I was listening to the podcast of this On Being episode this morning and get to wondering about its application to addiction treatment and recovery. (The first 15 minutes or so cover the really relevant concepts.)
The interviewee is Adele Diamond, an educator, researcher and scientist who focuses on early childhood and the role of executive function in academic and life success.
She broke executive function down into three areas:
- inhibitory control
- working memory-the ability to hold on to a concept and explore. examine or play with it
- cognitive flexibility
She has an early childhood curriculum that is focused on fostering/supporting the development of executive function. In the interview, she discussed some activities and tricks designed to develop or engage executive function. For example, her curriculum uses particular kinds of play and drama. She also gave an example of helping kids who mirror write by asking them to write problem characters in red pencil. (Just stopping writing and picking up the red pencil was enough of an intervention for most kids.)
This got me thinking about addiction as, in part, a disorder of the brain’s executive function. If one of the tasks of early recovery is to restore or re-develop executive function, what strategies and activities could help accomplish that? What strategies do we already use, or do mutual aid groups use, to achieve this?
What are our red pencils and how can we find more of them?
recoveryreview.blog 
Red pencils? Reflection; talking; connecting to others; having structure; narratives; personal/spiritual growth; meditation; mindfulness.
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Hi Jason, firstly, I really enjoy readfing your posts (although we are not always on the same page!) – I find that they usually get me thinking. A colleague at the University of Cape Town Department of Psychiatry is currently looking at cognitive training tasks and how they develop better top-down control via the dorso lateral pre-frontal cortex activation. Even after as little as 5 weeks we are seeing increased activity in this area. This research will be published next year.
I am hoping to look at the effects of cognitive training using an “n-back” application that this colleague has developed on those in recovery in community based settings. It is cheap, simple and fun and therfore easy to apply. I think we are going to find that these kinds of tests will be of great assistance to those in recovery, as we are finding with mindfulness. (As an adjunct, rather than an end in themselves!)
Both of these approaches encourage or assist with concious decision making, slowing things down. I will keep you posted on the progress.
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Thanks for the comments. I was thinking along the same lines. We’ve integrated DBT into our programs and it seems like it addresses inhibitory control and cognitive flexibility.
Also, for decades, our residential clients played a game we call “rhythm categories” that is described here: http://unbored.net/concentration-clapping-game/
Shaun, “n-back” is new to me, but I did google it. Would this be a computer application?
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Hi Jason, yes, it’s a computer application where there is a background field of coloured squares, on which a large letter is shown. These letters flash up in random order. The patient starts by hitting the space bar when the same letter is repeated with 1 other letter between. Once they score 80%, they then work on 2-back. again to 80% and then 3-back. This test has shown across multiple studies to stimulate the DLPFC.
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