The inability to control impulsive behavior has long been linked with alcohol consumption – both as it pertains to the initial urge to drink and do drugs, and to relapse behavior. For clients seeking alcohol or drug addiction rehabilitation, learning to control their own impulses is essential to successful recovery.
The notion that some people simply have a harder time suppressing their impulses has been backed up by recent psychological research. However, this does not mean that those struggling with impulse control disorders are helpless to change their own patterns. Instead, this same research indicates that behavioral therapy undergone at a rehab center can bring about physical changes in the part of the brain that governs impulses.
[Impulsivity](http://en.wikipedia.org/wiki/Impulsivity) can be defined as a failure or inability to resist any impulsive action, even when it may be harmful to oneself or others. The person committing the action gives little if any advance thought to the consequences of their behavior. Impulsivity manifests in different ways and can lead to a range of destructive habits, including gambling, abusive behavior and stealing. It also has strong ties to substance abuse.
However, not all who struggle with substance abuse exhibit impulse control problems. Further, researchers have found that those habitually abusing more than one substance demonstrate higher susceptibility to impulsivity. With this in mind, addiction treatment and rehab centers are keen on learning as much as they can about impulse control and its implications for overcoming alcoholism.
How Impulse Control Affects Alcoholics
Impulsivity affects alcoholics in two primary ways. First of all, the inability to restrain one’s impulses can, simply put, lead to excessive drinking. The person may have difficulty thinking through the consequences of their actions, leading them to drink more, more often, or in inappropriate situations. Secondly, difficulty controlling impulses increases the likelihood of relapse.
In both cases, this type of impulsivity could be referred to in layman’s terms as a __lack of willpower__. However, impulsivity – as understood in a psychiatric sense – has neurological implications and can be compounded by the loss of inhibition brought on by consuming alcohol. This means that those already struggling with an impulse control disorder may experience a much higher level of decision-making impairment during a period of relapse.
The Physiology of Impulsivity
The mind’s ability to control impulses is rooted in the [prefrontal cortex](http://en.wikipedia.org/wiki/Prefrontal_cortex). Physical damage to this part of the brain can lead to loss of inhibitions that are similar to those caused by alcohol consumption. Substantial psychiatric research has been conducted in this area. Factors beyond head trauma, including latent neurological disorders, can also lead to impulsivity.
Dopamine and gamma-amino butyric acid (GABA) are the neurotransmitters responsible for impulsivity. Alcohol increases the effects of both. For someone who already has an imbalance of these neurotransmitters, the least amount of alcohol in the bloodstream magnifies the inability to control impulses. This means that one drink can quickly lead to many more, which in turn triggers further impulsive behavior.
Controlling the Impulse to Drink
Professor Cella Olmstead, at Queen’s University in Toronto, is a lead researcher in impulse control disorders. She found that training can help clients overcoming impulsive behavior. The major discovery in this study was that behavioral training designed to rein in impulses can actually lead to physical changes in the frontal lobe. This is an encouraging development for alcoholics who previously saw their inability to control the urge to drink as unconquerable.
Olmstead published her findings in _[The Journal of Neuroscience](http://www.jneurosci.org/)_. The study began by exploring the way that young children are trained to control impulses in the classroom. For example, young students are prone to blurting out answers to questions when they first enter grade school. However, a relatively short period of classroom coaching sees them holding their tongues and raising their hands. This may seem like an insignificant behavioral shift compared to changing patterns of addiction, but the neurological dynamic is the same.
Research was also conducted with rats. One of Olmstead’s PhD students trained a group of rats to wait for a queue before acting on a reward-related impulse. The animals progressively learned to control their behavior. As this happened, electric signals transmitted across the frontal lobe became stronger. The hope is that honing in on this region of the brain will lead to more targeted treatments for addiction and other impulse-related disorders.
Helping Alcoholics Overcome Impulsivity
As alcohol dependence is directly correlated to an inability to control impulses, any breakthroughs in this field are of immediate use to addiction counselors. Furthermore, evidence that physical changes in the brain result from behavioral training means that longstanding change is more possible than previously thought.
To date, the most effective treatment methods in this area involve helping clients develop strategies for weighing future rewards and consequences. Pharmaceuticals may help boost function in the frontal lobe, but cognitive behavioral treatment is preferred whenever possible. In some cases, addiction counselors can work with their clients in assessing the risk and rewards of their actions. This makes it possible to plan for future situations in which controlling impulses may be difficult. Strategies developed during these sessions and implemented in real-world situations help alcoholics avoid relapse.
With the aversion of each potential relapse, impulse-resisting pathways are reinforced in the frontal lobe. In other words, one instance of success increases the odds of ongoing impulse control. This behavioral shift is literally hardwired into the brain over time, making it easier to choose to stay sober over the long run. This implies that addiction counseling encouraging impulse control is an excellent complement to a holistic addiction rehabilitation regimen.
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