Sunday, March 30, 2008

Book Reviews: The Craving Brain: By Dr. Ruden

The Craving Brain ~ By Dr. Ruden

...A bold new approach to breaking free from drug addiction, overeating, alcoholism and gambling.

Some believe that in 1997, Dr. Ruden turned the medical community on its collective head with his groundbreaking research into the root causes of addiction which clearly indicate that the causes of addiction most definitely do not lie in our character.

Dr. Ruden discovered that the causes of addiction lie in a complex chain reaction that originates in an ancient survival mechanism in the brain. When this system is inappropriately activated, it drives the body to crave, somtimes with addictive behavior as the end result.

"Wellness is a state of brain!"

In his book, The Craving Brain, Dr. Ruden has outlined his remarkably successful treatment program which he believes can cure this problem, offering crucial new insights into the world of addiction. "This revolutionary book will bring hope to the millions of people who suffer from a wide range of addictions, from gambling and alcohol to drugs and food."

Dr. Ruden enlightens the conflict inherent in the "gotta have it - now I got it" syndrome and describes how a simple re-balancing of two natural brain chemicals provides the pathway to a cure for addiction - note: not a treatment, a genuine cure.

The book is divided into two sections: the first aimed at readers who want to understand the roots of addiction; and the second part for those who want to explore the ideas via the primary scientific literature providing an understanding of the science of biobalance. Now in its second edition, the book includes a new chapter on how to keep stress from sabotaging your brain's chemistry.

"Reducing stress by seeking mindfitness and offering opportunities to biobalance the craving brain are the only biologically sound ways we have of handling addictive behavior. Ultimately and ideally, we need to create the sense that humans are all one herd. That we are all in this together. We need to utilize our biological nature to help alter those processes that lead to disease. "Gotta have it!" -- p. 136, The Craving Brain.

Dr. David M. McDowell, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons commented on Dr. Ruden's book: "A remarkable achievement. Dr. Ruden has managed to articulate a simple and elegant model that explains far-reaching aspects of human behavior, most notably the devastating problem of addiction...."

The second edition is available in paperback from

The Craving Brain: The Biobalance Approach to Controlling Addiction ~
by Dr. Ronald A. Ruden, with Marcia Byalick Reviewed by Katy P.

ISBN 0060186984

The mystery of alcoholism and addiction is one that has plagued us for years. Is it a disease? Is it a choice? Physiological or psychological? Experts and researchers have published various theories and thoughts on the subject, some easier to understand and digest than others. Those of us seeking answers to these questions are left to consider all possibilities and draw our own conclusions based on personal opinions and experiences. In Dr. Ronald A. Ruden's book "The Craving Brain," the scientific theory of biobalance is introduced as a key to understanding and treating substance abuse. Applying scientific explanations to the questions of addiction and alcoholism is nothing new. But Ruden is able to break his theory down and present medical and scientific concepts in a simple, non-threatening style. We're still left to draw our own conclusions on the issues, but Ruden gives us something attainable and cogent to mull over.

The title of the book comes from Ruden's handle for what society has historically referred to as alcoholism and addiction. He says these are "craving disorders" of the brain, caused by a "craving response" to life experiences and environment. A craving brain is a brain chemically out of balance, and the solution is to put it back into balance, or "biobalance." Along with alcohol and drug abuse, Ruden applies his theory to all addictions, including overeating, gambling and sex.

In the first section of the book, Ruden examines the brain and how this complicated organ works. The author keeps his explanations clear and palatable. He starts with defining survival instincts as they apply to the human brain, and goes on to describe how and why the brain releases certain chemicals, or neurotransmitters, to accommodate our human urges and needs. The two main chemicals Ruden refers to are dopamine and serotonin. He says these two work together to both regulate our urges and satisfy our needs.

Ruden goes on to explain his theory of where addictive behavior comes from. Depending on our early experiences, and the god-given layout of our brain, the neurotransmitters may not release correctly, and what is normally a self-regulating system is now disrupted. This could happen for any number of reasons, but the author cites experiencing "inescapable stress" for a prolonged period of time as one possibility. In this case, the landscape of the brain has been altered, sometimes permanently, and cannot balance itself. The person is now left to balance his or her brain manually, i.e. with substances or behaviors that stimulate the neurotransmitters.

