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One particularly dramatic demonstration of how alcoholics' cues and rewards can be transferred to new routines occurred in 2007 when Mueller, the German neurologist, and his colleagues at the University of Magdeburg implanted small electrical devices inside the brains of five alcoholics who had repeatedly tried to give up booze. The alcoholics in the study had each spent at least six months in rehab without success. One of them had been through detox more than sixty times.
The devices implanted in the men's heads were positioned inside their basal ganglia - the same part of the brain where the MIT researchers found the habit loop - and emitted an electrical charge that interrupted the neurological reward that triggers habitual cravings. After the men recovered from the operations, they were exposed to cues that had once triggered alcoholic urges, such as photos of beer or trips to a bar. Normally, it would have been impossible for them to resist a drink. But the devices inside their brains “overrode” each man's neurological cravings. They didn’t touch a drop.
"One of them told me the craving disappeared as soon as we turned the electricity on," Mueller said. “Then we turned it off and the craving came back immediately."
Eradicating the alcoholics' neurological cravings, however, wasn’t enough to stop their drinking habits. Four of them relapsed soon after the surgery, usually after a stressful event. They picked up a bottle because that's how they automatically dealt with anxiety. However, once they learned alternate routines for dealing with stress, the drinking stopped for good. One patient, for instance, attended AA meetings. Others went to therapy. And once they incorporated those new routines for coping with stress and anxiety into their lives, the successes were dramatic. The man who had gone to detox sixty times never had another drink. Two other patients had started drinking at twelve, were alcoholics by eighteen, drank every day, and now have been sober for four years.
Notice how closely this study hews to the Golden Rule of habit change: Even when alcoholics' brains were changed through surgery, it wasn’t enough. The old cues and cravings for rewards were still there, waiting to pounce. The alcoholics only permanently changed once they learned new routines that drew on the old triggers and provided a familiar relief. "Some brains are so addicted to alcohol that only surgery can stop it," said Mueller. "But those people also need new ways for dealing with life."
AA provides a similar, though less invasive, system for inserting new routines into old habit loops. As scientists have begun understanding how AA works, they've started applying the program’s methods to other habits, such as two-year-olds' tantrums, sex addiction, and even minor behavioral tics. As AA's methods have spread, they’ve been refined into therapies that can be used to disrupt almost any pattern.
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