By James W. Prescott, Ph.D.

The somatosensory affectional deprivation (SAD) theory of drug and alcohol use is a developmental psychobiological theory that is proposed to account for the common ground of the many and diverse theories of substance abuse.

The first basic proposition of this theory is that the neurobiology of our behavior is not only inseparable from, but is in fact largely shaped by, culture. The shaping process of culture upon the developing brain (the organ of behavior) is accomplished through our various sensory modalities and through the sensory processes of deprivation and stimulation.

With few exceptions, the developing mammalian brain, particularly the primate brain, is highly immature at birth and is dependent upon sensory stimulation for its normal growth, development, and functional and structural organization.

The richness or paucity of dendritic structures of the neurone (brain cell), for example, is largely influenced by the sensory processes of stimulation and deprivation during the formative periods of brain development. The complexities and possibilities of neuronal communication (and thus behavior) are dependent upon the complexity of dendritic structures of brain cells (Greenough 1975; Greenough and Juraska 1979; Rosenzweig 1979; Floeter and Greenough 1979; Riesen 1975; Globus et al. 1973; Coss and Globus 1979; Coleman and Riesen 1968; Horn et al. 1979; Spinelli and Jensen 1979; Blakemore and Cooper 1970; Hirsch and Spinelli 1970; and Hubel and Wiesel 1970).

Dendritic structures are analogous to telephone cables that interconnect various telephone centers (brain cells) with one another. These dendritic structures of brain cells form the structural basis of interneuronal communication. Another major element in the story of interneuronal communication is neurochemical transmitter substances which are present at synaptic junctions between dendrites and which make possible the transfer of ??oinformation??? from one brain cell to another.

These events are accompanied by electrophysiological activity, which is another manifestation of interneuronal communication. The point of this synoptic overview of interneuronal communication is to emphasize that the morphological (structural) and the neurochemical and electrophysiological (functional) processes of interneuronal  communication are all strongly influenced by the sensory processes of stimulation and deprivation.

Thus, the effects of the social, physical, and cultural environment are ultimately transformed into perceptual experiences through the encoding and decoding of sensory processes.

Further, whether certain perceptual experiences can ever be realized will be dependent upon the quality and quantity of our sensory experiences, as structured by our social, physical, and cultural environment during the formative periods of brain development (Prescott 1967, 1971a,b, 1972a,b, 1973, 1975, 1976a,b, 1977, 1978, 1979b).

The second basic proposition of SAD theory is that certain sensory modalities and processes are more important than others in accounting for emotional/social disturbances and substance abuse. Specifically, it is the emotional senses of somesthesis (touch), vestibulation (movement), and olfaction (smell), that are the primary mediators of our emotional/ affective behaviors.

Substance abuse that alters primarily our emotional/ affective state must be understood within the context of our emotional senses. It is the deprivation of our emotional senses and not our cognitive (visual-auditory) senses during the formative periods of brain development that can account for and predict our emotional/affective social behaviors, which include not only substance abuse but abusive social behaviors in general.

Thus, the question of destructive and exploitive behaviors toward ourselves and others becomes a question of whether affectional bonds are formed or not formed during the formative periods of brain development.

Within an evolutionary context, it should be noted that olfaction assumes a greater role in lower mammals, and vestibular functions assume a greater role in higher mammalian forms, specifically the primate, in the formation of affectional bonds (Prescott 1976a, 1977).

Similarly, substance abuse that alters primarily our cognitive state (e.g., hallucinogens) must be understood within the context of our cognitive (visual/auditory) senses. It should be noted that movement (vestibulation) is often involved in altered cognitive states and it has been proposed that the vestibular-cerebellar neuraxis may be a master integrating/regulating system of sensoryemotional and motor processes.

Thus, the vestibular-cerebellar system may serve as a ??obridge??? between our ??oemotional??? and ??ocognitive??? senses (Prescott 1976a, 1977; Erway 1975).

In previous studies, the SAD theory has been successful in predicting physical violence (high and low) in 100 percent of 49 primitive cultures distributed throughout the world. This was made possible by evaluating the degree of physical affection (touching, holding, carrying) of the infant by its mother or caretakers and by the degree of physical affection that was permitted to be expressed through the acceptance or rejection of premarital sexuality (Prescott 1975, 1977, 1979b).

The issue of violence, i.e., the failure of nurturance and the failure to form affectional bonds, is strongly related to the issue of substance abuse in several aspects. First, in a very general sense, the body needs and ??osearches??? for a state of harmony, contentment, and in higher life forms (homo sapiens), an altered and transcendent state of conscious ??obeing.???

A necessary condition for the attainment of this ??ostate of being??? is the experiencing of physical (somatosensory) pleasure that is essential for the formation of affectional bonds.

When somatosensory pleasure and affectional bonds are denied, then compensatory behaviors to reduce tension, discomfort, and ??oanomie??? become imperative.

