A Letter To Bill Moyers, Close To Home, and PBS


#29 - HYPOISM IS ACTUALLY A DISEASE OF THE "WILL"


#30 - Brookhaven Labs Provide More Evidence For Hypoism


#31 - Addiction Prevention Revisited


#32 - DRUG WAR EVALUATION BY THE NATIONAL ACADEMY OF SCIENCE


#33 - NIDA Is Close But No Cigar


#34 - Bush's Addict Discrimination and Hypocricy Begins


#35 - Maya Angelou's, "Still I Rise."


#36 - Leshner Lies To Congress


#37 - Addiction Combos


#38 Brain tumor proves Hypoism hypothesis


#39: So-called Availability Debunked as Contributor of Addictions


#40 - Hypoism Reproduced By A Pill


PIMMPAL Complex


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The Addiction Blog 4/17/11 -


The Addiction Blog 9/14/10 - 4/16/11


The Addiction Blog 11/12/09 - 9/14/10


The Addiction Blog 7/23/09 - 11/09/09


The Addiction Blog 5/16/09 - 7/22/09


The Addiction Blog 3/3/09 - 5/13/09


The Addiction Blog 8/3/08 - 3/3/09


The Addiction Blog 4/1/07 - 8/3/08

old letters



My NY Times Letters to the Editor page 1.


My NY Times Letters to the Editor page 2.


My NY Times Letters to the Editor page 3.


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My Letters to the editor of the NY Times page 7.


My Letters to the Editor of the NY Times page 8.


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NY Times letters p. 13


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Anorectic Murdered by Doctors out of Ignorance and "Desperation"(10/20/99)


Six Dead Heroin Addicts-Enough? 10/31/99


American Society of Addiction Medicine Discrimination


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Hypoics are born, not made.

Hypoism  
Dan F. Umanoff, M.D.  
941-926-5209  
8779 Misty Creek Dr.  
Sarasota, Florida 34241  

dan.umanoff.md@gmail.com  




Here’s a gem from the book, Hypoic’s Handbook.

 

A review of the way the limbic system works and the neurobiological reasons why the decision-making apparatus is unconscious. Thus, hypoic decisions of all kinds including the basic issue of use of addictors are unconscious, not willful or volitional choice of any kind. This neurobiology destroys the entire basis of the Hijacked Brain Hypothesis and all similar “volitional” theories of addictor use in addiction causation.

---------------------------------------------------------------------------------------------------------------

 

The Neurobiology

 

What follows is a short review of the biological and neurophysiological underpinnings of the Hypoism hypothesis. More of this kind of work is appearing as I write. Most of it has appeared since I began writing the book. It is the beginning of the Hypoism revolution. Also included in this chapter are some of the clinical manifestations of Hypoism as derived from the aforementioned biology.

As already stated, Hypoism is a genetically transmitted disease of decreased or diminished FOKS activity and, therefore, is etiologically independent of the environment. The FOKS is made up of several separate but functionally related parts of the limbic system, the hypothalamus, and their connections up and down the neural axis. Included are the neurotransmitters dopamine, serotonin, norepinephrine, endorphins, GABA, etc., and their neural connections to the cortex and brainstem. Ancillary neurotransmitters are the endocrine hormones, especially testosterone. This is what I mean when I use the term “neurotransmitter systems.”

Because this book is about a hypothesis and is conceptual in nature, the following discussion of the limbic system will be correspondingly conceptual. I put it here only to give a broad overview of its neuroanatomy, evolution, and functions. The functional concept of the FOKS is included here as well as its functional connections to the cortex and hard-wired instinctive behaviors. To fill in the background information, read 2, 3, 4, 6, 7, 12, 13, 18, and 20 in the bibliography.

Read the brief overview of the scientific material below because it is the basis of, and is followed by, the birth of the FOKS, the keystone of the Hypoism paradigm. It’s information that is critically important for the complete understanding of Hypoism. It’s short, you can handle it, and you need to know the vocabulary and concepts. It’s about your disease.

 

The Limbic System Concepts —What, Where, and Why?

 

At a basic evolutionary level, the brain is organized in three parts (the tripartite brain): 1) The reptilian brain brainstem (BODY): controls automatic life support and basic motor functions, and the basic instincts of territorial acquisition and defense, dominance striving, agonistic threat displays, and mating. 2) The limbic system (HEART or SOUL): assigns emotional context (emotional evaluation) to real situations and memory for decision-making purposes, and allows for and programs mammalian instincts. 3) The cortex (HEAD): does the rational thinking, analyzing, coordinating, calculating, and the associating of real and imaginary information, assigning meaning as well as use of language, speech and complex motor function. The key to the anatomy diagram below: Reptilian is black, Limbic (early mammalian) is shaded, and Cortex (late mammalian) is white. Words in parentheses are mine.

 

 

MacLean’s Tripartite Brain 

 

;

(from MacLean, P. D. (1973) A Triune Concept of the Brain and Behavior, University of Toronto Press, Toronto)

 

The structural parts of the reptilian brain are nucleus accumbens, basal ganglia, olfactory tubercle, and the corpus striatum.