If all of this sounds confusing, trust that Ruden does an excellent job of presenting these theories in a graspable, step-by-step manner. The author also uses bold type for words and phrases that may need further explanation, and he includes a glossary in the back of the book.

With his theory now uncovered, Ruden explains that an addict's craving response, the abuse of a substance or behavior, becomes the automatic response. This, he says, accounts for the "I can't stop myself" feelings most addicts experience. According to Ruden, if our brain landscape is severely primed for craving, no social or moral constraints will stop us. But the author makes it clear that once we understand these responses, and understand the landscape of the craving brain, we can then learn to balance the brain (biobalance) by adopting healthy, serotonin-boosting habits.

Ruden offers several methods for arresting the craving response. He gives brief explanations of ideas behind Buddhism, 12 step programs, rehabilitation centers, and drug therapy. Ruden says each of these possible solutions can offer the craving brain a new method of producing the correct amount of serotonin to interact with dopamine and achieve biobalance. According to the author, the brain is a primitive system designed to ensure survival. One of the ancient survival instincts humans are known to possess is the need to "herd," or come together with a close community of people for comfort, safety and support. Support groups, or "herding," can produce the needed chemicals for biobalance. Similarly, this can be achieved through the Buddhist approach of liberation from the self and from desire, and other spiritual teachings. Ruden also mentions service to others as a means of boosting good feelings and balancing the brain.

The section on drug therapy in treating the craving response is the one troubled section of this book. Ruden includes information on the now illegal diet drug Fen-Phen, along with personal accounts from food addicts who have used it. This was obviously published before the dangers of the drug were publicized. Ruden also quickly glosses over antidepressants, and addiction-specific drugs such as Antabuse, Naltrexone, and Methadone. But compared to the rest of the work, this section falls short in facts and explanations.

The final section of the book includes an extended bibliography that not only cites Ruden's sources, but also "offers (the) reader a glimpse into the scientific process and explanations that led to this new understanding."

Overall, Ruden's work makes an impressive argument for the physiological rationale behind alcoholism and other addictions. His thoughts are organized and clear. The work is peppered with personal accounts from addicts, which helps take the edge off the scientific nature of the book and adds some personality to the work. Throughout his theorizing, Ruden maintains that no one method of achieving biobalance is the right method, but that there is hope for every person with a craving brain to find a solution that will work. With a simplified presentation of his theory and a realistic opinion on how to achieve recovery, this book is an enjoyable, thought-provoking read.

Internet Link:

Scientists Identify Drug-Craving Brain Region

by Lisa Zyga, October 26, 2007

Nicotine is considered to be the most addictive drug. Credit: Kyle Rodriguez

Scientists from Chili have discovered that blocking a region of the brain called the insular cortex causes rats that are addicted to amphetamines to stop craving the drug. This understanding could lead to the development of new therapies to help treat drug addiction.

The insular cortex is located deep in the brain, and is part of the sensory system that monitors how an individual perceives their own physiological states and needs. When the body craves a drug, individuals can get irritable and anxious.

These types of physiological states appear to be controlled by the insular cortex, according to the study. When the researchers injected a drug that inactivated the insular cortex, drug-addicted rats that had previously shown symptoms of craving amphetamines suddenly stopped craving the drug. When the insular cortex was re-activated, the rats again showed signs of craving.

In effect, this means that the insular cortex informs the rest of the brain about craving. In the absence of the insular cortex, the rats did not realize that their body "needed" the drug.

"Since this region serves the perception of bodily needs and emotions, it may be a key structure in decision making by informing the executive prefrontal cortex of our needs as in the case of drug abuse," said researcher Fernando Torrealba of the Pontifical Catholic University of Chile.

In a second experiment, the scientists found that rats with inactive insular cortexes did not appear to suffer stomach aches induced by taking the drug lithium. This finding suggests that the insular cortex may play a far-reaching role in processing information about physiological states that guide behavior and self-awareness.

The researchers hope to find a method to prevent craving for longer time periods, along with alleviating some of the symptoms associated with drug addiction. The study is published in the journal Science.

Via: American Association for the Advancement of Science

Lisa Zyga
Science Blogger


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