The common compensatory behaviors are physical violence (toward others and oneself), alcoholism and drug abuse, and perseverative stimulus-seeking behaviors that attempt to provide the sensory   stimulation that was deprived early in life.

The stereotypical rocking behaviors of isolation-reared Harlow monkeys and of institutionalized children is a case in point. The ??oquieting??? effect of stimulant drugs upon some hyperactive children is another illustration of a ??oneed for neural activation??? that is met by pharmacological stimulation rather than by sensory stimulation.

The chronic stimulus-seeking behaviors, particularly of a sexual and violent nature, in the American culture (evidenced, for example, by massage parlors, pornography, violent films, rape) are also illustrative of this basic principle of stimulusseeking behaviors consequent to early somatosensory deprivation (Prescott 1972a, 1973, 1975, 1976a,b).

Additional studies that relate early sensory experiences to later behaviors, particularly aberrant sensory behaviors, can be usefully consulted (Ainsworth 1972; Cairns 1966, 1972; Bowlby 1969; Harlow 1971; Harlow et al. 1963; Dokecki 1973; Lichstein and Sackett 1971; Lynch 1970; Mason 1968, 1971; Mason and Kenney 1974; Mason and Berkson 1975; Fuller 1967; Freedman 1968; Friedman et al. 1968; Melzack and Burns 1965; Melzack and Thompson 1956; Melzack and Scott 1957; Mitchell 1968, 1970, 1975; Mitchell and Clark 1966; Sackett 1970; Riesen 1960, 1961a,b, 1965; Schaffer and Emerson 1964a,b; Spitz 1945, 1965; Suomi and Harlow 1972; Zubek 1969).

The self-mutilation and pain agnosia of children characterized by psychosocial dwarfism consequent to somatosensory affectional deprivation and child abuse reported by Money et al. (1972), is a classic verification at the human level of the same behaviors (self-mutilation and pain agnosia) found in animals reared under conditions of somatosensory affectional deprivation (social isolation) (Lichstein and Sackett 1971; Melzack and Burns 1965; Melzack and Scott 1957; and Mitchell 1968, 1970, 1975).

The pain aqnosia of children subjected to physical restraint and immobilizatibn reported by Friedman et al. (1968) is another demonstration of these relationships at the human level. Another important dimension to these early experiences and behaviors is the neurochemical and neuroendocrine mediators of pain hypersensitivity and pain hyposensitivity (pain agnosia) consequent to somatosensory deprivation. Harvey and Yunger (1973) have shown that decreases in brain serotonin (-5-HT) result in an increased sensitivity to pain, and Coleman (1971) has shown that isolation-reared monkeys who are characterized by both tactile hypersensitivity and hyposensitivity (Lichstein and Sackett 1971) have significantly decreased levels of platelet serotonin.

A number of investigators have also shown that there is significant reduction in growth hormone (GH) and adrenocorticotropin (ACTH) in psychosocial dwarfism (reversible hyposomatotropism) (Patton and Gardner 1975; Powell et al. 1967a,b; Wolff and Money 1973; Money and Wolff 1974; Brown 1976). Significant to these findings is the report that endoqenous opioids are involved in the regulation of serum growth hormone (GH) and prolactin (PRL).

Specifically, naloxone depresses basal serum concentration of GH and PRL. Related to the above are the well-known phenomena that stress elicits an increase of endogenous opioids in the brain; and of ACTH and ?Y-endorphin in the systemic circulation; and that serotonin increases prolactin, growth hormone, and adrenocorticotropin (Meites et al. 1979).

These observations are made to suggest that psychosocial dwarfism may well be characterized by abnormal endorphin mechanisms which may be responsible for the observed abnormalities of GH and ACTH in   psychosocial dwarfism. Thus, these speculations suggest that endorphin mechanisms may assume a much greater role and significance in somatosensory affectional deprivation phenomena than has heretofore been realized.

The findings of Behling (1979) highlight the relationship between alcohol abuse, child abuse, and failure of nurturance, showing that in 69 percent of 51 instances of child abuse, at least one parent had a history of alcohol abuse. In the context of the SAD theory, it is not surprising to find the compensatory behaviors of violence in the primitive culture study cited above or the finding of Barry (1976) that the single greatest predictor of drunkenness in 13 primitive cultures was the large amount of crying during infancy (r=0.77)

Drunkenness was also significantly correlated. with low general indulgence during infancy (r =0.40; N=26) and low duration of bodily contact with caretaker during later stages of infancy (r=0.42; N=23). Significant relationships between deprivation of parental physical affection and use of drugs and alcohol have been reported for college students (Prescott 1975), for prisoners (Prescott and Wallace 1978), for institutionalized alcoholics, and for participants in a drug treatment program (Prescott and Wallace 1976).