The limbic parts of the brain are cingulate cortex, fornix, hippocampus, , amygdala, prefrontal cortex, hypothalamus, and parts of the thalamus, and the pituitary gland delineated in the picture of the brain cut sideways below.

 

Limbic Brain

 

Mammals evolved from reptiles, and the limbic system was added into and onto the basic reptilian brain. Its added functions corresponded to the changing life functions (instincts) and systems of the emerging mammals, which had to do with maternal care, audio-visual communication for maintaining maternal-offspring contact, self-care, other care, playful behavior, and other mammalian instincts. For this new group of animals to survive in the face of their newly evolving form of placental reproduction of small numbers of extremely valuable offspring, new behavioral styles needed to co-evolve in support of this characteristic. For example, in The Limbic System-Functional Organization and Clinical Disorders, MacLean discusses the origin of one such instinctive limbic function: “For mammals, the separation of the sucklings from the mother is calamitous. Because of the fatal consequences of separation, nature appears to have assured that maternal-offspring separation in mammals induces severe distress comparable to pain. It is evident that the distress of separation continues later in life to affect affiliated individuals, as illustrated by the production of separation calls by adult members of a group. Apropos the pain of separation and the distressful nature of the isolation call, it is of timely interest that opiate receptors are found in high concentration in the primate cingulate cortex. Such considerations suggest that the thalamocingulate division may be implicated in the generation of “separation feelings,” which are conducive to drug addiction. The possibility exists that, more than the fleeting effects of euphoria, those suffering from opiate addiction seek release from an ineffable feeling of isolation and alienation.”

In similar fashion, other mammalian instincts evolved to support this new group of animals. Instincts continued to evolve and those that were successful were added to this complex neurologic support network via genetic mechanisms. These instincts will be discussed in more detail in Role of the Instincts, chapter 7.

In Modular Brain, Richard Restak discussed the emotional processing functions of the limbic connections, “that impulses from the hypothalamus were transmitted upward to the cortex or downward to the brainstem and spinal cord where they could evoke autonomic emotional reactions even, as with the animals surgically deprived of their upper brain areas, in the absence of a cerebral cortex. According to Papez, the projections upward from the hypothalamus and by way of the anterior thalamic nucleus  [this receives sensory inputs from the body] to the cingulate cortex provided the emotional underpinnings of “psychic” processes occurring in the cortex. Because these brain areas form an interconnecting circuit the hypothalamus could be activated either by direct sensory stimulation from the outside world via the thalamus or the emotion could originate in the cerebral cortex in the form of an emotion producing thought and work downward. Thus Papez’s circuit (limbic system) relegated emotional experience to the cerebral cortex and emotional expression to the hypothalamus and its subcortical connections.

“Summarizing a great deal of experimental work, it’s fair to say that depending on the areas stimulated (by electric current), the limbic system serves as a generator of agreeable-pleasurable or disagreeable-aversive affects. What’s more, these affects and their subsequent emotional expression can be produced by electrical stimulation in humans.” From what he is saying, we can see these feelings are built into the limbic system and are manifestations of hard-wired genetically blueprinted structural systems.

He goes on to discuss the unconscious nature of the limbic events: “Responding on the basis of nerve cell connections that bypass the cortex implies that much of our brain’s emotional processing occurs unconsciously and that the medial nucleus-to-amygdala circuit underlies our “unconscious” fear responses. That means that we as conscious creatures can and do react with fear even though we haven’t the slightest idea what it is that is frightening us. As opposed to this (unconscious) processing, the activity of the corticoamygdalar circuit would seem to imply a fully conscious processing of emotions. But I am skeptical about the possibility of our ever being completely conscious of our emotions.” And he quotes Joseph LeDoux about the unconscious nature of limbic emotional processes, “While the existence of an emotional processing circuit that bypasses the cortex strongly argues for unconscious emotional processing, it is likely that even when the amygdala is activated by the cortical sensory systems, the processing occurs unconsciously. When we are conscious of processing, we are aware of the consequences of processing after the fact rather than being aware of the processing itself. Emotion, like other information processing functions, is processed unconsciously and only the consequences of processing are represented as conscious intent, and only sometimes.”

Restak goes on to relate these ideas of unconscious emotions to what I call our “delusion of self-invention.” How can we be in control of inventing ourselves when we’re never fully aware of all our feelings to begin with? He states, “Our belief that we “consciously” determine our fear responses is only a reincarnation of the over-esteemed homunculus bequeathed to us for perpetual care by Descartes.” And, “Indeed, this finding that fear is organized within subcortical memory circuits explains in part why phobias and other fear and anxiety emotional disorders are so difficult to treat by psychotherapy and other “talk” therapies. Those subcortical circuits involving the amygdala particularly arouse emotional passions at levels inaccessible to conscious or willed deliberation.” For these same reasons, addictions are likewise unable to be thus treated.

