The Myth of Normal 187

ways that create a template for future dysfunction. Human and animal studies have both confirmed that any genetic risks for substance abuse can be offset by being reared in a nurturing environment.[3] One of the happiest email acknowledgments I ever received was from the grateful mother of a four-year-old. Her husband, a former alcoholic, refused to have children, so afraid had he been of passing the “alcoholism gene” to his offspring. Having read my book on addiction, he recognized the traumatic sources of his alcohol habit and gave up his fear of this nonexistent gene. And just in time—his wife had been nearly past the child-bearing age. I couldn’t suppress a self-satisfied chortle. I’d been thanked before for “saving” the lives of people I had never met, but never for having been the cause of one at long distance. The way childhood adversity engenders the neurobiology of addiction has to do with the interpersonal-biological science we have already examined. Experiences of stress in the womb can predispose to addiction, for example, by altering the brain’s ability to respond to stress in functional ways. They can also have long-term influence on the parts of the brain that modulate the incentive-motivation system impaired in all addictions, whether to drugs or behaviors.[*] As the psychiatric practitioner, neuroscientist, author, and leading trauma researcher Dr. Bruce Perry told me, “We’ve done work, and a lot of other people have done work, showing that essentially the number and density of dopamine receptors in these [brain] areas is determined in utero.”[4] Whoever coined the slang term “dope” for drugs was onto something, because all addictions, whether to drugs or behaviors, involve dopamine. Dopamine is the essential neurotransmitter in the motivation system, without which all mammals are inert, inactive, and lacking all incentive. A hungry laboratory mouse whose brain is artificially denuded of its dopamine apparatus will starve himself while standing in front of a plate of food. In fact, every addict is a dopamine fiend, outsourcing the hunt for the homegrown chemical hit that makes the present moment exciting and vibrant. For virtually every “positive” feeling or quality people derive from their substances or behavior of choice, there are endogenous—naturally occurring