Significant relationships between high drug and alcohol usage with attitudes rejecting premarital and extramarital sex have also been reported for college students (Prescott 1975). An interpretive statement of these relationships with respect to somatosensory pleasure seeking, isolation rearing (somatosensory affectional deprivation), altered neuronal communication, and altered states of ??oconsciousness??? appears necessary.

Briefly, the SAD theory postulates that somatosensory deprivation from isolation rearing leads to impaired brain neuronal systems that mediate pleasure which now lack the neuronal structural bases to interact with and influence higher brain (cognitive) centers (neocortex).

This impairment prevents an integration of somatosensory pleasure with higher brain centers and precludes the normal development of altered states of consciousness or states of ??otranscendent being.??? (See Teilhard de Chardin??Ts 1933 essay ??oThe Evolution of Chastity??? on the role of pleasure in achieving states of ??otranscendent being.??o)

Consequently, most of the somatosensory pleasure-stimulus-seeking behaviors of contemporary Western civilization (not just America) appear to be ??ononintegrative??? in nature, i.e., primarily ??oreflexive.??? This means the ??opleasure experience??? is a momentary and transitory phenomenon that produces a temporary reduction of physiological tension and discomfort but does not represent a true positive state of ??ointegrative pleasure??? that is essential for experiencing an ??oaltered state of consciousness.???

Thus, anomie remains, a high need for another ??opleasure fix??? remains, and the complex of perseverative behaviors remains. Drugs and alcohol ??obypass??? the somatosensory process and provide a direct route to higher brain centers that alter ??ostates of consciousness??? which simulate states of ??otranscendent being.???

It should be noted that somatosensory affectional deprivation from social isolation results in an aversion to touch and thus constitutes a barrier to the ??otouch therapy??? that is essential for rehabilitation, namely, the establishment of emotional/affective-social relationships. Within the context of SAD theory, three basic groups of substance abusers are proposed to exist and need to be evaluated and treated differently.

These are (a) pleasure seekers (marijuana, heroin, etc.),   (b) pleasure avoiders (alcohol, depressants, tranquilizers), and (c) ??oaltered states of consciousness??? seekers (hallucinogens).

A factor-analytic study involving items of drug and alcohol usage produced orthogonal (independent) factors for alcohol and marijuana usage (Prescott and Wallace 1976). Unfortunately, time and space do not permit review of these data or an elaboration of SAD theory of drug typologies and their implications for research and therapy.

It is suggested, however, that a sensory process orientation would be highly heuristic. Special attention should be given to evaluating vestibular-cerebellar processes in alcoholics, somesthetic-cerebellar processes in pleasure-seeking drug users, and visual/auditory neocortical processes in hallucinogen users. It should be recognized that these suggestions are highly speculative and have many limitations, but they may, nevertheless, have some merit in attempting to identify specific neurobiological brain processes with specific choices of substance use and abuse.

Evidence that social isolation rearing alters neurochemistry of brain function has been partially reviewed elsewhere (Prescott 1971a, 1976a; Lal et al. 1972; Essman 1971, 1974, 1979; Essman and Casper 1978; Welch and Welch 1969: Valzelli 1967; De Feudis and Marks 1973; Rosenzweig 1979; Rosenzweig et al. 1968).

Certain studies, however, deserve special commentary, and recent developments with respect to the endorphins are especially relevant to somatosensory affectional deprivation theory and data, as is the basic alteration of the CNS??Ts response to drugs that is induced by SAD of isolation rearing.

In this specific social-neurobiological context, Lal et al. (1972) have demonstrated that social isolation rearing of mice (somatosensory affectional deprivation) significantly altered the pharmacological effects of hexobarbital, pentobarbital, chloral hydrate, barbital, and chlorpromazine. Specifically, social isolation enhances stimulant drug effects and reduces CNS depressant effects.

Bonnet et al. (1976) reported that mice reared in social isolation (somatosensory affectional deprivation) for 20 weeks showed a significant reduction in narcotic agonist and antagonist binding. No differences could be found in stereospecific binding between the rearing groups with 15 weeks of differential rearing, but were found at 17 and 21 weeks.

These authors also reported a significant reduction of the number of opiate binding sites in the brains of isolation-reared mice compared to aggregation-reared mice. This loss of opiate receptor sites in isolation-reared mice may be analogous to the loss of dendrites consequent to social isolation rearing. Panksepp et al. (1978) and Herman and Panksepp (1978) reported a significant decrease in distress vocalizations of puppies which were briefly separated from their mothers (15 minutes) with an injection of 0.125 mg/kg of oxymorphone, and they found that naloxone increased group vocalization of two- to five-day-old white Leghorn chicks briefly separated from their mother.

These authors discuss the parallels between the biological nature of narcotic addiction and the formation of social bonds, and their theoretical position is similar to SAD theory and my belief that the brain endorphin systems may be one of the most important neurobiological systems mediating the development of affectional bonds, including sexual affectional bonds.