Why The Brains of High-Powered People Might Be More Prone to Addiction
It’s no secret that the best leaders among us – the most driven, dedicated, and outside-the-box thinkers – are wired a bit differently from the rest. In fact, it’s been suggested that a decent chunk of the “ C-Suite” crowd may have more sociopathic and psychopathic tendencies than the general population.
These traits, which ideally fall not too far into the realm of pathology, are thought to be the very qualifications that propel an individual into stardom in the first place. But there’s another comorbidity that’s also more common in the high-powered achievers: The likelihood for substance abuse. And most experts agree that this overlap is also quite logical, and it’s readily explained in psychological, molecular, and neurological terms. How to handle it in the office is a little less clear-cut.
David Linden, PhD, a neuroscience professor at Johns Hopkins’ School of Medicine and author of The Compass of Pleasure: How Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning, and Gambling Feel So Good, has spent some time analyzing the addiction research and has argued that the traits that make a good CEO – risk-taking, strong drive for success, obsession, dedication, novelty-seeking – are precisely what make a “good” addict.
He says that the pleasure derived from success, and in particular from risky or novel business ventures, is borne of the very same brain pathways that make substance use so irresistible to some. It’s all about pleasure-seeking and reward, but the mechanics of this push-pull system are not exactly what you might guess.
“The general idea is counterintuitive,” says Linden. “When you wonder what would make someone an addict, you might think, ‘if a person gets above-average pleasure from smoking or gambling, then they’d do it more.’ This is completely reasonable. But it’s completely, explicitly, 180 degrees wrong. The genetic variations that predispose a person to being an addict seem to be mutations that dampen the dopamine system.”
This can be any number of variations – to dopamine synthesizing enzymes, transporters, or receptors. “So what happens, then, is people seek set point of pleasure: A normal person can go to the tavern and have a couple of drinks for an effect, but my friend who has an addiction risk has to have ten to get to the same place.”
In this way, it’s not that people who are at higher risk for addiction derive more pleasure from their substance – it may be that they derive less. But the drive to get there is huge, says Linden. Evolution has endowed us with a robust set of skills to forge ahead in life and experience pleasure from that, but it’s the same set that makes us more likely to seek pleasure from substance. “My strong, strong suspicion,” says Linden, is that what makes some people more likely to rise to top is same thing that makes them more likely to be addicts.”
Of course, genetics only tells about 40% of the story, so 60% of the risk is coming from somewhere else.Constance Scharff, PhD, addiction researcher with Cliffside Malibu Treatment Center, and co-author of Ending Addiction for Good, says that there’s another twin pathway that she and her colleagues often see in high achievers. “What makes someone achieve at that level – the top executives – is often a stress or trauma that happened early on. There’s something, usually an early experience, that fuels that kind of drive, and oftentimes it’s the same thing that drives addiction. The vast majority didn’t have some sort of basic needs met as children, so they’re driven very, very hard to succeed. But the pain that goes with that is also what they’re self-medicating for.”
Linden adds that the portion of risk that comes from the environment can happen in early childhood or even in utero. “If you’re abused and neglected as child, you’re more likely be become an addict… Even if your mother has the flu while in utero, you’re more likely to become an addict. What this all points to is the stress hormones – when you get these in the brain early in life, it produces changes in brain circuitry, especially in the reward system. In the acute phase, this makes you crave, and in long term, lead you to have higher chance of developing addiction.” In this way, genetic predisposition and early life stress can singly or jointly increase one’s risk for addiction – and, in various ways, these factors may also boost one’s drive to push hard in life and to succeed.
To Intervene or Not to Intervene
The prevalence of substance abuse in the CEO circle is hard to gauge because it is so clandestine – these are not the people who are checking themselves into rehab, they’re the people who staying out of it and continuing to function. A recent study from the National Institute on Alcohol Abuse and Alcoholism found that about 20% of alcoholics are high functioning and well-educated. Prescription medication addiction is rising in many circles, the C-suite among them. “They’re not shooting heroin,” says Scharff. “It’s almost always alcohol or prescription meds, usually pain killers, in this group. They come to us because their home life is falling apart because of their addiction. They usually have enough assistants that they can continue to achieve at work.”
