The Neurocircuitry of Attachment and Recovery in Alcoholics Anonymous

Abstract

Neurophysiological circuitries mediate avoidance and approach by valencing events and establishing a reward-based gradient. Normal separation–attachment behaviors and end goals maintain attractiveness along this gradient. Circumstances—abnormal in nature and/or adverse in nurturance—can lead to pathogenic circuits. Attachment-related disorders such as substance use disorders may result. The case is made that addiction represents a distortion of separation–attachment circuitries brought about by receptor systems hijacked by substances. Spirituality may help patients meet the challenge of this substance-induced distortion. Perhaps the greatest examples are to be found in the 12-Step programs for alcoholism and drug addiction.

KEYWORDS:

• attachment
• separation
• neurocircuitry
• anterior cingulate
• alcohol use disorder
• addiction