Note: The reason I’m spending so much time on this “unconscious” area concerns my contention that the thinking and feeling part of the brain is often unconscious. Addictions stem from this unconscious area of the brain. The following section discusses the basis for the most important concept of the Hypoism paradigm, that which describes the reality of the unconscious biological and physiological nature of the FOKS working inside the decision-making apparatus. As I discuss more fully later in the book, this characteristic of the limbic system and FOKS is the reason hypoics need to have their recovery run by another person, a sponsor, and why conscious and rational thought processes are useless, even inimical, for recovery.

Restak quotes LeDoux again: “It is easy to imagine how genetic variation [diversity] in the extent to which thalamo-amygdala and cortico-amygdala circuits function independently could predispose individuals to different degrees of control of emotional behavior and to differences in their sense of being in control.” Thus, genetic diversity in the limbic system makeup predisposes certain people to more or less conscious control over their decision-making.

Joseph LeDoux’s most recent book, The Emotional Brain, culminates 25 years of his and others’ research on the neurobiology of emotions up to the present. This book is necessary for anyone who is interested in this topic. He discusses therein the neuroanatomy and functional significance of some of the most important parts of the limbic system. In particular, he notes the roles played by the amygdala, hypothalamus, anterior thalamus, hippocampus, cingulate cortex, lateral and medial prefrontal cortex (the main anatomical areas of the limbic system) in processing external stimuli from the senses, and internal stimuli from the cortex (thoughts) into emotional feelings (consciousness), actions (behavior), memories, bodily sensations, and emotional assessments of these stimuli. I will summarize briefly his conclusions, which are critical to an understanding of why the psychological-religious (conscious control) paradigm has no way to deal with addictions and why the Hypoism paradigm (surrender of control) does:

·    1. “Brain systems that generate emotional behavior are highly conserved through many levels of evolutionary history; that the neural organization of particular emotional behavioral systems is pretty similar across species; [that] what it means to be human involves an appreciation of the ways in which we are like other animals as well as the ways in which we are different.” [Our neurological systems dealing with emotions have evolved over hundreds of millions of years]

·    2. “When one of these evolutionarily old systems (like the system that produces defensive behaviors in the presence of danger) goes about its business in a conscious brain, emotional feelings (like being afraid) are the result. Otherwise, the brain accomplishes its behavioral goals in the absence of robust awareness. And absence of awareness is the rule of mental life, rather than the exception, throughout the animal kingdom. If we do not need conscious feelings to explain what we would call emotional behavior in some animals, then we do not need them to explain the same behavior in humans. Emotional responses are, for the most part, generated unconsciously.” [These systems function at an unconscious level]

·    3. “Conscious feelings are in one sense no different from other states of consciousness [which] occur when the system responsible for awareness becomes privy to the activity occurring in unconscious processing systems.” [Conscious awareness of emotional processes are rare and unpredictable]

·    4. “Emotions are things that happen to us rather than things we will to occur. We have little direct control over our emotional reactions. While conscious control over emotions is weak, emotions can flood consciousness. This is so because the wiring of the brain at this point in our evolutionary history is such that connections from the emotional systems to the cognitive systems are stronger than the connections from the cognitive systems to the emotional systems.” [Conscious control of emotional responses is nonexistent]

·    5. “One of the major conclusions about cognition and emotion that comes from this approach is that both seem to operate unconsciously, with only the outcome of cognitive or emotional processing entering awareness and occupying our conscious minds, and only in some instances.” [The thinking process and associated feelings derived from it are again, for the most part, occurring unconsciously]

The critical conclusion he reaches about emotions by the end of the book is:

·        6. “You can have an emotional feeling without being conscious of the eliciting stimulus, without the actual eliciting stimulus being represented in a short-term cortical buffer and held in working memory. Stimuli that are not noticed, or that are noticed but their implications aren’t, can unconsciously trigger emotional behaviors and visceral responses. In such situations, the stimulus content of working memory will be amplified by the arousal and feedback that result, causing you to attribute the arousal and bodily feelings to the stimuli in working memory. However, because the stimuli in working memory, [what is in your face at that moment], did not trigger the brain, the situation will be misdiagnosed. Moreover, if there is nothing particular occupying working memory, you will be in a situation where your feelings are not understood. If emotions are triggered by stimuli that are processed unconsciously, you will not be able to later reflect back on those experiences and explain why they occurred with any degree of accuracy. Contrary to the primary supposition of cognitive appraisal theories, the core of an emotion is not an introspectively accessible conscious representation. Even when we do have introspective access, the conscious content is not likely to be what triggered the emotional responses in the first place. The emotional responses and the conscious content are both products of specialized emotion systems that operate unconsciously.” [Conscious misinterpretation of the emotional underpinnings of decision-making and the resultant behavior is the rule rather than the exception]

 

The above principles of emotional processing (cortical-limbic interaction) form the basis of the Hypoism paradigm’s representation of the decision-making apparatus and its function in producing the peculiarities of the addiction process (discussed later in the chapter) and why our current distorted, fanciful, and unfounded view of this process has led to the P/R paradigm’s mistakes in its perception of addictions, in particular, that addictions are consciously derived, a choice (willful), and that conscious control could have any utility in prevention or “treatment.”

 










You can take the addiction out of the hypoic, but you can't take the Hypoism out of the addict.




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