Our brains are dynamic. Rather than being static or still, brains respond to stimuli constantly. However, there is one key way that our brain keeps changing – that is through neuroplasticity. Brains are able to adapt and alter over time. This means that the brain can repair itself after a traumatic event such as an injury or a stroke. It means that we can continue to learn and respond to new experiences throughout our lifetimes. Ultimately, this means that the brain is not ‘stuck.’ There is almost always a way for it to adapt and change. This is not only a fascinating feature – it also provides a tangible opportunity for recovery in more ways than one. The plasticity of our brains is relied upon unconsciously as we move through our lives. However, this malleability can also be consciously tapped into during rehab. However, neuroplasticity is not always wholly positive. This is especially clear in cases of addiction. In a similar way to how the brain has learned to reinforce addiction, the dynamic nature of our brains can be used to break addiction cycles and aid recovery. But how is it possible to do both?

What is Neuroplasticity?

Neuroplasticity is a process that involves adaptive structural and functional changes to the brain.’ Put simply, neuroplasticity (sometimes also known as brain plasticity) refers to the brain’s ability to alter in response to stimuli. The brain works through a vast array of networks. These networks are built through connections we make throughout our lives. We see plasticity at work when we learn new things; our brains ‘rewire’ to forge new links. When we are younger, neuroplasticity is thought to be at its strongest. This is why it is considered to be easier to learn or ‘pick up’ new skills and information during childhood than during middle age or our elderly years. But in order for the networks we build to be maintained, they need to be reinforced. It’s almost like a muscle – for a connection to be sustained, we need to keep returning to it. If we do not sustain a connection, the pathway can die off. 

If you learnt to speak French in school but do not regularly practise the language, you may find that you only remember a handful of words now. This is because our brains make thousands of new connections. In order to maintain new ones, old, ill-used connections are sometimes severed. This is known as synaptic ‘pruning.’ When the brain prunes a network, we may lose some of the skills, knowledge, or associations that were linked with that pathway. The brain can then create a new pathway in its place. This ability of the brain to change and create new links can be very beneficial, but sometimes, the creation of links can be harmful. So what are the benefits of neuroplasticity, and are there any associated risks when it comes to addiction and psychological distress? 

Specialists describe neuroplasticity as having three potential components:

1. Beneficial plasticity 
2. Neural plasticity 
3. Negative plasticity

The positives

The plasticity of the brain can have a range of potential benefits for our general function. These include:

• Stronger memory
• Sharper recall 
• Recovery from brain injury 
• Recovery from neurological illness
• Helps to retain focus as we age 
• Adjusts due to sensory input
• Helps manage psychological distress such as depression 

Plasticity can be regenerative, meaning that we can relearn or rebuild connections that have previously been lost. This can be especially useful in situations such as a stroke, where individuals may need to learn how to walk and talk again. In these cases, neuroplasticity can have a significant impact on our ability to recover. This is not only physically powerful, but can also restore a sense of confidence and motivation  in individuals in active recovery. 

The negatives

The key negatives of neural plasticity are:

• pruning means we can lose previous knowledge and connections 
• regeneration means we can re-learn previous problematic behaviours 
• we can reinforce harmful behaviours 
• we can heighten psychological distress (such as anxiety and depression)
• we can heighten physical distress (such as pain management and the ability to sleep)

Unfortunately, we can learn negative information and behaviours as well as positive ones. This is known as ‘maladaptive plasticity.’ This type of plasticity ‘indicated hindered functional recovery of the development of an unwanted symptom.’ In short, maladaptive plasticity is when a new connection leads to a more negative experience. This could lead, for example, to a deficit in our brain’s ability to manage pain. 

However, one of the ways maladaptive plasticity can manifest is through the development of new, harmful behaviours. This typically happens due to reinforcement over time. It can lead to compulsive, addictive or obsessive behaviours that can ultimately be harmful. This can include the reliance of addiction to any of the following:

• Drugs 
• Alcohol
• Caffeine 
• Nicotine 
• Sex
• Porn
• The internet 
• Social media
• Food 
• Gambling 
• Shopping 

Once an addiction has developed, it can be particularly difficult to break. This is because cycles of behaviour reinforce themselves over time., making it hard for us to ‘stop’ engaging with a specific act. 

Neuroplasticity and Addiction

In addiction, one of the key neuroplastic changes is to the reward systems. Our brains function on a series of systems present to regulate our emotions, cognition and other basic processes such as sleep and appetite. One of the key actors in the brain is our reward system. The reward system functions through the release and reception of a dopamine neurotransmitter. When we feel pleasure, it is typically due to the rush of dopamine we feel in our brains. If we repeat the same action and continue to receive the same dopamine hit, our brains can create new pathways which establish this behaviour as something that is ‘good’ and should be sought out in the future. This means that our brains change (both in terms of function and structure) in a way that highlights the significance of a specific activity – such as drinking, taking drugs, gambling or overspending. 

In this sense, we can see addiction as functioning through a neuroplastic model of psychiatry, where ‘brain changes in mental illness represent an interplay between opposing effects of illness burden and compensatory processes.’ The issue with this is that the addiction treatment then needs to be two-pronged. It needs first to address the new connections that have been reinforced in the brain before it can begin to treat the underlying causes of addiction as in more traditional forms of treatment.

Treating addiction through neuroplasticity

When we stop doing something, we can ‘unlearn’ it. This is because our brain can prune those previously made associations. This is not an easy process, but with attention, diligence and care, neuroplasticity can help us to break unhelpful connections. This means that it is possible to ‘unlearn’ watching porn or using cocaine as a source of all consuming pleasure. Neuroplasticity is used most tangibly in Mindfulness-Based Relapse Prevention (MBRP) therapy, where controlled exposure to specific contexts can allow you to rebuild pathways more favourable to recovery. This targeted pruning showcases the incredible ability of our brain to adapt, overcome, and overall, to recover.