There may be a lot of concealing and “assisting” going on at the office, says Scharff, but the reality is that the system can crash at any moment. And since a lot of people – and often the success of the company – may be depending on the person to function at top level, the breakdown is important to prevent. “If you’re Donald Trump, you can’t afford for your CEO to just snuff it,” says Scharff. “These people aren’t replaceable. The message should be, ‘We want to invest in you so that you can come back and work.’ So you really support that person taking a leave away and then coming back.” Get them back, she stresses – because they’re going to be incredibly grateful and loyal when they do. “We’ve never seen someone who hasn’t at least doubled in productivity after treatment.”
Companies, of course, differ in their climates and policies on this issue, but if addiction is obvious in a peer or boss, it should generally be addressed with HR, and ultimately with an external consultant. “This is really something to consult with HR about first,” says Sarah Allen Benton, MS, LMHC, a therapist at McLean Hospital and author of Understanding the High-Functioning Alcoholic. “There are outside consultants and interventionists, and you can speak with someone who specializes in corporate situations. It’s not necessarily the colleagues’ role to come in, but it is their role to take some kind of action and alert the appropriate professionals internally or externally.”
Treating C-Level Addiction
For people who are functioning at high levels, Allen Benton points out, there’s often the if it ain’t broke, don’t fix it mentality. “People always ask, ‘Why stop drinking if it’s working?’ The answer is that there’s a rebound effect when you stop drinking – drinking is not balancing out brain chemistry, rather it’s actually worsening the cycle, so it’s a band-aid. There are much better methods, which actually address the underlying problem. It is important to treat both the mental health issue and the substance problem.”
Treating the high-functioning crowd can be complicated for a number of reasons, says Scharff, one of which is that across the board, “the smarter people are, the harder to treat, whether they’re powerful or not. But the high-level folks also tend to be less trusting – they always have to be on guard.” That said, successful treatment is certainly possible, even if it takes a couple of visits to treatment to do it.
Scharff adds that much of the trick, at least on the part of the treatment center, is building trust at the outset, by listening to the individual in ways they might not expect. “For example,” she says, “one high-level individual from a big company made the stipulation that before he’d come, his sheets had to be ironed every day. Hey, if that’s what it takes to get him in, fine! The truth is that this has nothing to do with the sheets. It’s about listening to ‘me.’ That’s how we start to build trust, in the most basic ways.”
The other part is taking the most comprehensive approach possible – which typically doesn’t center around the 12-steps. Though it’s effective for some, says Scharff, it may not work so well in the high-power crowd. More often, a medley of psychological and behavioral approaches, medication when needed, and mind-body methods are more effective. “We do use the 12 steps, but it’s not 12-step program, because in 12-step the logic is, ‘you’re powerless.’ If you try to break these guys down in that way, they’ll leave. They’re pulling in more than a treatment center makes in a year – they’re not going to make their bed in morning! They’re going to call their three assistants, and get some work done. This is what really relaxes them, and makes them want to stay.” Supporting the needs of a businessperson helps the person feel still a part of his or her former life – and this is what makes treatment become a viable option to them.
Allen Benton adds that people should remember that this problem is relatively common, and there is a number of resources for specific groups to continue with their treatment in the long-term. “Remember that you’re in no way alone,” she says. “There are treatment centers and support groups for different professions and specialties. There are self-help meetings that are off the books but for execs. There are privately run groups where you can be anonymous.”
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While addiction may be somewhat more common in high achievers than in the general population, it’s not something that should be considered acceptable, or ignored by colleagues for fear of getting fired. For offices grappling with the problem or the possibility, it’s important to create a space where’s speaking up is OK, says Scharff. “Creating a culture where it’s appropriate for an assistant to say to someone, HR or whomever it is, ‘you know what, I think this person needs some help,” is the key. Always say help. If you know that you’re not going to get fired, you’ll be a lot more willing to speak up.”
Linden stresses that addiction is so common because it is, after all, just another form of learning. Since high-achieving people are if nothing else good learners, it makes sense that they might be more likely to be substance dependent – the trick, with anyone, is to “unlearn” the behavior, get to the root of any underlying issues, and learn healthier ways of coping with stress and unhappiness. “Instead of Pavlov’s dog, you’re learning association to gambling or alcohol. The molecular mechanisms underlying reward in the different forms of learning… they’re really the same.”
